Leite humano processado em bancos de leite para o recém-nascido de baixo peso: análise nutricional e proposta de um novo complemento Milk from human milk banks for low birthweight newborns: nutritional contents and supplementation

OBJETIVO: Analisar a composição de macro e micronutrientes minerais no leite humano coletado e processado em bancos de leite e desenvolver um complemento que, incorporado a esse leite, satisfaça as exigências nutricionais específicas do recém-nascido de baixo peso. MÉTODO: Para a determinação de macronutrientes, 46 amostras de leite pasteurizado obtidas de dois bancos de leite foram analisadas em triplicata: 26 amostras de leite maduro, 10 de colostro e 10 de leite de mães de bebês prematuros. Em 30 dessas amostras (10 de cada tipo) foram determinados também os micronutrientes. Após a determinação dos macro e micronutrientes, desenvolveu-se um complemento de simples preparo, composto de hidrolisado protéico e minerais quelatos. RESULTADOS: A composição variou tanto entre os diferentes tipos de leite quanto entre doadoras do mesmo tipo de leite. Os valores de micro e macronutrientes foram inferiores às necessidades dos recém-nascidos de baixo peso. A composição média observada (e desvio-padrão) para leite maduro, colostro e leite de mães de prematuros foi: lipídios (g/100 mL), 2,56 (± 0,8), 2,48 (± 0,91), 2,48 (± 0,76); lactose (g/100 mL), 8,6 (± 0,93), 7,05 (± 0,92), 6,56 (± 1,41); proteínas (g/100 mL), 1,07 (± 0,22), 1,71 (± 0,29), 1,72 (± 0,4); calorias (kcal/100 mL), 61,67 (± 8,92), 57,36 (± 8,37), 55,44 (± 8,00); cálcio (mg/100 mL), 17,88 (± 5,56), 22,75 (± 10,24), 22,03 (± 9,39); magnésio (mg/ 100 mL), 2,15 (± 0,39), 2,64 (± 0,67), 2,16 (± 0,26); potássio (mg/100 mL), 35,53 (± 7,54), 43,75 (± 14,32), 44,37 (± 12,83); sódio (mg/100 mL), 16,27 (± 5,92), 43,36 (± 11,34), 37,98 (± 11,34); zinco (mg/100 mL), 0,46 (± 0,26), 0,75 (± 0,25), 0,72 (± 0,26); fósforo (mg/100 mL), 9,98 (± 1,72), 9,31 (± 4,30), 8,47 (± 2,43). Com a adição do complemento, os níveis de proteína e dos minerais estudados passaram a se enquadrar nas recomendações para recém-nascidos de baixo peso. CONCLUSÃO: Com base nos resultados obtidos é justificável a complementação do leite armazenado em bancos para uso por recém-nascidos de baixo peso. O complemento desenvolvido mostrou viabilidade operacional, não interferindo na qualidade microbiológica do leite humano.OBJECTIVE: To determine the macronutrient and micronutrient contents of human milk from milk banks as well as to develop a supplement for addition to this milk that could satisfy the specific nutritional requirements of low birthweight newborns. METHOD: For the determination of macronutrients, 46 samples of pasteurized milk obtained from two milk banks were analyzed in triplicate: 26 samples of mature milk, 10 samples of foremilk and 10 samples of milk from mothers of preterm babies. Thirty of these samples (10 of each type of milk) were also analyzed for their micronutrient content. Following the determination of macronutrients and micronutrients, an easy-to-prepare supplement was developed. The supplement was made from protein hydrolysate powder and chelate minerals. RESULTS: The nutritional content varied both among the different types of milk and among the donors of the same type of milk. The levels of macronutrients and micronutrients were below the requirements for low birthweight newborns. The mean composition (and standard deviation) observed for mature milk, foremilk, and preterm milk, respectively, was as follows: fats (g/100 mL), 2.56 (± 0.8), 2.48 (± 0.91), 2.48 (± 0.76); lactose (g/100 mL), 8.6 (± 0.93), 7.05 (± 0.92), 6.56 (± 1.41); protein (g/ 100 mL), 1.07 (± 0.22), 1.71 (± 0.29), 1.72 (± 0.4); calories (kcal/100 mL), 61.67 (± 8.92), 57.36 (± 8.37), 55.44 (± 8.00); calcium (mg/100 mL), 17.88 (± 5.56), 22.75 (± 10.24), 22.03 (± 9.39); magnesium (mg/100 mL), 2.15 (± 0.39), 2.64 (± 0.67), 2.16 (± 0.26); potassium (mg/100 mL), 35.53 (± 7.54), 43.75 (± 14.32), 44.37 (± 12.83); sodium (mg/100 mL), 16.27 (± 5.92), 43.36 (± 11.34), 37.98 (± 11.34); zinc (mg/100 mL), 0.46 (± 0.26), 0.75 (± 0.25), 0.72 (± 0.26); and phosphorus (mg/100 mL), 9.98 (± 1.72), 9.31 (± 4.30), 8.47 (± 2.43). After the addition of the supplement, the protein and mineral contents reached the levels recommended for low birthweight newborns. CONCLUSION: Based on our results obtained, the supplementation of human milk from milk banks is warranted for use with low birthweight newborns. The proposed supplement was shown to be practical and safe, and it did not interfere with the microbiological quality of human milk