According to the research titled, Composition of breast milk from mothers of preterm infants, the influence of daily mechanical expression of breast milk on nutritional composition was examined by comparing expressed milk from 12 mothers who delivered preterm with milk from two groups of mothers delivering at term: nine mothers who mechanically expressed all milk and five mothers who nursed their infants at the breast.

Collections were obtained at four-hour intervals over a period of 24 hours so that variability of constituents in milk of different mothers, as well as variability in the same mother over a 24-hour period, could be assessed.

The study authors report that, “Preterm milk contained significantly higher concentrations of protein, sodium, and chloride, and lower concentrations of lactose than the milk from either group of mothers delivering at term.

Continuing, the study noted that the mean concentrations of protein, sodium, chloride, and potassium in early preterm milk were adequate to meet the estimated requirements for the preterm infant.

However, it said, “there was large variability in nutritional composition of milk among mothers and among samples from the same mother.”

Speaking in an interview with PUNCH HealthWise, Olutekunbi said that milk composition changes with postnatal age.

She noted that preterm milk has a higher protein content than term milk, which helps the baby to achieve growth potentials, especially brain growth and later-life cognitive functions.

The physician further said that electrolytes are slightly higher in preterm milk than term milk, especially sodium and chloride; but it has a lower calcium and phosphate content than term milk.

Electrolytes are minerals that carry an electric charge. They’re found in the blood, urine, and sweat and are vital to specific processes that keep the body functioning as it should.

“Carbohydrate increases in human milk over time, but more so in preterm milk.

Lactose is a crucial energy source in breast milk. Oligosaccharides (human milk oligosaccharides) are prebiotics in breast milk that serve as food for probiotics (live microorganisms also known as the good bacteria) which fight disease-causing bacteria and strengthen the immune system.

“Preterm milk has a higher level of elements that protect against infection and inflammation apart from the prebiotic and probiotics. These include cells that destroy offending organisms and lactoferrin — a protein which aids digestion and improves gut health,” the paediatrician said.

She noted that breast milk is the best form of nutrition for babies, as it provides all the nutritional needs of the growing child.

“It is recommended that all babies be exclusively breastfed for the first six months of life and they should commence complementary feeding at six months, with continued breastfeeding till the age of two,” she said.

On how to improve breast milk quality for children, including preterm babies, Olutekunbi said all breastfeeding mothers must eat well and be well-hydrated.

“Relax, take enough rest and not be anxious; eat balanced meals and be well hydrated

“Pump breasts in-between feeds for non-nutritive suck (preterms); or, in the case of term babies, put baby to the breast for feeding. This is to aid the ‘let-down’ reflex for more breast milk supply to the baby.

“Milk should be pumped from both breasts and breastfeeding mothers should receive prompt medical attention for any illness.

“Breastfeeding mothers should be supported by their husbands and other family members in terms of caring for the baby and helping with house chores,” she said.

The paediatrician said breastfeeding mothers can eat foods that are considered to be galactogogues — that is substances that promote lactation and are usually used to treat low breast milk supply.

“It may be synthetic (drugs) or of food origins such as lactation cookies, whole grains, leafy vegetables, ginger, and some spices,” she noted.

To prevent breast engorgement and pain when a woman has still-born, the pysician advised women to express milk from the breast, just enough to ease pain but not to encourage the production of more milk.

“Use pain relievers for pain, apply cold packs on breasts, wear comfortable, supportive bra with breast pads, not tight bras.

“Consult the doctor immediately if there are tender breast lumps, fever, and flu-like symptoms, because it may be mastitis.

“Doctors may prescribe some medications that can suppress breast milk production if necessary,” Olutekunbi said.

source: Punch