Nutrient Composition of Hindmilk Produced by Mothers of Very Low Birth Weight Infants Born at Less Than 28 Weeks' Gestation

Abstract

The objectives of this study were to describe and compare retinol, alpha-tocopherol and gamma-tocopherol, fat, energy, and nitrogen concentrations between the foremilk and hindmilk fractions of 24-hour milk collected by 24 mothers of very preterm (< 28 weeks' gestation) infants and to relate milk vitamins A and E content to maternal vitamin intake. Concentrations of retinol were significantly higher in hindmilk than in foremilk (1.6-fold), as were concentrations of alpha-tocopherol (1.6-fold), gamma-tocopherol (1.5-fold), fat (1.7-fold), energy (1.3-fold), and nitrogen (1.05-fold). Retinol, alpha-tocopherol, and gamma-tocopherol were positively related (P < .05) to milk fat and energy but not to maternal intake. Estimates of vitamins A and E intakes of infants fed hindmilk with added human milk fortifier surpassed current recommended upper level of intakes. The higher fat-soluble vitamin content of hindmilk produced by mothers of very low birth weight infants needs to be considered in the design and recommendations for use of human milk fortifier.

Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants

“…Instead, lactose is similar to norms (70 g l À1 ), 10,22 and the protein is somewhat lower, (13-18 g l À1 ). 9,10 The investigators performing the analyses of samples in this report followed the same technique used in their previously published reports on milk composition. In addition, they have recently compared the esterified fat analysis with infrared spectophotometric analysis and found good agreement between the two methods.…”

“…[9][10][11] A possible influence of breast massage on milk composition was proposed by Foda et al, 12 who reported total solids, lipids, casein and gross energy increase in milk hand expressed after using a Japanese method of breast massage.…”

“…6 Special attributes of human milk fat for preterm infants have included the benefits of polyunsaturated fatty acids on neuronal development, 7 the superiority of absorption of human milk fat versus cow milk formula fat, 8 the improved caloric value of high fat feeding, and increased availability of fat-soluble vitamins. 9 Concerns about the nutritional inadequacies of human milk for the preterm infant have led to routine multi-nutrient fortification of human milk both pre-and post-discharge, with limited regard for compositional variation. 3 If expression techniques consistently and significantly affect the nutritional value, a more selective approach to fortification may be appropriate.…”

Feeding and Fluids in the Premature and Sick Newborn in the Low-Middle Income Countries

“…For infants feeding at the breast, the first milk extracted from the breast is high in lactose, is sweet to the infant and entices the infant to feed more. The last milk in the breast or expressed near the end of the pumping or feeding session is high in fat and can be over 30 calories per ounce (Bishara et al 2008;Ogechi et al, 2007;Slusher et al, 2003). Feedings of hind milk alone contribute to weight gain in the infant (Ogechi, et al, 2007).…”

Human Milk: An Ecologically Functional Food

“…The education of health care professionals who work with mothers and infants regarding the dynamics of breastfeeding is necessary to allow them to effectively assist mothers. The recommendations suggest that every breastfeeding mother should have a health care professional observe at least one feeding while she is in the hospital or birthing center to ensure the proper transfer of milk to the baby and to decrease the risk of premature weaning (Bishara et al, 2008).…”