Plasma Amino Acid Differences in Very Low Birth Weight Infants Fed either Human Milk or Whey-Dominant Cow Milk Formula

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Abstract
Midmorning plasma amino acid levels were measured in 31 healthy, very low birth weight infants (mean age 16 days, mean birth weight 1180 g, gestation 29 wk) during 96-h balance studies. All infants received continuous enteral infusion of isonitrogenous, isocaloric preparations of either human milk fortified with pasteurized, lyophilized fractions of mature human milk (n = 18) or whey-dominant cow milk-based formula (n = s13). Weight gain (15 g/kg/day), nitrogen retention (303 mg/kg/day), and metabolizable energy (104 kcal/kg/day) were similar between groups. Plasma levels of threonine, valine, and the sum of essential amino acids were significantly greater in the whey-dominant formula-fed infants (p < 0.01). Taurinend cystine were measured in significantly greater concentrations in the fortified human milk and threonine, valine, methionine, and lysine in the whey-dominant cow milk formula (p < 0.01). Relationships between plasma aminoacid levels and indices of nitrogen utilization differed between groups. These differences suggest that further modifications of whey-dominant formulas may be indicated.