1
|
Zielinska-Pukos MA, Michalska-Kacymirow M, Kurek E, Bulska E, Grabowicz-Chądrzyńska I, Wesołowska A, Hamulka J. Breastmilk mineral composition among well-educated mothers from Central Poland - Associations with maternal dietary intake, dietary patterns and infant psychomotor development. J Trace Elem Med Biol 2024; 83:127393. [PMID: 38271826 DOI: 10.1016/j.jtemb.2024.127393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
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.
Collapse
Affiliation(s)
- Monika A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska St. 159c, 02-776 Warsaw, Poland.
| | - Magdalena Michalska-Kacymirow
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | - Eliza Kurek
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | - Ewa Bulska
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | | | - Aleksandra Wesołowska
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska St. 159c, 02-776 Warsaw, Poland
| |
Collapse
|
2
|
Basrowi RW, Zulfiqqar A, Sitorus NL. Anemia in Breastfeeding Women and Its Impact on Offspring's Health in Indonesia: A Narrative Review. Nutrients 2024; 16:1285. [PMID: 38732532 PMCID: PMC11085192 DOI: 10.3390/nu16091285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.
Collapse
Affiliation(s)
- Ray Wagiu Basrowi
- Danone Specialized Nutrition Indonesia, Jakarta 12940, Indonesia;
- Occupational Medicine Program, Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 12300, Indonesia
| | - Andy Zulfiqqar
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia;
| | | |
Collapse
|
3
|
Fatima T, Faridi MMA, Srivastava G. Iron status of exclusively breastfed low-birth-weight infants born to anemic mothers and effect of maternal iron supplementation for 3 versus 6 months: A randomized double-blind placebo control trial. Front Pediatr 2022; 10:880431. [PMID: 36034548 PMCID: PMC9402978 DOI: 10.3389/fped.2022.880431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of maternal iron supplementation during lactation on the iron status of exclusively breastfed low-birth-weight (LBW) infants is not known. OBJECTIVE (1) To find out the number of LBW exclusively breastfed infants having hemoglobin < 10.5 g/dL at 6 months when mothers received iron. (2) To find out the proportion of anemic infants when mothers received iron for 3 and 6 months. DESIGN The Clinical Trials Registry, India (CTRI) registered trial (CTRI/2018/08/015516) double-blind randomized control trial participants: A total of 80 anemic mothers and exclusively breastfed LBW infants. INTERVENTION A total of 80 anemic mothers and exclusively breastfed infants, birth weight 1,500-2,499 g, randomized into two groups of 40 each. Mothers received daily iron for 3 months and placebo for the next 3 months in group A and iron for 6 months in group B. Iron profile of mothers and infants measured at recruitment and 6 months. RESULTS In total, 26.6% infants developed anemia till 6 months of age, and number of anemic infants were similar whether mothers received iron for 3 (n = 9) or 6 months (n = 11). Hemoglobin (12.89 + 0.46 vs. 12.44 + 0.48 g/dL; p < 0.001) and serum ferritin (27.45 + 7.60 vs. 18.94 + 5.36 ng/mL; p < 0.001) were significantly higher in infants at 6 months of age whose mothers received iron for 6 months in comparison to 3 months. Conclusion: totally, 26.6% exclusively breastfed infants developed anemia till 6 months of age when mothers took iron; number of anemic infants were not different if mothers received iron for 3 or 6 months. A significant increase was noted in serum ferritin with slightly higher hemoglobin of infants when mothers received iron for longer duration. CLINICAL TRIAL REGISTRATION [http://ctri.nic.in/Clinicaltrials/pubview.php], identifier [CTRI/2018/08/015516].
Collapse
Affiliation(s)
- Tarannum Fatima
- ERA's Lucknow Medical College, Lucknow, Uttar Pradesh, India
| | | | | |
Collapse
|
4
|
Pang WW, Geddes DT, Lai CT, Chan SY, Chan YH, Cheong CY, Fok D, Chua MC, Lim SB, Huang J, Pundir S, Tan KH, Yap F, Godfrey KM, Gluckman PD, Shek LP, Vickers MH, Eriksson JG, Chong YS, Wlodek ME. The association of maternal gestational hyperglycemia with breastfeeding duration and markers of milk production. Am J Clin Nutr 2021; 114:1219-1228. [PMID: 33963740 PMCID: PMC7611668 DOI: 10.1093/ajcn/nqab142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/05/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Previous studies focusing on the association between gestational diabetes and breastfeeding duration have been inconclusive. OBJECTIVES We aimed to determine whether maternal gestational hyperglycemia is associated with the duration of breastfeeding and the concentrations of markers linked to breastmilk production. METHODS Data from the prospective, multiethnic Growing Up in Singapore Towards Healthy Outcomes study were used to assess the association of fasting plasma glucose (FPG) and 2-h postglucose challenge (2hPG) measured at 26-28 wk of gestation with duration of breastfeeding and concentrations of protein, lactose, citrate, sodium, potassium, and zinc in breastmilk 3 wk postpartum. RESULTS Of the 1035 participants, 5.2% and 9.5% had elevated FPG and 2hPG, respectively, consistent with a diagnosis of gestational diabetes mellitus based on International Association of Diabetes and Pregnancy Study Groups criteria. FPG ≥5.1 mmol/L was associated with a crude reduction in median breastfeeding duration of 2.3 mo. In a model adjusted for maternal prepregnancy BMI and intention to breastfeed, FPG ≥5.1 mmol/L predicted earlier termination of any breastfeeding (adjusted HR: 1.47; 95% CI: 1.04, 2.08) but not full breastfeeding (adjusted HR: 1.08; 0.76, 1.55). 2hPG ≥8.5 mmol/L was not significantly associated with the durations of any (adjusted HR: 0.86; 95% CI: 0.62, 1.19) or full (adjusted HR: 0.85; 95% CI: 0.62, 1.18) breastfeeding. Maternal FPG was significantly and positively associated with breastmilk sodium (adjusted coefficient: 1.28; 95% CI: 1.08, 1.51) and sodium-to-potassium ratio (adjusted coefficient: 1.29; 95% CI: 1.08, 1.54) but not with other measured breastmilk components. CONCLUSIONS Women with FPG ≥5.1 mmol/L during pregnancy breastfeed for a shorter duration. Future work involving measurement of milk production is needed to determine whether low milk production predicts breastfeeding duration among women with elevated FPG. This trial was registered at www.clinicaltrials.gov as NCT01174875.
Collapse
Affiliation(s)
- Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Western Australia, Australia
| | - Ching-Tat Lai
- School of Molecular Sciences, The University of Western Australia, Western Australia, Australia
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Yiong Huak Chan
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Clara Y. Cheong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Doris Fok
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mei Chien Chua
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore
| | - Sok Bee Lim
- Department of Child Development, KK Women’s & Children’s Hospital, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shikha Pundir
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, UK,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore
| | - Mark H. Vickers
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Johan G. Eriksson
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland,Folkhälsan Research Center, Helsinki, Finland
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mary E. Wlodek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of Physiology, School of Biomedical Science, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| |
Collapse
|
5
|
Bzikowska-Jura A, Sobieraj P, Michalska-Kacymirow M, Wesołowska A. Investigation of Iron and Zinc Concentrations in Human Milk in Correlation to Maternal Factors: An Observational Pilot Study in Poland. Nutrients 2021; 13:nu13020303. [PMID: 33494328 PMCID: PMC7912200 DOI: 10.3390/nu13020303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to evaluate iron and zinc concentrations in the mature human milk (HM) and to investigate the relationship between these concentrations and maternal factors. HM samples were collected between 4–6 weeks postpartum from 32 healthy, exclusively breastfeeding mothers. The assessment of dietary intake during breastfeeding was based on a food frequency questionnaire and three-day dietary records. Nutritional status of participants was assessed with body mass index and body composition analysis, measured with bioelectrical impedance. HM intake was assessed with infants’ weighting, whereas iron and zinc contents in HM were determined by inductively coupled plasma mass spectrometer. The median intake of HM was 492.5 mL (466–528.5) and the concentrations of HM iron and zinc were 0.33 mg/L (0.26–0.46) and 2.12 mg/L (1.97–2.45), respectively. Maternal total zinc and iron intake (diet + supplementation) was positively correlated with their concentrations in HM. Consumption frequency of meat, vegetables and legumes was revealed to be a significant factor influencing zinc concentration in HM. Regarding iron, it was the consumption frequency of meat, fish and seafood, vegetables and legumes, nuts and seeds. The intake of iron from HM was low, and after assuming a mean fractional iron absorption, it was only 0.038 mg/d. Our results show that maternal diet influences iron and zinc content in HM, suggesting that adequate intake of food rich in investigated minerals may be a positive factor for their concentrations in HM.
Collapse
Affiliation(s)
- Agnieszka Bzikowska-Jura
- Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciolka Str. 27, 01-445 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-572-09-31
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Faculty of Medicine, Medical University of Warsaw, Banacha Str. 1a, 02-097 Warsaw, Poland;
| | - Magdalena Michalska-Kacymirow
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury Str. 101, 02-089 Warsaw, Poland;
| | - Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research, Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Science, Department of Medical Biology, Medical University of Warsaw, Litewska Str. 14/16, 00-575 Warsaw, Poland;
| |
Collapse
|
6
|
Dumrongwongsiri O, Chongviriyaphan N, Chatvutinun S, Phoonlabdacha P, Sangcakul A, Siripinyanond A, Suthutvoravut U. Dietary Intake and Milk Micronutrient Levels in Lactating Women with Full and Partial Breastfeeding. Matern Child Health J 2020; 25:991-997. [PMID: 33230681 DOI: 10.1007/s10995-020-03049-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Micronutrient intake and status in lactating women may impact micronutrient levels in milk. OBJECTIVES This study aimed to determine the micronutrient intake and status in lactating women, and their association with micronutrient levels in human milk. METHODS Lactating women were enrolled at 4-6 months postpartum. A 24h food recall was examined and nutrient intakes were analyzed using INMUCAL software. Human milk samples were collected to analyze calcium, copper, iron, and zinc levels. Plasma zinc and serum ferritin levels were determined. RESULTS Thirty-four women participated; 19 were classified as full breastfeeding and 15 as partial breastfeeding. Mean levels of calcium, copper, iron, and zinc in human milk were 243, 0.2, 0.2, and 1.56 mg/L, respectively. The prevalence of zinc deficiency (plasma zinc < 10.7 µmol/L) was 11.8%. No lactating women had iron deficiency. Nutrient intakes were lower than the recommended amounts in 38%-70% of participants, and were not correlated with corresponding nutrient levels in human milk. Multiple linear regression showed significant association between zinc levels in human milk and plasma for lactating women with full breastfeeding (β = 0.034, 95% confidence interval [0.003, 0.067], p = 0.040). CONCLUSIONS Lactating women were at risk of micronutrient deficiency. There was an association between zinc levels in human milk and plasma of lactating women with full breastfeeding. As the nutritional status of lactating women influences the quality of human milk, we should encourage good nutrient intake for lactating women.
Collapse
Affiliation(s)
- Oraporn Dumrongwongsiri
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Nalinee Chongviriyaphan
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| | - Suthida Chatvutinun
- Pediatrics Nursing Division, Nursing Service Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| | - Phanphen Phoonlabdacha
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| | - Areeporn Sangcakul
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| | - Atitaya Siripinyanond
- Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Mahidol University, 272, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| | - Umaporn Suthutvoravut
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand
| |
Collapse
|
7
|
Sánchez C, Fente C, Barreiro R, López-Racamonde O, Cepeda A, Regal P. Association between Breast Milk Mineral Content and Maternal Adherence to Healthy Dietary Patterns in Spain: A Transversal Study. Foods 2020; 9:foods9050659. [PMID: 32443751 PMCID: PMC7278811 DOI: 10.3390/foods9050659] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 01/20/2023] Open
Abstract
The composition of breast milk is influenced by many factors, some of which dependent on the mother and others on the child. Changes in lactation and other factors depending on the mother's physiology and anthropometric characteristics, as well as her nutritional status and diet, are of key importance. Breast milk minerals have been extensively studied with highly uneven results. In this work, a comparison will made with data across the world. To understand the factors that might explain the disparity, several minerals (Na, K, Ca, P, Mg, Fe, Se and I) have been analyzed using ICP-MS in a set of human milk samples (n = 75). The samples had an identical geographical origin (Galicia, in northwestern Spain) but different lactation circumstances, including maternal anthropometric data, lactating time, newborn sex and maternal adherence to healthy dietary patterns (Mediterranean Diet, MD, or Atlantic Diet, AD). The required concentrations of essential elements reported in the literature are similar to those found in these Spanish women. A univariate approach revealed that factors such as lactating time, body mass index (BMI) and newborn sex have a significant influence in breastmilk mineral content. According to multivariate linear regression analysis, minerals in milk are particularly associated with lactating time, but also with newborn sex, maternal BMI, age and diet pattern in some cases. More precisely, these results suggest that the iron and selenium concentrations in the milk of Galician donors may be positively influenced by maternal adherence to AD and MD, respectively.
Collapse
Affiliation(s)
- Cristina Sánchez
- Pharmacy Faculty, Campus Monteprincipe, San Pablo-CEU University, 28668 Madrid, Spain;
| | - Cristina Fente
- Department of Analytical Chemistry, Nutrition and Bromatology, Santiago de Compostela University, 27002 Lugo, Spain; (R.B.); (O.L.-R.); (A.C.); (P.R.)
- Correspondence: ; Tel.: +34-600-942349
| | - Rocío Barreiro
- Department of Analytical Chemistry, Nutrition and Bromatology, Santiago de Compostela University, 27002 Lugo, Spain; (R.B.); (O.L.-R.); (A.C.); (P.R.)
| | - Olga López-Racamonde
- Department of Analytical Chemistry, Nutrition and Bromatology, Santiago de Compostela University, 27002 Lugo, Spain; (R.B.); (O.L.-R.); (A.C.); (P.R.)
- Midwifery Service at San Roque Health Center, SERGAS (Servizo Galego de Saúde), 27002 Lugo, Spain
| | - Alberto Cepeda
- Department of Analytical Chemistry, Nutrition and Bromatology, Santiago de Compostela University, 27002 Lugo, Spain; (R.B.); (O.L.-R.); (A.C.); (P.R.)
| | - Patricia Regal
- Department of Analytical Chemistry, Nutrition and Bromatology, Santiago de Compostela University, 27002 Lugo, Spain; (R.B.); (O.L.-R.); (A.C.); (P.R.)
| |
Collapse
|
8
|
Hampel D, Shahab‐Ferdows S, Gertz E, Flax VL, Adair LS, Bentley ME, Jamieson DJ, Tegha G, Chasela CS, Kamwendo D, van der Horst CM, Allen LH. The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers. MATERNAL & CHILD NUTRITION 2018; 14:e12503. [PMID: 28851037 PMCID: PMC5832511 DOI: 10.1111/mcn.12503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/27/2017] [Accepted: 07/12/2017] [Indexed: 12/03/2022]
Abstract
We evaluated effects of antiretroviral (ARV) therapy and lipid-based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV-infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post-partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant-pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post-partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80-90% of copper and zinc and <50% of iron concentrations met the current adequate intake for infants at 2 weeks and only 1-19% at 24 weeks. Pregnancy haemoglobin was negatively correlated with milk iron at 2 and 6 weeks (r = -.18, p < .02 for both). The associations of the milk minerals with each other were the strongest correlations observed (r = .11-.47, p < .05 for all); none were found with infant biomarkers. At 2 weeks, moderately anaemic women produced milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α-1-acid glycoprotein and C-reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation.
Collapse
Affiliation(s)
- Daniela Hampel
- USDA, ARS Western Human Nutrition Research CenterDavisCaliforniaUSA
- Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
| | | | - Erik Gertz
- USDA, ARS Western Human Nutrition Research CenterDavisCaliforniaUSA
| | - Valerie L. Flax
- Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Linda S. Adair
- Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Margaret E. Bentley
- Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | | | | | - Charles S. Chasela
- UNC ProjectLilongweMalawi
- School of Public HealthUniversity of WitwatersrandJohannesburgSouth Africa
| | | | | | - Lindsay H. Allen
- USDA, ARS Western Human Nutrition Research CenterDavisCaliforniaUSA
- Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
| |
Collapse
|
9
|
Jorgensen JM, Yang Z, Lönnerdal B, Chantry CJ, Dewey KG. Effect of iron supplementation during lactation on maternal iron status and oxidative stress: A randomized controlled trial. MATERNAL & CHILD NUTRITION 2017; 13:e12394. [PMID: 27896921 PMCID: PMC6866113 DOI: 10.1111/mcn.12394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/14/2016] [Accepted: 09/19/2016] [Indexed: 01/08/2023]
Abstract
We examined the effect of iron-containing prenatal vitamin-mineral supplements taken postpartum on biomarkers of iron status and oxidative stress. Lactating women (n = 114) were randomly assigned to consume daily one iron-free prenatal vitamin-mineral supplement plus either 27 mg of iron or placebo for approximately 3.5 months. The placebo group took the tablets between meals, while those given iron took the tablets either with (Fe-W) or between meals (Fe-B). Blood and urine samples were collected before and after the supplementation period to analyze hemoglobin (Hb), ferritin, hepcidin, transferrin saturation (TfSat), total plasma iron, and biomarkers of oxidative stress (isoprostane and 8-hydroxy-2-deoxyguanosine (8-OHdG)) and inflammation (C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP)). There was a trend toward a greater change in Hb among women in the Fe-B group compared to placebo (+2.5 vs. -3.7 g/L, respectively, p = 0.063). When the iron groups were combined, there was a greater change in Hb (+1.4 g/L) compared to placebo (p = 0.010). There were trends toward greater changes in TfSat (p = 0.087) and total plasma iron (p = 0.065) in the iron groups compared to placebo, yet no significant differences between the three groups in change in hepcidin (p = 0.291), isoprostane (p = 0.319), or 8-OHdG (p = 0.659), nor in change in ferritin among those with elevated CRP at baseline (60% of women; p = 0.946); among those without elevated CRP (40% of women), ferritin increased more in the iron groups compared to placebo (p = 0.001). Iron consumption during lactation moderately increased iron status, particularly among women without elevated CRP, and increased Hb, but did not significantly increase oxidative stress.
Collapse
Affiliation(s)
| | - Zhenyu Yang
- National Institute for Nutrition and HealthChinese Center for Disease Control and PreventionBeijingChina
- Key Laboratory of Trace Element NutritionMinistry of Health of ChinaBeijingChina
| | - Bo Lönnerdal
- Department of NutritionUC DavisDavisCaliforniaUSA
| | | | | |
Collapse
|
10
|
Klein LD, Breakey AA, Scelza B, Valeggia C, Jasienska G, Hinde K. Concentrations of trace elements in human milk: Comparisons among women in Argentina, Namibia, Poland, and the United States. PLoS One 2017; 12:e0183367. [PMID: 28817665 PMCID: PMC5560670 DOI: 10.1371/journal.pone.0183367] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/02/2017] [Indexed: 12/31/2022] Open
Abstract
Human milk contains essential micronutrients for growth and development during early life. Environmental pollutants, such as potentially toxic metals, can also be transferred to the infant through human milk. These elements have been well-studied, but changing diets and environments and advances in laboratory technology require re-examining these elements in a variety of settings. The aim of this study was to characterize the concentrations of essential and toxic metals in human milk from four diverse populations. Human milk samples (n = 70) were collected in Argentina (n = 21), Namibia (n = 6), Poland (n = 23), and the United States (n = 20) using a standardized mid-feed collection procedure. Milk concentrations of calcium, zinc, iron, copper, manganese, lead, arsenic, and cadmium were determined using inductively coupled plasma mass spectrometry (ICP-MS). We used standard multiple linear regression models to evaluate differences among populations, while including infant age, infant sex, and maternal parity status (multiparous or primiparous) as covariates. Concentrations of all elements, except zinc, varied across populations after controlling for infant age, infant sex, and maternal parity. Calcium and magnesium showed more differences across populations than iron or copper. There were no significant differences among population in zinc concentrations. Mean concentrations of lead, but not arsenic, were low compared to recently published values from other populations. The concentrations of trace elements in human milk are variable among populations. Limitations due to small sample sizes and environmental contamination of some samples prevent us from drawing robust conclusions about the causes of these differences.
Collapse
Affiliation(s)
- Laura D. Klein
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Alicia A. Breakey
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Brooke Scelza
- Department of Anthropology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Claudia Valeggia
- Department of Anthropology, Yale University, New Haven, Connecticut, United States of America
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| | - Katie Hinde
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, United States of America
- Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, United States of America
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, United States of America
| |
Collapse
|
11
|
Djurović D, Milisavljević B, Mugoša B, Lugonja N, Miletić S, Spasić S, Vrvić M. Zinc concentrations in human milk and infant serum during the first six months of lactation. J Trace Elem Med Biol 2017; 41:75-78. [PMID: 28347466 DOI: 10.1016/j.jtemb.2017.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 11/19/2022]
Abstract
Normal supply of zinc to the newborn via milk is essential for normal development. Using ICP-OES, we analyzed changes in the level of Zn in milk and infant serum in the neonatal period (Day 1 and Day 28 post partum) and at 6 months after delivery, in the cohort of 60 mothers and exclusively breastfed babies. Zn level in the serum showed increase (significant at 6 months) during this period (mg/mL): Day 1: 0.52±0.12; Day 28: 0.59±0.19; 6 months: 0.68±0.28. The concentration of Zn in the milk showed an opposite (decreasing) trend during the follow up: Day 1: 4.70±1.74mg/L; Day 28: 2.65±1.06; 6 months: 0.46±0.36. A significant negative correlation was established between serum and milk [Zn] at day 28 (R=-0.338; p=0.008), whereas a positive correlation was found at 6 months between these parameters (R=0.306; p=0.018). There was no significant correlation between [Zn] in the milk and serum and infants' body mass, mothers' age and mass at delivery. The level of Zn in the milk at 6 months of lactation is not sufficient to meet the recommended values. This implies that in Serbian population, Zn supplementation might be needed in the later phase of lactation.
Collapse
Affiliation(s)
- Dijana Djurović
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | | | - Boban Mugoša
- Institute of Public Health of Montenegro, Džona Džeksona bb, Podgorica, Montenegro
| | - Nikoleta Lugonja
- Department of Chemistry of the Institute of Chemistry, Technology and Metallurgy, University of Belgrade, Njegoševa 1, Belgrade, Serbia
| | - Srđan Miletić
- Department of Chemistry of the Institute of Chemistry, Technology and Metallurgy, University of Belgrade, Njegoševa 1, Belgrade, Serbia.
| | - Snežana Spasić
- Department of Chemistry of the Institute of Chemistry, Technology and Metallurgy, University of Belgrade, Njegoševa 1, Belgrade, Serbia
| | - Miroslav Vrvić
- Faculty of Chemistry, University of Belgrade, Studentski trg 12-16, Belgrade, Serbia
| |
Collapse
|
12
|
Choi YK, Kim JM, Lee JE, Cho MS, Kang BS, Choi H, Kim Y. Association of Maternal Diet With Zinc, Copper, and Iron Concentrations in Transitional Human Milk Produced by Korean Mothers. Clin Nutr Res 2016; 5:15-25. [PMID: 26839873 PMCID: PMC4731858 DOI: 10.7762/cnr.2016.5.1.15] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 01/19/2016] [Accepted: 01/20/2016] [Indexed: 11/25/2022] Open
Abstract
The aims of this study were to evaluate zinc, copper, and iron concentrations in the transitory milk of Korean lactating mothers and to investigate the relationship between these concentrations and maternal diet. Human milk samples were collected between 5 and 15 days postpartum from 96 healthy, lactating mothers in postpartum care centers in Seoul, Korea. Dietary intake during lactation was determined based on a 3-day dietary record. The mean zinc, copper, and iron concentrations in the human milk samples collected were 3.88 ± 1.74 mg/L, 0.69 ± 0.25 mg/L, and 5.85 ± 8.53 mg/L, respectively. The mothers who consumed alcoholic beverages during pregnancy had tended to have lower concentrations of zinc and copper, as well as significantly lower concentrations of iron, in their milk (p < 0.047). In contrast, the mothers who took daily supplements had much higher iron concentrations in their milk (p = 0.002). Dietary intakes of zinc, copper, and iron during lactation did not affect the concentrations of zinc, copper, and iron in the milk samples analyzed. Intakes of vitamin C, selenium, and iodine were associated with the concentration of copper in the milk samples analyzed, and consumption of food categorized as 'meat and meat products' was positively associated with the concentration of zinc. Consumption of rice was the top contributor to the concentrations of all three minerals. In conclusion, associations between maternal diet and nutrient concentrations in transitory human milk can provide useful information, particularly in regard to infant growth.
Collapse
Affiliation(s)
- Yun Kyung Choi
- Department of Clinical Nutrition, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu 11644, Korea
| | - Ji-Eun Lee
- Department of Physical Education, College of Education, Chung-Ang University, Seoul 06974, Korea
| | - Mi Sook Cho
- Department of Clinical Nutrition, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea.; Department of Nutritional Sciences and Food Management, Ewha Womans University, Seoul 03760, Korea
| | | | | | - Yuri Kim
- Department of Clinical Nutrition, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea.; Department of Nutritional Sciences and Food Management, Ewha Womans University, Seoul 03760, Korea
| |
Collapse
|
13
|
Hare DJ, Arora M, Jenkins NL, Finkelstein DI, Doble PA, Bush AI. Is early-life iron exposure critical in neurodegeneration? Nat Rev Neurol 2015; 11:536-44. [DOI: 10.1038/nrneurol.2015.100] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
14
|
Andrade MTS, Ciampo LAD, Ciampo IRLD, Ferraz IS, Junior FB. Breast Milk Micronutrients in Lactating Mothers from Ribeirão Preto (SP), Brazil. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/fns.2014.513130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|