Abstract
Human milk is recommended for feeding preterm infants. The current pilot study aims to determine whether breast-milk lipidome had any impact on the early growth-pattern of preterm infants fed their own mother’s milk. A prospective-monocentric-observational birth-cohort was established, enrolling 138 preterm infants, who received their own mother’s breast-milk throughout hospital stay. All infants were ranked according to the change in weight Z-score between birth and hospital discharge. Then, we selected infants who experienced “slower” (n = 15, −1.54 ± 0.42 Z-score) or “faster” (n = 11, −0.48 ± 0.19 Z-score) growth; as expected, although groups did not differ regarding gestational age, birth weight Z-score was lower in the “faster-growth” group (0.56 ± 0.72 vs. −1.59 ± 0.96). Liquid chromatography–mass spectrometry lipidomic signatures combined with multivariate analyses made it possible to identify breast-milk lipid species that allowed clear-cut discrimination between groups. Validation of the selected biomarkers was performed using multidimensional statistical, false-discovery-rate and ROC (Receiver Operating Characteristic) tools. Breast-milk associated with faster growth contained more medium-chain saturated fatty acid and sphingomyelin, dihomo-γ-linolenic acid (DGLA)-containing phosphethanolamine, and less oleic acid-containing triglyceride and DGLA-oxylipin. The ability of such biomarkers to predict early-growth was validated in presence of confounding clinical factors but remains to be ascertained in larger cohort studies.
Highlights
A large body of epidemiologic evidence supports the short- and long-term benefit of breastfeeding in healthy term infants [1]
The development of comorbidities was defined as any of the following outcomes: intraventricular hemorrhage (IVH), defined as IVH associated with ventricular dilatation, cystic periventricular leukomalacia and ventricular dilatation, and/or severe bronchopulmonary dysplasia (BPD), defined as the administration of oxygen for at least 28 days plus the need for 30% or more oxygen and/or mechanical ventilator support or continuous positive airway pressure at 36 weeks’ postmenstrual age [39]
The precision associated with sample preparation and Liquid Chromatography–High-Resolution-Mass Spectrometry (LC-HRMS) measurement was determined based on a quality control (QC) consisting of a pool of 10 mothers’ milk provided by the milk bank of Nantes Hospital
Summary
A large body of epidemiologic evidence supports the short- and long-term benefit of breastfeeding in healthy term infants [1]. To the best of our knowledge, no previous study has explored in depth the relationships between lipid components in human milk and the early growth of preterm infants during their hospital stay. To fill this gap, the current study aims at shedding light on the relationships between breast milk lipidome and growth pattern of preterm infants nourished by their own mother’s milk. In the present pilot study, we chose to select two groups of preterm infants, presenting very different growth trajectories during hospital stay, and selected within the ongoing LACTACOL birth cohort The aim of the present work was: (i) to assess lipidome in the breast milk received by preterm infants during their first weeks of life; (ii) to evaluate the association between breast milk lipidome and the weight gain of infants between birth and time of discharge, by using multivariate statistical tools that accurately discriminate the two groups of preterm infants; and (iii) to identify a few breast milk lipid species and evaluate their predictive ability on the postnatal weight growth trajectory of the preterm infants, taking into account confounding clinical factors
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