Abstract
Abstract Preterm infants show postnatal deficits of long-chain polyunsaturated fatty acids (LCPUFAs) which are essential for adequate growth and neurodevelopment. Human milk is a primary source of fatty acids (FAs) for the preterm infant, and therefore, knowledge about milk FA levels is required to design appropriate supplementation strategies. Here, we expanded on our previous study (Nilsson et al., 2018, Acta Paediatrica, 107, 1020–1027) determining FA composition in milk obtained from mothers of extremely low gestational age (<28 weeks) infants on three occasions during lactation. There was a clear difference in FA composition in milk collected at Day 7 and milk collected at postmenstrual weeks (PMW) 32 or PMW 40. Notably, the proportion of LCPUFAs was low and declined significantly during milk maturation. These results strengthen previous data that the content of FAs required by the preterm infant is not supplied in sufficient amounts when the mother’s own milk is the sole source of these essential nutrients.
Highlights
Fetal growth and development depend on the selective placental transport of long-chain polyunsaturated fatty acids (LCPUFAs)
Accumulating evidence indicates that infants born at extremely low gestation obtain insufficient amounts of LCPUFAs to fulfill their nutritional needs in the perinatal period (Robinson, 2017), the omega-3 FA docosahexaenoic acid (DHA, 22:6 n-3) and the omega-6 FA arachidonic acid (AA, 20:4 n-6) (Hellström, 2021)
We have previously reported on the FA profiles of milk from women delivering at extremely low gestation and how the FA composition changes during three stages of lactation: at one week after delivery, and at postmenstrual weeks 32 and 40 (PMW 32 and PMW 40, mature milk) (Nilsson, 2018)
Summary
Fetal growth and development depend on the selective placental transport of LCPUFAs. Fetal growth and development depend on the selective placental transport of LCPUFAs After premature birth, this transfer is disrupted and the infant becomes reliant on FAs provided from intravenous lipid emulsions and human milk and/or preterm formula. Accumulating evidence indicates that infants born at extremely low gestation obtain insufficient amounts of LCPUFAs to fulfill their nutritional needs in the perinatal period (Robinson, 2017), the omega-3 FA docosahexaenoic acid (DHA, 22:6 n-3) and the omega-6 FA arachidonic acid (AA, 20:4 n-6) (Hellström, 2021). Maternal milk LCPUFAs content must be considered when the best clinical supplementation strategies in this fragile group of infants are investigated
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