Review of Preterm Human-Milk Nutrient Composition

Area of Science:

• Neonatal Nutrition
• Human Milk Composition
• Infant Growth and Development

Background:

• Human milk-fed preterm infants face risks of growth failure, nutrient deficiencies, and neurocognitive delays.
• While beneficial, human milk alone does not meet the high nutritional demands of preterm infants, necessitating fortification.
• Current fortification practices rely on assumed preterm human milk composition, highlighting a need for accurate data.

Purpose of the Study:

• To systematically review existing evidence on macronutrient and micronutrient concentrations in preterm human milk.
• To identify critical knowledge gaps in the compositional data of preterm human milk.

Main Methods:

• Conducted a literature search of PubMed and CINAHL databases.
• Included original research articles published from January 1950 to December 2019.
• Analyzed data from 27 articles reporting on macronutrient and micronutrient content.

Main Results:

• Most recent studies (post-2011) focused on macronutrients and infants born between 28-36 weeks gestation.
• Significant variability exists in milk collection, study design, and analytical methods across studies.
• Limited geographical representation, with a notable lack of studies from certain regions and on specific maternal populations.

Conclusions:

• Literature lacks representation of African American women and infants born before 28 weeks gestation.
• Comprehensive and representative human milk nutrient data are essential for accurate and targeted fortification.
• Aggregated data reveal trends in macronutrient and micronutrient composition related to lactation stage and gestational age, aiding feeding plan design.