Saarela, Timo; Kokkonen, Jorma; Koivisto, Maila
Acta Paediatrica, Volume 94, Number 9, September 2005, pp. 1176-1181(6)
Aim: To study the macronutrient and energy contents of human milk fractions during the first 6 mo of lactation.
Study design: A total of 483 milk samples, including 52 pairs of fore- and hindmilk samples from 20 mothers, 253 samples from 53 donor mothers and 126 samples from 36 mothers of preterm infants, were collected longitudinally, starting at 1 wk postpartum and continuing monthly up to 6 mo. Protein, lactose and fat contents were measured and energy density estimated.
Results: The protein content was significantly lower in fore- and hindmilk than in donor or preterm milk during the first months of lactation. In donor and preterm milk, the protein content declined consistently from 2.0 g/100 ml at 1 wk to half of that at 6 mo, and a similar trend was observed in fore- and hindmilk. Lactose content showed no significant changes between the groups or in the course of lactation. The fat content was highest in hindmilk, being approximately two- to threefold that of foremilk. Accordingly, hindmilk included 25–35 kcal/100 ml more energy on average than foremilk.
Conclusions: The fat content of human milk increases in relation to breast emptying, while the other macronutritients of milk show only slight changes. When enteral feeding with high-energy human milk is preferred, as in the case of very preterm infants, hind milk, with its higher fat content, would be a natural choice.
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