Shiwani Mahajan1, Deepak Chawla, Jasbinder Kaur, Suksham Jain. 1. Departments of Pediatrics and *Biochemistry, Government Medical College and Hospital, Chandigarh, India. Correspondence to: Dr Deepak Chawla, Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India. drdeepakchawla@gmail.com.
Abstract
OBJECTIVE: To evaluate the variability in macronutrient and energy content of breastmilk of Indian women delivering at ≤34 weeks of gestation. METHODS: In this cross-sectional study, samples of breastmilk expressed manually for feeding of preterm neonates were collected from 106 mothers at 3±1 (n=26), 7±2 (n=34), 14±2 (n=24), 21±3 (n=12) and 28±3 (n=10) days after birth. Protein, fat and carbohydrate content were estimated and total energy content was calculated. RESULTS: Protein content in the human milk declined from 4.1±2.1 g/dL on the 3rd postpartum day to 2.2±0.6 g/dL by the 28th day postpartum. Lactose (from 2.2±0.7 g/dL to 3.0±0.9 g/dL), fat (1.9±1.8 g/dL to 3.4±2.1 g/dL) and energy (42.3±18.8 Kcal/dL to 51.9±21.5 Kcal/dL) contents increased from day 3 to day 28. CONCLUSION: Preterm human milk has high temporal and inter-individual variation in the macronutrient composition and without fortification is unlikely to meet the nutritional requirement of preterm neonates.
OBJECTIVE: To evaluate the variability in macronutrient and energy content of breastmilk of Indian women delivering at ≤34 weeks of gestation. METHODS: In this cross-sectional study, samples of breastmilk expressed manually for feeding of preterm neonates were collected from 106 mothers at 3±1 (n=26), 7±2 (n=34), 14±2 (n=24), 21±3 (n=12) and 28±3 (n=10) days after birth. Protein, fat and carbohydrate content were estimated and total energy content was calculated. RESULTS: Protein content in the human milk declined from 4.1±2.1 g/dL on the 3rd postpartum day to 2.2±0.6 g/dL by the 28th day postpartum. Lactose (from 2.2±0.7 g/dL to 3.0±0.9 g/dL), fat (1.9±1.8 g/dL to 3.4±2.1 g/dL) and energy (42.3±18.8 Kcal/dL to 51.9±21.5 Kcal/dL) contents increased from day 3 to day 28. CONCLUSION: Preterm human milk has high temporal and inter-individual variation in the macronutrient composition and without fortification is unlikely to meet the nutritional requirement of preterm neonates.