Department of Neonatology, Tel Aviv Medical Center, Dana Dwek Children's Hospital, Tel Aviv, 6997801, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Pediatr. 2024 Jun;183(6):2671-2682. doi: 10.1007/s00431-024-05485-8. Epub 2024 Mar 21.
To describe the variability in carotenoid content of human milk (HM) in mothers of very to extremely low birth weight preterm infants throughout lactation and to explore the relationship between lutein in HM and the occurrence of retinopathy of prematurity (ROP) in preterm infants. We recruited healthy mothers along with their preterm infants that were born at gestational age 24 + 2 to 29 + 6 weeks or with a birth weight under 1500 g and were exclusively breastfed HM. Each participant provided up to 7 HM samples (2-10 ml) on day 0-3 and once a week until 6 weeks. Additionally, when possible, a blood sample was collected from the infant at week 6. Concentrations of the major carotenoids (lutein, zeaxanthin, beta-carotene, and lycopene) in all HM and blood samples were assessed and compared. Thirty-nine mother-infant dyads were included and 184 HM samples and 21 plasma samples were provided. Mean lutein, zeaxanthin, beta-carotene, and lycopene concentration decreased as lactation progressed, being at their highest in colostrum samples (156.9 vs. 66.9 vs. 363.9 vs. 426.8 ng/ml, respectively). Lycopene (41%) and beta-carotene (36%) were the predominant carotenoids in colostrum and up to 2 weeks post-delivery. Inversely, the proportion of lutein and zeaxanthin increased with lactation duration to account for 45% of the carotenoids in mature HM. Lutein accounted for 58% of the carotenoids in infant plasma and only 28% in HM. Lutein content of transition and mature HM did not differ between mothers of ROP and non-ROP infants.Conclusion Carotenoid content of HM was dynamic and varied between mothers and as lactation progressed. Infant plasma displayed a distinct distribution of carotenoids from HM.
描述极低出生体重早产儿（VLBWI）母亲在整个哺乳期母乳（HM）中类胡萝卜素含量的变化，并探讨 HM 中叶黄素与早产儿视网膜病变（ROP）发生的关系。我们招募了健康的母亲及其早产儿，这些早产儿的胎龄为 24+2 至 29+6 周或出生体重低于 1500g，并且只母乳喂养 HM。每位参与者在第 0-3 天和每周提供多达 7 份 HM 样本（2-10ml），直到 6 周。此外，当可能时，从婴儿在第 6 周采集血液样本。评估并比较所有 HM 和血液样本中主要类胡萝卜素（叶黄素、玉米黄质、β-胡萝卜素和番茄红素）的浓度。共纳入 39 对母婴对，提供了 184 份 HM 样本和 21 份血浆样本。随着哺乳期的进展，叶黄素、玉米黄质、β-胡萝卜素和番茄红素的平均浓度降低，在初乳样本中最高（分别为 156.9、66.9、363.9 和 426.8ng/ml）。在初乳和分娩后 2 周内，番茄红素（41%）和β-胡萝卜素（36%）是主要类胡萝卜素。相反，叶黄素和玉米黄质的比例随着哺乳期的延长而增加，占成熟 HM 中类胡萝卜素的 45%。婴儿血浆中的叶黄素占类胡萝卜素的 58%，而在 HM 中仅占 28%。ROP 和非 ROP 婴儿的母亲之间过渡和成熟 HM 中的叶黄素含量没有差异。
结论 HM 中的类胡萝卜素含量是动态的，并且在母亲之间以及随着哺乳期的进展而变化。婴儿血浆中类胡萝卜素的分布与 HM 明显不同。
