Neonatal Department, Necker Enfants Malades Hospital, 75015 Paris, France.
Milk Bank Ile de France, Necker Enfants Malades Hospital, 75015 Paris, France.
Nutrients. 2020 Feb 6;12(2):421. doi: 10.3390/nu12020421.
Most studies assessing the macronutrient content of human milk are published retrospectively using analyzers that fail to determine sodium content and do not take into account the role of volume in milk composition. We aimed to describe macronutrient content and sodium content in human milk over time, observe any associations between them, and determine the factors associated with the evolution of milk composition. A prospective, longitudinal, monocentric study was undertaken. Contents of protein, fat, and lactose of 102 milk samples from 40 mothers were determined using a human milk analyzer and that of sodium with a flame spectrophotometer. Milk volumes along with clinical data were recorded. Protein content in the fourth quartile of volume was significantly lower than that in the first three, suggesting the existence of a volume threshold for protein content at approximately 445 mL. After multivariate analysis, it was found that maternal age, average volume, and lactation period remained significantly associated with protein content, maternal age remained significantly associated with fat content, and only average volume with sodium content. In consideration of previous findings along with our data, we suggest that extra care should be taken with fortification for feeding preterm infants when the mother's milk volume is greater than 400-450 mL.
大多数评估人乳宏量营养素含量的研究都是使用未能确定钠含量且未考虑体积在乳成分中作用的分析仪进行回顾性发表的。我们旨在描述随时间推移人乳中的宏量营养素含量和钠含量，观察它们之间的任何关联，并确定与乳成分演变相关的因素。进行了一项前瞻性、纵向、单中心研究。使用人乳分析仪测定了 40 位母亲的 102 份母乳样本中的蛋白质、脂肪和乳糖含量，并使用火焰分光光度计测定了钠含量。同时记录了奶量以及临床数据。第四四分位数的蛋白质含量明显低于前三分位数，这表明蛋白质含量存在约 445 毫升的体积阈值。经多变量分析发现，母亲年龄、平均奶量和哺乳期与蛋白质含量显著相关，母亲年龄与脂肪含量显著相关，仅平均奶量与钠含量显著相关。考虑到以前的发现以及我们的数据，我们建议当母亲的奶量大于 400-450 毫升时，对于喂养早产儿的强化配方应格外小心。
