15N-tracer investigations into the nitrogen metabolism of preterm infants fed mother's milk and a formula diet.

Protein synthesis, protein breakdown, protein-N turnover, and other parameters describing the nitrogen metabolism were measured in five male preterm infants. The weight of the subjects at birth was 2,064 +/- 107 g and the measurements were performed at age 16.0 +/- 4.5 days in the case of the mother's milk diet and 27.4 +/- 6.8 days in the case of the formula diet containing 1.8% protein. The parameters were measured by means of the 15N-tracer technique using [15N]glycine (95 atom %) applied in a single oral dose of 20 mg/kg as a tracer. The three-pool model proposed by Winkler and Faust was used to calculate the whole body protein parameters. No difference in net protein gain, protein synthesis, protein breakdown, or the other protein metabolism parameters were recorded despite the different protein inputs. Renal nitrogen excretion and the rate of endogenous urea N excretion were significantly higher for the formula diet than for the mother's milk diet. The protein synthesis rate of 7.9 g X kg-1 X day-1 was, as has previously been observed, higher than in other age groups. The protein metabolism of the preterm infant older than 33 weeks of gestational age does not benefit from a formula diet based on cow's milk that is richer in protein than mother's milk.