Customizing breast milk for premature children
About 7 percent of all Danish children are born prematurely. This is significant to the child and affects a mother's body which unexpectedly must produce nutrition for her newborn.
Research has previously demonstrated that breast milk from women who give birth prematurely is different from breast milk from women who give birth to full-term babies. Those examinations focused on milk's macro nutrients such as protein, fat and carbohydrates. That research documented that milk from women who give birth prematurely typically has a higher content of macro nutrients compared with milk from pregnant women who give birth after week 37. Thus, breast milk partly compensates for the fact the baby is not fully developed, while protecting the infant by healthy colonization of beneficial bacteria to its' intestinal tract.
Now, new research from Aarhus University, Denmark, published in the journal Nutrients, shows that breast milk from women who give premature birth not only have a different composition of macro nutrients, but their composition of micro nutrients (metabolites) is also different. Metabolites are the small molecules approximate to the parent structure they derive from. They tend to fall into two categories: (1) those that are abundant and fleeting, and sometimes non-detectable, or (2) important in function and affecting cell regulation.
Ulrik Sundekilde, a postdoctral student in the Department of Food Science, at Aarhus University, was responsible for making a very detailed analysis of breast milk using global metabolomics to specifically measure the unique chemical fingerprints breast milk metabolites leave behind.
Breast milk is the best example of customized food that we know, in that the infant gets the exact nutrition it needs. Therefore, the question remained: does nature incorporate a metabolic compensation to ensure optimum nutrition for the pre-term infant, added Sundekilde.
The new research demonstrated that a few weeks after birth, the composition of breast milk is identical to the one available to full-term babies. If a woman gives birth in week 25 she will, as early as week 30, produce milk similar to the milk produced for a full-term baby.
But, not all of the nutritional importance of metabolites is understood. As premature infants have more specialized nutritional needs, it may be a challenge to be fed milk you are not fully developed to digest. Particularly in a period of extreme growth and development.
Ulrik Sundekilde, postdoctural student, Department of Food Science, Aarhus University, Denmark
The scientists achieved their results by analyzing the metabolite content of breast milk samples from 45 women covering a period of up to 14 weeks following birth.This may be the first time that an extensive comparison of micro nutrient content in breast milk, over time and in a group of pre-term mothers, has ever been done.
Next the scientists will conduct a more extensive study expanding the number of mothers, for a closer look at infant development as affected by breast milk. Following a child for a number of years may point out how specific factors in breast milk are or are not impacting a child's physical and neural growth.
Such a long-term perspective based on the clinical analysis of breast milk beginning with birth might allow for customization of breast milk, adapting it to an infant's needs. Today, macro nutrients are added when the natural content of food is insufficient. Any new research might call for improvement of micro nutrients of breast milk, as well. Ulrik Sundekilde explains why such solutions may not be easy to obtain.
It will take extensive testing to demonstrate a connection between breast milk's nutrient content and infant development.
Most Danish hospitals already have the ability to measure metabolites, what is needed is significant research to establish causal connections between micronutrients and premature newborn infant needs developmentally.
Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery.
Authors: Ulrik K. Sundekilde 1,*, Eimear Downey 2, James A. O’Mahony 2, Carol-Anne O’Shea 3, C. Anthony Ryan 3, Alan L. Kelly 2 and Hanne C. Bertram 1
1 Department of Food Science, Aarhus University, Årslev 5792, Denmark
2 School of Food and Nutritional Sciences, University College Cork, Cork T12 YN60, Ireland
3 Department of Paediatrics and Child Health, University College Cork, Cork T12 YN60, Ireland
Received: 1 April 2016 / Accepted: 16 May 2016 / Published: 19 May 2016
Keywords: pre-term; infant; nutrition; human milk; metabolites; NMR; metabolomics
Return to top of page
Aug 18, 2016 Fetal Timeline Maternal Timeline News News Archive
Breast milk is the best example of customized food that we know.
Image Credit: Public Domain