He Bi-Zi, Sun Xiu-Jing, Quan Mei-Ying, Wang Dan-Hua
Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jul;16(7):679-83.
To study the dynamic changes in macronutrients and energy in human milk from mothers of premature infants.
A total of 339 human milk samples were collected from 170 women who delivered preterm or full-term infants in the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital between November 2012 and January 2014. Macronutrients (proteins, fats and carbohydrates and energy were measured using a MIRIS human milk analyzer and compared between groups.
In milk samples from premature infants' mothers, the protein levels were the highest in colostrum (2.22±0.49 g/dL), less in transitional milk (1.83±0.39 g/dL), and the least in mature milk (1.40±0.28 g/dL) (P<0.01), and the levels of fats (2.4±1.3 g/dL vs 3.1±1.1 g/dL; P<0.01), carbohydrates (6.4±0.9 g/dL vs 6.6±0.4 g/dL; P<0.05) and energy (55±9 kcal/dL vs 62±8 kcal/dL; P<0.01) were significantly lower in colostrum than in transitional milk. The protein levels in colostrum from premature infants' mothers were significantly higher than those in colostrum from term infants' mothers (2.22±0.49 g/dL vs 2.07±0.34 g/dL; P<0.05). The colostrum from mothers of premature infants with a gestational age of ≤30 weeks had significantly higher protein levels than those from mothers of premature infants with gestational ages of 30(+1)-33(+6) weeks and ≥34 weeks (2.48±0.68 g/dL vs 2.11±0.25 g/dL and 2.22±0.39 g/dL respectively, P<0.05); the energy levels in colostrum from mothers of premature infants with a gestational age of ≤30 weeks group (51±6 kcal/dL) were significantly lower than those in colostrum from mothers of premature infants with a gestational age of 30(+1)-33(+6) weeks (58±8 kcal/d; P<0.05). The carbohydrate levels in transitional milk from mothers of premature infants with a gestational age of ≤30 weeks were significantly higher than those in transitional milk from mothers of premature infants with gestational ages of 30(+1)-33(+6) weeks and ≥34 weeks (P<0.05). The protein levels in mature milk from mothers of premature infants with a gestational age of 30(+1)-33(+6) weeks were significantly higher than those in mature milk from mothers of premature infants with gestational ages of ≤30 weeks and ≥34 weeks (P<0.05).
The levels of macronutrients and energy in milk from mothers of premature infants vary significantly between colostrum, transitional milk, and mature milk. Protein levels are significantly higher in colostrum from premature infants' mothers than in colostrum from term infants' mothers, but the significant difference is not seen for mature milk. Macronutrient and energy levels show significant differences between milk samples from mothers of premature infants with different gestational ages, so as to meet different needs of premature infants.
研究早产儿母亲母乳中常量营养素和能量的动态变化。
2012年11月至2014年1月期间，在北京协和医院妇产科收集了170名分娩早产或足月婴儿的女性的339份母乳样本。使用MIRIS母乳分析仪测量常量营养素（蛋白质、脂肪和碳水化合物）和能量，并进行组间比较。
在早产儿母亲的母乳样本中，初乳中的蛋白质水平最高（2.22±0.49 g/dL），过渡乳中较少（1.83±0.39 g/dL），成熟乳中最少（1.40±0.28 g/dL）（P<0.01），初乳中的脂肪（2.4±1.3 g/dL对3.1±1.1 g/dL；P<0.01）、碳水化合物（6.4±0.9 g/dL对6.6±0.4 g/dL；P<0.05）和能量（55±9 kcal/dL对62±8 kcal/dL；P<0.01）水平均显著低于过渡乳。早产儿母亲初乳中的蛋白质水平显著高于足月儿母亲初乳中的蛋白质水平（2.22±0.49 g/dL对2.07±0.34 g/dL；P<0.05）。孕周≤30周的早产儿母亲的初乳中蛋白质水平显著高于孕周为30（+1）-33（+6）周和≥34周的早产儿母亲的初乳（分别为2.48±0.68 g/dL对2.11±0.25 g/dL和2.22±0.39 g/dL，P<0.05）；孕周≤30周组的早产儿母亲初乳中的能量水平（51±6 kcal/dL）显著低于孕周为30（+1）-33（+6）周的早产儿母亲初乳中的能量水平（58±8 kcal/d；P<0.05）。孕周≤30周的早产儿母亲的过渡乳中的碳水化合物水平显著高于孕周为30（+1）-33（+6）周和≥34周的早产儿母亲的过渡乳中的碳水化合物水平（P<0.05）。孕周为30（+1）-33（+6）周的早产儿母亲的成熟乳中的蛋白质水平显著高于孕周≤30周和≥34周的早产儿母亲的成熟乳中的蛋白质水平（P<0.05）。
早产儿母亲母乳中常量营养素和能量水平在初乳、过渡乳和成熟乳之间存在显著差异。早产儿母亲初乳中的蛋白质水平显著高于足月儿母亲初乳中的蛋白质水平，但成熟乳中未见显著差异。不同孕周的早产儿母亲的母乳样本中常量营养素和能量水平存在显著差异，以满足早产儿的不同需求。
