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Journal of Human Lactation, Vol. 24, No. 2, 159-167 (2008)
DOI: 10.1177/0890334408316085

Nutrient Composition of Hindmilk Produced by Mothers of Very Low Birth Weight Infants Born at Less Than 28 Weeks' Gestation

Rosine Bishara, RD, MSc

Sunnybrook Health Sciences Center, Toronto, Ontario

Michael S. Dunn, MD, FRCP C

Neonatal Intensive Care Unit at Sunnybrook Health Sciences Center, Toronto, Department of Paediatrics at the University of Toronto, Ontario

Susan E. Merko, RD

Sunnybrook Health Sciences Center, Toronto, Ontario

Pauline Darling, PhD, RD

Department of Nutritional Sciences, University of Toronto, St Michael's Hospital, Toronto, Ontario, darlingp{at}smh.toronto.on.ca

The objectives of this study were to describe and compare retinol, {alpha}-tocopherol and {gamma}-tocopherol, fat, energy, and nitrogen concentrations between the foremilk and hindmilk fractions of 24-hour milk collected by 24 mothers of very preterm (< 28 weeks' gestation) infants and to relate milk vitamins A and E content to maternal vitamin intake. Concentrations of retinol were significantly higher in hindmilk than in foremilk (1.6-fold), as were concentrations of {alpha}-tocopherol (1.6-fold), {gamma}-tocopherol (1.5-fold), fat (1.7-fold), energy (1.3-fold), and nitrogen (1.05-fold). Retinol, {alpha}-tocopherol, and {gamma}-tocopherol were positively related (P < .05) to milk fat and energy but not to maternal intake. Estimates of vitamins A and E intakes of infants fed hindmilk with added human milk fortifier surpassed current recommended upper level of intakes. The higher fat-soluble vitamin content of hindmilk produced by mothers of very low birth weight infants needs to be considered in the design and recommendations for use of human milk fortifier. J Hum Lact . 24(2):159-167.

Key Words: very low birth weight • preterm infant • hindmilk • vitamin A • vitamin E • human milk


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