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Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study

1
Clinic of Neonatology, Department Woman Mother Child, University Hospital of Lausanne, 1011 Lausanne, Switzerland
2
Nestlé Institute of Health Sciences, Nestlé Research, 1000 Lausanne, Switzerland
3
Clinical Development Unit, Nestlé Research Asia, Singapore 138567, Singapore
4
Nestlé Institute of Food Safety & Analytical Science, Nestlé Research, 1000 Lausanne, Switzerland
5
Nestlé Research Asia, Singapore 138567, Singapore
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1525; https://doi.org/10.3390/nu11071525
Received: 2 May 2019 / Revised: 14 June 2019 / Accepted: 1 July 2019 / Published: 4 July 2019
(This article belongs to the Special Issue Human Milk and Lactation)
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Abstract

Background: Mother’s own milk is the optimal source of nutrients and provides numerous health advantages for mothers and infants. As they have supplementary nutritional needs, very preterm infants may require fortification of human milk (HM). Addressing HM composition and variations is essential to optimize HM fortification strategies for these vulnerable infants. Aims: To analyze and compare macronutrient composition in HM of mothers lactating very preterm (PT) (28 0/7 to 32 6/7 weeks of gestational age, GA) and term (T) infants (37 0/7 to 41 6/7 weeks of GA) over time, both at similar postnatal and postmenstrual ages, and to investigate other potential factors of variations. Methods: Milk samples from 27 mothers of the PT infants and 34 mothers of the T infants were collected longitudinally at 12 points in time during four months for the PT HM and eight points in time during two months for the T HM. Macronutrient composition (proteins, fat, and lactose) and energy were measured using a mid-infrared milk analyzer, corrected by bicinchoninic acid (BCA) assay for total protein content. Results: Analysis of 500 HM samples revealed large inter- and intra-subject variations in both groups. Proteins decreased from birth to four months in the PT and the T HM without significant differences at any postnatal time point, while it was lower around term equivalent age in PT HM. Lactose content remained stable and comparable over time. The PT HM contained significantly more fat and tended to be more caloric in the first two weeks of lactation, while the T HM revealed higher fat and higher energy content later during lactation (three to eight weeks). In both groups, male gender was associated with more fat and energy content. The gender association was stronger in the PT group, and it remained significant after adjustments. Conclusion: Longitudinal measurements of macronutrients compositions of the PT and the T HM showed only small differences at similar postnatal stages in our population. However, numerous differences exist at similar postmenstrual ages. Male gender seems to be associated with a higher content in fat, especially in the PT HM. This study provides original information on macronutrient composition and variations of HM, which is important to consider for the optimization of nutrition and growth of PT infants. View Full-Text
Keywords: human milk; preterm; term; neonate; infant; macronutrients; protein; fat; lactose; nutrition human milk; preterm; term; neonate; infant; macronutrients; protein; fat; lactose; nutrition
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Fischer Fumeaux, C.J.; Garcia-Rodenas, C.L.; De Castro, C.A.; Courtet-Compondu, M.-C.; Thakkar, S.K.; Beauport, L.; Tolsa, J.-F.; Affolter, M. Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study. Nutrients 2019, 11, 1525.

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