Linda Friend

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• Perrin, M. T., Friend, L. L., & Sisk, P. M. (2022). Fortified Donor Human Milk Frequently Does Not Meet Sodium Recommendations for the Preterm Infant. The Journal of pediatrics, 244, 219-223.e1.
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  We measured the sodium content of donor human milk (DHM) and calculated the estimated intake at a feeding volume of 160 mL/kg/day. The mean sodium content of unfortified DHM was 102.0 mg/L (4.4 mEq). Because
• Friend, L. L., & Perrin, M. T. (2021). Methods of mixing donor human milk during bottling results in fat differences between samples within a pool. Journal of dairy science, 104(5), 5256-5264.
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  The influence of milk-banking processes on nutrients in donor human milk (DHM) is largely unknown. Previous studies have measured nutrients between pools of DHM, but within-pool nutrient differences (between bottles from the same pool) have yet to be elucidated. The objective of this study was to gain a better understanding of the effect of different mixing characteristics on the distribution of fat, protein, IgA, and lysozyme in bottled, raw DHM. Pools of DHM were created in a laboratory setting according to published human milk-banking guidelines and assigned to a mixing treatment (mixing during bottling method, pooling container material, and refrigerated hold time). Four mixing protocols using glass pooling containers and a 1-h refrigerated hold time were tested: control (no mixing during bottling); manual-A (Man-A, hand swirl after pouring 3 bottles); manual-B (Man-B, hand swirl after pouring every bottle); and mechanical-G (Mech-G, continuous stirring with a magnet). As secondary objectives, we compared the effect of a glass and a plastic pooling container with mechanical mixing (mechanical-P, Mech-P), and compared refrigerated delays of 1 and 24 h before bottling with manual mixing (manual-A24, Man-A24). To control for differences in nutrient content, comparisons between treatments were made using absolute percent difference from the treatment-specific mean; and comparisons within a treatment were made using the ratio of fat content in a bottle to fat content in the first bottle of the same pool. We did not observe differences in nutrient distribution between Man-A, Man-B, and Mech-G in pools held for 1 h, but all were significantly different from the control for fat. There were no differences between glass or plastic pooling containers when mechanical mixing was used. Holding a pool in the refrigerator for 24 h before bottling created significantly greater fat distribution than holding a pool for 1 h. Outcomes were the result of controlled experiments. In summary, manual and mechanical mixing of 1,700-mL DHM pools produces similar fat and protein distributions when DHM is pooled and bottled after a 1-h hold time. When DHM is held for 24 h before bottling, more research is needed to determine the duration of initial mixing needed to reduce fat variability between bottles.
• Friend, L. L., Gutierrez Dos Santos, B., El-Khouri, K. G., & Perrin, M. T. (2021). Method for Removing Thawed Human Milk From a Plastic Storage Bag Impacts Fat Retention. Journal of pediatric gastroenterology and nutrition, 72(2), 306-310.
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  Determine how thaw stage and bag manipulation (folding and squeezing) influence the retention of fat and number of aerobic bacteria colony-forming units when decanting human milk (HM) from plastic storage bags.
• Friend, L. L., & Perrin, M. T. (2020). Fat and Protein Variability in Donor Human Milk and Associations with Milk Banking Processes. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 15(6), 370-376.
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  The impact of milk banking processes on macronutrient variability in donor human milk (DHM) is largely unknown. To gain a better understanding of fat and protein composition in DHM and assess potential relationships with modifiable milk bank processes. Samples of raw, pooled DHM were collected from 20 milk banks ( = 300) along with the following processing attributes: if macronutrient analysis was used to select donors for pooling (target pooling; yes/no), number of donors per pool, pooling container material (glass/plastic/other), and method for mixing during bottling (manual/mechanical). Fat and protein were assessed. Homoscedasticity was assessed and magnitude of the spread was quantified. : Fat ranged from 1.9 to 6.1 g/dL ( = 298) and protein ranged from 0.7 to 1.4 g/dL ( = 300). Variability in fat was significantly lower in samples that had been target pooled ( = 0.04), contained more donors per pool ( 
• Friend, L. L., & Perrin, M. T. (2020). Re: "The Effect of Processing Donor Milk on Its Nutrient and Energy Content" by Chang et al. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 15(11), 747.
• Perrin, M. T., Pawlak, R., Dean, L. L., Christis, A., & Friend, L. (2019). A cross-sectional study of fatty acids and brain-derived neurotrophic factor (BDNF) in human milk from lactating women following vegan, vegetarian, and omnivore diets. European journal of nutrition, 58(6), 2401-2410.
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  Essential fatty acids are critical for brain growth and neurodevelopment in infancy. Maternal diet and supplement use have a significant impact on the fat composition of human milk. The objective of this study is to assess supplement utilization patterns and fatty acid and brain-derived neurotrophic factor (BDNF) concentrations in the breast milk of women following vegan, vegetarian, and omnivore diet patterns.