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Changes in the choline content of human breast milk in the first 3 weeks after birth

H C Holmes1, G J Snodgrass, R A Iles

  • 1Cellular and Molecular Mechanisms Research Group, Medical Unit, St Bartholomew's and The Royal London School of Medicine and Dentistry, 5th Floor, Alexandra Wing, The Royal London Hospital, Whitechapel, London E1 1BB, UK. R.A.Iles@mds.qmw.ac.uk

European Journal of Pediatrics
|February 9, 2000
PubMed

Insights

Human breast milk choline levels double after birth, meeting infant needs. However, premature infants may have inadequate choline intake from formula or lower milk volumes.

Area of Science:

  • Biochemistry
  • Human Nutrition
  • Pediatrics

Background:

  • Choline is vital for developing brains and livers, forming essential membrane phospholipids.
  • Neonates excrete significant amounts of betaine, a choline metabolite, suggesting high choline demand.
  • Previous estimates indicated potential choline insufficiency in newborns based on intake versus excretion.

Purpose of the Study:

  • To quantify choline content in human breast milk (colostrum, mature milk) and infant formulas.
  • To compare choline levels in breast milk and formula with neonatal choline requirements.
  • To investigate choline ester composition in human milk.

Main Methods:

  • Proton nuclear magnetic resonance spectroscopy (1H-NMR) was used to measure choline in milk samples.
  • Analysis included aqueous (free choline, phosphocholine, glycerophosphocholine) and lipid fractions (phosphatidylcholine, sphingomyelin).
  • Choline content was assessed in colostrum (2-6 days), mature milk (7-22 days), and infant formulas.

Main Results:

  • Choline was detected in both aqueous and lipid fractions of colostrum.
  • Total choline content in breast milk increased by 114% after 6-7 days postpartum, mainly due to phosphocholine and glycerophosphocholine.
  • Most infant formulas had choline levels similar to colostrum, but lower than mature human milk.

Conclusions:

  • Human breast milk choline content doubles post-birth, likely sufficient for healthy term neonates.
  • Many infant formulas may not provide adequate choline compared to mature breast milk.
  • Premature infants, with higher choline demands and lower milk intake, may face inadequate choline supply.
Abstract

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