| [Abstract] Objective:to explore the effect of fortified human milk feeding on growth, metabolism and complications of premature infants during hospital stay. Methods: Totally,148premature infants of gestational age<36weeks and birth weight≤1800g, admitted to NICU between January lst,2009and December31st,2012, were retrospectively enrolled and divided into two groups. Infants fed predominantly (>50%) with fortified human breast milk,combined with formula when breast milk was insufficient during hospital stay, were named HMF group(n=73),and those fed exclusively with premature formula were called premature formula feeding group(PF group, n=75). Data of infants on growth, metabolism and incidence of various complications were compared between the two groups. Results:Among the148cases included, there was no significant difference in gestational age, birth weight, head circumference, length at birth, time for regaining birth weight, SGA at birth, RDS, intraventricular hemorrhage over grade III, asphyxia rate between HMF and PF group(all P>0.05). Infants of the HMF group showed shorter duration of parenteral nutrition [18d (14d,25d) vs.24d (18d,31d), z=-2.950,P=0.003],smaller age to achieve120ml/kg.d through enteral feeding [16d (12d,23d) vs.22d(16d,30d),z=-2.895,P=0.004], smaller age to achieve total energy intake of120kcal/(kg.d)[11d (8d,15d) vs.14d (10d,17.5d), z=-2.392, P=0.017] than those of the PF group. Medical cost during hospital stay in the HMF group was significantly less than in the PF group [RMB:47078yuan (30802yuan,67039yuan) vs.58400yuan (38166yuan,82737yuan), z=-1.970, P=0.049]. The time for initial feeding, rat of feeding intolerance, daily weight gain after regaining birth weight, weekly increase of body length and head circumference, weight, body length and head circumference at discharge, proportion of small for gestational age infants at discharge, z scores of both birth weight and weight at discharge showed no significant difference(all P>0.05).The level of blood alkaline phosphates before discharge in HMF group was significantly higher than that of the PF group[347.65±149.42U/L vs.288.62±108.75U/L,t=2.570,P=0.011]. The incidence of sepsis in HMF group was slightly lower than that in the PF group[11.0%(8/73) vs.20.0%(15/75)] without significant difference(χ2=2.30,P>0.05), neither the morbidity of retinopathy of premature, bronchopulmonary dysplasia, necrotizing enterocolitis of newborns(all P>0.05). Conclusion:HMF for premature infants may ensure the same growth pattern as those fed by premature formula, and it also can accelerate the enteral feeding process, reduce the incidence of sepsis and decrease the medical cost during hospital stay. [Abstract] Objective:to study the macronutrients and energy levels in human milk from mothers of both premature and term infants. Methods:Human milk samples were collected from170mothers, among them82were mothers of premature infants, and88were mothers of term infants. In total339samples were collected at3-7days,7-14days and30-42days, and samples from23premature infants mothers were collected twice a week. Protein (g/dl), fat (g/dl), carbohydrates (g/dl), dry matter (g/dl) and energy (kcal/dl) were detected with the MIRIS human milk analyzer. Results:(1) in premature infants’ mothers, protein in colostrums(2.22±0.49g/dl)was significantly higher than that in transitional milk (1.83±0.39g/dl,P<0.01), and protein in transitional milk was significantly higher than that in mature milk(1.40±0.28g/dl,P<0.05),fat in colostrums(2.40±1.27g/dl)was significantly lower than that in transitional milk(3.07±1.05g/dl,P<0.01), carbohydrates in colostrums(6.40±0.91g/dl) was significantly lower than that in transitional milk(6.63±0.40g/dl,P<0.05). No significant differences were found in dry matter between colostrums and transitional milk(P>0.05), energy in colostrums(55.3±8.5kcal/dl) was significantly lower than that in transitional milk(62.4±8.3kcal/dl, P<0.01). No significant differences were found in fat, carbohydrates, dry matter and energy between transitional milk and mature milk (P>0.05).(2)Protein levels in premature colostrums(2.22±0.49g/dl) were significantly higher than that in term infants colostrums (2.07±0.34g/dl,P<0.05), but fat, carbohydrates, dry matter and energy in both colostrums and mature milk from premature and full infants’mothers showed no significant difference (P>0.05).(3)In the milk samples from premature infants’ mothers, proteins levels in colostrums from≤30weeks (2.48±0.68g/dl),30+1-33+6w (2.11±0.25g/dl) and≥34weeks (2.22±0.39g/dl) showed significant difference (P<0.05); fat levels from30+1-33+6weeks group(2.52±0.76g/dl) was significantly higher than that in≤30weeks group (1.74±0.84g/dl, P<0.05); energy levels in colostrums from30+1-33+6weeks group (58.4±7.6kcal/dl) was significantly higher than that in the ≤30weeks group (51±6.4kcal/dl, P<0.05); no significant differences were found in protein and fat levels among different gestational age groups in premature transitional milk (P>0.05); carbohydrates in≤30weeks (6.85±0.27g/dl)were higher than the other two groups (P<0.05); Protein levels in30+1-33+6weeks premature mature milk (1.53±0.37g/dl) were higher than two other groups (P<0.05); No significant differences were found in fat, carbohydrate and energy from different gestational age mature milk (P>0.05);(4) In premature mother’s samples, no significant difference were found in milk protein, fat, carbohydrates, dry matter and energy levels between the SGA group and AGA group (P>0.05);(5)In the premature group, samples from elderly mothers showed no significant difference in macronutrients and energy levels compared to that from the appropriate age mothers(P>0.05).(6)Milk protein levels declined throughout lactation, fat levels increased first and got stable, while carbohydrates levels. Conclusion:(1) Macronutrients and energy in milk from mothers of premature infants varied during the lactation.(2)Protein levels in colostrums from mothers of premature infants were significantly higher than that from mothers of term infants.(3) Macronutrients and energy in milk did not differ between SGA and AGA mothers, among different gestational age groups, different maternal age groups.(4) Protein and energy levels in milk from mothers of premature infants declined during the lactation, while fat levels increased first then got stable, and carbohydrate levels remained stable. [Abstract] Objective To evaluate dietary intakes and possible associations with macronutrients and energy in human milk from mothers of premature and term infants. Methods Dietary intakes were surveyed in mothers of premature and term infants at2and6weeks postpartum using a24-hour dietary questionnaire. Milk samples were collected at the same time. Macronutrients (including protein, fat, carbohydrate and dry matter) and energy were measured by Miris milk analyzer. Results:In total77questionnaires were collected, in which46were from mothers of premature infants (30at2weeks and16at6weeks) and31were from mothers of term infants at6weeks postpartum.(1) There were many problems in the general dietary intakes among mothers of premature infants:their general protein intakes were significantly lower than recommended dietary intakes(RDIs)(p<0.05), while energy intakes were either lower or much higher than RDIs, mineral intakes including calcium, iron and zinc were not enough.(2) In the group of mothers of premature infants, dietary intakes did not differ between2weeks and6weeks postpartum (p>0.05), and at6weeks postpartum, general dietary intakes didn’t differ between mothers of premature infants and term infants (p>0.05).(3) There was no significantly difference in milk macronutrients and energy between normal BMI group and overweight group (p>0.05).(4) Milk intergredient did not differ between different protein and energy intake groups (p>0.05).(5) No association was found between the dietary intakes and the macronutrients and energy in milk from mothers of premature infants. Conclusions:(1) Mothers of premature infants need more instructions on their postpartum dietary intakes.(2) There was no proof on the association between the dietary intakes and the macronutrients and energy in milk from mothers of premature infants. |
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