The use of fat-free human milk in infants with chylous pleural effusion

Objective: The purpose of this study is to describe the processing of human milk to remove its fat content and its use in seven infants with chylothorax. Study design: The mother's milk was centrifuged at 3000 r.p.m. for 15 min at 2 degrees C. After centrifugation, the milk separated into a solidified-fat top layer and a lower liquid portion. The fat-free liquid portion was then poured into collection cups and frozen for the patient's use at a later date. A sample of the mother's milk before and after processing was stored and analyzed for fat, sodium, potassium, calcium and zinc. Results: The mean fat removed was 5 +/- 1 g/dl ( mean +/- s.d.), which was the same as the pre-fat content of the mother's milk. Seven infants with chylous pleural effusions used the fat-free human milk. All infants started on the fat-free milk after a month of age for an average of 16 days duration ( 7 to 34 days range). There was no reaccumulation of the chylous pleural effusions with the use of the fat-free mother's milk. Mother's milk electrolytes were similar before and after processing. Conclusion: Fat-free human milk may be an important additional dietary therapy for infants with chylothorax and may add the immunologic properties of human milk that other feedings cannot provide.