Comparison of Breast Milk Compositions Among Mothers Delivering Small-for-Gestational Age, Appropriate-for-Gestational Age, and Large-for-Gestational Age Infants

Phattraprayoon, Nanthida; Kraisonsin, Nadaprapai; Kanjanapattanakul, Wiboon

doi:10.1089/bfm.2018.0043

Cited by 9 publications

(12 citation statements)

References 8 publications

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“…18 Clinically, significant thresholds may additionally require antenatal diagnostic measures of growth restriction such as abnormal biometric, biophysical, and Doppler flow measures. 18 In studies relating the intrauterine nutrition status with mothers' milk composition of preterm infants, some authors have used the 10th percentile as threshold for SGA, 14 31 while others have preferred the 5th percentile. 12 13 We have refined the diagnostic approach by increasing the sensitivity for detecting FGR through choosing either the 10th percentile for birth weight to define SGA neonates, or FGD even in AGA neonates.…”

Section: Discussionmentioning

confidence: 99%

Does Fetal Growth Adequacy Affect the Nutritional Composition of Mothers' Milk?: A Historical Cohort Study

et al. 2021

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Objective The study aimed to assess the association between intrauterine growth of preterm infants and energy and macronutrient contents in their mothers' milk. Study Design A historical cohort of mothers of preterm infants was assessed according to offspring's intrauterine growth. Fetal growth restriction (FGR) was defined as small-for-gestational age or appropriate for gestational age with fetal growth deceleration. During the first 4 weeks after delivery, the composition of daily pool samples of mothers' milk was measured by using a mid-infrared human milk analyzer. Explanatory models for milk energy, true protein, total carbohydrate, and fat contents were obtained by generalized additive mixed effects regression models. Results In total, 127 milk samples were analyzed from 73 mothers who delivered 92 neonates. Energy content was significantly higher in mothers with chronic hypertension (average: +6.28 kcal/dL; 95% confidence interval [CI]: 0.54–12.01; p = 0.034) and for extremely preterm compared with very preterm infants (average: +5.95 kcal/dL; 95% CI: 2.16–9.73; p = 0.003), and weakly associated with single pregnancies (average: +3.38 kcal/dL; 95% CI: 0.07–6.83; p = 0.057). True protein content was significantly higher in mothers with chronic hypertension (average: +0.91 g/dL; 95% CI: 0.63–1.19; p < 0.001) and with hypertension induced by pregnancy (average: +0.25 g/dL, 95% CI: 0.07–0.44; p = 0.007), and for extremely preterm compared with very and moderate preterm infants (average: +0.19; 95% CI: 0.01–0.38; p = 0.043 and +0.28 g/dL; 95% CI: 0.05–0.51; p = 0.017, respectively). Fat content was weakly and negatively associated with FGR, both in SGA infants and AGA infants with fetal growth deceleration (average: −0.44 g/dL; 95% CI: −0.92 to −0.05; p = 0.079 and average: −0.36 g/dL; 95% CI: −0.74 to −0.02; p = 0.066, respectively). Conclusion Energy and macronutrient contents in mothers' milk of preterm infants was significantly and positively associated with the degree of prematurity and hypertension. The hypothesis that the composition of milk is associated with FGR was not demonstrated. Key Points

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Section: Discussionmentioning

confidence: 99%

Does Fetal Growth Adequacy Affect the Nutritional Composition of Mothers' Milk?: A Historical Cohort Study

et al. 2021

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“…Interestingly, the macronutrient milk composition differed considerably from reference ranges for term breastfed infants in this SGA case, despite other studies failing to show differences [11, 14–16]. This is likely due to a combination of sampling limitations that exist in previous literature.…”

Section: Discussionmentioning

confidence: 56%

“…Lactose is the principal carbohydrate in human milk, providing approximately 40% of the total energy the infant receives from milk, and remains the most constant throughout lactation [27]. The average lactose concentrations in this case did not lie outside the reference range, which is in contrast to one study which found total carbohydrates to be significantly lower than those in the milk provided to average- and large-for-gestational age infants, although this was not considered a clinically significant reduction in carbohydrates for the infant [16]. However, when using the measured concentrations of fat, protein and lactose and the milk volume we found that the infant was receiving only 49% of its daily required energy.…”

Section: Discussionmentioning

confidence: 71%

“…Months 4 ( n = 6), 5 ( n = 6) and 6 ( n = 4) mixed breast and formula feeding, with solids introduced at 5 months. Dotted lines indicate macronutrient reference ranges for healthy term infants, from Mitoulas et al [16]…”

Section: Case Presentationmentioning

confidence: 99%

“…Animal studies have reported that infant growth restriction results in compromised maternal quantity and quality of milk [13]. This is in contrast to the few human studies that have reported no change in milk composition in cases of growth restriction [14–16]. These studies, however, used inappropriate sampling methods for fat analysis, collecting samples from one time point in the first 28 days post-partum, and did not consider the daily or monthly variation of fat [11, 17].…”

Section: Introductionmentioning

confidence: 99%

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Breastfeeding a small for gestational age infant, complicated by maternal gestational diabetes: a case report

George

Wlodek

Geddes

2019

BMC Pregnancy Childbirth

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Background Small for gestational age (SGA) infants are those born small for their gestational age, with weight below the 10th percentile. Not only do SGA infants suffer growth issues after birth, they have elevated risk for the development of metabolic and cardiovascular diseases later in life. Current research has suggested that in cases of SGA infants, maternal milk and breastfeeding are not affected. Case summary The mother of an SGA infant was diagnosed with placental insufficiency and Gestational Diabetes Mellitus (GDM) during her pregnancy. The infant was born term, at 38 weeks 3 days, and SGA. The mother had a low milk supply and her milk composition differed from reference values such that the daily infant intake provided less than 50% of the required energy intake at 3 months. Conclusion In cases of SGA and/or GDM, maternal milk quality and quantity may be compromised. This requires follow-up in order to reduce the disease risk for SGA infants and the corresponding public health implications.

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Infant factors that impact the ecology of human milk secretion and composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 3

Krebs

Belfort

Meier

et al. 2023

The American Journal of Clinical Nutrition

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Comparison of Breast Milk Compositions Among Mothers Delivering Small-for-Gestational Age, Appropriate-for-Gestational Age, and Large-for-Gestational Age Infants

Cited by 9 publications

References 8 publications

Does Fetal Growth Adequacy Affect the Nutritional Composition of Mothers' Milk?: A Historical Cohort Study

Does Fetal Growth Adequacy Affect the Nutritional Composition of Mothers' Milk?: A Historical Cohort Study

Breastfeeding a small for gestational age infant, complicated by maternal gestational diabetes: a case report

Infant factors that impact the ecology of human milk secretion and composition—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 3

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