Abstract
Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery.
Highlights
Human milk (HM) is the recognised gold standard for feeding new-born full-term healthy infants.HM is a unique food source that contains all the exacting amounts of required nutrients to support the growth and development of term infants during the first six months of life
Age of the mothers of pre-term infants ranged from 26–45 years, and all had at least one previous pregnancy longer than 24 weeks gestation (Table 1)
From the Principal component analysis (PCA) model, it is apparent that the milk metabolite profile from mothers of pre-term infants older than 5–7 weeks resembles that of full-term milk, as they are positioned in close proximity to the full-term milk samples, independent of time of gestation at delivery (Figure 5)
Summary
Human milk (HM) is the recognised gold standard for feeding new-born full-term healthy infants. Mother’s milk is inadequate for rapidly growing pre-term neonates, which can be ascribed to a higher protein and energy requirement of pre-term neonates, those of low birth weight and
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