Skimmed breast milk in newborns with chylothorax: Options with a personalised nutrition unit

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recién nacidos con quilotórax: opciones con una unidad de nutrición personalizadaTo the editor: Newborns with congenital chylothorax or chylothorax secondary to cardiac or thoracic surgery are at high risk of malnutrition and infection due to continuous losses of fat, albumin and lymphocytes in the chyle. 1 Treatment usually consists in placement of a chest drain, restriction of long-chain triglycerides and, therefore, discontinuation of breastfeeding, parenteral nutrition and enteral nutrition with formulas with medium-chain triglycerides (MCTs) as the sole for a period ranging from 2 to 6 weeks, which usually results in permanent discontinuation of breastfeeding.In order to optimise nutrition in these patients, the personalised nutrition unit (PNU) in our hospital, which has been operating since 2018, offers the possibility of centrifuging human milk (HM) to remove the fat while maintaining certain immune features that may have an additional beneficial effect in this population of immunosuppressed patients.We conducted a retrospective descriptive study in newborns (NBs) with chylothorax secondary to surgery that received centrifuged maternal or donor HM supplemented with fats in order to optimise energy and nutritional intake.The PNU is an on-site production unit within the department of neonatology that meets all the standards of the Asociación Española de Bancos de Leche (Spanish Association of Human Milk Banks), 2 where all the donors are mothers of hospitalised NBs.We describe epidemiological and clinical variables in 5 NBs with postsurgical chylothorax in 2018, as well as the volumes of milk contributed by donor mothers and the volumes obtained after centrifugation, along with their respective fat contents (Table 1).Table 2 summarises relevant clinical and outcome data.Chylothorax was identified as a complication of surgery between 24 h and 15 days after the procedure, requiring ଝ

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