Long‐Chain Polyunsaturated Fatty Acids and Lipid Peroxidation Products in Donor Human Milk in the United Kingdom: Results From the LIMIT 2‐Centre Cross‐Sectional Study.

Abstract

Background: Donor human milk is increasingly used as alternative to mother’s own milk to feed preterm infants, however, it may provide less long-chain polyunsaturated fatty acid (LCPUFA), and more oxidised lipids, which may be detrimental for preterm infant health and development. Levels have not been reported for donor human milk in the U.K. Methods: Donor human milk (n=19) from two neonatal units, milk from preterm mothers from a neonatal unit (n=10), and term mothers from the community (n=11) were analysed for fatty acid, malondialdehyde, 4-hydroxy-2-nonenal, and hexanal content. Study registration: NCT03573531 Results: Donor human milk had significantly lower absolute LCPUFA content compared to term milk (P<0.001) and significantly lower omega-3 PUFAs than preterm milk (P<0.05), although relative LCPUFA composition did not differ. Exclusive donor human milk feeding leads to significantly lower fat (3.7 vs. 6.7 g/d) and LCPUFA (DHA: 10.6 vs. 16.8 mg/d; ARA: 17.4 vs. 25.2 mg/d) intake than recommended by ESPGHAN, and provides only 17.3% and 43.1% of the in utero accreted ARA and DHA. Donor human milk also had the highest proportion of lipid peroxidation. Conclusions: This study confirms that donor human milk in the U.K. has insufficient levels of LCPUFAs for preterm infants. It demonstrates for the first time that donor human milk has the highest level of lipid peroxidation, compared to preterm or term milk. This has important implications for preterm infant nutrition, as exclusive donor human milk feeding might not be suitable long-term, and may contribute to the development of major preterm neonatal morbidities.