RESUMEN
Circulating docosahexaenoic acid (DHA) and arachidonic acid (ARA) in total red blood cells (RBC) are considered indicators of fatty acid status. In this study, healthy term infants received study formula through 120 days of age. All study formulas had 17â¯mg DHA/100â¯kcal. Investigational formulas had 1) 25 g ARA/100â¯kcal and no added prebiotic blend (ARA-25; nâ¯=â¯29) or 2) 34â¯mg ARA/100 kcal and a prebiotic blend (1:1 ratio; 4â¯g/L) of polydextrose and galactooligosaccharides (PDX/GOS; nâ¯=â¯20). The control formula had 34â¯mg ARA/100â¯kcal and no added prebiotic blend (Control: nâ¯=â¯31). Fatty acids in total RBCs and plasma phospholipids (PPLs) at 120 days and buccal epithelial PLs at 14 and 120 days of age were assessed by capillary column gas chromatography. The calculated 90% confidence interval (CI) of each investigational formula relative to the Control for total RBC ARA (ARA-25: 93-105%; PDX/GOS: 96-110%) and total RBC DHA (ARA-25: 95-113%; PDX/GOS: 94-113%) fell within the pre-specified equivalence limit (85-118%), establishing study formula equivalence with respect to ARA and DHA. At day 120, total RBC and buccal epithelia PL ARA (µg/ml) were not significantly correlated (râ¯=â¯0.041; pâ¯=â¯0.732); correlation in total RBC and buccal epithelia PL DHA was low, albeit significant (râ¯=â¯0.324; pâ¯=â¯0.006). Consequently, buccal epithelial may not provide a suitable substitute for RBC when assessing fatty acid status and availability. The present RBC data suggest availability of DHA for central nervous system development and function is equivalent among infants receiving formulas that had 34 or 25â¯mg/100â¯kcal ARA and 17â¯mg/100â¯kcal DHA.
Asunto(s)
Ácido Araquidónico/sangre , Estatura/fisiología , Peso Corporal/fisiología , Ácidos Docosahexaenoicos/sangre , Fórmulas Infantiles/química , Ácido Araquidónico/administración & dosificación , Estatura/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Ácidos Docosahexaenoicos/administración & dosificación , Método Doble Ciego , Eritrocitos/química , Ácidos Grasos/sangre , Femenino , Glucanos/administración & dosificación , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante/efectos de los fármacos , Recién Nacido , Masculino , Mucosa Bucal/química , Oligosacáridos/administración & dosificación , Fosfolípidos/sangre , Estudios ProspectivosRESUMEN
We report the fatty acid composition of mother׳s own human milk from one of the largest US cohorts of lactating mothers of preterm infants. Milk fatty acid data were used as a proxy for intake at enrollment in infants (n=150) who received human milk with a powder human milk fortifier (HMF; Control) or liquid HMF [LHMF; provided additional 12mg docosahexaenoic acid (DHA), 20mg arachidonic acid (ARA)/100mL human milk]. Mothers provided milk samples (n=129) and reported maternal DHA consumption (n=128). Infant blood samples were drawn at study completion (Study Day 28). Human milk and infant PPL fatty acids were analyzed using capillary column gas chromatography. DHA and ARA were within ranges previously published for US term and preterm human milk. Compared to Control HMF (providing no DHA or ARA), human milk fortified with LHMF significantly increased infant PPL DHA and ARA and improved preterm infant DHA and ARA status.
Asunto(s)
Ácido Araquidónico , Ácidos Docosahexaenoicos , Alimentos Fortificados , Recien Nacido Prematuro/sangre , Leche Humana , Adulto , Ácido Araquidónico/administración & dosificación , Ácido Araquidónico/sangre , Ácidos Docosahexaenoicos/administración & dosificación , Ácidos Docosahexaenoicos/sangre , Método Doble Ciego , Femenino , Humanos , Recién NacidoRESUMEN
OBJECTIVE: A prospective, double-blind, randomized, controlled trial was conducted to evaluate the growth and nutritional status of preterm infants receiving preterm human milk supplemented with a newly formulated powdered human milk fortifier (HMF), study fortifier (SF), or a powdered commercial HMF (CF). METHODS: Infants (n = 144) with a birth weight =1600 g and gestational age at birth of =33 weeks were enrolled and randomized before 21 days of life. Study day (SDAY) 1 was defined as the day full-strength fortification (4 packets/100 mL) began and the infant reached an intake of at least 100 mL/kg/day. Growth, biochemical indices of nutritional status, enteral intake, feeding tolerance, clinical histories, and morbidity were assessed serially. The primary outcome variable was weight gain (g/kg/day) from SDAYs 1 to 29 or hospital discharge, whichever came first. RESULTS: Infants fed human milk supplemented with SF consistently grew more rapidly from SDAYs 1 to 29 (or hospital discharge), regardless of whether the statistical analyses were performed on all subjects who were randomized into the study and reached SDAY 1 (intent-to-treat) or were limited to those able to adhere strictly to the feeding protocol of the study (subgroup). Using mean values adjusted for study site (least square [LS] means), the weight gain differences were 2.6 and 3.8 g/kg/day for the intent-to-treat and subgroup analyses, respectively. Likewise, the length-gain differences were.14 and.18 cm/week for the intent-to-treat and subgroup analyses, respectively. Infants in the SF group reached a weight of 1800 g at SDAY 18, and those in the CF group at SDAY 25. Mean alkaline phosphatase values among infants in the SF group were higher than for the CF infants (eg, LS means: 327 U/L vs 272 U/L, intent-to-treat analysis), likely reflecting the more rapid linear growth of the SF infants. Mean serum calcium values tended to be lower in the SF group in the intent-to-treat analysis and were significantly lower in the subgroup analysis (LS means: 10.3 mg/dL vs 11.2 mg/dL). Both fortifiers were generally well-tolerated, although an increased number of infants in the CF group exited the feeding protocol because of gastric residuals and abdominal distention. CONCLUSION: A new powdered HMF was shown to enhance the growth of preterm infants, compared with a commercially available powdered HMF in the United States.
Asunto(s)
Suplementos Dietéticos , Recién Nacido de Bajo Peso , Recien Nacido Prematuro/crecimiento & desarrollo , Leche Humana , Antropometría , Método Doble Ciego , Estudios de Evaluación como Asunto , Humanos , Recién Nacido , Estado Nutricional , Estudios ProspectivosRESUMEN
The purpose of this study was to compare the effects of rat colostrum and mature milk on newborn rat gastrointestinal growth under conditions that controlled the possible confounding effects of energy intake and mode of feeding. Newborn Sprague-Dawley rat pups were tubefed equicaloric amounts of rat colostrum or mature rat milk for 40 h before they were killed. Compared to littermates that were killed immediately after birth, both groups of fed rats demonstrated increases in the weights of stomach and intestine, but there was no organ weight difference detected between colostrum-fed and mature milk-fed rat pups. However, both the concentration of DNA and the rate of synthesis of DNA in the intestines were greater in rats fed colostrum than in those at birth or those mature milk. Although the pancreas exhibited no detectable increase in weight by 41 h, the DNA concentration and total DNA content increased and RNA/DNA ratio decreased in both fed groups, also without apparent difference between rats fed colostrum and those fed mature milk. The rate of 3H-thymidine incorporation into DNA in pancreas, however, was greater in colostrum-fed pups than in mature milk-fed pups. These differences at 40 h age in intestinal and pancreatic cell replication activity, but not organ weights, can be ascribed to feeding colostrum.