title: Intake and macronutrient content of human milk given to extremely preterm infants.
abstract: BACKGROUND
  Human milk (HM) is the preferred basis of nutrition for infants, including those born prematurely. Information on HM macronutrient content is necessary to optimize nutritional support of preterm infants.
  
  
  OBJECTIVE
  This study aimed to describe the types and amounts of enteral feeds given to Swedish extremely preterm infants during hospitalization and to investigate the energy and macronutrient contents in HM given to these infants.
  
  
  METHODS
  A population-based study of Swedish extremely preterm infants (n = 586) born before 27 gestational weeks was conducted. Data on ingested volumes of different milk during hospitalization and analyses of macronutrient content in HM samples were obtained from hospital records. Nutritional content of HM was determined by mid-infrared spectrophotometry analysis.
  
  
  RESULTS
  During the first 4 weeks of life, 99% of the infants were exclusively fed HM, and at 4 weeks of life, 70% of the infants received only mother's own milk (MOM). Nutritional content in 821 MOM samples was analyzed. Protein content in MOM decreased significantly from 2.2 to 1.2 g/100 mL during the first 112 postpartum days, whereas fat and energy content were highly variable within and between MOM samples. In addition, 354 samples of donor milk were analyzed. Content of protein, fat, and energy in pooled donor milk (n = 129) was lower compared to single donor milk.
  
  
  CONCLUSIONS
  Swedish extremely preterm infants receive MOM to a large extent during hospitalization. Protein, carbohydrates, and energy in MOM changed significantly with time. Weekly analyses of MOM during the first month of lactation would allow more individualized nutritional support for these vulnerable infants.
authors.affiliation: Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden elisabeth.stoltz.sjostrom@kost.umu.se.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Stoltz Sjöström
authors.affiliation: Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Ohlund
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Tornevi
authors.affiliation: Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Domellöf
mesh_terms: D015331:Cohort Studies; D002149:Energy Intake; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D009751:Nutritional Requirements; D011247:Pregnancy; D013548:Sweden
keywords: breastfeeding; donor milk; enteral nutrition; extremely preterm infants; human milk; neonatal nutrition; protein