Impact de la pasteurisation et de l’homogénéisation sur la digestion du lait maternel chez le nouveau-né : Etudes in vitro et in vivo

Abstract : When breastfeeding is not possible, pasteurized human milk (PHM) from milk banks is preferentially administered, especially for vulnerable hospitalized newborns. Holder pasteurization (62.5°, 30 min) is applied for sanitary reasons but may reduce fat absorption through inactivation of milk endogenous lipases. This could be counteracted by homogenization of PHM through an increase of the specific surface available for enzyme adsorption. The objective of this thesis was to study the impact of Holder pasteurization and ultrasonic homogenization on the digestion of HM in the newborn. An in vitro dynamic model was used to evaluate the gastrointestinal digestion of raw HM (RHM) vs. PHM at preterm and term stages. A clinical trial was conducted on hospitalized preterm newborns for comparing the gastric digestion of (A) RHM vs. PHM and (B) PHM vs. pasteurized-homogenized HM (PHHM). Pasteurization and homogenization affected the HM initial structure and its digestive kinetics and structural disWhile gastric lipolysis was reduced after pasteurization in term in vitro study, no impact was observed at the preterm stage. Intestinal lipolysis, in vitro, was reduced by pasteurization. Gastric proteolysis was selectively affected by pasteurization, being, in vivo, faster for lactoferrin and slower for a-lactalbumin. Homogenization increased lipolysis and proteolysis of serum albumin. Some physiological gastric conditions were affected by treatments: RHM had enhanced postprandial lipolytic activity and PHHM had a reduced gastric emptying time. The in vivo data described here may help to i
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Samira Cássia de Oliveira. Impact de la pasteurisation et de l’homogénéisation sur la digestion du lait maternel chez le nouveau-né : Etudes in vitro et in vivo. Alimentation et Nutrition. Agrocampus Ouest, 2016. Français. ⟨NNT : 2016NSARB284⟩. ⟨tel-01649869⟩

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