Preterm ve Term Bebeklerden Elde Edilen Anne Sütlerinin Makro ve Mikro Besin Bileşimlerinin Karşılaştırmalı Analizi: Beslenme Stratejileri İçin Çıkarımlar

Year 2025, Volume: 14 Issue: 2, 226 - 239, 24.12.2025

Meryem Aydemir Atasever

https://doi.org/10.31196/huvfd.1698662

Abstract

Anne sütü (HM), bebeğin gelişimsel ihtiyaçlarına göre özelleşmiş besinler ve immünolojik bileşenler sağlayan dinamik ve biyolojik olarak aktif bir sıvıdır. HM'nin bileşimi, gebelik yaşı, anne beslenmesi, genetik geçmiş ve çevresel faktörlere bağlı olarak önemli ölçüde değişiklik gösterir. Bu derlemenin amacı, preterm ve term bebeklerden elde edilen HM'nin makro ve mikro besin bileşimlerini sistematik bir şekilde karşılaştırmak ve bu farkların neonatal büyüme, bağışıklık fonksiyonu ve klinik beslenme stratejileri üzerindeki etkilerini değerlendirmektir. Preterm sütü, özellikle protein kalitesi, serbest amino asit içeriği, yağ asidi profili, vitamin konsantrasyonları ve immünolojik faktörler açısından term sütünden belirgin şekilde farklıdır. α-laktalbumin, laktoferrin, sIgA, lizozim ve orta zincirli trigliseritler ile zenginleşmiş olan preterm sütü, bağışıklık fonksiyonu ve nörogelişimi desteklemede önemli bir rol oynar. Ancak, genellikle glutamin, DHA ve demir ile fosfor gibi mineraller gibi temel besin öğeleri bakımından daha düşüktür ve bu nedenle hedeflenmiş takviye gereklidir. Anne diyetinin alımı, vitaminler (örneğin, A, D, B12 ve C) ve yağ asitleri seviyelerini önemli ölçüde etkilerken, genetik polimorfizmler de HM'nin lipid ve oligosakkarit bileşimini etkiler. Preterm ve term HM arasındaki bileşimsel farkların anlaşılması, bireyselleştirilmiş beslenme müdahaleleri için yol gösterici olacaktır. Preterm bebekler, yeterli besin sağlanması, bağışıklık desteği ve optimal nörogelişimsel sonuçlar için anne sütü takviyesi ve anne diyetinin optimize edilmesinden fayda görebilir.

Keywords

Anne sütü , Preterm bebekler , Term bebekler , Makro besinler , Mikro besinler , Beslenme stratejileri

Comparative Analysis of Macronutrient and Micronutrient Composition in Human Milk from Preterm and Term Infants: Implications for Nutritional Strategies

Abstract

Human milk (HM) is a dynamic and bioactive fluid that provides essential nutrients and immunological components tailored to infant developmental needs. The composition of HM varies significantly depending on gestational age, maternal nutrition, genetic background, and environmental factors. This review aims to systematically compare the macronutrient and micronutrient composition of HM from preterm and term infants, and to evaluate the implications of these differences for neonatal growth, immune function, and clinical nutrition strategies. Preterm milk differs markedly from term milk, particularly in protein quality, free amino acid content, fatty acid profile, vitamin concentrations, and immunological factors. It is enriched with α-lactalbumin, lactoferrin, sIgA, lysozyme, and medium-chain triglycerides, offering enhanced support for immune function and neurodevelopment. However, it is often lower in key nutrients such as glutamine, DHA, and minerals like iron and phosphorus, necessitating targeted fortification. Maternal dietary intake significantly affects the levels of vitamins (e.g., A, D, B12, and C) and fatty acids, while genetic polymorphisms also influence the lipid and oligosaccharide composition of HM. Understanding the compositional differences between preterm and term HM is essential for guiding individualized nutritional interventions. Clinically, fortification of preterm HM and alignment with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), the American Academy of Pediatrics (AAP), and the World Health Organization (WHO) guidelines are critical to ensure adequate nutrient delivery and optimal neurodevelopmental outcomes. Future research should focus on the long-term effects of variable DHA and HMO levels, and the influence of maternal nutrition and genetics on milk composition.

Keywords

Human milk , Preterm infants , Term infants , Macronutrients , Micronutrients , Nutritional strategies

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