The composition of preterm milk in relation to the degree of prematurity

Lepage, Guy; Collet, Sylvie; Bouglé, D.; Kien, L C; Lepage, Danielle; Dallaire, Louis; Darling, Pauline B.; Roy, Claude

doi:10.1093/ajcn/40.5.1042

Cited by 43 publications

(21 citation statements)

References 37 publications

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“…Atwater specific factor system (20) Atwater general factor system (45) Heats of combustion factors (18,33,38,40) Bomb calorimetry (6,16,17) 267·8 205·0-309·6 64·0 49·0-74·0 (34) †, Corvaglia (13) , Ehrenkranz (37) , Gross (20) *, Guerrini (39) , Jitta (40) , Lemons (16) †, Lepage (42) †, Lucas (43) *, Maas (44) †, Sann (46) , Stevens (48) , Silber (47) † Kjeldahl (16,34,42) Kjeldahl with NPN not accounted for (13,18,20,33,44,47,48) Micro Kjeldahl (17) Semi-micro Kjeldahl (21) Semi-micro Kjeldahl without NPN (32,43) Biuret (46) Lowry-Peterson (6) IR spectrophotometry (13) Esbach/Bogg (40) 1·67…”

Section: Biological Outcomesmentioning

confidence: 99%

“…Atwater specific factor system (20) Heats of combustion factors (18,33,40,44) Bomb calorimetry (16,17,42,47) 295·8 258·6-325.5 70·7 61·8-77·8 (34) †, Ehrenkranz (37) , Gross (20) *, Jitta (40) , Lemons (16) †, Lucas (43) *, Maas (44) †, Saarela (45) , Stevens (48) Kjeldahl (16,34) Kjeldahl without NPN correction (18,20,44,45,48) Semi-micro Kjeldahl (21) Semi-micro Kjeldahl without NPN correction (32,43) Lowry-Peterson (6) Esbach/Bogg (40) 1·37 0·88-2·10 Folch (37) Roese-Gottlieb (20,44,45) Colorimetry (16,18) Creamatocrit (6,40) 3·84 3·24-4·80 Lactose: Chromatography (16) Boehringer lactose assay kit (18,44) Unidentified (40) Unidentified (45) Unidentified (20) Total carbohydrate: Carbohydrate by difference (44) Colorimetry (6) 6·07 7·42…”

Section: ·31-6·86 7·0-7·19mentioning

confidence: 99%

“…Amino acid analysis is the most accurate method for determining true protein content (22) ; however, this method is time consuming and costly. (22) The Kjeldahl method is the most accurate indirect determination of protein content (57,58) , and it -or its more sensitive derivations (59) (micro and semi-micro Kjeldahl) -is the most commonly used method employed by studies in this review (13,(16)(17)(18)20,21,(32)(33)(34)(42)(43)(44)(45)47,48) . The Kjeldahl method involves liberation of TN from a sample (60) .…”

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

“…Lactation weeks 2-8 1·27/1·24 (1·02-1·58) (13,(16)(17)(18)20,21,(32)(33)(34)36,(41)(42)(43)(44)(45)47,48) 3·46/3·54 (3·25-3·69) (20,35,37,(44)(45)(46) 7·34/7·28 (7·11-7·53) (18,44) 6·15/6·04 (5·93-6·32) (16,18,33,44,46) 274·5/274·9 (264·72-281·04) 65·6/65·7 (63·27-67·17)…”

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

“…Despite the potential for confounding errors in a multistep process, Maas et al (44) used sound methodology, calculating total carbohydrate by difference, and provided the greatest contribution to the carbohydrate trend, reporting values over weeks 2-8. Energy. Bomb calorimetry accurately measures total energy content and was used in a number of studies (6,16,17,42,47) ; however, it does not differentiate between gross and metabolisable energy, which is dependent on the bioavailability of each macronutrient in the food source. This difference can result in an overestimation of energy based on inaccuracies in each macronutrient (protein 5·7 kJ/g (1·36 kcal/g), lipids 1·92 kJ/g (0·46 kcal/g) and carbohydrate 0·33 kJ/g (0·08 kcal/g)) (18,30,71) , which is important when considering the energy value, the PER of milk feeds and the energy intake of preterm infants.…”

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

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Preterm human milk composition: a systematic literature review

et al. 2016

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There are wide variations in the macronutrient values adopted by neonatal intensive care units and industry to fortify milk in efforts to achieve recommended intakes for preterm infants. Contributing to this is the variation in macronutrient composition of preterm milk between and within mothers and the variable quality of milk analyses used to determine the macronutrient content of milk. We conducted a systematic review of the literature using articles published in English between 1959 and 2013 that reported the concentrations of one or more macronutrients or energy content in human preterm milk, sampled over a representative 24-h period. Searched medical databases included Ovid Medline, Scopus, CINAHL and the Cochrane Library. Results are presented as mean values and ranges for each macronutrient during weeks 1-8 of lactation, and preferred mean values (g/100 ml) for colostrum (week 1) and mature milk (weeks 2-8; protein: 1·27, fat: 3·46, lactose: 6·15 and carbohydrate: 7·34), using data from studies employing the highest-quality analyses. Industry-directed fortification practices using these mean values fail to meet protein targets for infants weighing <1000 g when the fortified milk is fed <170-190 ml/kg per d, and the protein:energy ratio of the fortified milk is inadequate. This study aimed to provide additional information to industry in order to guide their future formulation of breast milk fortifiers. Quality macronutrient analyses of adequately sampled preterm breast milk would improve our understanding of the level of fortification needed to meet recommended protein and energy intakes and growth targets, as well as support standardised reporting of nutritional outcomes.

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Section: Biological Outcomesmentioning

confidence: 99%

Section: ·31-6·86 7·0-7·19mentioning

confidence: 99%

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

Section: Justification For the Preferred Reference Values Of Preterm mentioning

confidence: 99%

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Preterm human milk composition: a systematic literature review

et al. 2016

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Milk Protein Quality in Mothers Delivering Prematurely

Britton

1986

J. pediatr. gastroenterol. nutr.

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SummaryBecause reports comparing the nitrogen content of breast milk from mothers delivering prematurely and at term have conflicted, the present study sought to compare these milks during the first month of lactation with respect to total protein and the distribution of protein among individual protein species and amino acids. No significant differences in total protein concentration were established. However, immunoglobulin comprised a greater proportion of protein in preterm milk than in term milk. The major component of the milk casein fraction, β‐casein, was present in similar proportions in early term and preterm milk, yet increased with time in term milk but not preterm milk. Lactoferrin and lactalbumin were similar in both milks. Differences in amino acid composition were found for serine, arginine, and tyrosine. With respect to protein composition, preterm milk and term milk thus differ during the first month of lactation, and the different patterns of change in individual components suggest that factors other than milk volume contribute to protein content.

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Immunological and Nutritional Composition of Human Milk in Relation to Prematurity and Mothers' Parity During the First 2 Weeks of Lactation

Montagne,

Cuillière,

Molé

et al. 1999

J. pediatr. gastroenterol. nutr.

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Background:To investigate the effect of prematurity and parity on the dynamics of the major immunologic and nutritional proteins of human milk over the first 2 weeks of lactation.Methods:Microparticle‐enhanced nephelometric immunoassays were developed for the quantification of α‐lactalbumin, β‐casein, serum albumin, lactoferrin, and lysozyme in human milk. These components, immunoglobulin A, and total proteins were assayed in 368 individual samples collected from 74 mothers.Results:The dynamics of the major immunologic and nutritional proteins in early lactation presented similar patterns in preterm and term human milks. In comparison with term milk, preterm milk was globally characterized by higher concentrations of immune proteins and lower concentrations of nutritive proteins. These differences were increased by the degree of prematurity, which, however, influenced the absolute and relative protein concentrations differently, depending on the stage of lactation. The protein composition of term milk was similar, whatever the mother's parity. Conversely, the influence of prematurity on the levels of milk proteins during the first days of lactation was even greater in primiparous mothers.Conclusions:This precise description of the composition of preterm and term milk, regarding the main nutritional and immunologic proteins, confirms the influence of both prematurity and parity on milk components and demonstrates the combined effect of these two conditions.

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The composition of preterm milk in relation to the degree of prematurity

Cited by 43 publications

References 37 publications

Preterm human milk composition: a systematic literature review

Preterm human milk composition: a systematic literature review

Milk Protein Quality in Mothers Delivering Prematurely

Immunological and Nutritional Composition of Human Milk in Relation to Prematurity and Mothers' Parity During the First 2 Weeks of Lactation

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