Effect of different breast milk extraction techniques on mothers of preterm newborns in the composition of macronutrients

INTRODUCTION: Breast milk is the ideal food for full-term and preterm newborns and its composition varies according to several factors that may be maternal, environmental and even genetic. It can be milked through manual expression or with the aid of a pump (electric or manual). The effect of different milking techniques on the composition of macronutrients is still unclear in the literature. In this way, knowledge of the most effective breast milk extraction techniques, in order to favor a greater concentration of nutrients, becomes essential to enrich a recommendation that guides this expression in mothers of preterm newborns during the period of hospitalization. OBJECTIVES: To analyze the difference in the concentration of macronutrients in the milk of mothers of newborns according to the milk extraction technique (manual milking technique and using an electric pump). METHODOLOGY: A randomized crossover clinical trial was carried out with 32 mothers of preterm newborns admitted to the Neonatal Unit of the Fernandes Figueira National Institute of Women, Children and Adolescent Health (IFF/Fiocruz). 248 samples of raw human milk extracted by electric pump and manual milking were evaluated to evaluate energy macronutrients (proteins, fats and carbohydrates) using the Human Milk Analyzer – MIRIS in the colostrum, transition milk and mature milk phases. RESULTS: We did not observe statistically significant differences between the right and left breasts in pump extraction and manual extraction, however there was a difference in the composition of macronutrients. In colostrum, we observed a higher carbohydrate concentration in manual extraction; In transitional milk, the fat concentration and total energy value were higher in manual extraction and in mature milk, protein and carbohydrate concentrations were higher in electric pump extraction. CONCLUSION: We observed differences in the composition of macronutrients in all phases of human milk depending on the form of extraction. This result can guide recommendations for mothers of preterm newborns admitted to the neonatal unit, in order to provide nutritional support closer to ideal.