Department of Pediatrics, Division of Neonatology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
J Perinat Med. 2019 Sep 25;47(7):785-791. doi: 10.1515/jpm-2019-0105.
Background Human milk is the optimal source of nutrition for preterm infants. However, breast milk alone is often not sufficient to satisfy the high nutritional needs for growth and development in preterm infants. Fortified human breast milk is the best way to meet the nutritional needs of preterm infants. Human breast milk is fortified according to the estimated nutrient content of mature breast milk; however, because the content of breast milk is highly variable, the macronutrient support may be more or less than needed. The goal of this study was to analyze the macronutrient content of preterm human milk during the first 6 weeks of lactation. Methods The study included 32 mothers of preterm infants with a gestational age of ≤32 weeks. Breast milk was collected in 24-h cycles and analyzed daily using mid-infrared (MIR) spectroscopy. We measured protein, fat and lactose concentrations in the breast milk, and the energy content was calculated. Results The protein content was high during the first weeks of lactation, but decreased as lactation progressed. The fat, energy and lactose contents of the breast milk were low during the first 2 weeks of lactation, increased as lactation progressed and remained constant thereafter. In women with high body mass index (BMI), higher protein levels were found in transitional milk. In women who had high income level, higher fat and energy levels were found in transitional milk. Conclusion Our findings indicate that the macronutrient content of preterm breast milk changes throughout the course of lactation, with BMI and income level. Knowledge of the macronutrient composition of breast milk is necessary to ensure that preterm infants receive the appropriate types and quantities of nutrients to promote optimal growth, and to ensure that breast milk is fortified according to individual needs. Our findings may be useful for the provision of optimal nutritional support for preterm infants.
母乳是早产儿最佳的营养来源。然而，单纯母乳喂养往往无法满足早产儿生长发育所需的高营养需求。强化母乳是满足早产儿营养需求的最佳方法。母乳根据成熟母乳的估计营养素含量进行强化；然而，由于母乳的含量变化很大，宏量营养素的支持可能或多或少地超过所需。本研究的目的是分析早产儿母乳在哺乳期最初 6 周的宏量营养素含量。
本研究纳入了 32 名胎龄≤32 周的早产儿的母亲。采用中红外（MIR）光谱法在 24 小时周期内收集母乳，并每天进行分析。我们测量了母乳中的蛋白质、脂肪和乳糖浓度，并计算了能量含量。
在哺乳期的最初几周，母乳中的蛋白质含量较高，但随着泌乳的进行而降低。在哺乳的前 2 周，母乳中的脂肪、能量和乳糖含量较低，随着泌乳的进行而增加，并在此后保持不变。在体重指数（BMI）较高的女性中，过渡乳中的蛋白质水平较高。在收入水平较高的女性中，过渡乳中的脂肪和能量水平较高。
我们的研究结果表明，早产儿母乳的宏量营养素含量在整个哺乳期都会发生变化，与 BMI 和收入水平有关。了解母乳的宏量营养素组成对于确保早产儿获得适当类型和数量的营养以促进最佳生长非常重要，并确保根据个体需求进行母乳强化。我们的研究结果可能对为早产儿提供最佳营养支持有用。
