臺灣博碩士論文加值系統

母乳是嬰兒最佳的營養來源，當早產兒的母親無法提供母乳給自己的嬰兒時，可改由來自母乳庫的捐贈乳，本研究由民國九十四年二月至九十四年八月收集臺北市立聯合醫院40位捐乳婦女，包含產後1-17月的249個捐乳樣本，分析母乳中三大營養及鐵、鎂、磷、銅、鈣、鋅、硒、鋁的含量，進而評估餵食母乳庫捐贈乳之新生兒礦物質攝取狀況，並找出簡單預測母乳礦物質之因子。各成份含量為水份88±2％；熱量百分比分別為：蛋白質8±2％；脂肪28±8％；鈣21.7 ± 6.4 mg/100 ml；鎂3.26 ± 0.54 mg/100 ml；磷 9.30 ± 1.56 mg/100 ml；銅20.79 ± 11μg/100 ml；鐵126.4 ± 32.2 μg/100 ml；鋅78.07 ± 62.46 μg/100 ml；硒1.27 ± 0.31μg/100 ml；鋁為108.3 ± 24.2 μg/L，除水份、脂肪、鎂、鈣、鋁外，蛋白質及其他礦物質隨著哺乳期增加有顯著的降低；生產一胎的捐贈乳鈣含量較生產胎數大於一胎者高（P<0.05）；鈣含量與捐乳婦女年齡呈負相關(P<0.05，r= -0.66)；硒含量與出生新生兒體重成正相關(P<0.05，r = 0.66)。由本研究結果估算接受捐贈乳的新生兒礦物質攝取量，其值皆低於建議量；而鋁在安全攝取範圍內，本研究可作為評估使用捐乳的新生兒生長發育情形之參考。

Human milk is considered to be the optimal nutritional source for the infant. When mother’s own milk is not available, one of the alternatives is donor milk from human milk bank. Human milk samples during the period of 1 to 17 months of lactation were collected from 40 donor women in Taipei City Hospital from February to August 2005. The proximal composition, calcium, phosphorus, magnesium, iron, copper, zinc, selenium and aluminium contents in the breast milk were analyzed. Then, dietary mineral intakes of newborn from human milk bank were evaluated. The results indicated that H2O, content of the breast milk was 88±2% while protein, fat and carbohydrate were 28± 8%,, 8±2﹪and 64±8﹪(% calories) respectively。Macro-mineral contents (Ca, P and Mg) of the breast milk were 21.7 ± 6.4, 9.30 ± 1.56 and 3.26 ± 0.54 mg/100 ml. The trace elements concentrations of the milk samples were as following: iron, 126.4±32.2 mg/100 ml; copper, 20.79 ± 11μg/100 ml；zinc, 78.07 ± 62.46 μg/100 ml；selenium, 1.27 ± 0.31μg/100 ml and aluminium, 108.3 ± 24.2 μg/L. Except H2O、 fat、 carbohydrate、, magnesium、 calcium and aluminum, protein and other mineral markedly decrease as the lactation prolonged. The calcium content was higher（P<0.04）in the milk of primiparous mother than that from non-primiparous ones. The negative correlation between calcium content in the milk and maternal age（P<0.02，r= -0.66）, but the positive correlation between infant birth weight and calcium content in the milk（P<0.03，r = 0.66）were shown. The results showed dietary mineral intakes of premature infants fed with breast milk from human bank milk was lower than the recommended levels. On the other hand aluminum intake is in the safe range.

～目 錄～
頁次
第一章 前言………………………………………………………………………………..1
第二章 文獻回顧…………………………………………………………………………..2
一、捐贈乳之使用……………………………………………………………………..2
二、評估影響母乳中乳脂肪含量之因子……………………………………………..4
三、母乳中礦物質缺乏與生物利用率………………………………………………..5
四、母乳礦物質濃度可能影響因素之研究………..………………………………..9
研究目的……………………………………………………………………………..11
第三章 材料與方法………………………………………………………………………..12
一、母乳捐贈者資料及捐贈乳樣本收集…………………………………………..12
二、捐贈乳樣本之分析……………………………………………………………..13
第四章 統計方法………………………………………………………………………….26
第五章 結果……………………………………………………………………………….27
一、母乳捐贈者之基本資料……………………………………………………….27
二、建立母乳庫捐乳營養素基本資料…………………………………………….27
三、分析不同哺乳期，捐乳中營養素之變化…………………………………….27
四、不同胎數捐贈者捐乳中礦物質含量之比較………………………………….28
五、捐贈乳者年齡與新生兒體重和第1-2月乳汁礦物質含量的相關性……….28
第六章 討論………………………………………………………………………………29
一、母乳中礦物質各含量與基本資料的相關性探討……………………………29
二、探討母乳中營養素與礦物質隨著哺乳時期之變化並設定最佳捐乳時間…..29
三、本捐贈乳與日本產後婦女母乳中礦物質含量的比較………………………30
四、探討母乳庫捐贈乳，對於新生兒礦物質攝取量之研究……………………31
五、對於使用母乳庫捐贈乳，礦物質攝取不足之解決策略……………………34
六、未來之努力方向……………...............……………………………………….36
第七章 結論………………………………………………………………………………38
第八章 參考文獻…………………………………………………………………………61

～表 目 錄～
表一 各國母乳中鋅濃度比較……………………………………………………….39
表二 各國母乳中銅濃度之比較…………………………………………………….40
表三 各國母乳中鐵濃度比較……………………………………………………….41
表四 各國母乳中鈣濃度比較……………………………………………………….42
表五 各國母乳中磷濃度比較……………………………………………………….43
表六 各國母乳中鎂濃度比較……………………………………………………….44
表七 各國母乳中硒濃度比較……………………………………………………….45
表八 DRC II ICP-MS之操作參數………………………………………………….46
表九 母乳礦物質分析方法偵測極限與精密度…………………………………….48
表十 母乳礦物質分析方法回收率測試…………………………………………….49
表十一 母乳（1-17月）之水分、三大營養素百分比及礦物質組成…………………50
表十二 不同哺乳期母乳水份、三大營養素百分比及礦物質含量………………….51
表十三 不同胎數捐贈者1-2月母乳礦物質含量之比較……………………………..52
表十四 母親年齡、新生兒出生體重與1-2月母乳礦物質含量之相關性…………….53
表十五 產後早產兒攝取母乳庫捐乳的礦物質含量………………………………….54
表十六 產後足月病童由母乳庫捐乳每日攝食礦物質含量………………………….55
表十七 產後早產兒攝取母乳庫1個月捐贈乳的礦物質含量……………………….56

～圖 目 錄～
圖一 ICP-MS的基本儀器構造……………………………………………………...15
圖二 ICP燄炬(Torch)基本構造……………………………………………………..16
圖三 DRC-ICP-MS儀器圖………………………………………………………….20
圖四 鐵氟龍消化瓶裝置…………………………………………………………….22
圖五 母乳中元素之分析流程圖……………………………………………………23
圖六 母乳庫捐贈乳與日本母乳中鈣濃度之比較………………………………….57
圖七 母乳庫捐贈乳與日本母乳中磷濃度之比較………………………………….57
圖八 母乳庫捐贈乳與日本母乳中鎂濃度之比較………………………………….58
圖九 母乳庫捐贈乳與日本母乳中鐵濃度之比較…………………………………58
圖十 母乳庫捐贈乳與日本母乳中銅濃度之比較…………………………………59
圖十一 母乳庫捐贈乳與日本母乳中鋅濃度之比較…………………………………59
圖十二 母乳庫捐贈乳與日本母乳中硒濃度之比較…………………………………60

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