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, α-tocopherol and γ-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 α-tocopherol (1.6-fold), γ-tocopherol (1.5-fold), fat (1.7-fold), energy (1.3-fold), and nitrogen (1.05-fold). Retinol, α-tocopherol, and γ-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. J Hum Lact . 24(2):159-167.

Los objetivos de este estudio fueron describir y comparar concentraciones de retinol, α y γ tocoferol, grasa, energía y nitrógeno en fracciones de leche materna del principio y del final de muestras obtenidas en 24 horas de 24 madres de bebes muy pretermino (< 28 semanas de gestación) y la relación del contenido de vitamina A y E en la leche con la ingesta materna de vitaminas. Las concentraciones de retinol fueron significativamente mas altas en la leche del final que en la del principio (1.6 veces mas), como las concentraciones de α-tocoferol (1.6 veces mas), γ-tocoferol (1.5 veces mas), grasa (1.7 mas), energía (1.3 mas), y nitrógeno (1.05 veces mas). El retinol, α-tocoferol, γ-tocoferol se relacionaron positivamente (P < .05) con la energía y grasa de la leche, pero no con la ingesta materna. Estimados de ingesta o consumo de vitamina A y E de los bebes alimentados con leche del final junto a fortificantes de leche materna sobrepasaron los niveles mas altos de ingesta recomendados. El alto contenido de vitaminas solubles producida en la leche del final de madres de bebes de muy bajo peso al nacer necesita consideración en el diseño y las recomendaciones del uso de fortificantes de leche materna (HMF).

Keywords

very low birth weight preterm infant hindmilk vitamin A vitamin E human milk

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