Weber A, Loui A, Jochum F, Bührer C, Obladen M
Department of Neonatology, Charité Virchow-Hospital, Humboldt University, Berlin, Germany.
Acta Paediatr. 2001 Jul;90(7):772-5.
While breast milk appears to be superior to formula for the development of very low birthweight (VLBW) infants, it is supplemented to meet the metabolic demands of the rapidly growing premature infant. To estimate the nutritional variability of breast milk from mothers of VLBW infants, protein (bicinchoninic acid method) and fat content (creamatocrit) were measured in breast-milk spot samples from mothers of 20 VLBW infants, collected 4 times a day during the first 4 wk of lactation. Protein content (median 1.9 g dl(-1), range 1.1-3.5 g dl(-1)) and fat content (3.8/1.0-14.6 g dl(-1)) were highly variable and lacked a normal distribution over all samples and in individual women's milk. There was only a weak correlation between fat and protein (rs=0.416, p < 0.001). Fat but not protein was lower in morning samples than in samples collected later in the day (p < 0.001). Protein but not fat content decreased during the weeks of lactation (rs =-0.446, p < 0.001). No impact of the baby's gestational age was observed.
The fat and protein content of breast milk from mothers of VLBW infants is highly variable, calling into question the clinical feasibility of individualized supplementation of breast milk for VLBW infants based on spot sample measurements.
虽然母乳似乎比配方奶更有利于极低出生体重（VLBW）婴儿的发育，但仍需补充母乳以满足快速生长的早产儿的代谢需求。为了评估VLBW婴儿母亲母乳的营养变异性，对20名VLBW婴儿母亲的母乳斑点样本中的蛋白质（二辛可宁酸法）和脂肪含量（乳脂比容）进行了测量，在哺乳期的前4周每天采集4次。蛋白质含量（中位数1.9 g dl(-1)，范围1.1 - 3.5 g dl(-1)）和脂肪含量（3.8/1.0 - 14.6 g dl(-1)）在所有样本以及个体母亲的乳汁中高度可变且缺乏正态分布。脂肪和蛋白质之间仅有微弱的相关性（rs = 0.416，p < 0.001）。早晨样本中的脂肪含量低于当天晚些时候采集的样本（p < 0.001），而蛋白质含量并非如此。蛋白质含量而非脂肪含量在哺乳期的几周内有所下降（rs = -0.446，p < 0.001）。未观察到婴儿胎龄的影响。
VLBW婴儿母亲的母乳中脂肪和蛋白质含量高度可变，这使得基于斑点样本测量对VLBW婴儿进行个性化母乳补充的临床可行性受到质疑。
