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Fatty acid balance studies in preterm infants fed formula milk containing long-chain polyunsaturated fatty acids
C Morgan1, J Stammers, J Colley
1Department of Paediatrics, North Staffordshire Hospital, Nottingham, UK.
Insights
A new milk formula for preterm infants showed similar fat absorption to standard formula, but human milk provided better long-chain polyunsaturated fatty acid (LCP) absorption.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Biochemistry
Background:
- A novel milk formula, Prematil-LCP, enriched with long-chain polyunsaturated fatty acids (LCP) to mimic breast milk's fatty acid profile, is now available for preterm infants.
- Understanding the absorption and utilization of LCPs in preterm infants is crucial for optimizing their growth and development.
Purpose of the Study:
- To compare the fatty acid absorption, specifically LCPs, between Prematil-LCP, standard Prematil formula, and human milk in preterm infants.
- To assess the impact of different feeding regimens on LCP bioavailability and plasma lipid profiles.
Main Methods:
- A double-blind randomized controlled trial involving 30 preterm infants, divided into three groups: Prematil-LCP (n=10), standard Prematil (n=10), and human milk (n=11).
- Three-day fat balance studies were conducted once full enteral feeding was established.
- Plasma samples were analyzed on the final day to determine fatty acid composition.
Main Results:
- Total fat absorption percentages were comparable between Prematil (82.0%) and Prematil-LCP (82.9%), but lower than human milk (87.8%).
- All groups showed detectable LCP excretion, with significantly higher LCP disappearance in the human milk group compared to Prematil-LCP, especially for n-6 LCP (p < 0.01).
- Despite differences, excreted LCP represented less than 30% of the dietary intake in the Prematil-LCP group. Plasma lipid fatty acid composition varied according to dietary LCP intake.
Conclusions:
- Prematil-LCP demonstrates adequate fat absorption in preterm infants, comparable to standard formula.
- Human milk supports superior absorption and utilization of long-chain polyunsaturated fatty acids (LCPs) compared to Prematil-LCP.
- Further research may be needed to optimize LCP content and bioavailability in preterm infant formulas.
Abstract:
A milk formula (Prematil-LCP) containing long-chain polyunsaturated fatty acids (LCP) and with a fatty acid profile closely resembling breast milk has recently been introduced for preterm infants. A double-blind randomized controlled trial was performed comparing fatty acid absorption from Prematil-LCP (n=10) and standard Prematil (n=10). Formula-fed preterm infants underwent 3 d fat balances (once full enteral feeds were established) along with a parallel human milk fed group (n=11). Plasma samples were taken on the last day. Median total fat excretion (absorption, %) was 2.34g kg(-1) (82.0), 2.64g kg(-1) (82.9) and 1.65g kg(-1) (87.8) with Prematil, Prematil-LCP and human milk feeding, respectively. This reflected differences in the excretion and absorption of long-chain saturated fatty acids. All groups excreted detectable LCP. LCP disappearance was higher in infants fed human milk than in those fed Prematil-LCP, particularly for n-6 LCP (p < 0.01). Nevertheless, excreted LCP equated to < 30% dietary intake, with Prematil-LCP feeding. Plasma lipid fatty acid composition reflected differences in dietary LCP intake.