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Nitrogen and fat balances in very low birth weight infants fed human milk fortified with human milk or bovine milk protein

  • Neonatology
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Abstract

The study was designed to compare two different human milk fortifiers in a group of very low birth weight (VLBW) infants by analysing nitrogen and fat balances, serum concentrations of alpha-amino-nitrogen, urea, and prealbumin as well as growth rates when human milk enriched with one of the two studied fortifiers was fed to the infants. Fortifier A contained different bovine proteins, peptides and amino acids and had an amino acid composition comparable to that of the nutritional available proteins in human milk, with carbohydrates, and minerals. Fortifier B was composed of freeze-dried skimmed human milk and minerals to achieve a similar macronutrient composition in both fortifiers.

Eleven infants were fed with human milk enriched with fortifier A and 13 with fortifier B. After a 10-day equilibration period, a 3-day metabolic balance was performed. On the 14th day of the study blood was obtained preprandially for serum analysis and growth rates were estimated. The nitrogen absorption rate (93.8% vs 93.5%) as well as the retention rate (80.8% vs 78.5%) were no different between the groups. The fat absorption rate (92.3% vs 91.5%) as well as the weight gain (32.1 vs 31.1 g/day) were similar and there were no differences in the serum parameters studied. The results indicate that feeding VLBW infants with human milk enriched with a well-balanced bovine fortifier fulfil their nutritional requirements as well as diets composed exclusively of human milk protein.

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Abbreviations

HM:

human milk

VLBW:

very low birth weight

References

  1. American Academy of Pediatrics, Committee on nutrition (1985) Nutritional needs of low-birth-weight infants. Pediatrics 75:976–986

    Google Scholar 

  2. Atkinson SA, Bryan MH, Anderson GH (1978) Human milk: difference in nitrogen concentrations from mothers of term and preterm infants. J Pediatr 93:67–69

    PubMed  Google Scholar 

  3. Boehm G, Springer S, Lorenz I, Müller DM, Beyreiß K (1986) Konsequenzen des unterschiedlichen Proteingehaltes der Muttermilch für die Ernährung untergewichtiger Neugeborener. Kinderärztl Praxis 54:25–32

    Google Scholar 

  4. Boehm G, Senger H, Friedrich M, Müller DM, Beyreiß K (1990) Protein supplementation of human milk for the nutrition of VLBW-infants: human milk protein versus meat protein hydrolysate. Klin Pädiatrie 202:316–320

    Google Scholar 

  5. Boehm G, Borte M, Müller DM, Senger H, Rademacher C (1991) Die Ernährung Frühgeborener mit angereicherter Frauenmilch: EOPROTIN im Vergleich mit Humanalbumin. Kinderärztl Prax 59:293–298

    Google Scholar 

  6. Chapell JE, Clandinin MT, Kearney-Volpe C, Reichman B, Swyer PW (1986) Fatty acid balance studies in premature infants fed human milk or formula: effect of calcium supplementation. J Pediatr 108:439–447

    PubMed  Google Scholar 

  7. Ehrenkranz RA, Gettner PA, Nelli CM (1989) Nutrient balance studies in premature infants fed premature formula or fortified preterm human milk. J Pediatr Gastroenterol Nutr 8:58–67

    PubMed  Google Scholar 

  8. Hamosh M (1987) Lipid metabolism in premature infants. Biol Neonate 52 [Suppl 1]:50–57

    PubMed  Google Scholar 

  9. Harzer G, Bindels JG (1987) Main compositional criteria of human milk and their implications on nutrition in early infancy. In: Xanthou M (ed) New aspects of nutrition in pregnancy, infancy and prematurity. Elsevier, Amsterdam, pp 83–94

    Google Scholar 

  10. Koletzko B (1990) Langkettige Polyenfettsäuren in der Ernährung Frühgeborener. Ernährungs-Umschau 37:427–432

    Google Scholar 

  11. Lemons JA, Moye L, Hall D, Simmons M (1982) Differences in the composition of preterm and full term human milk during early lactation. Pediatr Res 16:113–117

    PubMed  Google Scholar 

  12. Lubchenco LO, Hausmann C, Dressler M (1963) Intrauterine growth as estimated from life-born birth weight data at 24–42 week's gestation. Pediatrics 32:793–798

    PubMed  Google Scholar 

  13. Lucas A, Morley R, Cole TJ, et al (1990) Early diet in preterm babies and developmental status at 18 month. Lancet 335:1477–1481

    Article  PubMed  Google Scholar 

  14. Moro G, Fulconis F, Minoli I, Pohlandt F, Räihä NCR (1989) Growth and plasma amino acid concentrations in very low birthweight infants fed either human milk protein fortified human milk or a whey-predominant formula. Acta Paediatr Scand 78:18–22

    PubMed  Google Scholar 

  15. Moro GE, Minoli I, Fulconis F, Clementi M, Räihä NCR (1991) Growth and metabolic responses in low-birth-weight infants fed human milk fortified with human milk protein or with a bovine milk protein preparation. J Pediatr Gastroenterol Nutr 13:150–154

    PubMed  Google Scholar 

  16. Narayanan I, Prakash K, Gujral VV (1981) The value of human milk in the prevention of infection in the high-risk low-birth-weight infant. J Pediatr 99:496–498

    PubMed  Google Scholar 

  17. Persson P-H, Welder B-M (1986) Intrauterine weight curves obtained by ultrasound. Acta Obstet Gynecol Scand 65:169–173

    PubMed  Google Scholar 

  18. Polberger SKT, Axelsson IA, Räihä NCR (1989) Growth of very low birth weight infants on varying amounts of human milk protein. Pediatr Res 25:414–419

    PubMed  Google Scholar 

  19. Polberger SKT, Axelsson IE, Räihä NCR (1990) Urinary and serum urea as indicators of protein metabolism in very low birthweight infants fed varying human milk protein intakes. Acta Paediatr Scand 79:737–742

    PubMed  Google Scholar 

  20. Putet G, Rigo J, Salle B, Senterre J (1987) Supplementation of pooled human milk with casein hydrolysate: Energy and nitrogen balance and weight gain composition in very low birth weight infants. Pediatr Res 21:458–461

    PubMed  Google Scholar 

  21. Raschko PK, Hiller JL, Benda GI, Buist NRM, Wilcox K, Reynolds JW (1989) Nutritional balance studies of VLBW infants fed their mothers' milk fortified with a liquid human milk fortifier. J Pediatr Gastroenterol Nutr 9:212–218

    PubMed  Google Scholar 

  22. Report of the Joint FAO/WHO ad hoc Expert Committee (1973) In: Energy and protein requirements. FAO Nutritional series 17. Food and Agriculture Organisation of the United Nations. Rome, pp 102–117

    Google Scholar 

  23. Rönnholm KAR, Perheentupa J, Siimes MA (1986) Supplementation with human milk protein improves growth of small premature infants fed human milk. Pediatrics 77:649–653

    PubMed  Google Scholar 

  24. Salle B, Senterre J, Putet G, Rigo J (1986) Effects of calcium and phosphorus supplementation on calcium retention and fat absorption in preterm infants fed pooled human milk. J Pediatr Gastroenterol Nutr 5:638–642

    PubMed  Google Scholar 

  25. Schanler RJ, Garza C, Nichols BL (1985) Fortified mothers' milk for very low birth weight infants: Results of growth and nutrient balance studies. J Pediatr 107:437–445

    PubMed  Google Scholar 

  26. Schanler RJ, Goldblum RM, Garza C, Goldman AS (1986) Enhanced fecal excretion of selected immune factors in very low birth weight infants red fortified human milk. Pediatr Res 20:711–715

    PubMed  Google Scholar 

  27. Tönz O, Schubinger G (1985) Feeding of very-low-birth-weight infants with breast milk enriched by energy, nitrogen and minerals: FM 85. Helv Paediatr Acta 40:235–238

    PubMed  Google Scholar 

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Boehm, G., Müller, D.M., Senger, H. et al. Nitrogen and fat balances in very low birth weight infants fed human milk fortified with human milk or bovine milk protein. Eur J Pediatr 152, 236–239 (1993). https://doi.org/10.1007/BF01956152

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  • DOI: https://doi.org/10.1007/BF01956152

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