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Development of macronutrient composition of very preterm human milk

Published online by Cambridge University Press:  22 August 2007

Yolande G. H. Maas*
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Jeanet Gerritsen
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Augustinus A. M. Hart
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Mijna Hadders-Algra
Affiliation:
Department of Medical Physiology, University of Groningen, Bloemsingel 10, 9712 KZ Groningen, The Netherlands
Jan M. Ruijter
Affiliation:
The Netherlands Ophthalmic Research Institute and Laboratory of Medical Physics, PO Box 12141, 1100 AC Amsterdam, The Netherlands
Pieter Tamminga
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Majid Mirmiran
Affiliation:
Netherlands Institute for Brain Research, Meibergdreef 33, 1105 AZ Amsterdam, The Netherlands
Henk Spekreijse
Affiliation:
The Netherlands Ophthalmic Research Institute and Laboratory of Medical Physics, PO Box 12141, 1100 AC Amsterdam, The Netherlands
*
*Corresponding author: Dr Y. G. H. Maas, fax +31 20 6965 099, email y.g.maas@amc.uva.nl
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Abstract

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The effects of gestational age at delivery (GA), postnatal age (PNA) and post-menstrual age (PMA=PNA+GA, an indicator of autonomous developmental processes not affected by the moment of birth) on macronutrient composition of very preterm milk were studied. Total N, fat, lactose and carbohydrate concentrations, energy density and 24 h volume were determined in 282 24 h milk samples collected at weekly intervals (days 7–55 of lactation) from seventy-nine women delivering their babies between 25 and 29 weeks of gestation. GA related differences were found for carbohydrate concentration only: carbohydrate concentration was lower with increasing GA. PNA was related to a decrease in total N and an increase in lactose concentration. PMA was not related to milk composition. Our data indicate that PNA strongly influences the development of the composition of very preterm human milk, while GA affects carbohydrate content with a negligible effect on the nutritional value of the milk. We conclude that in accordance with current opinion in paediatrics, human milk is the best source of nutrients even for very preterm (< 30 weeks GA) infants.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1998

References

Anderson, DM, Williams, FH, Merkatz, RB, Schulman, PK, Kerr, DS & Pittard, WB (1983) Length of gestation and nutritional composition of human milk. American Journal of Clinical Nutrition 37, 810814.CrossRefGoogle ScholarPubMed
Anderson, GH (1984) The effect of prematurity on milk composition and its physiological basis. Federation Proceedings 43, 24382442.Google ScholarPubMed
Anderson, GH, Atkinson, SA & Bryan, MH (1981) Energy and macronutrient content of human milk during early lactation from mothers giving birth prematurely and at term. American Journal of Clinical Nutrition 34, 258265.CrossRefGoogle ScholarPubMed
Atkinson, SA, Anderson, GH & Bryan, MH (1980) Human milk: comparison of the nitrogen composition in milk from mothers of premature and full-term infants. American Journal of Clinical Nutrition 33, 811815.CrossRefGoogle ScholarPubMed
Atkinson, SA, Bryan, MH & Anderson, GH (1978) Human milk: difference in nitrogen concentration in milk from mothers of term and premature infants. Journal of Pediatrics 93, 6769.CrossRefGoogle ScholarPubMed
Beijers, RJW, Graaf, FVD, Schaafsma, A & Siemensma, AD (1992) Composition of premature breast-milk during lactation: constant digestible protein content (as in full term milk). Early Human Development 29, 351356.CrossRefGoogle ScholarPubMed
Boerhinger Mannheim GmbH (1989) Methods of Biochemical Analysis and Food Analysis: Using Test-Combinations, pp. 8083. Mannheim, Germany: Boerhinger Mannheim GmbH.Google Scholar
Box, GEP & Cox, DR (1964) Analysis of transformations. Journal of the Royal Statistical Society 26B, 211252.Google Scholar
Butte, NF, Garza, C, Johnson, CA, Smith, EO & Nichols, BL (1984) Longitudinal changes in milk composition of mothers delivering preterm and term infants. Early Human Development 9, 153162.CrossRefGoogle ScholarPubMed
Coppa, GV, Gabrielli, O, Pierani, P, Catassi, C, Carlucci, A & Giorgi, PL (1993) Changes in carbohydrate composition in human milk over 4 months of lactation. Pediatrics 91, 637641.CrossRefGoogle ScholarPubMed
Coppa, GV, Gabrielli, O, Pierani, P, Zampini, L, Rotolli, G, Carlucci, A & Giorgi, PL (1991) Qualitative and quantitative studies of carbohydrates of human colostrum and mature milk. Rivista Italiana di Pediatria 17, 303307.Google Scholar
Darwish, AEH, Dakroury, AM, El-Feel, MS & Nour, NM (1989) Comparative study on breast milk of mothers delivering preterm and term infants. Protein, fat and lactose. Nahrung 33, 249251.CrossRefGoogle ScholarPubMed
Dawodu, AH, Osibanjo, O & Damole, IO (1990) Nutrient composition of milk produced by mothers of preterm infants in Nigeria. East African Medical Journal 67, 873877.Google ScholarPubMed
Dixon, WJ (editor) (1992) In BMDP Statistical Software Manual. Berkeley, Los Angeles and Oxford: University of California Press.Google Scholar
Dubowitz, LMS, Dubowitz, V & Goldberg, C (1970) Clinical assessment of gestational age in newborn infants. Journal of Pediatrics 77, 110.CrossRefGoogle Scholar
Gross, SJ, David, RJ, Bauman, L & Tomarelli, RM (1980) Nutritional composition of milk produced by mothers delivering preterm. Journal of Pediatrics 96, 641644.CrossRefGoogle ScholarPubMed
Gross, SJ, Geller, J & Tomarelli, RM (1981) Composition of breast milk from mothers of preterm infants. Pediatrics 68, 490493.CrossRefGoogle ScholarPubMed
Guerrini, P, Bosi, G, Chierici, R & Fabbri, A (1981) Human milk: relationship of fat content with gestational age. Early Human Development 5, 187194.CrossRefGoogle ScholarPubMed
Helrich, K (editor) (1990) In Official Methods of Analysis of the AOAC, 15th ed. Arlington, VA: Association of Official Analytical Chemists Inc.Google Scholar
Hibberd, CM, Brooke, OG, Carter, ND, Haug, M & Harzer, G (1982) Variation in the composition of breast milk during the first 5 weeks of lactation: implications for the feeding of preterm infants. Archives of Disease in Childhood 57, 658662.CrossRefGoogle ScholarPubMed
Hytten, FE (1954) Clinical and chemical studies in human lactation. IV. Trends in milk composition during course of lactation. British Medical Journal 1, 249253.CrossRefGoogle Scholar
Jain, S & Bijlani, RL (1989) The significance of some significant features of breast milk. Indian Journal of Physiology and Pharmacology 33, 118128.Google ScholarPubMed
Lawrence, PB (1994) Breast milk. Best source of nutrition for term and preterm infants. Pediatric Clinics of North America 41, 925941.CrossRefGoogle ScholarPubMed
Lemons, JA, Moye, L, Hall, D & Simmons, M (1982) Differences in the composition of preterm and term human milk during early lactation. Pediatric Research 16, 113117.CrossRefGoogle ScholarPubMed
Lemons, JA, Reyman, D & Moye, L (1983) Amino acid composition of preterm and term breast milk during early lactation. Early Human Development 8, 323329.CrossRefGoogle ScholarPubMed
Lepage, G, Collet, S, Bougié, D, Kien, LC, Lepage, D, Dallaire, L, Darling, P & Roy, CC (1984) The composition of preterm milk in relation to the degree of prematurity. American Journal of Clinical Nutrition 40, 10421049.CrossRefGoogle Scholar
Pamblanco, M, Ten, A & Comin, J (1986) Proteins in preterm and term milk from mothers delivering appropriate or small-for-gestational age infants. Early Human Development 14, 267272.CrossRefGoogle ScholarPubMed
Pierse, P, Van Aerde, J & Clandinin, MT (1988) Nutritional value of human milk. Progress in Food and Nutrition Science 12, 421447.Google ScholarPubMed
Prechtl, HFR (editor) (1984) Continuity of Neural Functions from Prenatal to Postnatal Life. Clinics in Developmental Medicine, vol. 94. Oxford: SIMP/Blackwell.Google Scholar
Schanler, RJ & Oh, W (1980) Composition of breast milk obtained from mothers of premature infants as compared to breast milk obtained from donors. Journal of Pediatrics 96, 679681.CrossRefGoogle ScholarPubMed