Circadian changes in the composition of human milk macronutrients depending on pregnancy duration: a cross-sectional study

Abstract

Background: The purpose of this study was to evaluate the circadian variation of human milk macronutrients and energy content depending upon pregnancy duration. Methods: One hundred eighty fresh human milk samples from 45 mothers (27 of preterm and 18 of full-term newborns) were collected on a single day chosen between the 14th to 16th day after delivery. The samples were taken four times per day at 12 PM, 6 PM, 12 AM and 6 AM. Only lactating women, who could not breastfeed their hospitalized newborns and expressed milk by breast pump, were enrolled in the study. Human milk macronutrient composition and energy count were evaluated by mid-infrared spectrophotometry. Results: Significant differences in macronutrient content were observed between 6 AM and 12 PM for mean protein content (t = - 4.62, df = 44, p < 0.001), for mean fat content (t = - 2.10, df = 44, p = 0.04) and for mean energy content (t = - 2.24, df = 44, p = 0.03); between 6 AM and 6 PM for mean protein content (t = - 2.41, df = 43, p = 0.02), for mean fat content (t = - 3.76, df = 43, p = 0.001) and for mean energy content (t = - 3.85, df = 43, p < 0.001); between 12 PM and 12 AM for mean protein content (Wilcoxon test V = 75.5, p = 0.001), for mean fat content (t = 2.50, df = 44, p = 0.02) and for mean energy content (t = 2.74, df = 44, p = 0.01); between 6 PM and 12 AM for mean protein content (V = 229, p = 0.02), for mean fat content (t = 4.39, df = 43, p < 0.001) and for mean energy content (t = - 4.57, df = 43, p < 0.001). The average content of carbohydrates did not change significantly during the 24 h. The samples of preterm newborns' mothers had more apparent diurnal fluctuations in macronutrient content. Conclusions: Our study revealed significant diurnal variations in protein and fat in human milk, and these circadian fluctuations were more apparent in the milk of mothers of preterm infants.