Abstract
Objectives
To evaluate the variability in macronutrient and energy content of breastmilk of Indian women delivering at ≤34 weeks of gestation.
Methods
In this cross-sectional study, samples of breastmilk expressed manually for feeding of preterm neonates were collected from 106 mothers at 3±1 (n=26), 7±2 (n=34), 14±2 (n=24), 21±3 (n=12) and 28±3 (n=10) days after birth. Protein, fat and carbohydrate content were estimated and total energy content was calculated.
Results
Protein content in the human milk declined from 4.1±2.1 g/dL on the 3rd postpartum day to 2.2±0.6 g/dL by the 28th day postpartum. Lactose (from 2.2±0.7 g/dL to 3.0±0.9 g/dL), fat (1.9±1.8 g/dL to 3.4±2.1 g/dL) and energy (42.3±18.8 Kcal/dL to 51.9±21.5 Kcal/dL) contents increased from day 3 to day 28.
Conclusions
Preterm human milk has high temporal and inter-individual variation in the macronutrient composition and without fortification is unlikely to meet the nutritional requirement of preterm neonates.
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References
Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. 2012;129:e827–41.
Agostoni C, Buonocore G, Carnielli VP, de Curtis M, Darmaun D, Decsi T, et al. Enteral nutrient supply for preterm infants: Commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50:85–91.
Gidrewicz DA, Fenton TR. A systematic review and metaanalysis of the nutrient content of preterm and term breast milk. BMC Pediatr. 2014;14:216.
Rozé J-C, Darmaun D, Boquien C-Y, Flamant C, Picaud JC, Savagner C, et al. The apparent breastfeeding paradox in very preterm infants: relationship between breast feeding, early weight gain and neurodevelopment based on results from two cohorts, EPIPAGE and LIFT. BMJ Open. 2012;2:e000834.
Kreissl A, Zwiauer V, Repa A, Binder C, Thanhaeuser M, Jilma B, et al. Human Milk Analyser shows that the lactation period affects protein levels in preterm breastmilk. Acta Paediatr. 2016;105:635–40.
Reali A, Greco F, Fanaro S, Atzei A, Puddu M, Moi M, et al. Fortification of maternal milk for very low birth weight (VLBW) pre-term neonates. Early Hum Dev. 2010;86:33–6.
Lowry OH, Rosebrough NJ, Farr AL, Randall RJ. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951;193:265–75.
Paul VK, Singh M, Srivastava LM, Arora NK, Deorari AK. Macronutrient and energy content of breast milk of mothers delivering prematurely. Indian J Pediatr. 1997;64:379–82.
Nichols BL. Atwater and USDA nutrition research and service: a prologue of the past century. J Nutr. 1994;124:1718S-27S.
de Halleux V, Rigo J. Variability in human milk composition: benefit of individualized fortification in verylow-birth-weight infants. Am J Clin Nutr. 2013;98:529S-35S.
Faerk J, Skafte L, Petersen S, Peitersen B, Michaelsen KF. Macronutrients in milk from mothers delivering preterm. Adv Exp Med Biol. 2001;501:409–13.
Bauer J, Gerss J. Longitudinal analysis of macronutrients and minerals in human milk produced by mothers of preterm infants. Clin Nutr Edinb Scotl. 2011;30:215–20.
Narang APS, Bains HS, Kansal S, Singh D. Serial composition of human milk in preterm and term mothers. Indian J Clin Biochem. 2006;21:89–94.
Radmacher PG, Lewis SL, Adamkin DH. Individualizing fortification of human milk using real time human milk analysis. J Neonatal Perinatal Med. 2013;6:319–23.
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Mahajan, S., Chawla, D., Kaur, J. et al. Macronutrients in breastmilk of mothers of preterm infants. Indian Pediatr 54, 635–637 (2017). https://doi.org/10.1007/s13312-017-1124-0
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DOI: https://doi.org/10.1007/s13312-017-1124-0