Choline Content of Term and Preterm Infant Formulae Compared to Expressed Breast Milk-How Do We Justify the Discrepancies?

Choline/phosphatidylcholine concentrations are tightly regulated in all organs and secretions. During rapid organ growth in the third trimester, choline requirement is particularly high. Adequate choline intake is 17-18 mg/kg/day in term infants, whereas ~50-60 mg/kg/day is required to achieve fetal...

Full description

Saved in:
Bibliographic Details
Published in:Nutrients 2020-12, Vol.12 (12), p.3815
Main Authors: Shunova, Anna, Böckmann, Katrin A, Minarski, Michaela, Franz, Axel R, Wiechers, Cornelia, Poets, Christian F, Bernhard, Wolfgang
Format: Article
Language:English
Subjects:
Babies
Breast
Breast milk
Breastfeeding & lactation
Chloride
Choline
Enteral feeding
Enteral nutrition
Fetuses
formula
fortification
Gestational age
glycerophosphocholine
Homocysteine
Infants
Lecithin
Mass spectrometry
Mass spectroscopy
maternal milk
Metabolites
Milk
Neonates
Newborn babies
Nutrition
Organs
Phosphatidylcholine
Phosphocholine
Placenta
Plasma
Premature babies
Scientific imaging
Secretions
Standard deviation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Choline/phosphatidylcholine concentrations are tightly regulated in all organs and secretions. During rapid organ growth in the third trimester, choline requirement is particularly high. Adequate choline intake is 17-18 mg/kg/day in term infants, whereas ~50-60 mg/kg/day is required to achieve fetal plasma concentrations in preterm infants. Whereas free choline is supplied via the placenta, other choline carriers characterize enteral feeding. We therefore quantified the concentrations and types of choline carriers and choline-related components in various infant formulae and fortifiers compared to breast milk, and calculated the supply at full feeds (150 mL/kg/day) using tandem mass spectrometry. Choline concentration in formula ranged from values below to far above that of breastmilk. Humana 0-VLB (2015: 60.7 mg/150 mL; 2020: 27.3 mg/150 mL), Aptamil-Prematil (2020: 34.7 mg/150 mL), Aptamil-Prematil HA (2020: 37.6 mg/150 mL) for preterm infants with weights < 1800 g, and Humana 0 (2020: 41.6 mg/150 mL) for those > 1800 g, comprised the highest values in formulae studied. Formulae mostly were rich in free choline or phosphatidylcholine rather than glycerophosphocholine and phosphocholine (predominating in human milk). Most formulae (150 mL/kg/day) do not supply the amounts and physiologic components of choline required to achieve fetal plasma choline concentrations. A revision of choline content in formulae and breast milk fortifiers and a clear declaration of the choline components in formulae is required to enable informed choices.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu12123815