No description available.

Although it is well-established that the fatty acid profile of breast milk will reflect the dietary fatty acids, the response time with which this occurs is not known. We hypothesized that fatty acids from a given meal would be transferred acutely from chylomicrons into breast milk. To test this hypothesis, the following experiment was performed. Fourteen lactating women drank 700 Calorie breakfast formulas containing six different test fats: 40 grams of cocoa butter, coconut, safflower or canola oil, 20 grams of menhaden oil or 7 grams of herring oil. Each fat contained a specific fatty acid whose appearance was tracked in the milk. After consuming the breakfast formula, subjects collected mid-feeding milk samples at 0, 6, 10, 14 and 24 hours, and one morning sample on days two through seven. Fatty acids specifically tracked in milk samples were: C12:0 (coconut oil), C18:0 (cocoa butter), C18:2n-6 (safflower oil), C18:3n-3 (canola oil), C22:ln-ll (herring oil), and C20:5n-3 and C22:6n-3 (menhaden oil). There was a significant increase in each of these fatty acids in human milk (p<0.001). Elevation of these fatty acids was first observed at 6 hours. Maximum increases of these fatty acids occurred 10 h after safflower oil (177% of baseline), 14 hours after cocoa butter (154%), coconut oil (216%), canola oil (206%) and menhaden oil (C20:5n-3 [1157%]), and 24 hours after the herring oil (2621%) and menhaden oil (C22:6n-3 [506%]). Compared to baseline, these fatty acids were significantly elevated (p<0.05) from 10 to 24 hours. However, after menhaden oil, C20:5n-3 was significantly elevated for 3 days and C22:6n-3 for 2 days. These data support the hypothesis that there is an acute transfer of dietary fatty acids from chylomicrons into human milk. / Graduation date: 1996

No description available.

[Truncated abstract] Mothers who deliver prematurely often have a delay in lactogenesis II and subsequent milk supply. Furthermore, due to the inability of their babies to breastfeed immediately after birth, these mothers are 'pump dependent' during both initiation and establishment of lactation. Apparently, there are no evidence based guidelines for the expression regime but some data suggesting that expression regimes for both breasts should be at least five times per day and at least 100 minutes expressing time per day. The project was set out to document the self selected current expression regimes of the preterm mothers from day 10 to 60 postpartum. It defined how various aspects of breast expression, such as frequency and interval, impact on the synthesis and production of milk. In addition, it determined the variations in the composition of preterm mother's milk. The collection of 24hr expression data and milk samples at each expression of each breast, each day, of 25 preterm mothers (<32 gestation age) from the neonatal intensive care unit in King Edward Memorial Hospital, Western Australia on day 10, 15-20, 30, 40, 50 and 60 postpartum showed that during the 'pump dependent' period (day 10 20), the frequency of expression for both breasts was 6, 6-7, 3-9 times per day (median, IQR, range) and total duration with the pump was 115, 80-160, 32-320 minute per day (median, IQR, range). Furthermore, during the 'transition from exclusively expressing to exclusively breastfeeding' period (day 30-60), frequency of expression/breastfeed and total duration of milk removal (both expressing and breastfeeding) for both breasts were 6, 5-7, 1-9 and 135, 75-170, 25-320, respectively (median, IQR, range). ... These nutrients make up the energy content of milk, thus the energy content of milk also varied greatly between mothers. Therefore, milk from individual preterm mothers varies greatly for individual values for fat, total protein, lactose and energy and this should be taken into account when calculating the level of fortification required for individual babies. The results suggest that when fortifying mother's milk, weekly measurement of fat and protein in milk would provide good estimates on which to base fortification requirements. The concentration of sIgA plus lactoferrin formed 32% of the total proteins in breastmilk. However there was large variations in the concentration of sIgA and lactoferrin (median, IQR, range: 0.82, 0.59-1.13, 0.05-2.93g/l and 2.41, 1.52-3.52, 0.04-8.82g/l, respectively) between mothers. Therefore the level of protection provided by these two proteins could differ greatly between babies. Further research on the relationship between the concentration of sIgA and lactoferrin in milk and the onset of infection would indicate the minimum amount of these proteins needed for the babies to benefit from the immune protection provided by their mother's milk. The hourly breast expression method and regression analysis of actual milk yield and interval since previous expression provides information that identifies the potential milk synthesis capacity of the breasts of the mothers and the impact of the interval between expressions on the milk production of the mothers. This information can be applied to individualize the interval between expression regimes to optimise milk production and minimize the demand on the mother. In addition, determining the changes in the milk composition of individual mothers would provide a more precise base to fortify their milk for their preterm babies.