Choline and polyunsaturated fatty acids in preterm infants’ maternal milk

Maas, Christoph; Franz, Axel R.; Shunova, Anna; Mathes, Michaela; Bleeker, Christine; Poets, Christian F.; Schleicher, Erwin; Bernhard, Wolfgang

doi:10.1007/s00394-016-1220-2

Cited by 45 publications

(41 citation statements)

References 44 publications

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“…Consistent with previous studies [6,11,12], PhosC and GPC were the major choline forms in both preterm and donor milk samples, and the proportions of WSC compounds did not seem to vary by milk group. In our study, PhosC ranged between 57%–59%, GPC between 27%–30%, and FC between 13%–16% of the total milk WSC compounds.…”

Section: Discussionsupporting

confidence: 90%

“…Alternatively, this may be explained by the pooling of milk from various donors to produce a larger batch of pasteurized donor milk. Additionally, total WSC concentration seems to vary across lactation [12] and a wide difference in lactation age between the two milk groups may be a contributing factor. We are limited by lack of data on the age of infants at the time their mothers donated milk used in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Donor milk processing protocols typically involve pooling of milk from multiple women at different stages of lactation into one batch, followed by pasteurization and aliquoting into smaller volumes. The concentrations of total and individual WSC compounds in milk vary widely across women [6,11], and total choline concentration in milk seems to decrease with postnatal age [12]. Additionally, milk samples from women who delivered preterm ( n = 353; milk collected at postnatal age 6–85 days) were recently reported to be significantly lower in total choline compounds, GPC, and PhosC and higher in FC compared to milk from women who delivered at term ( n = 9; milk collected at postnatal age 6–118 days) [6,12].…”

Section: Introductionmentioning

confidence: 99%

“…The concentrations of total and individual WSC compounds in milk vary widely across women [6,11], and total choline concentration in milk seems to decrease with postnatal age [12]. Additionally, milk samples from women who delivered preterm ( n = 353; milk collected at postnatal age 6–85 days) were recently reported to be significantly lower in total choline compounds, GPC, and PhosC and higher in FC compared to milk from women who delivered at term ( n = 9; milk collected at postnatal age 6–118 days) [6,12]. We questioned whether preterm infants fed donor milk in our neonatal intensive care unit (NICU) consume milk with different WSC compounds concentrations compared to those fed their mother’s own milk.…”

Section: Introductionmentioning

confidence: 99%

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Relationships among Different Water-Soluble Choline Compounds Differ between Human Preterm and Donor Milk

et al. 2017

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Choline is essential for infant development. Human milk choline is predominately present in three water-soluble choline (WSC) forms: free choline (FC), phosphocholine (PhosC), and glycerophosphocholine (GPC). It is unclear whether mother’s own preterm milk and pooled donor milk differ in WSC composition and whether WSC compounds are interrelated. Mother’s own preterm milk (n = 75) and donor milk (n = 30) samples from the neonatal intensive care unit, BC Women’s Hospital were analyzed for WSC composition using liquid chromatography tandem mass spectrometry (LC-MS/MS). Associations between different WSC compounds were determined using Pearson’s correlations, followed by Fischer r-to-z transformation. Total WSC concentration and concentrations of FC, PhosC, and GPC did not significantly differ between mother’s own milk and donor milk. FC was negatively associated with PhosC and GPC in mother’s own milk (r = −0.27, p = 0.02; r = −0.34, p = 0.003, respectively), but not in donor milk (r = 0.26, p = 0.181 r = 0.37, p = 0.062, respectively). The difference in these associations between the two milk groups were statistically significant (p = 0.03 for the association between PhosC and FC; and p = 0.003 for the association between FC and GPC). PhosC and GPC were positively associated in mother’s own milk (r = 0.32, p = 0.036) but not donor milk (r = 0.36, p = 0.062), although the difference in correlation was not statistically significant. The metabolic and clinical implications of these associations on the preterm infant need to be further elucidated.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationships among Different Water-Soluble Choline Compounds Differ between Human Preterm and Donor Milk

et al. 2017

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“…A number of studies have indicated the utility of adding choline to infant feed (111). The addition of choline, as well as melatonin, to infant feeding requires investigation, especially as to whether there are any synergistic effects, including in the gut and in the regulation of the gut-brain axis, as preclinical data would suggest (39).…”

Section: Melatonin Addition To Formula Feedmentioning

confidence: 99%

Breastfeeding and the gut-brain axis: is there a role for melatonin?

Anderson¹,

Vaillancourt²,

Maes

et al. 2017

Biomolecular Concepts

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The benefits of breastfeeding over formula feed are widely appreciated. However, for many mothers breastfeeding is not possible, highlighting the need for a significant improvement in the contents of formula feed. In this article, the overlooked role of melatonin and the melatonergic pathways in breast milk and in the regulation of wider breast milk components are reviewed. There is a growing appreciation that the benefits of breastfeeding are mediated by its effects in the infant gut, with consequences for the development of the gut-brain axis and the immune system. The melatonergic pathways are intimately associated with highly researched processes in the gut, gut microbiome and gut-brain axis. As the melatonergic pathways are dependent on the levels of serotonin availability as a necessary precursor, decreased melatonin is linked to depression and depression-associated disorders. The association of breastfeeding and the gut-brain axis with a host of medical conditions may be mediated by their regulation of processes that modulate depression susceptibility. The biological underpinnings of depression include increased levels of pro-inflammatory cytokines, oxidative stress, kynurenine pathway activity and dysregulation of the hypothalamic-pituitary adrenal axis, all of which can decrease melatonergic pathway activity. The inclusion of the melatonergic pathways in the biological interactions of breast milk and gut development has significant theoretical and treatment implications, as well as being important to the prevention of a host of infant-, child-and adult-onset medical conditions.

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Effect of Enteral Lipid Supplement on Severe Retinopathy of Prematurity

et al. 2021

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Key Points Question Does enteral fatty acid supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA) from birth to 40 weeks’ postmenstrual age reduce severe retinopathy of prematurity (ROP) in extremely preterm infants? Findings This randomized clinical trial found that enteral AA and DHA supplementation lowered the risk of severe ROP by 50%. In addition, the group that received enteral AA and DHA supplementation showed higher serum levels of both AA and DHA compared with controls. Meaning Supplementing the diet of the most immature infants born at less than 27 weeks’ gestational age with an enteral lipid solution with AA:DHA had no significant adverse effects and seems to be a promising intervention to prevent sight-threatening ROP and thereby reduce visual impartment and blindness.

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Choline and polyunsaturated fatty acids in preterm infants’ maternal milk

Abstract: This study was registered at www.clinicaltrials.gov. Identifier: NCT01773902.

Cited by 45 publications

References 44 publications

Relationships among Different Water-Soluble Choline Compounds Differ between Human Preterm and Donor Milk

Relationships among Different Water-Soluble Choline Compounds Differ between Human Preterm and Donor Milk

Breastfeeding and the gut-brain axis: is there a role for melatonin?

Effect of Enteral Lipid Supplement on Severe Retinopathy of Prematurity

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