Abstract
(1) Background: Premature infants require mothers’ milk fortification to meet nutrition needs, but breast milk composition may be variable, leading to the risk of inadequate nutrition. We aimed at determining the factors influencing mothers’ milk macronutrients. (2) Methods: Milk samples were analyzed for the first five weeks after premature delivery by infrared spectroscopy. Mothers’ nutritional intake data were obtained during standardized interviews with dieticians, and then analyzed with reference software. (3) Results: The composition of 367 milk samples from 81 mothers was (median (range) g/100 mL): carbohydrates 6.8 (4.4–7.3), lipids 3.4 (1.3–6.4), proteins 1.3 (0.1–3.1). There was a relationship between milk composition and mothers’ carbohydrates intake only (r = 0.164; p < 0.01). Postnatal age was correlated with milk proteins (r = −0.505; p < 0.001) and carbohydrates (r = +0.202, p < 0.001). Multiple linear regression analyses showed (coefficient) a relationship between milk proteins r = 0.547 and postnatal age (−0.028), carbohydrate intake (+0.449), and the absence of maturation (−0.066); associations were also found among milk lipids r = 0.295, carbohydrate intake (+1.279), and smoking (−0.557). Finally, there was a relationship among the concentration of milk carbohydrates r = 0.266, postnatal age (+0.012), and smoking (−0.167). (4) Conclusions: The variability of mothers’ milk composition is differentially associated for each macronutrient with maternal carbohydrate intake, antenatal steroids, smoking, and postnatal age. Improvement in milk composition could be achieved by the modification of these related factors.
Highlights
Premature infants require mothers’ milk fortification to meet their nutrition needs [1]
Improvement in milk composition could be achieved by the modification of these related factors
Studies have suggested that breast milk composition variability may be much wider than expected [3,4], leading to inadequate newborn nutrition
Summary
Premature infants require mothers’ milk fortification to meet their nutrition needs [1]. McLeod et al performed a survey of protein and energy intake by milk analysis within the first 28 days of life in 63 infants born before 33 weeks’ gestation to assess their effect on growth [3]. Their results show that breast milk composition vary for all of the macronutrients with median protein concentrations of 16.6 g/L ranging from 13.4 g/L to 27.6 g/L, and median caloric intake of 73.3 Kcal/100 mL ranging from 63 Kcal/100 mL to 93 Kcal/100 mL. We aimed at determining factors, including mothers’ nutritional intake, which may be associated and explain breast milk macronutrient variability after premature delivery before 34 weeks’ gestational age
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