25. SUPPLEMENTATION OF FRESH HUMAN MILK WITH HUMAN MILK PROTEIN FOR FEEDING VERY-LOW-BIRTH-WEIGHT (VLBW) INFANTS

Abstract

18 VLBW-infants (BW = 800-1600 g, AGA) were studied until discharge at a weight of 2000 g. All infants received mother's own milk. 9 received such milk supplemented with 1 g of ultrafiltrated human milk protein. At a milk intake of 180 ml/kg/d the protein intake varied between 2 and 4.5 g/kg/d. Protein fortification of human milk produced a higher weight gain (32.2 g/d vs. 26.4 g/d, p<0.005). The best protein utilization (weight gain per g of protein) was obtained at a protein intake of about 3 g/kg/d. Blood urea nitrogen (BUN) concentrations and other indices of protein metabolism correlated to protein intake. The mean BUN concentration was 7.2 mg% in the protein supplemented group. Protein supplementation resulted in an elevation of plasma total amino acid concentrations at the end of the study (2788 vs. 2316 μmoles/l). Individual plasma amino acid concentrations also varied with protein intake. A daily human milk protein intake of about 3 g/kg produced a rate of weight gain corresponding to that found in utero at the corresponding gestational age in VLBW-infants. The plasma responses of protein metabolism observed at this protein intake are similar to those found in term infants, breast-fed. We suggest that these results can be used as a model when evaluating feeding regimens with non-human proteins in VLBW-infants.