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Related Experiment Video

Updated: Mar 16, 2026

Individualized Reconstitution of Human Milk Microbiota: A Feasible Approach in Real-World Settings
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Preterm human milk composition: a systematic literature review.

Catherine Boyce1, Mistral Watson1, Grace Lazidis1

  • 11Faculty of Medicine, Dentistry and Health Sciences,The University of Western Australia,35 Stirling Highway,Crawley,WA 6009,Australia.

The British Journal of Nutrition
|August 16, 2016
PubMed
Summary

Variations in preterm breast milk composition and analysis quality affect milk fortification. Current industry practices may not meet protein targets for very low birth weight infants, highlighting the need for improved fortification strategies.

Keywords:
BMF breast milk fortifiersBreast milkCompositionEBM expressed breast milkFortificationMacronutrientsNPN non-protein nitrogenPER protein:energy ratioPN protein nitrogenPreterm infantsTN total nitrogen

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Area of Science:

  • Neonatal Nutrition
  • Human Milk Composition
  • Infant Fortification

Background:

  • Significant variability exists in macronutrient fortification of preterm human milk.
  • Inconsistent milk analysis quality and inter/intra-mother variations in milk composition contribute to fortification discrepancies.
  • Current fortification practices may not meet the nutritional needs of preterm infants, particularly those weighing less than 1000g.

Purpose of the Study:

  • To systematically review and present macronutrient data for human preterm milk.
  • To provide updated information for the breast milk fortifier industry.
  • To guide future formulation of breast milk fortifiers to meet infant needs.

Main Methods:

  • Systematic literature review of studies published between 1959 and 2013.
  • Included articles reporting macronutrient or energy content in human preterm milk sampled over 24 hours.
  • Utilized data from studies with high-quality analyses, presenting results for weeks 1-8 of lactation.

Main Results:

  • Preferred mean macronutrient values for colostrum (week 1) and mature milk (weeks 2-8) were determined (e.g., protein: 1.27 g/100ml, fat: 3.46 g/100ml).
  • Industry fortification based on these means may not achieve protein targets for infants <1000g if intake is <170-190 ml/kg/d.
  • The protein:energy ratio in fortified milk was found to be inadequate for some preterm infants.

Conclusions:

  • Accurate macronutrient analysis of preterm breast milk is crucial for appropriate fortification.
  • Improved understanding of milk composition can optimize fortification levels to meet infant growth and nutritional targets.
  • Standardized reporting of nutritional outcomes is needed to assess fortification efficacy.