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捐赠人母乳的营养成分及其与早产儿母乳的比较。

Nutrient Composition of Donor Human Milk and Comparisons to Preterm Human Milk.

机构信息

Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA.

Department of Pediatrics, College of Medicine, Baylor University, Houston, TX.

出版信息

J Nutr. 2023 Sep;153(9):2622-2630. doi: 10.1016/j.tjnut.2023.07.012. Epub 2023 Jul 28.

Abstract

BACKGROUND

Human milk is the preferred diet for very low birth weight (VLBW, <1500 g) infants. When mother's own milk is unable to meet the needs of VLBW infants, donor human milk (DHM) is the preferred alternative. Unfortunately, the composition of DHM remains elusive and no comparative studies between preterm human milk and DHM have been performed previously.

OBJECTIVES

We aimed to analyze the nutrient content of commercial pooled DHM and compare nutrient content in DHM with that of early and mature preterm human milk.

METHODS

We analyzed nutrient content in 15 DHM samples provided from 7 commercial milk banks including calories, carbohydrate, fat, protein, sodium, chloride, potassium, zinc, calcium, phosphorus, magnesium, and vitamin D and compared each nutrient to early (7 d of life) and mature (28 d of life) preterm human milk samples (n = 28-36 per nutrient, gestational age = 28 ± 3 wk). Protein-to-energy ratio and carbohydrate-to-nonprotein energy ratio were calculated for each sample and compared.

RESULTS

Mean values for all macro- and micronutrients in DHM are reported. In comparison to early or mature preterm human milk, DHM had significantly lower protein, sodium, chloride, potassium, and zinc content. Calorie, carbohydrate, calcium, phosphorus, magnesium, and vitamin D content did not differ statistically between DHM and early or mature preterm human milk. Fat content was modestly lower in early but not mature human milk when compared with DHM.

CONCLUSIONS

We provide mean values for several macro- and micronutrients for DHM and identify key differences between DHM and preterm human milk, which may be considered when designing human milk-based feeding plans. This study was registered at clinicaltrials.gov as NCT05742815.

摘要

背景

母乳是极低出生体重(VLBW,<1500 克)婴儿的首选喂养方式。当母亲自身的乳汁无法满足 VLBW 婴儿的需求时,捐献母乳(DHM)是首选的替代方案。然而,DHM 的成分仍然难以确定,以前也没有对早产儿母乳和 DHM 进行过比较研究。

目的

我们旨在分析商业汇集 DHM 的营养成分,并比较 DHM 与早期和成熟早产儿母乳的营养成分。

方法

我们分析了来自 7 家商业母乳库的 15 份 DHM 样本的营养成分,包括热量、碳水化合物、脂肪、蛋白质、钠、氯、钾、锌、钙、磷、镁和维生素 D,并将每种营养素与早期(生命第 7 天)和成熟(生命第 28 天)早产儿母乳样本进行比较(每种营养素 n = 28-36,胎龄 = 28 ± 3 周)。计算了每个样本的蛋白质与能量比和碳水化合物与非蛋白质能量比,并进行了比较。

结果

报告了 DHM 中所有宏量和微量营养素的平均值。与早期或成熟早产儿母乳相比,DHM 的蛋白质、钠、氯、钾和锌含量显著较低。DHM 与早期或成熟早产儿母乳之间的热量、碳水化合物、钙、磷、镁和维生素 D 含量无统计学差异。与 DHM 相比,早期母乳的脂肪含量略低,但成熟母乳的脂肪含量没有差异。

结论

我们提供了 DHM 中几种宏量和微量营养素的平均值,并确定了 DHM 与早产儿母乳之间的关键差异,在设计基于母乳的喂养计划时可以考虑这些差异。本研究在 clinicaltrials.gov 上注册为 NCT05742815。

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