EFFECT OF CONTINUOUS INFUSION ON THE CONTENT AND COMPOSITION OF THE LIPIDS IN HUMAN BREAST MILK

Abstract

Premature newborn infants are often fed breast milk by nasogastric or nasojejeunal infusion in order to provide a constant supply of nutrients. Many lipophilic compounds have been shown to be taken up by infusion tubing. We examined the effect of infusion tubing on the lipid content and fatty acid (FA) composition of breast milk. Frozen breast milk samples were thawed, loaded into a syringe and pumped at 2 ml/hr through infusion tubing. Samples were taken from the syringe reservoir at time 0, 4, 8, 12 hrs and collected under N₂ from the tubing effluent at 0, 1, 2, 3, 4, 8, and 12 hrs. Milk from the tubing effluent at 4 hrs had a small decrease in the percent of oleic (-1.5%), linoleic (-0.6%) and α-linolenic (-0.13%) acids and an increase in the percent of myristic (+1.09%), palmitic (+0.54%), and stearic (+0.49%) acids. These changes were more pronounced in the 12-hr tubing effluent. The polyunsaturated/saturated FA ratio of the milk decreased from an initial value of 1.13 to 1.03 in the 4 hr effluent. The amount of total lipid decreased by a mean of 18% and 24% after infusion for 4 and 12 hrs respectively. Separation of the lipid classes by TLC suggested that the loss of lipids led to an increase in the free FA and decrease in the triglyceride content of the milk. The data indicates that a substantial amount of the lipids (and therefore calories) were lost from human breast milk delivered by continuous infusion. The relative amount of the individual lipid classes may also be altered by interaction with the tubing.

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