The lowest creamatocrit, calories and fat concentration was indicated in the preterm milk obtained in the morning (4.86%, 663.8 kcal/L and 33.6 g/L, respectively). The highest milk parameters were observed in the night samples of full-term milk and measured (9.6%, 919.7 kcal/L, and 60.7 g/L, respectively). No significant differences in analysed parameters were observed between preterm and full-term milk (p>0.05). In summary, creamatocrit, calories and lipid concentration in breast milk shows the daily differences. Colostrum and mature milk from mothers of preterm neonates differed from colostum and mature milk from mothers of term neonates. They had lipid contents, creamatocrit level and calorific value.

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The rate of post-transplant mothers who breastfeed while on immunosuppression is progressively increasing. Data on breastfeeding while on cyclosporine-based regimens are limited. Therefore, we assessed the amount of cyclosporine and its metabolites that might be ingested by a breastfed infant by measuring the concentration of cyclosporine and its metabolites in the colostrum of seven post-transplant mothers. The mean concentration of cyclosporine in the colostrum was 22.40 ± 9.43 mcg/L, and the estimated mean daily dose of the drug was 1049.22 ± 397.41 ng/kg/24 h. Only three metabolites (AM1, DHCsA, and THCsA) had mean colostrum amounts comparable to or higher than cyclosporine itself, with the daily doses being 468.51 ± 80.37, 2757.79 ± 1926.11, and 1044.76 ± 948.56 ng/kg/24 h, respectively. Our results indicate a low transfer of cyclosporine and its metabolites into the colostrum in the first two days postpartum and confirm the emerging change to the policy on breastfeeding among post-transplant mothers. A full assessment of the safety of immunosuppressant exposure via breastmilk will require further studies with long-term follow-ups of breastfed children.

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