Analysis of Human Milk Composition After Preterm Delivery With and Without Fortification
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METHODOLOGICAL NOTES
Analysis of Human Milk Composition After Preterm Delivery With and Without Fortification Peter Krcho • Vladimira Vojtova • Michaela Benesova
Ó Springer Science+Business Media New York 2015
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
P. Krcho V. Vojtova (&) Department of Pediatrics (Neonatology), Pavol Jozef Sˇafa´rik University, Trieda SNP 1, 040 11 Kosice, Slovak Republic e-mail: [email protected] M. Benesova Institute of Mathematics and Descriptive Geometry, Brno University of Technology, Brno, Czech Republic
continuous analysis of breast milk composition. Customized fortification would provide more optimal nutrition to preterm infants to support better growth and development. Keywords Breast milk Human milk fortifier Protein intake Preterm infant Adjustable fortification
Introduction Breast milk is the ideal nutrition for newborns and contains immunocompetent cells and IgA, which have protective effects on the intestinal mucosa. This, plus colonization of the gut with non-pathogenic bacteria, is believed to protect preterm infants from necrotizing enterocolitis (NEC) [1–3]. Several studies have shown that infants fed only breast milk had a lower incidence of NEC than those fed formula [4–8]. In 1990, in a multi-center trial that included nearly 1,000 premature infants weighing less than 1,850 g, Lucas and Cole demonstrated that the incidence of confirmed NEC was six times higher in formula-fed infants than in those who had been fed exclusively breast milk or pasteurized human donor milk. A lower incidence of NEC in infants fed only breast milk compared with those wh
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