Abstract
Human milk oligosaccharides (HMOs) are a major component of human milk, and play an important role in protecting the infant from infections. Preterm infants are particularly vulnerable, but have improved outcomes if fed with human milk. This study aimed to determine if the HMO composition of preterm milk differed from that of term milk at equivalent stage of lactation and equivalent postmenstrual age. In all, 22 HMOs were analyzed in 500 samples of milk from 25 mothers breastfeeding very preterm infants (< 32 weeks of gestational age, < 1500 g of birthweight) and 28 mothers breastfeeding term infants. The concentrations of most HMOs were comparable at equivalent postpartum age. However, HMOs containing α-1,2-linked fucose were reduced in concentration in preterm milk during the first month of lactation. The concentrations of a number of sialylated oligosaccharides were also different in preterm milk, in particular 3′-sialyllactose concentrations were elevated. At equivalent postmenstrual age, the concentrations of a number of HMOs were significantly different in preterm compared to term milk. The largest differences manifest around 40 weeks of postmenstrual age, when the milk of term infants contains the highest concentrations of HMOs. The observed differences warrant further investigation in view of their potential clinical impact.
Highlights
Human milk is the optimal source of nutrition for infants, and it is widely recommended that infants are exclusively or predominantly breastfed for the first 6 months of life [1,2]
Ten Human milk oligosaccharides (HMOs) were quantified against genuine standards with known purity; 20 -fucosyllactose (20 FL), 3-fucosyllactose
The HMO composition and concentration trajectory of term and preterm milk are largely comparable at equivalent infant postpartum age, suggesting that birth triggers a program that defines the HMO trajectory during lactation
Summary
Human milk is the optimal source of nutrition for infants, and it is widely recommended that infants are exclusively or predominantly breastfed for the first 6 months of life [1,2]. As nutritional needs of preterm infants are higher compared to those of term infants, human milk composition may not match the nutritional needs of very preterm infants (< 32 weeks of gestational age, < 1500g of birthweight) during the first weeks of life. In this context, human milk fortification in energy, proteins and minerals is commonly recommended in routine nutritional neonatal. Additional knowledge on human milk composition and opportunities in nutrient supplementation remain to be further explored
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