Human Milk: An Ideal Food for Nutrition of Preterm Newborn

Abstract

Human milk is the best food for newborn nutrition. There is no ideal composition of human milk and also no easy way to control the complexity of its nutritional quality and the quantity received by breastfed infants. Pediatricians and nutritionists use charts of infant growth (weight, size, head circumference) and neurodevelopment criteria that reflect the food that these infants receive. These charts reflect first the infant physiology and likely reflect the composition of human milk when infants are breastfed. In a situation of preterm birth, mother physiology impacts partly breast milk composition and this explains how this is more difficult to correlate infant growth or neurodevelopment with milk composition. Some biomarkers (lipids, oligosaccharides) have been identified in breast milk but their function is not always yet known. A better knowledge on how human milk could act on infant development to the mid- and long-term participating thus to nutritional programming is a challenging question for a better management of infants' nutrition, especially for preterm infants who are most fragile.

Comprehensive Preterm Breast Milk Metabotype Associated with Optimal Infant Early Growth Pattern

“…Indeed, putative benefits of breastfeeding in new born full-term infants are, at least in part, due to its complex composition in various macronutrients, micronutrients, and other bioactive compounds [2,3,4]. Maternal breast milk is the recommended nutrition for feeding pre-mature infants [5], due to its reported health benefits such as (i) a significant decrease in the risk of developing prematurity-related morbidities [6,7], including necrotizing enterocolitis [8] and infection [8,9]; (ii) a significant decrease in the feeding intolerance [8,10]; and (iii) an improvement in neurodevelopmental outcomes [8,11]. However, feeding unfortified human milk may lead to insufficient or inadequate postnatal nutritional intake for many preterm infants in the first few weeks of extra-uterine life, particularly the very preterm infants born with a low birth weight and before 28 weeks gestation.…”

Human Milk Oligosaccharides in the Milk of Mothers Delivering Term versus Preterm Infants

“…In such cases HMO supplementation may also be beneficial. Clinical evidence shows that premature infants greatly benefit from being fed own mother’s milk [3,50], or, alternatively, being fed donor human milk [50]. For very preterm infants the milk needs to be fortified with energy, proteins and minerals [3].…”

“…Clinical evidence shows that premature infants greatly benefit from being fed own mother’s milk [3,50], or, alternatively, being fed donor human milk [50]. For very preterm infants the milk needs to be fortified with energy, proteins and minerals [3]. Now that HMOs start to be commercially available, HMO fortification is also possible, but further work is needed to confirm the potential benefits and the appropriate timing and dosages for intervention.…”

“…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]. In preterm neonates, human milk feeding is known to have several important specific protective actions and it is strongly encouraged too [1,3,4]. Preterm infants consuming human milk have notably improved immunity [5], are less likely to develop necrotizing enterocolitis (NEC) [6], have improved neurodevelopmental outcomes [1,7] and a better long term health outcome [8,9].…”

Questionnaire on the breastfeeding and the donation of 70 mothers\donors.

“…Mother's milk is the best feeding for premature infants and his protective effect against the complications of prematurity has also been demonstrated [1][2][3][4][5][6].…”