Maternal Adherence to a Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern and the Relationship to Breast Milk Nutrient Content

Association of healthy eating index (HEI), alternative healthy eating index (AHEI) with antioxidant capacity of maternal breast milk and infant's urine: a cross-sectional study

Maternal dietary quality may alter the nutrient content of breast milk. In this study, we aimed to investigate the relationship between the healthy eating index (HEI) and alternative healthy eating index (AHEI) of a breastfeeding mother's diet with the antioxidant profile of her breast milk and her infant's urine. This study included 300 healthy mother-infant pairs. The participants' dietary intake was estimated using a validated semi-quantitative food frequency questionnaire. The diet quality of participants was assessed using the HEI and AHEI. The total antioxidant content of the breast milk and infant's urine was evaluated using ferric reducing antioxidant power (FRAP), 2, 2'-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Thiol quantification assays. After adjusting for confounding factors, the odds of a low malondialdehyde (MDA) content of breast milk were significantly higher in the highest quartile of HEI than in the lowest quartile. The odds of low DPPH and FRAP in infant urine decreased in the highest quartile of HEI compared to the lowest quartile. No significant relationship was found between AHEI and antioxidant levels of breast milk and the infant's urine. Our findings demonstrate that a high quality diet of breastfeeding mothers, identified by a higher HEI, can affect the oxidant-antioxidant balance of a mother's breast milk and her infant's urine.

Maternal Mediterranean Diet During Lactation and Infant Growth

Background: Human milk is considered the optimal source of nutrition for infants. Maternal diet is associated with the composition of human milk. The Mediterranean diet (MedDiet) has been studied in pregnancy and during lactation, and it has been associated with changes in milk composition, yet there is a lack of research on MedDiet during lactation and infant outcomes. Methods: Mother-infant dyads (n = 167) from ABC Baby, a prospective observational study, were included in this analysis. Maternal diet was obtained using an adapted version of the National Cancer Institute Diet History Questionnaire II, at 2 weeks or 2 months postpartum. Maternal MedDiet score was calculated using servings of vegetables, fruits, whole grains, nuts and seeds, legumes, fish, monounsaturated-to-saturated fatty acid ratio, red and processed meats, and added sugar. Infants' length, weight, and flank skinfold thickness were measured at 6 months. Using World Health Organization standards, weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) Z-scores were calculated. Multiple linear regression models were adjusted for potential confounders. Results: Higher maternal MedDiet score and intake of fruit and fish were associated with lower flank skinfold thickness (β = -0.33, -0.52, and -1.26, respectively). Intake of nuts and seeds was associated with higher WLZ (β = 0.29). Intake of red and processed meats was associated with lower WAZ (β = -0.18) and LAZ (β = -0.18). Energy-adjusted added sugar intake was associated with lower WLZ (β = -0.02). Conclusions: The maternal MedDiet score was associated with lower skinfold thickness, while its components were associated with differences in anthropometric Z-scores. Further research on the maternal MedDiet and corresponding human milk composition is needed to explore this relationship.

Breastmilk mineral composition among well-educated mothers from Central Poland - Associations with maternal dietary intake, dietary patterns and infant psychomotor development

BACKGROUND

Maternal dietary habits could affect breastmilk mineral composition, which may influence infant development. Mineral dietary intake or supplementation slightly affects its breastmilk concentration. However, the intake of selected food groups or dietary patterns that reflect diet complexity could have a greater impact. Hence, the aim of the study was to assess breastmilk mineral composition at one, three, and six months of lactation among mothers living in urban area of Central Poland, as well as the evaluate maternal dietary determinants and associations with infant anthropometric and psychomotor development.

METHODS

The study was conducted among 43 healthy and exclusively breastfeeding mothers. In the first, third, and sixth months of lactation, we collected breastmilk samples and assessed the concentration of Ca, P, Zn, Fe, Se, Ni, As, Pb, and Cd using the ICP-MS method. Maternal dietary habits were evaluated by a food frequency questionnaire in the first month of lactation, whereas in the third and sixth by the three-day food record. Based on the collected data adherence to the Polish-adapted Mediterranean (Pl-aMED; 1 month) and the DASH diet (Mellen's Index; 3 and 6 months) was assessed. In the third and sixth months of lactation infant anthropometric parameters and the sixth month of lactation psychomotor development were evaluated.

RESULTS

Breastmilk Se, Ni, As, Pb, and Cd levels were under the LOQ in all the breastmilk samples at all study visits. Median breastmilk mineral concentrations of Ca, P, Zn, and Fe in the first, third, and sixth months of lactation varied from 381.9 to 332.7 mg/L, 161.6 to 139.1 mg/L, 2.2 to 0.8 mg/L, and 0.26 to 0.17 mg/L, respectively. Maternal dietary intake and supplementation did not affect breastmilk Ca, P, Zn, and Fe. Pl-aMED scores were associated with breastmilk Ca (β = 0.489, 95% CI 0.180 - 0.799, p = 0.003) and Zn (β = 0.499, 95% CI 0.199 - 0.798, p = 0.002) in the first month of lactation, whereas no association with the DASH diet were observed in the third and sixth month of lactation. Breastmilk Fe in the third month was associated with infant motor development (β = 0.420, 95% CI 0.113 - 0.727, p = 0.009) in the sixth month of life, but no other associations with anthropometric or psychomotor development were observed. Moreover, we estimated that few infants meet their adequate intake (AI) requirements for P, Zn, and Fe.

CONCLUSION

Our study showed that maternal adherence to Pl-aMED is a significant predictor of breastmilk Ca and Zn in the first month of lactation, which may be especially important considering that more than 75% of infants had inadequate Zn intake. Moreover, we found that breastmilk Fe positively influenced infant motor development, despite the majority of infants having inadequate intake. On the other hand, no infant had deficiency symptoms, which emphasizes the necessity to evaluate of AI norms for infants.