Dietary Protein Intake, Breast Feeding and Growth in Human Milk Fed Preterm Infants

Emma Tonkin, Jacqueline Miller, Maria Makrides, Andrew J. McPhee, Scott A. Morris, Robert A. Gibson and Carmel T. Collins
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Emma Tonkin: Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5001, Australia
Jacqueline Miller: Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5001, Australia
Maria Makrides: Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
Andrew J. McPhee: Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
Scott A. Morris: Centre for Perinatal Medicine Flinders Medical Centre and School of Medicine, Flinders University, Adelaide, SA 5042, Australia
Robert A. Gibson: Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia
Carmel T. Collins: Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia

IJERPH, 2018, vol. 15, issue 6, 1-11

Abstract: Protein intakes of preterm infants are frequently below recommendations, but few studies report accurate intakes due to the difficulty of analysing human milk clinically. This observational analysis from a randomised trial of infants born <31 weeks’ gestation, investigating two levels of protein fortification, reports protein intakes compared with requirements and determines the association of direct breastfeeding on growth. Ninety-two infants (median gestational age 28 weeks, Interquartile range (IQR) 26–29; mean birth weight 1040 g, SD 300 g) were studied. Infants born weighing <1000 g were underfed protein compared with recommendations (median (IQR) intake of 3.0 (2.0–3.7) g/kg/day in week 2 versus recommendation of 4–4.5 g/kg/day), while those born weighing ≥1000 g met recommended protein intakes after the first week of life (median (IQR) intake of 3.7 (3.0–4.0) g/kg/day in week 2 versus recommendation of 3.5–4.5 g/kg/day). A moderate, negative correlation between the mean number of breast feeds and change in rate of weight gain ( r = −0.37, p = 0.001) was found. Protein intakes of infants <1000 g did not meet recommendations and all infants were underfed protein and energy in the first week of life. Current protein fortification is inadequate for infants born <1000 g. Exploratory analysis showed faltering rate weight gain associated with increasing number of breast feeds and these results warrant confirmation.

Keywords: breast feeding; dietary proteins; enteral nutrition; infant–premature; milk–human; weight gain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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