Dietary Protein Intake, Breast Feeding and Growth in Human Milk Fed Preterm Infants

Emma Tonkin, Jacqueline Miller, Maria Makrides, Andrew McPhee, Scott Morris, Robert Gibson, Carmel Collins

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
9 Downloads (Pure)


Protein intakes of preterm infants are frequently below recommendations, but few studies report accurate intakes due to the difficulty of analysing human milk clinically. This observational analysis from a randomised trial of infants born <31 weeks’ gestation, investigating two levels of protein fortification, reports protein intakes compared with requirements and determines the association of direct breastfeeding on growth. Ninety-two infants (median gestational age 28 weeks, Interquartile range (IQR) 26-29; mean birth weight 1040 g, SD 300 g) were studied. Infants born weighing <1000 g were underfed protein compared with recommendations (median (IQR) intake of 3.0 (2.0-3.7) g/kg/day in week 2 versus recommendation of 4-4.5 g/kg/day), while those born weighing ≥1000 g met recommended protein intakes after the first week of life (median (IQR) intake of 3.7 (3.0-4.0) g/kg/day in week 2 versus recommendation of 3.5-4.5 g/kg/day). A moderate, negative correlation between the mean number of breast feeds and change in rate of weight gain (r = –0.37, p = 0.001) was found. Protein intakes of infants <1000 g did not meet recommendations and all infants were underfed protein and energy in the first week of life. Current protein fortification is inadequate for infants born <1000 g. Exploratory analysis showed faltering rate weight gain associated with increasing number of breast feeds and these results warrant confirmation.

Original languageEnglish
Article number1196
JournalInternational Journal of Environmental Research and Public Health
Issue number6
Publication statusPublished - 7 Jun 2018

Bibliographical note

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited


  • breast feeding
  • dietary proteins
  • enteral nutrition
  • infant - premature
  • milk - human
  • weight gain
  • Dietary proteins
  • Enteral nutrition
  • Milk-human
  • Infant-premature
  • Breast feeding
  • Weight gain


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