Nutritional composition of milk produced by mothers delivering preterm

doi:10.1016/S0022-3476(80)80729-3

The Journal of Pediatrics

Volume 96, Issue 4, April 1980, Pages 641-644

https://doi.org/10.1016/S0022-3476(80)80729-3 Get rights and content

The nutritional composition of milk obtained during the first month postpartum from 33 mothers delivering preterm and 18 mothers delivering at term was determined. Milk produced by mothers delivering preterm contained significantly higher concentrations of protein, sodium, and chloride, and significantly lower concentrations of lactose than milk produced by mothers delivering at term. The caloric concentration of milk produced by the two groups of mothers was similar, as were the concentrations of potassium, calcium, phosphorus, and magnesium. PT milk appears to approximate more closely the nutritional needs of the preterm infant than does other breast milk.

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Cited by (218)

Biochemistry of human milk
2021, Human Milk Biochemistry and Infant Formula Manufacturing Technology
Human milk plays an important part in the health of infants and has a unique chemical composition and biochemistry compared with bovine milk. It contains a higher level of lactose, and much lower content of protein and ash than the latter. Breast milk does not contain any β-lactoglobulin or α_s1-casein. The composition of human milk changes as lactation progresses. This change in composition is caused by both physiological and external factors, with some external factors having a negative effect on milk quality. This chapter mainly reviews the biochemistry of human milk and the factors affecting chemical composition in human milk.
Macronutrient composition in human milk from mothers of preterm and term neonates is highly variable during the lactation period
2019, Clinical Nutrition Experimental
Citation Excerpt :
The other possibility is that the nutritional needs of the preterm infant are matched by the composition of HM produced by mothers delivering prematurely. These data have led to studies designed to evaluate the nutritional composition and adequacy of HM produced by mothers delivering to ≥37 weeks of gestation [34,45,60–62]. To minimize variations that may affect milk composition in this study, each participant received professional support by lactation consultants providing instruction in sampling milk during the entire investigation including home visits after discharge.
To investigate the macronutrient content of human milk during the first 28 days of lactation of mothers who delivered preterm infants, and to compare preterm to term milk.
A prospective and longitudinal study of mothers at various stages of lactation was conducted in the Amiens-Picardie University Hospital (France). Fat, true protein, carbohydrate and energy contents were estimated in human milk collected from each participant.
Macronutrients in human milk were: fat (g/100 mL), 3.36±1.01; true protein ( g/100 mL), 1.34±0.61; carbohydrate ( g/100 mL), 7.23±0.68; energy (kcal/100 mL), 72.97±9.21 for extremely preterm human milk; fat (g/100 mL), 3.47±1.14; true protein (g/100 mL) 1.32±0.63; carbohydrate g/100 mL), 7.28±1.10; energy (kcal/100 mL), 76.18±12.84 for very preterm human milk; fat (g/100 mL), 3.48±0.87; true protein (g/100 mL), 1.26±0.46; carbohydrate (g/100 mL), 7.36±0.47; energy (kcal/100 mL), 76.47±8.21 for moderate preterm human milk; fat (g/mL), 3.48±1.57; true protein (g/100 mL), 1.23±1.03; carbohydrate (g/100 mL), 7.36±0.63; energy (kcal/100 mL), 76.56±13.57 for term human milk.
Marked variations in macronutrient contents were observed between preterm and term human milk. The macronutrient score of extremely and moderate preterm human milk versus term human milk was significant, p=0.0001.
Postnatal nutritional deficit is an independent predictor of bronchopulmonary dysplasia among extremely premature infants born at or less than 28 weeks gestation
2019, Early Human Development
Citation Excerpt :
We did not analyse the macronutrient contents of breast milk in this study but instead used a factor of 68 Cal/100 ml for energy, 6.8 g/100 ml for carbohydrates, 1.35 g/100 ml for protein and 4.2 g/100 ml for fats for unfortified breast milk. This estimate was based on reference nutritional data from previous studies [14–16] which correlated with the average values from a recent study by Maly et al. [17] Macronutrients information for formula milk were obtained from the supplied product information sheet. Statistical analysis was performed using Statistical Package for Social Science (SPSS, Mac version 22.0; IBM Corp).
To investigate the relationship between growth, nutritional and fluid intake in the first month of life and the likelihood of developing bronchopulmonary dysplasia.
This is a retrospective case-control study conducted in a tertiary perinatal centre between January 2011 and December 2013.
Thirty-three preterm infants without bronchopulmonary dysplasia (BPD) were identified and matched with those with BPD, based on period of birth within a cohort of infants with a birth weight of ≤1000 g and gestational age ≤28 weeks that were admitted to the unit during the study period.
We reported the weekly and 4-week mean daily caloric and fluid intake, and growth status as changes in Fenton z-scores and weight velocity. The predictors of bronchopulmonary dysplasia were identified using multivariable logistic regression analysis.
The 4-week mean daily caloric and fluid intake were significantly lower in the BPD group. Mean z-scores of weights, weight velocity and proportions of infants with weights below the 10th percentile on day 28 of life were similar in both groups. The odds of developing BPD were increased when invasive ventilatory support was required at day 28 (OR = 16.5), and were decreased with a higher 4-week averaged daily caloric intake (OR = 0.89).
Infants with BPD received a lower caloric and fluid intake in the first month of life. In multivariable regression analysis, two independent predictors for BPD development were the need for invasive ventilatory support and a lower 4-week averaged daily caloric intake.
Breastfeeding
2018, Avery's Diseases of the Newborn: Tenth Edition
- •
  Hospital policies must support mothers who intend to breastfeed and should reflect and incorporate the Baby-Friendly Hospital Initiative's Ten Steps to Successful Breastfeeding.
- •
  Breastfeeding advocacy should reach into the community: breastfeeding is a public health issue with evidence-based health and economic benefits.
- •
  All pediatricians must be knowledgeable about lactation management and be prepared to lead healthcare teams that support the breastfeeding dyad.
- •
  Every home-going infant should receive medical care at a pediatric office that has seamless access to appropriately trained lactation specialists.
- •
  Breastfeeding education and support should be offered by trained peers and medical health providers, both prepartum and postpartum, both in the community and in medical settings, and to the mother, her partner, and all in her support system.
- •
  Changes in national health policy, such as availability of free lactation services and paid maternity leave, hold promise for reducing health disparities associated with breastfeeding rates.
- •
  Each neonatal intensive care unit should have protocols and guidelines to support lactation for mothers of hospitalized neonates.
Longitudinal evolution of true protein, amino acids and bioactive proteins in breast milk: a developmental perspective
2017, Journal of Nutritional Biochemistry
The protein content of breast milk provides a foundation for estimating protein requirements of infants. Because it serves as a guideline for regulatory agencies issuing regulations for infant formula composition, it is critical that information on the protein content of breast milk is reliable. We have therefore carried out a meta-analysis of the protein and amino acid contents of breast milk and how they evolve during lactation. As several bioactive proteins are not completely digested in the infant and therefore represent “non-utilizable” protein, we evaluated the quantity, mechanism of action and digestive fate of several major breast milk proteins. A better knowledge of the development of the protein contents of breast milk and to what extent protein utilization changes with age of the infant will help improve understanding of protein needs in infancy. It is also essential when designing the composition of infant formulas, particularly when the formula uses a “staging” approach in which the composition of the formula is modified in stages to reflect changes in breast milk and changing requirements as the infant ages.
Breastfeeding
2017, Avery's Diseases of the Newborn, Tenth Edition
- •
  Hospital policies must support mothers who intend to breastfeed and should reflect and incorporate the Baby-Friendly Hospital Initiative's Ten Steps to Successful Breastfeeding.
- •
  Breastfeeding advocacy should reach into the community: breastfeeding is a public health issue with evidence-based health and economic benefits.
- •
  All pediatricians must be knowledgeable about lactation management and be prepared to lead healthcare teams that support the breastfeeding dyad.
- •
  Every home-going infant should receive medical care at a pediatric office that has seamless access to appropriately trained lactation specialists.
- •
  Breastfeeding education and support should be offered by trained peers and medical health providers, both prepartum and postpartum, both in the community and in medical settings, and to the mother, her partner, and all in her support system.
- •
  Changes in national health policy, such as availability of free lactation services and paid maternity leave, hold promise for reducing health disparities associated with breastfeeding rates.
- •
  Each neonatal intensive care unit should have protocols and guidelines to support lactation for mothers of hospitalized neonates.

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Original articleNutritional composition of milk produced by mothers delivering preterm

J Pediatr

Human milk in premature infant feeding: Summary of a workshop

Pediatrics

Human milk and the small premature infant

Am J Dis Child

Adequacy of expressed breast milk for early growth of preterm infants

Arch Dis Child

Is human milk the best food for low birth weight babies?

Pediatric Res

Official Methods of Analysis of the Association of Official Analytical Chemists

Original article
Nutritional composition of milk produced by mothers delivering preterm