Human Milk Lacto-Engineering: Growth Nitrogen Metabolism,and Energy Balance in Preterm Infants

ABSTRACT. Fourteen 3-day metabolic balance studies were carried out in 8 healthy male preterm infants (birthweight 1270±170 g, gestational age 30±2 weeks) fed 183±7 ml/kg/day of a human milk formula made of incompletely skimmed human milk enriched with lyophilized whole human milk, minerals, medium chain triglycerides and linoleate. Daily intakes per kilo bodyweight were for protein 3.5±0.3 g, fat 7.0±2.1 g, and energy 573±88 kj (137 kcal). Weight gain was 29±5 g per day and nitrogen retention was 317±52 mg/kg/day. Fat absorption was 76± 12 %. Renal acid and solute loads were low and there was no metabolic acidosis, hyperazotemia or hyperaminoacidemia, except for tyrosine. It is concluded that preterm infants fed a human milk formula have similar growth rates and nitrogen retentions as foetuses in utero or preterm infants fed their own mother's milk.     

Human Milk Lacto-Engineering: Growth Nitrogen Metabolism, and Energy Balance in Preterm Infants

ABSTRACT. Fourteen 3-day metabolic balance studies were carried out in 8 healthy male preterm infants (birthweight 1270±170 g, gestational age 30±2 weeks) fed 183±7 ml/kg/day of a human milk formula made of incompletely skimmed human milk enriched with lyophilized whole human milk, minerals, medium chain triglycerides and linoleate. Daily intakes per kilo bodyweight were for protein 3.5±0.3 g, fat 7.0±2.1 g, and energy 573±88 kj (137 kcal). Weight gain was 29±5 g per day and nitrogen retention was 317±52 mg/kg/day. Fat absorption was 76± 12 %. Renal acid and solute loads were low and there was no metabolic acidosis, hyperazotemia or hyperaminoacidemia, except for tyrosine. It is concluded that preterm infants fed a human milk formula have similar growth rates and nitrogen retentions as foetuses in utero or preterm infants fed their own mother's milk.     

Growth and Plasma Amino Acid Concentrations in Very Low Birthweight Infants Fed Either Human Milk Protein Fortified Human Milk or a Whey-Predominant Formula

ABSTRACT. In a prospective, study involving 20 VLBW-infants (AGA), divided into two study groups of 10 infants, we have evaluated the effects on growth and metabolism of human milk fortified with ultrafiltrated human milk protein and a whey-predominant (whey/ casein = 60/40) formula containing 2 g/dl of protein. The study was initiated at a mean age of 30 days when an oral intake of 180 ml/kg/d was tolerated and continued until a weight of 2 kg was reached. The protein intake in both groups was about 3.7 g/kg/d. All infants in both groups reached intrauterine rates of growth for the age, weight gain 18.0 g/kg/d, and length 1.2 cm/week. BUN, acid-base status, total protein and albumin were normal and similar in the two groups. Plasma levels of threonine, glycine, citrulline and methionine were significantly greater in the formula-fed infants. Taurine and proline had higher concentrations in the protein fortified human milk group. There was good tolerance of protein from both sources but the differences in plasma amino acid profiles suggest that the dietary protein quality in formulas for preterm infants must be further modified, if the goal of formula feeding is to achieve metabolic indices of protein metabolism similar to those found when human milk protein is used.     

谷氨酰胺及低乳糖配方乳对早产儿坏死性小肠结肠炎的预防

目的观察谷氨酰胺及低乳糖配方乳对早产儿坏死性小肠结肠炎(NEC)的预防效果。方法选取新生儿科病房收治的早产极低出生体质量儿90例按不同营养方式分为3组。A组:予常规静脉营养及母乳或配方乳喂养;B组:静脉营养及喂养方法与A组相同,另外胃肠喂养开始即添加谷氨酰胺口服(0.25 g.kg-1,2次.d-1);C组:静脉营养方法与A组相同,胃肠喂养采用低乳糖配方乳,另外添加谷氨酰胺口服(0.25 g.kg-1,2次.d-1)。3组患儿均于出生24 h内、出生5 d、10 d后取静脉血测定其胱抑素C(CysC)和超敏C反应蛋白(hsCRP),出生10 d取2 g左右患儿大便定性测定乳糖水平,并在出生30 d内分别计算各组患儿NEC的发生率。结果经过不同营养方法处理后,3组患儿hsCRP均逐渐升高,但喂养5 d及10 d后C组升高不明显,与A、B组比较差异有统计学意义;各组CysC逐渐升高,A组升高明显,C组升高不明显,在出生10 d时最低,与A、B组比较差异有统计学意义。3组患儿大便乳糖分析显示A组阳性率较高,C组最低。患儿NEC发生率A组为6.7%,B、C组发生率相同为3.3%,A组与B、C组比较差异有统计学意义。结论早产儿喂养谷氨酰胺联合低乳糖配方乳可以减轻炎性反应,增加乳糖吸收,降低NEC的发生,对NEC的发生起到一定预防作用。