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Mandiá N, Bermejo-Barrera P, Herbello P, López-Suárez O, Fraga JM, Fernández-Pérez C, Couce ML. Human Milk Concentrations of Minerals, Essential and Toxic Trace Elements and Association with Selective Medical, Social, Demographic and Environmental Factors. Nutrients 2021; 13:1885. [PMID: 34072740 PMCID: PMC8228089 DOI: 10.3390/nu13061885] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022] Open
Abstract
This study aims to quantify concentrations of minerals and trace elements in human milk (HM) and infant formula (IF) and evaluate associations with medical, social, environmental, and demographic variables. A prospective, case series study of 170 nursing mothers was made. HM samples were obtained from full-term (colostrum, intermediate and mature HM) and preterm (mature HM) mothers. Variables of interest were assessed by a questionnaire. For comparison, IF samples (n = 30) were analyzed in a cross-sectional study. Concentrations of 35 minerals, essential and toxic trace elements were quantified, 5 for the first time: thallium in HM and IF; strontium in preterm HM; and gallium, lithium and uranium in IF. In preterm and full-term HM, levels of selenium (p < 0.001) were significantly lower than recommended and were associated with low birth weight (p < 0.002). Cesium and strontium concentrations were significantly higher than recommended (p < 0.001). Associations were observed between arsenic and residence in an urban area (p = 0.013), and between lead and smoking (p = 0.024) and well-water consumption (p = 0.046). In IF, aluminum, vanadium, and uranium levels were higher than in HM (p < 0.001); uranium, quantified for the first time, was 100 times higher in all types of IF than in HM. Our results indicate that concentrations of most trace elements were within internationally accepted ranges for HM and IF. However, preterm infants are at increased risk of nutritional deficiencies and toxicity. IF manufacturers should reduce the content of toxic trace elements.
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Affiliation(s)
- Natalia Mandiá
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Pilar Bermejo-Barrera
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, University of Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain; (P.B.-B.); (P.H.)
| | - Paloma Herbello
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, University of Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain; (P.B.-B.); (P.H.)
| | - Olalla López-Suárez
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Jose M. Fraga
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Cristina Fernández-Pérez
- Department of Preventive Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela University, 15704 Santiago de Compostela, Spain;
| | - María L. Couce
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- MetabERN, via Pozzuolo 330, 33100 Udine, Italy
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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.
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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
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Dumrongwongsiri O, Winichagoon P, Chongviriyaphan N, Suthutvoravut U, Grote V, Koletzko B. Determining the Actual Zinc and Iron Intakes in Breastfed Infants: Protocol for a Longitudinal Observational Study. JMIR Res Protoc 2020; 9:e19119. [PMID: 33155573 PMCID: PMC7679214 DOI: 10.2196/19119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 09/25/2020] [Accepted: 10/02/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Zinc and iron deficiencies among breastfed infants during the first 6 months of life have been reported in previous studies. The amounts of zinc and iron intakes from breast milk are factors that contribute to the zinc and iron status of breastfed infants. OBJECTIVE This study aims to quantitatively determine zinc and iron intakes by breastfed infants during the first 4 months of life and to investigate the factors that predict zinc and iron status in breastfed infants. METHODS Pregnant women at 28 to 34 weeks of gestation were enrolled. Zinc and iron status during pregnancy was assessed. At delivery, cord blood was analyzed for zinc and iron levels. Participants and their babies were followed at 2 and 4 months postpartum. Maternal dietary intakes and anthropometric measurements were performed. The amount of breast milk intake was assessed using the deuterium oxide dose-to-mother technique. Breast milk samples were collected for determination of zinc and iron levels. The amount of zinc and iron consumed by infants was calculated. Zinc and iron status was determined in mothers and infants at 4 months postpartum. RESULTS A total of 120 pregnant women were enrolled, and 80 mother-infant pairs completed the study (56 provided full breastfeeding, and 24 provided breast milk with infant formula). All data are being managed and cleaned. Statistical analysis will be done. CONCLUSIONS This study will provide information on zinc and iron intakes in exclusively breastfed infants during the first 4 months of life and explore predictive factors and the possible association of zinc and iron intakes with infant growth and nutrient status. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19119.
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Affiliation(s)
- Oraporn Dumrongwongsiri
- Center for International Health, Lugwig-Maximilians-Universitaet Munich, Munich, Germany.,Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pattanee Winichagoon
- Community/International Nutrition, Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand
| | - Nalinee Chongviriyaphan
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Umaporn Suthutvoravut
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Veit Grote
- Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Lugwig-Maximilians-Universitaet Munich, Munich, Germany
| | - Berthold Koletzko
- Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Lugwig-Maximilians-Universitaet Munich, Munich, Germany
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Kim H, Jung BM, Lee BN, Kim YJ, Jung JA, Chang N. Retinol, α-tocopherol, and selected minerals in breast milk of lactating women with full-term infants in South Korea. Nutr Res Pract 2017; 11:64-69. [PMID: 28194267 PMCID: PMC5300949 DOI: 10.4162/nrp.2017.11.1.64] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was performed to measure fat-soluble vitamins and minerals in breast milk of Korean lactating mothers who exclusively breastfed their babies. SUBJECTS/METHODS Breast milk samples were collected from 334 mothers. Concentrations of retinol and α-tocopherol were analyzed by high performance liquid chromatography ultraviolet spectrometry while concentrations of minerals were measured by inductively coupled plasma optical emission spectrometry. RESULTS Retinol and α-tocopherol contents of breast milk were 39.58 ± 19.64 µg/dL and 0.23 ± 0.13 mg/dL, respectively. Average sodium, potassium, calcium, phosphorus, and magnesium levels in breast milk were 11.11 ± 5.16, 38.56 ± 9.01, 27.87 ± 6.10, 13.56 ± 3.30, and 3.05 ± 0.65 mg/dL, respectively. Contents of trace elements such as iron, zinc, copper, and manganese were 40.26 ± 46.21, 98.40 ± 62.47, 24.09 ± 9.03, and 0.90 ± 1.63 µg/dL, respectively. Fat-soluble vitamin concentration was positively correlated with total fat in milk samples, but no significant differences were observed in levels of retinol, α-tocopherol, or minerals based on whether or not lactating women were taking dietary supplements. CONCLUSIONS Micronutrient contents of breast milk samples from Korean lactating women were comparable to those of other nations. Retinol and α-tocopherol levels were correlated and also with total fat in breast milk.
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Affiliation(s)
- Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Byung-Mun Jung
- Maeil Asia Human Milk Research Center, Maeil Dairies Co., Ltd, 50, Jongno-1-gil, Jongno-Gu, Seoul 03142, Korea
| | - Bum-Noh Lee
- Maeil Asia Human Milk Research Center, Maeil Dairies Co., Ltd, 50, Jongno-1-gil, Jongno-Gu, Seoul 03142, Korea
| | - Yun-Je Kim
- Maeil Asia Human Milk Research Center, Maeil Dairies Co., Ltd, 50, Jongno-1-gil, Jongno-Gu, Seoul 03142, Korea
| | - Ji A Jung
- Maeil Asia Human Milk Research Center, Maeil Dairies Co., Ltd, 50, Jongno-1-gil, Jongno-Gu, Seoul 03142, Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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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.
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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
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Balzer MS, Gross MM, Lichtinghagen R, Haller H, Schmitt R. Got Milk? Breastfeeding and Milk Analysis of a Mother on Chronic Hemodialysis. PLoS One 2015; 10:e0143340. [PMID: 26571490 PMCID: PMC4646653 DOI: 10.1371/journal.pone.0143340] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/03/2015] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Women on dialysis rarely become pregnant. However, the overall rate of successful pregnancies is increasing in this patient population and breastfeeding becomes an option for mothers on dialysis. In this study we performed a systematic breast milk composition analysis of a mother on chronic hemodialysis (HD). METHODS Specimens of breast milk and blood were collected in regular intervals before and after HD from a 39-year old woman starting on day 10 postpartum. Samples were analyzed for electrolytes, retention solutes, nutrients and other laboratory measurements. Breast milk samples from low-risk mothers matched for postpartum age were used as controls. RESULTS Significantly higher levels of creatinine and urea were found in pre-HD breast milk when compared to post-HD. A similar post-dialytic decrease was only found for uric acid but not for any other investigated parameter. Conversely, sodium and chloride were significantly increased in post-HD samples. Compared to controls creatinine and urea were significantly higher in pre-HD samples while the difference remained only significant for post-HD creatinine. Phosphate was significantly lower in pre- and post-HD breast milk when compared to controls, whereas calcium showed no significant differences. In terms of nutrient components glucose levels showed a strong trend for a decrease, whereas protein, triglycerides and cholesterol did not differ. Similarly, no significant differences were found in iron, potassium and magnesium content. CONCLUSION To the best of our knowledge this is the first report on a breastfeeding mother on chronic dialysis. Although we found differences in creatinine, urea, sodium, chloride and phosphate, our general analysis showed high similarity of our patient's breast milk to samples from low-risk control mothers. Significant variations in breast milk composition between pre- and post-HD samples suggest that breastfeeding might be preferably performed after dialysis treatment. In summary, our findings indicate that breastfeeding can be considered a viable option for newborns of mothers on dialysis.
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Affiliation(s)
- Michael S Balzer
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Mechthild M Gross
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Ralf Lichtinghagen
- Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - Hermann Haller
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
| | - Roland Schmitt
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
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Burke RM, Leon JS, Suchdev PS. Identification, prevention and treatment of iron deficiency during the first 1000 days. Nutrients 2014; 6:4093-114. [PMID: 25310252 PMCID: PMC4210909 DOI: 10.3390/nu6104093] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/09/2014] [Accepted: 09/16/2014] [Indexed: 12/20/2022] Open
Abstract
Iron deficiency is a global problem across the life course, but infants and their mothers are especially vulnerable to both the development and the consequences of iron deficiency. Maternal iron deficiency during pregnancy can predispose offspring to the development of iron deficiency during infancy, with potentially lifelong sequelae. This review explores iron status throughout these "first 1000 days" from pregnancy through two years of age, covering the role of iron and the epidemiology of iron deficiency, as well as its consequences, identification, interventions and remaining research gaps.
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Affiliation(s)
- Rachel M Burke
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
| | - Juan S Leon
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
| | - Parminder S Suchdev
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA.
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