Levels of lipids in preterm infants fed breast milk.
BACKGROUND
Actual recommendations in preterm infants limit parenteral fat intake to 3-4 g/kg/d. This is based on clinical studies where fat administration was adjusted to achieve levels close to those recommended in adults for atherosclerosis prevention. Data about lipid profiles of breast fed preterm infants who may have fat intakes of up to 7 g/kg/d and could serve as reference are not available.


OBJECTIVE
To establish full lipid profiles in healthy fully breast fed preterm infants and to test the hypothesis that breast milk fat intake leads to serum triglycerides higher than those achieved under full parenteral fat administration.


METHODS
Serum triglycerides, cholesterol, VLDL, LDL, HDL (all pre- and postprandial), as well as triglycerides in breast milk were measured in 65 healthy, fully breast fed, stable growing preterm infants stratified in 500 g intervals (mean gestational age: 31+/-4 weeks, birth weight: 1500+/-600 g, age at study: 25+/-16 d).


RESULTS
Median fat intake was 7.0 g/kg/d (interquartile range: 5.8;8.1) and led to the following serum levels: triglycerides 0.9 (0.6;1.1), cholesterol 3.1 (2.6;3.5), VLDL 0.5 (0.3;0.6), LDL 1.3 (1.1;1.6), HDL 1.1 (0.8;1.4)mmol/L. Small for gestational age infants showed higher triglycerides (p=0.005). Triglycerides (r2=0.08, p=0.023), postprandial triglyceride increase (r2=0.21, p<0.001), cholesterol (r2=0.16, p<0.001) and HDL (r2=0.16, p<0.001) were correlated with weight at study.


CONCLUSIONS
Though higher by a factor of two, fat intake by breast milk leads to considerably lower lipid levels when compared to published values obtained under parenteral fat intake. Results suggest that either fat absorption is reduced in preterm infants, or the composition of breast milk supports a lower profile of fat levels when compared to commercially available parenteral fat emulsions.
Rochow
Niels
N
Division of Neonatology, University Children's Hospital, Ernst-Moritz-Arndt University, D-17475 Greifswald, Germany.
Möller
Sandra
S
Fusch
Gerhard
G
Drogies
Tim
T
Fusch
Christoph
C
D001942:Breast Feeding; D002784:Cholesterol / Q000097:blood; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008055:Lipids / Q000097:blood*; D008297:Male; D010288:Parenteral Nutrition / Q000706:statistics & numerical data; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol