Objective: To study the association of fatty acid composition in human milk with breast milk jaundice (BMJ) in neonates.
Methods: A total of 30 full-term neonates who were admitted to the neonatal intensive care unit from October 2016 to October 2017 and were diagnosed with late-onset BMJ were enrolled as the BMJ group. Thirty healthy neonates without jaundice or pathological jaundice who were admitted to the confinement center during the same period of time were enrolled as the control group. Related clinical data were collected, including sex, mode of birth, feeding pattern, gestational age, birth weight, gravida, parity, and peak level of total serum bilirubin. Breast milk was collected from the mothers, and the MIRIS human milk analyzer was used to measure macronutrients (fat, protein, and carbohydrate) and calorie. Gas chromatography was used to analyze the content of different fatty acids in breast milk.
Results: The control group had higher levels of macronutrients in human milk than the BMJ group, with significant differences in fat, dry matter, and calorie (P < 0.05). In addition, 25 fatty acids were detected in breast milk, including 9 saturated fatty acids, 6 monounsaturated fatty acids, and 10 polyunsaturated fatty acids. The comparison of the percentage composition of different fatty acids showed that compared with the control group, the BMJ group had significantly lower percentage compositions of C15:0, C16:0, C17:0, C18:0, C20:0, C18:1n9t, C20:1n9, C18:3n6, C22:2, and C22:6n3 (DHA) and higher percentage compositions of C10:0, C12:0, C14:0 in breast milk (P < 0.05).
Conclusions: Some macronutrients and fatty acid composition in human milk may be associated with the pathogenesis of BMJ in neonates.
目的: 探讨人乳中不同脂肪酸组分与新生儿母乳性黄疸（BMJ）的相关性。
方法: 选取2016年10月至2017年10月入住该院新生儿重症监护室，临床诊断为晚发性母乳性黄疸的足月儿作为BMJ组，同期入住月子会所的无黄疸或无病理性黄疸健康新生儿为对照组，每组30例。分别收集两组新生儿的临床资料（包括性别、出生方式、喂养方式、胎龄、出生体重、胎次、产次及总胆红素峰值）及其母亲乳汁，使用MIRIS母乳分析仪检测人乳脂肪、蛋白质、碳水化合物等宏量营养素含量和热卡，采用气相色谱法分析母乳中不同脂肪酸组分含量。
结果: 对照组人乳各种宏量营养素组分均高于BMJ组，其中脂肪、干物质和热卡差异有统计学意义（P < 0.05）。另测得母乳脂肪酸共25种，其中饱和脂肪酸9种，单不饱和脂肪酸6种，多不饱和脂肪酸10种。比较两组不同脂肪酸百分含量发现，BMJ组人乳中C15：0、C16：0、C17：0、C18：0、C20：0、C18：1n9t、C20：1n9、C18：3n6、C22：2、C22：6n3（DHA）等10种长链脂肪酸百分含量均低于对照组，3种脂肪酸C10：0、C12：0、C14：0百分含量均高于对照组（P < 0.05）。
结论: 部分人乳宏量营养素及脂肪酸组分可能与新生儿母乳性黄疸发生机制有关。