Fernández-Tuñas María Del Carmen, Torres-López Lorena, Vidal-Martínez Sandra, García-Couceiro Nuria, Pérez-Muñuzuri Alejandro, Couce María L
Department of Neonatology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
IDIS-Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.
Sci Rep. 2025 Jun 6;15(1):19876. doi: 10.1038/s41598-025-04740-8.
Maternal age, type of delivery, and newborn sex can influence the volume and composition of human milk (HM) expressed by mothers of premature infants. Initiating and maintaining breastfeeding in these mothers is a significant challenge, and records of milk volume expressed during the first few days are crucial for sustaining adequate production. To assess HM production in mothers of preterm infants during the first 15 days of life, examining the relationship between production, type of delivery, and maternal age. Additionally, we aim to analyze the macronutrient composition of HM based on various factors, such as the infant's sex, type of delivery, and maternal age. This is a prospective longitudinal study conducted over 2 years, evaluating HM production and macronutrient composition in 45 mothers of 52 premature infants born at ≤ 32 weeks of gestational age and/or weighing ≤ 1500 g, admitted to the NICU of the University Clinical Hospital of Santiago de Compostela, a Level III Q3+ facility. The study focused on the first 15 days of life, recording the volume of milk expressed and collecting milk samples on days 3, 7, and 15 for nutritional analysis of macronutrients. The study examined the influence of maternal age, type of delivery, and newborn sex on these factors. Vaginal deliveries and maternal age < 35 years were associated with a trend toward greater volumes of milk expressed compared to cesarean deliveries and maternal age ≥ 35 years. If the amount of HM expressed on day 4 was less than 140 mL/day, it significantly predicted a total expression of < 500 mL/day by day 15. We found that 64.3% of our sample expressed less than 140 mL/day on day 4, and 73.8% of these mothers did not reach 500 mL/day by day 15. Regarding macronutrients, HM contained more fat following vaginal delivery compared to cesarean delivery, with significant differences observed on day 3 of life. No differences were observed based on maternal age or newborn sex. In conclusion, HM production on day 4 is a good predictor of production by day 15; maternal age and cesarean delivery seem to negatively influence HM production; the composition of HM shows higher fat content in the colostrum of mothers who had vaginal deliveries.
产妇年龄、分娩方式和新生儿性别会影响早产儿母亲挤出的母乳（HM）的量和成分。让这些母亲开始并维持母乳喂养是一项重大挑战，头几天挤出的奶量记录对于维持充足的产量至关重要。为了评估早产儿母亲在出生后15天内的母乳产量，研究产量与分娩方式和产妇年龄之间的关系。此外，我们旨在根据各种因素分析母乳的宏量营养素组成，如婴儿性别、分娩方式和产妇年龄。这是一项为期2年的前瞻性纵向研究，评估了圣地亚哥德孔波斯特拉大学临床医院三级Q3+重症监护病房收治的52例孕周≤32周和/或体重≤1500克的早产儿的45位母亲的母乳产量和宏量营养素组成。该研究聚焦于出生后的头15天，记录挤出的奶量，并在第3天、第7天和第15天采集奶样进行宏量营养素的营养分析。该研究考察了产妇年龄、分娩方式和新生儿性别对这些因素的影响。与剖宫产和产妇年龄≥35岁相比，阴道分娩和产妇年龄<35岁与挤出的奶量更多的趋势相关。如果第4天挤出的母乳量少于140毫升/天，则显著预测到第15天总挤出量<500毫升/天。我们发现，我们样本中的64.3%在第4天挤出量少于140毫升/天，其中73.8%的母亲到第15天未达到500毫升/天。关于宏量营养素，与剖宫产相比，阴道分娩后母乳中的脂肪含量更高，在出生后第3天观察到显著差异。未观察到基于产妇年龄或新生儿性别的差异。总之，第4天的母乳产量是第15天产量的良好预测指标；产妇年龄和剖宫产似乎对母乳产量有负面影响；母乳成分显示，阴道分娩母亲的初乳中脂肪含量更高。
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