Urinary excretion of lactose and oligosaccharides in preterm infants fed human milk or infant formula
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S Rudloff1, G Pohlentz, L Diekmann
1Research Institute of Child Nutrition, Dortmund, FRG.
Insights
Human milk oligosaccharides are metabolized differently than those in formula, impacting preterm infant urine composition. Specific human milk oligosaccharides were detected in the urine of infants fed human milk but not formula.
Area of Science:
- Neonatal Nutrition
- Human Milk Composition
- Infant Metabolism
Background:
- Limited understanding of human milk (HM) oligosaccharide absorption and metabolism in preterm infants.
- Investigating differences in renal excretion of lactose and complex oligosaccharides between HM-fed and formula-fed preterm infants.
Purpose of the Study:
- To compare the renal excretion of lactose and oligosaccharides in preterm infants fed human milk versus cow's milk-based infant formula.
- To characterize the specific oligosaccharide profiles in the urine of these infants.
Main Methods:
- Analysis of urine samples from preterm infants fed either HM or formula.
- Quantification of lactose and neutral sugar excretion.
- High-pH anion exchange chromatography with pulsed amperometric detection (HPAE-PAD) and fast atom bombardment-mass spectrometry (FAB-MS) for oligosaccharide characterization.
Main Results:
- Slightly lower renal excretion of lactose in HM-fed infants compared to formula-fed infants.
- Similar excretion of neutral sugars derived from oligosaccharides between the two groups.
- More complex urinary oligosaccharide patterns in HM-fed infants, including HM-specific oligosaccharides like lacto-N-tetraose and lacto-N-fucopentaoses, which were absent in formula-fed infants.
Conclusions:
- Infant nutrition significantly influences the urinary oligosaccharide profile.
- Preterm infants fed human milk excrete HM-specific oligosaccharides, suggesting differential absorption and metabolism compared to formula.
- These findings highlight the unique impact of human milk on infant metabolism.
Abstract:
At present, not much is known about the absorption and metabolism of human milk (HM) oligosaccharides in term and preterm infants. We investigated the renal excretion of lactose and complex oligosaccharides in preterm infants fed HM (n = 9, mean actual body weight 2290 g) or a cow's milk-based infant formula (n = 9, mean actual body weight 2470 g). We found that the renal excretion of lactose in HM-fed infants was slightly lower than in formula-fed infants (14.0 +/- 7.4 versus 20.4 +/- 8.7 mg kg-1 day-1, mean +/- SD). The excretion of neutral sugars deriving from oligosaccharides was similar in HM-fed and formula-fed infants (3.8 +/- 2.1 versus 2.9 +/- 0.9 mg kg-1 day-1); the difference between means was not statistically significant. The separation and characterization of oligosaccharides by high-pH anion exchange chromatography with pulsed amperometric detection (HPAE-PAD) and subsequent analysis by fast atom bombardment-mass spectrometry (FAB-MS) revealed a more complex pattern in HM-fed infants compared to the formula-fed group. Lactose-derived oligosaccharides characteristic for HM (e.g. lacto-N-tetraose, and lacto-N-fucopentaoses I and II) were excreted in HM-fed but not in formula-fed infants. These results indicate that nutrition has a significant impact on the oligosaccharide composition in urine of preterm infants.