DEVELOPMENT OF MACRONUTRIENT COMPOSITION OF VERY PRETERM HUMAN-MILK

The effects of gestational age at delivery (GA), postnatal age (PNA) a nd post-menstrual age (PMA=PNA+ GA, an indicator of autonomous develop mental processes not affected by the moment of birth) on macronutrient composition of very preterm milk were studied. Total N, fat, lactose and carbohydrate concentrations, energy density and 24 h volume were d etermined in 282 24 h milk samples collected at weekly intervals (days 7-55 of lactation) from seventy-nine women delivering their babies be tween 25 and 29 weeks of gestation. GA related differences were found for carbohydrate concentration only: carbohydrate concentration was lo wer with increasing GA. PNA was related to a decrease in total N and a n increase in lactose concentration. PMA was not related to milk compo sition. Our data indicate that PNA strongly influences the development of the composition of very preterm human milk, while GA affects carbo hydrate content with a negligible effect on the nutritional value of t he milk. We conclude that in accordance with current opinion in paedia trics, human milk is the best source of nutrients even for very preter m (< 30 weeks GA) infants.