Breast Milk for Premature Infants: Nutritive and health Aspects

Breast milk is considered to be the only and the best nutrition for newborn infants until six months of age. However, some of the most important problems regarding the nutrition of infants after preterm delivery are due to the fact that preterm milk is produced before complete maturation of mammary glands and that the preterm infant’s gastrointestinal tract is not mature enough at the time of partition. Since human milk has unique properties in promoting gastrointestinal maturation and immunological benefits, it is very important to implement strategies of fortification to appropriately actuate its benefits. Donor breast milk from milk banks is widely used when mother’s own milk is not available or when it is in short supply for preterm infants. While donor breast milk retains some of the biological properties and clinical benefits of mother’s own milk, it requires additional care in terms of fortification, especially if the donor milk is from a pool of term breast milk which is somewhat different than preterm breast milk. As nutritional strategies improve, the ultimate goal is to minimize extrauterine growth restriction and promote appropriate growth and development of premature infants. Another problem with breast milk, which is quite often overlooked, is that after six months, there is not enough of essential microelements (Zn, Fe and Cu) to satisfy baby’s needs, and therefore, the milk must be effectively supplemented. In this chapter we review the following aspects of breast milk for preterm infants: 1) The main nutritive factors of breast milk; 2) The use of fortifier as breast milk supplement; 3) Significance of microelements in preterm nutrition; and 4) Health outcomes of breast milk for preterm infants