Impact of perinatal factors on breast milk composition and volume in preterm infants

Abstract Maternal age, type of delivery, and newborn sex can influence the volume and composition of human milk (HM) expressed by mothers of premature infants. Initiating and maintaining breastfeeding in these mothers is a significant challenge, and records of milk volume expressed during the first...

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Main Authors: María del Carmen Fernández-Tuñas, Lorena Torres-López, Sandra Vidal-Martínez, Nuria García-Couceiro, Alejandro Pérez-Muñuzuri, María L. Couce
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04740-8
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author María del Carmen Fernández-Tuñas
Lorena Torres-López
Sandra Vidal-Martínez
Nuria García-Couceiro
Alejandro Pérez-Muñuzuri
María L. Couce
author_facet María del Carmen Fernández-Tuñas
Lorena Torres-López
Sandra Vidal-Martínez
Nuria García-Couceiro
Alejandro Pérez-Muñuzuri
María L. Couce
author_sort María del Carmen Fernández-Tuñas
collection DOAJ
description Abstract Maternal age, type of delivery, and newborn sex can influence the volume and composition of human milk (HM) expressed by mothers of premature infants. Initiating and maintaining breastfeeding in these mothers is a significant challenge, and records of milk volume expressed during the first few days are crucial for sustaining adequate production. To assess HM production in mothers of preterm infants during the first 15 days of life, examining the relationship between production, type of delivery, and maternal age. Additionally, we aim to analyze the macronutrient composition of HM based on various factors, such as the infant’s sex, type of delivery, and maternal age. This is a prospective longitudinal study conducted over 2 years, evaluating HM production and macronutrient composition in 45 mothers of 52 premature infants born at ≤ 32 weeks of gestational age and/or weighing ≤ 1500 g, admitted to the NICU of the University Clinical Hospital of Santiago de Compostela, a Level III Q3+ facility. The study focused on the first 15 days of life, recording the volume of milk expressed and collecting milk samples on days 3, 7, and 15 for nutritional analysis of macronutrients. The study examined the influence of maternal age, type of delivery, and newborn sex on these factors. Vaginal deliveries and maternal age < 35 years were associated with a trend toward greater volumes of milk expressed compared to cesarean deliveries and maternal age ≥ 35 years. If the amount of HM expressed on day 4 was less than 140 mL/day, it significantly predicted a total expression of < 500 mL/day by day 15. We found that 64.3% of our sample expressed less than 140 mL/day on day 4, and 73.8% of these mothers did not reach 500 mL/day by day 15. Regarding macronutrients, HM contained more fat following vaginal delivery compared to cesarean delivery, with significant differences observed on day 3 of life. No differences were observed based on maternal age or newborn sex. In conclusion, HM production on day 4 is a good predictor of production by day 15; maternal age and cesarean delivery seem to negatively influence HM production; the composition of HM shows higher fat content in the colostrum of mothers who had vaginal deliveries.
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spelling doaj-art-3ff18f3f8d03457cb48537f5fc13ba9b2025-08-20T03:10:32ZengNature PortfolioScientific Reports2045-23222025-06-011511910.1038/s41598-025-04740-8Impact of perinatal factors on breast milk composition and volume in preterm infantsMaría del Carmen Fernández-Tuñas0Lorena Torres-López1Sandra Vidal-Martínez2Nuria García-Couceiro3Alejandro Pérez-Muñuzuri4María L. Couce5Department of Neonatology, University Clinical Hospital of Santiago de CompostelaDepartment of Neonatology, University Clinical Hospital of Santiago de CompostelaTeaching Area, University Clinical Hospital of Santiago de CompostelaFaculty of Nursing, University of Santiago de CompostelaDepartment of Neonatology, University Clinical Hospital of Santiago de CompostelaDepartment of Neonatology, University Clinical Hospital of Santiago de CompostelaAbstract Maternal age, type of delivery, and newborn sex can influence the volume and composition of human milk (HM) expressed by mothers of premature infants. Initiating and maintaining breastfeeding in these mothers is a significant challenge, and records of milk volume expressed during the first few days are crucial for sustaining adequate production. To assess HM production in mothers of preterm infants during the first 15 days of life, examining the relationship between production, type of delivery, and maternal age. Additionally, we aim to analyze the macronutrient composition of HM based on various factors, such as the infant’s sex, type of delivery, and maternal age. This is a prospective longitudinal study conducted over 2 years, evaluating HM production and macronutrient composition in 45 mothers of 52 premature infants born at ≤ 32 weeks of gestational age and/or weighing ≤ 1500 g, admitted to the NICU of the University Clinical Hospital of Santiago de Compostela, a Level III Q3+ facility. The study focused on the first 15 days of life, recording the volume of milk expressed and collecting milk samples on days 3, 7, and 15 for nutritional analysis of macronutrients. The study examined the influence of maternal age, type of delivery, and newborn sex on these factors. Vaginal deliveries and maternal age < 35 years were associated with a trend toward greater volumes of milk expressed compared to cesarean deliveries and maternal age ≥ 35 years. If the amount of HM expressed on day 4 was less than 140 mL/day, it significantly predicted a total expression of < 500 mL/day by day 15. We found that 64.3% of our sample expressed less than 140 mL/day on day 4, and 73.8% of these mothers did not reach 500 mL/day by day 15. Regarding macronutrients, HM contained more fat following vaginal delivery compared to cesarean delivery, with significant differences observed on day 3 of life. No differences were observed based on maternal age or newborn sex. In conclusion, HM production on day 4 is a good predictor of production by day 15; maternal age and cesarean delivery seem to negatively influence HM production; the composition of HM shows higher fat content in the colostrum of mothers who had vaginal deliveries.https://doi.org/10.1038/s41598-025-04740-8Premature newbornBreastfeedingVolumeMacronutrientsMaternal ageType of delivery
spellingShingle María del Carmen Fernández-Tuñas
Lorena Torres-López
Sandra Vidal-Martínez
Nuria García-Couceiro
Alejandro Pérez-Muñuzuri
María L. Couce
Impact of perinatal factors on breast milk composition and volume in preterm infants
Scientific Reports
Premature newborn
Breastfeeding
Volume
Macronutrients
Maternal age
Type of delivery
title Impact of perinatal factors on breast milk composition and volume in preterm infants
title_full Impact of perinatal factors on breast milk composition and volume in preterm infants
title_fullStr Impact of perinatal factors on breast milk composition and volume in preterm infants
title_full_unstemmed Impact of perinatal factors on breast milk composition and volume in preterm infants
title_short Impact of perinatal factors on breast milk composition and volume in preterm infants
title_sort impact of perinatal factors on breast milk composition and volume in preterm infants
topic Premature newborn
Breastfeeding
Volume
Macronutrients
Maternal age
Type of delivery
url https://doi.org/10.1038/s41598-025-04740-8
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