title: Analysis of Human Milk Composition After Preterm Delivery With and Without Fortification.
abstract: Human milk is often assumed to have a consistent composition, and when fortification is needed, fortifiers are added at fixed doses. However, if the milk contains less than the assumed quantities of nutrients, then the infant drinking that milk may receive inadequate nutrition. In this study, we compared changes in the concentrations of the main constituents of human breast milk before and after fortification. We tested the hypothesis that the protein concentration would increase less than that of other nutrients. Thirty breast milk samples were obtained from mothers of preterm infants (gestational age 28-36 weeks; birthweight 900-2,470 g). The concentrations of fat, carbohydrates, dry matter, protein and energy in the breast milk samples were analyzed and compared with the concentrations of these nutrients in the same samples of milk fortified with a standard amount of HMF FM 85. Dry matter and energy content increased the most after fortification. Although protein also increased, the magnitude of this increase was small relative to the increases in the other components. Lipid concentrations did not significantly change with fortification. Protein is needed for adequate growth in premature infants; however, fortification of breast milk from the mothers of preterm infants resulted in only a small increase in this essential nutrient. Based on these results, we conclude that fortification of human milk must be individually adjusted based on continuous analysis of breast milk composition. Customized fortification would provide more optimal nutrition to preterm infants to support better growth and development.
authors: Department of Pediatrics (Neonatology), Pavol Jozef Šafárik University, Trieda SNP 1, 040 11, Kosice, Slovak Republic.
authors: Peter
authors: P
authors: Krcho
authors: Vladimira
authors: V
authors: Vojtova
authors: Michaela
authors: M
authors: Benesova
mesh_terms: D001724:Birth Weight; D005260:Female; D005527:Food, Fortified; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000254:growth & development*; D008894:Milk Proteins / Q000008:administration & dosage*; D008895:Milk, Human / Q000737:chemistry*; D009035:Mothers; D009751:Nutritional Requirements; D011247:Pregnancy; D047928:Premature Birth; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D008894:Milk Proteins
references: Pediatr Res. 1982 Feb;16(2):113-7
references: 7058078
references: J Pediatr. 2013 Dec;163(6):1592-1595.e1
references: 23968744
references: Arch Dis Child Fetal Neonatal Ed. 1994 Mar;70(2):F141-6
references: 8154907
references: Clin Perinatol. 2002 Jun;29(2):225-44
references: 12168239
references: Br J Nutr. 2009 Oct;102(8):1179-86
references: 19445820
references: Pediatrics. 2005 Aug;116(2):400-6
references: 16061595
references: Acta Paediatr. 2001 Jul;90(7):720-3
references: 11519972
references: Clin Nutr. 2011 Apr;30(2):215-20
references: 20801561
references: J Perinatol. 2006 Oct;26(10):614-21
references: 16885989
references: Pediatr Neonatol. 2010 Aug;51(4):198-207
references: 20713283
references: J Perinatol. 2001 Sep;21(6):356-62
references: 11593368
references: J Perinatol. 2003 Dec;23(8):620-3
references: 14647156
references: J Pediatr. 2010 Apr;156(4):562-7.e1
references: 20036378
references: Arch Dis Child Fetal Neonatal Ed. 2003 Jan;88(1):F11-4
references: 12496220
references: J Nutr. 2000 Feb;130(2S Suppl):426S-431S
references: 10721920
references: BMC Pediatr. 2012 Aug 17;12:124
references: 22900590
references: Am J Hum Biol. 2013 Jan-Feb;25(1):1-11
references: 23109280
references: Lancet. 1990 Jun 23;335(8704):1477-81
references: 1972430
references: Lancet. 1990 Dec 22-29;336(8730):1519-23
references: 1979363
references: J Pediatr. 2013 Oct;163(4):1001-7
references: 23769498
references: J Perinatol. 2009 Jul;29(7):489-92
references: 19444237
references: J Nutr. 2005 Jan;135(1):1-4
references: 15623823
references: J Pediatr. 2006 Mar;148(3):300-305
references: 16615955
references: J Pediatr Gastroenterol Nutr. 1999 Sep;29(3):332-8
references: 10468001