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早产儿母乳宏量营养素浓度与出生时的胎龄无关。

Preterm human milk macronutrient concentration is independent of gestational age at birth.

机构信息

Department of Paediatrics, Division of Neonatology, Faculty of Medicine, Charles University, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.

Department of Neonatology, Thomayer Hospital, Prague, Czech Republic.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2019 Jan;104(1):F50-F56. doi: 10.1136/archdischild-2016-312572. Epub 2018 Jan 20.

Abstract

OBJECTIVE

To evaluate the amount of macronutrients in aggregate of human milk samples after preterm delivery during the first 2 months of lactation.

METHODS

Analysis of the donated single milk samples, gained by complete emptying of the whole breast at the same daytime between 24+0 and 35+6 gestational age (GA), was designed as prospective observational cohort trial. Two milk samples were analysed every postnatal week up to the discharge from the hospital, week 9 or loss of lactation. 24-Hour milk collection was not done. Analysis was performed using the MIRIS Human Milk Analyser (MIRIS AB, Uppsala, Sweden).

RESULTS

A set of 1917 human milk samples donated by 225 mothers after preterm labour was analysed. Group A (24-30 GA) contains 969 milk samples; group B (31-35 GA) contains 948 milk samples. No difference in milk composition between the groups was identified. Median of true protein content decreased from 1.6 g/dL in group A and 1.5 g/dL in group B in the first week of life, to 1.1 g/dL in both groups at the end of week 3, and then remained stable up to week 9. Content of carbohydrates and fat was stable during the whole observation, with interindividual differences.

CONCLUSION

Human milk does not differ as a function of degree of prematurity. Protein content of preterm human milk is low and decreases during the first 3 weeks of lactation. Recommended daily protein intake cannot be achieved with routine fortification in majority of milk samples.

摘要

目的

评估早产儿在出生后前 2 个月的泌乳期内,母乳样本中宏量营养素的总量。

方法

设计了一项前瞻性观察队列试验,对在妊娠 24+0 至 35+6 周(GA)之间的同一白天通过排空整个乳房获得的捐赠的单个母乳样本进行分析。每个新生儿周都要分析两次母乳样本,直到出院、第 9 周或停止哺乳。没有进行 24 小时奶液收集。分析使用 MIRIS 母乳分析仪(MIRIS AB,乌普萨拉,瑞典)进行。

结果

分析了 225 位早产母亲捐赠的 1917 份母乳样本。A 组(24-30GA)包含 969 份样本;B 组(31-35GA)包含 948 份样本。两组之间的母乳成分没有差异。真蛋白含量中位数从 A 组的第 1 周的 1.6g/dL 和 B 组的 1.5g/dL,下降到第 3 周的两组均为 1.1g/dL,之后直到第 9 周保持稳定。碳水化合物和脂肪的含量在整个观察期间保持稳定,存在个体差异。

结论

母乳不因早产程度而有所不同。早产儿母乳的蛋白质含量低,在哺乳期的前 3 周内逐渐下降。在大多数母乳样本中,常规强化无法满足推荐的每日蛋白质摄入量。

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