Isabell Nessel1, Laura De Rooy2, Minesh Khashu1,3, Jane L Murphy4, Simon C Dyall5. 1. Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK. 2. Neonatal Unit, St George's University Hospitals NHS Foundation Trust, London, UK. 3. Neonatal Unit, Poole Hospital NHS Foundation Trust, Poole, UK. 4. Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK. 5. Department of Life Sciences, University of Roehampton, London, UK.
Abstract
BACKGROUND: Donor human milk (DHM) is used as alternative to maternal milk to feed preterm infants; however, it may provide less long-chain (LC) polyunsaturated fatty acids (PUFAs) and more oxidized lipids, which may be detrimental to preterm infant health and development. Levels have not been reported for DHM in the United Kingdom. METHODS: DHM (n = 19) from 2 neonatal units, preterm milk from a neonatal unit (n = 10), and term milk from the community (n = 11) were analyzed for fatty acids, malondialdehyde, 4-hydroxy-2-nonenal, and hexanal. STUDY REGISTRATION: NCT03573531. RESULTS: DHM had significantly lower absolute LCPUFA content than term (P < .001) and significantly lower ω-3 PUFAs than preterm milk (P < .05), although relative LCPUFA composition did not differ. Exclusive DHM feeding leads to significantly lower fat (3.7 vs 6.7 g/d) and LCPUFA (docosahexaenoic acid [DHA]: 10.6 vs 16.8 mg/d; arachidonic acid [ARA]: 17.4 vs 25.2 mg/d) intake than recommended by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, and provides 17.3% and 43.1% of the in utero accreted ARA and DHA. DHM had the highest proportion of lipid peroxidation. CONCLUSIONS: This study confirms that DHM in the United Kingdom has insufficient LCPUFAs for preterm infants. It demonstrates for the first time that DHM has the highest level of lipid peroxidation, compared with preterm or term milk. This has important implications for preterm infant nutrition, as exclusive DHM feeding might not be suitable long term and may contribute to the development of major preterm neonatal morbidities.
BACKGROUND:Donorhuman milk (DHM) is used as alternative to maternal milk to feed preterm infants; however, it may provide less long-chain (LC) polyunsaturated fatty acids (PUFAs) and more oxidized lipids, which may be detrimental to preterm infant health and development. Levels have not been reported for DHM in the United Kingdom. METHODS: DHM (n = 19) from 2 neonatal units, preterm milk from a neonatal unit (n = 10), and term milk from the community (n = 11) were analyzed for fatty acids, malondialdehyde, 4-hydroxy-2-nonenal, and hexanal. STUDY REGISTRATION: NCT03573531. RESULTS: DHM had significantly lower absolute LCPUFA content than term (P < .001) and significantly lower ω-3 PUFAs than preterm milk (P < .05), although relative LCPUFA composition did not differ. Exclusive DHM feeding leads to significantly lower fat (3.7 vs 6.7 g/d) and LCPUFA (docosahexaenoic acid [DHA]: 10.6 vs 16.8 mg/d; arachidonic acid [ARA]: 17.4 vs 25.2 mg/d) intake than recommended by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, and provides 17.3% and 43.1% of the in utero accreted ARA and DHA. DHM had the highest proportion of lipid peroxidation. CONCLUSIONS: This study confirms that DHM in the United Kingdom has insufficient LCPUFAs for preterm infants. It demonstrates for the first time that DHM has the highest level of lipid peroxidation, compared with preterm or term milk. This has important implications for preterm infant nutrition, as exclusive DHM feeding might not be suitable long term and may contribute to the development of major preterm neonatal morbidities.