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Development of macronutrient composition of very preterm human milk

Published online by Cambridge University Press:  22 August 2007

Yolande G. H. Maas*
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Jeanet Gerritsen
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Augustinus A. M. Hart
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Mijna Hadders-Algra
Affiliation:
Department of Medical Physiology, University of Groningen, Bloemsingel 10, 9712 KZ Groningen, The Netherlands
Jan M. Ruijter
Affiliation:
The Netherlands Ophthalmic Research Institute and Laboratory of Medical Physics, PO Box 12141, 1100 AC Amsterdam, The Netherlands
Pieter Tamminga
Affiliation:
Department of Neonatology, Academic Medical Center, University of Amsterdam, Emma Childrens' Hospital, PO Box 22700, 1100 DE Amsterdam, The Netherlands
Majid Mirmiran
Affiliation:
Netherlands Institute for Brain Research, Meibergdreef 33, 1105 AZ Amsterdam, The Netherlands
Henk Spekreijse
Affiliation:
The Netherlands Ophthalmic Research Institute and Laboratory of Medical Physics, PO Box 12141, 1100 AC Amsterdam, The Netherlands
*
*Corresponding author: Dr Y. G. H. Maas, fax +31 20 6965 099, email y.g.maas@amc.uva.nl
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Abstract

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The effects of gestational age at delivery (GA), postnatal age (PNA) and post-menstrual age (PMA=PNA+GA, an indicator of autonomous developmental processes not affected by the moment of birth) on macronutrient composition of very preterm milk were studied. Total N, fat, lactose and carbohydrate concentrations, energy density and 24 h volume were determined in 282 24 h milk samples collected at weekly intervals (days 7–55 of lactation) from seventy-nine women delivering their babies between 25 and 29 weeks of gestation. GA related differences were found for carbohydrate concentration only: carbohydrate concentration was lower with increasing GA. PNA was related to a decrease in total N and an increase in lactose concentration. PMA was not related to milk composition. Our data indicate that PNA strongly influences the development of the composition of very preterm human milk, while GA affects carbohydrate content with a negligible effect on the nutritional value of the milk. We conclude that in accordance with current opinion in paediatrics, human milk is the best source of nutrients even for very preterm (< 30 weeks GA) infants.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1998

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