• Journal of Nutrition and Health
• /
• v.28 no.2
• /
• pp.127-136
• /
• 1995

In this study, the nutritional composition of colostrum milk obtained from 22 mothers delivering perterm infants and 17 mothers delivering term infants was analyzed. The energy content of colostrum was yielded based on nitrogen, lactose, and lipid data. Preterm milk is more close the nutritional needs of the preterm infant than dose other breast milk. The results are as follows : 1) Protein concentration was significantly higher, but carbohydrate and lipid concentration were lower in preterm milk than fullterm milk. Energy content yielded from total nitrogen, lactose and lipid concentration was higher in the fullterm milk than preterm milk. 2) Calcium was higher in the preterm milk than fullterm colostrum. Phosphate was lower in fullterm milk than pretem milk. Calcium/Phosphate ratio were 2.61/1 in the preterm and 2.06/1 in the fullterm milk. Magnesium was higher in the preterm milk than fullterm milk. Zinc, Copper and Manganese concentrations were tended to lower in the preterm milk than fullterm milk.

• Journal of Nutrition and Health
• /
• v.27 no.3
• /
• pp.215-227
• /
• 1994

Changes in total lipid content, total cholesterol content and fatty acid composition of preterm milk were investigated during early lactation. Milk samples were collected from Korean mothers of 16 premature(34 to 36 weeks gestation age) infants on day 2 to 5(colostrum) and at 6 weeks(mature) postpartum. We estimated the lipid nutrition of preterm milk by comparing with the lipids of term milk. The total lipid content of preterm colostrum was significantly lower than the lipid content of preterm mature milk(p<0.001). Lipid content, determined gravimetrically in colostrum and matured milk, was 1.50g/이 and 3.2g/dl, respectively. Also the total cholesterol content(mg/dl) in preterm milk tends to increase from 14.16mg/dl to 15.20mg/dl, while the total cholesterol(mg/g lipid) concentration higher significantly in colostrum(12.36mg/g) than in mature(5.73mg/g)(p<0.001). The total unsaturated fatty acid contents in preterm milk were higher in colostrum than in mature milk and the total saturated fatty acids were higher in mature milk. The average DHA contents of colostrum and matured milk was 0.64%, 0.53% and the P/M/S ratio of preterm milk were 0.63 : 1.05 : 1.00, 0.47 : 0.79 : 1.00, respectively. Also, $\omega$6/$\omega$3 ratio of preterm milk were 2.35 in colostrum and 5.81 in mature. Therefore, colostrum in preterm milk contained higher amounts of $\omega$3 PUFA than mature milk. The levels of total lipid in preterm milk were higher than term milk. Also, preterm milk is richer in cholesterol, and long chain polyunsaturated fatty acid than term. It appears that the milk secreted by mothers who delivered prematurely differs from milk in several important respect. These components may serve as precursors for membrane, myelin development in the preterm infants. Therefore, it would be necessary to study further into the machanism of how the gestation age might affect to the lipid composition in human milk. These data may provide a basis for better construction of infant formaulas to provide more adequately for the lipid requirements of the Korean premature infant.

• Journal of Nutrition and Health
• /
• v.28 no.5
• /
• pp.406-414
• /
• 1995

Nitrogen(N) concentration of preterm(PT) and term (T) milk in various fractions, such as total, protein, nonprotein, whey protein and casein were determined at 2-5 days, 1, 2, 4 and 6 weeks of postpartum. The purpose of this study was to investigate the nitrogen concentration of human milk from mothers delivering at preterm and term, and the propriety of preterm milk for premature infants. The concentration of total N, nonprotein N, protein N, whey protein N and casein N in preterm milk was decreased significantly with time postpartum. Total N was 374mg/이 at colostrum, 232mg/dl at mature milk. Whey protein N was decreased from 42mg/dl at 2-5 days to 32mg/dl at 4-6 weeks. Protein N was 332mg/dl at colostrum, 202mg/dl at mature milk. The proportion of whey protein N and casein N were 39:61 at colostrum, 28:72 at mature milk. No difference were found between T and PT milk for total nitrogen excepted 2 weeks. In this report we show that nitrogen concentration except casetpt casein N is smaller in milk from mothers giving birth prematurely than in milk from mothers giving birth at term, over the first two weeks of lactationl But protein N was higher in preterm milk than term milk, whey protein nitrogen was lower. By comparing predicted nitrogen intakes to estimated requirements of preterm infants fed 150 to 200ml/kg/day of their own mother's milk, we predict that the quantities of protein provided would be adequate to meet the requirements of the prematured infants during the early weeks of life.

• Journal of Nutrition and Health
• /
• v.28 no.2
• /
• pp.137-143
• /
• 1995

In this study, lipid composition of milk obtained in colostrum from 22 mothers delivering preterm infants and 17 mothers delivering term infants was analyzed. Fatty acid composition and vitamin E content were analyzed as well as the concentrations of total lipids in preterm and fullterm milk. Lipid and cholestol concentrations were higher in the fulltrm milk than preterm milk. PUFA and P/S ratio in preterm milk were higher than those in fullterm milk. On the other hand, SFA and MUFA contents were higher in the fullterm milk. Vitamin E which is related to PUFA concentration in colostrum was also higher in the preterm milk than fullterm milk.

• Neonatal Medicine
• /
• v.16 no.2
• /
• pp.121-130
• /
• 2009

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.

• Journal of Nutrition and Health
• /
• v.33 no.2
• /
• pp.186-192
• /
• 2000

In this study, total lipid and cholesterol contents and fatty acid composition of colostrum milk obtained from 30 normal mothers, 10 mothers who was delivered of preterm infant and 8 pregnancy induced hypertensive mothers were analyzed. While total cholesterol content in preterm colostrum was significantly lower than other groups (p<0.05), total lipid content was not different among three groups, ranged 2.24-.2.2g/dl. Composition of saturated fatty acide, such as lauric acid and myristic acid which are medium chain fatty acids in preterm milk were higher than those of normal-term and hypertensive mother's milk. There was no difference n total composition of polyunsaturated fatty acids and the rationh of $\omega$6/$\omega$3 among 3 group mother's colostrum, ranged 19.45-21.45% and 6.42-7.87, respectively. but the composition of arachidonic acid and DHA in colostrum of hypertensive mothers were significantly higher than those of normal and preterm mothers. These data indicates that gestational length and complications during pregnancy may change the lipid profile and fatty acid composition of hyman milk colosstrum.

• Journal of Korean Academy of Nursing
• /
• v.49 no.2
• /
• pp.126-136
• /
• 2019

Purpose: This study was conducted to evaluate the effect of breast milk olfactory stimulation on physiological responses, oral feeding progression, and body weight in preterm infants. Methods: A repeated measures design with nonequivalent control group was used. The participants were healthy, preterm infants born at a gestational age of 28~32 weeks; 12 in the experimental group and 16 in the control group. Data were collected prospectively in the experimental group, and retrospectively in the control group, by the same methods. Breast milk olfactory stimulation was provided 12 times over 15 days. The data were analyzed using the chi-square test, Mann-Whitney U test, Wilcoxon signed rank test and linear mixed models using SPSS 19. Results: The gastric residual volume (GRV) of the experimental group was significantly less than that of the control group. The heart rate, oxygen saturation, respiration rate, transition time to oral feeding, and body weight were not significantly different between the two groups. Conclusion: These findings indicate that breast milk olfactory stimulation reduces GRV and improves digestive function in preterm infants without inducing distress.

• Journal of Nutrition and Health
• /
• v.28 no.4
• /
• pp.321-330
• /
• 1995

Concentrations of total vitamin B-6 in human milk as well as individual, B-6 vitamers have important implications for the nutritional management of breast-fed(BF) infants. Vitamin B-6 status was assessed in 3 groups of infants : two groups preterm (PT) BF infants whose mothers were supplemented with 2 or 27mg pyridoxine(PN)-HCI ; a sub group of formula-fed (FF) PT infants. Mothers and infants were assessed weekly during the 28-day post feeding. Throughout the neonatal period, levels of total vitamin B-6 and percentages of pyridoxal(PL) in breast milk were lower in PT than T mothers, even in mothers supplemented with 27mg PN-HCI. Total vitamin B-6 levels in PT milk paralleled maternal supplementation but percentage distributions of B-6 vitamers did not change. Vitamin B-6 intakes of BF preterm infants paralleled their mothers' level of infants in the 2mg group was suggested by vitamin status parameters. Vitamin B-6 inadequacy of infants correlated with their plasma pyridoxal-5-phosphate(PLP) levels and erythrocyte alanine aminotransferase(E-ALAT) activity; all parameters such as plasma PLP, PL/PLP ratio and stimulation % of E-ALAT were highest for FF PT infants. The positive correlation of vitamin B-6 levels in breast milk gestational age may contraindicate its adequacy for some PT infants.

• Clinical and Experimental Pediatrics
• /
• v.53 no.1
• /
• pp.7-13
• /
• 2010

Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

• Neonatal Medicine
• /
• v.18 no.1
• /
• pp.104-110
• /
• 2011

Purpose: The unique nutrient requirements of premature infants necessitate knowledge of the composition of human milk produced by mothers of such infants. We investigated longitudinal changes in iron concentration of preterm human milk and compared to those observed in human milk of mothers of 1-week old term infants to determine optimal iron supplementation guidelines when preterm infants are nourished exclusively by breast feeding. Methods: Human milk samples were collected at 1, 2, 4, 6, 8 and 12 weeks postpartum from 103 mothers who delivered infants of gestational age <34 weeks or weighing <1,800 g. Term human milk samples were collected at 1 week postpartum from 24 mothers. Results: There were no significant differences in the iron concentrations of preterm human milk obtained at 2 to 8 weeks postpartum (36.3${\pm}$23.1 to 45.8${\pm}$26.0 $\mu$g/dL), but these concentrations were higher than those noted at 1 week in preterm (23.1${\pm}$14.6 $\mu$g/ dL) and term (25.2${\pm}$7.55 $\mu$g/dL) infants. The iron concentration in preterm human milk obtained at corrected term age (42.2${\pm}$19.4 $\mu$g/dL) was significantly higher than that of mature term human milk (25.2${\pm}$7.55 $\mu$g/dL). Conclusion: The concentration of iron in preterm human milk was consistently low during the first 3 months of lactation. Supplementation with iron of at least 2 mg/kg/day should be considered for preterm infants who are exclusively breastfed and who have low body iron stores, to meet the minimum enteral iron requirements recommended by AAP-CON (2004).