Relationships between the amount of total protein in human milk, the volume of produced milk and food intake

The concentration of total protein in human milk on the 5th or 6th day after full-term, normal delivery was measured in 145 women, and the amount of protein per 24 hours was calculated by multiplying protein concentration by 24-hour milk production for the same day. Relationships between the concentration and amount of protein, milk volumes and food intake during the latter period of the pregnancy were investigated. Quantification theory III statistical analysis was applied to analyze food intake patterns. While no individual food item was shown to be effective in improving quality and quantity of mother's milk, the results suggest that mothers who consumed meat, fish, food prepared with oil, seaweed, cow's milk and fruits frequently, and rarely used coffee; or mothers who consumed confectioneries and food prepared with oil frequently, rarely used coffee and alcohol beverages and disliked spices produced greater volumes of milk or milk containing a greater amount of protein.     

A study on immunoglobulin A in human milk. Relationship between the amount of IgA and perinatal factors including food intake

The concentrations of IgA in human milk on the 5th or 6th day after delivery were measured in 117 women who delivered maturely, and the amount of IgA per 24 hours was calculated by multiplying the IgA concentration by the total milk volume of the same day. The relationship between the amount of IgA and perinatal factors, including food intake during the latter half of the pregnancy, were investigated. Subjects were divided into three groups (little, moderate, much) by the amount of IgA per 24 hrs and quantification theory II statistical analysis was applied to discriminate among the three groups using 13 factors concerning the perinatal period and food intake as explanatory variables. 1. The ratio of correct classification into the three groups was relatively high, suggesting that there is a relation between the amount of IgA in milk and perinatal and food intake factors. 2. Among the perinatal factors, the age, the gestation period and the number of experienced deliveries were effective for the amount of IgA. The obtained results showed that women 20-29 years old who had the first delivery after 38-40 weeks of gestation were liable to have the greatest amount of IgA in milk. 3. The amount of IgA of the women who ate less in the latter period of pregnancy compared with pre-pregnancy, or had a "less frequent intake of protein" was liable to be the greatest, and that of women with a "large volume" or "frequent protein intake" was liable to be greater than that of those with "the same volume" or "moderately frequent protein intake." The amount of IgA of the women with a "frequent intake of salted dried fish" was the greatest. The fact that the amounts of IgA of the women who "ate less" or had a "less frequent intake of protein" were liable to be the greatest was considered to show that toxemia or the tendency to near abortion or preterm delivery greatly affected the amount of IgA.     

Ethinyl estradiol in human milk and plasma after oral administration

In order to estimate the concentration of ethinyl estradiol in milk, four fully lactating women were given an oral contraceptive containing 50 μg ethinyl estradiol + 4 mg megestrol acetate, starting two months after delivery, and four women who wanted to stop nursing after a lactation period of 6–18 months were given one tablet of 500 μg ethinyl estradiol. Milk and blood samples were taken simultaneously after 3, 7, 11 and 23 hours. The concentration of ethinyl estradiol in plasma and milk were estimated by radioimmunoassay. The method for the assay of ethinyl estradiol in milk is evaluated in this paper.The concentration of ethinyl estradiol in milk from the women taking the oral contraceptive was below the detection limit of the assay. In the women taking 500 μg of ethinyl estradiol, the plasma:milk ratio of ethinyl estradiol was found to be about 100:25. The relative dose of ethinyl estradiol ingested by a fully nursed baby, when its mother takes an oral contraceptive containing 50 μg of ethinyl estradiol, has been calculated to be about 10 ng per day, which is 0.02 per cent of the dose given to the mother.     

Assessing severe maternal anemia and its consequences: the value of a simple examination of the coloration of palpebral conjunctiva

The aims of this study were: (1) to investigate the relationship between pre-delivery hemoglobin (Hb) concentration and the outcome of the pregnancy for the mother and child and (2) to assess the extent to which the pallor of the conjunctiva indicates severe anemia in pregnancy (Hb < 7 g/dl). We carried out a prospective study in 1995, in the maternity department of the National Sour? Sanou Hospital (Bobo-Dioulasso, Burkina Faso). Women arriving to give birth at the maternity unit gave verbal consent and underwent a physical examination including the assessment of conjunctiva coloration. Finger-prick blood samples were taken from all the women selected and Hb was determined with a portable hemoglobin meter (HemoCue AB, Sweden). For each woman, information about age, obstetric history, the condition of mother and child at admission and delivery and any post-delivery complications in the first 48 hours was collected before discharge from the maternity unit, 3 to 5 days after the delivery. Women with multiple pregnancies were excluded from the study and 247 women were included overall. Endometriosis was observed in only three cases. Three women died, two due to septic shock. The third woman died from hypovolemic shock. The Hb concentrations of these women were 8 g/dl, 10.2 g/dl and 2.6 g/dl respectively. The mean Hb concentration for our population was 10.1 g/dl (SD = 2.08), with 165 women (67%) having less than 11 g Hb/dl. Forty-one women (17%) had less than 9 g Hb/dl and 16 (6%) had less than 7 g Hb/dl. Severe maternal anemia and pallor of the conjunctiva were significantly associated with pre-term delivery and perinatal death, but not with low birth weight. The sensitivity of the pallor of the conjunctiva for detection of severe maternal anemia was 87%, and its specificity was 88%. We found no evidence that maternal Hb levels of 9 to 10.9 g/dl were associated with a high risk of poor pregnancy outcome for either the mother or the child, although women with such levels of Hb are classed as anemic by the World Health Organization criteria. These results show that poor pregnancy outcome is associated with severe maternal anemia. Examination of the coloration of the conjunctiva is a suitable and affordable screening method for the detection of severe anemia. Mothers with severe anemia present with signs and symptoms of anemia and could therefore be given iron treatment to improve their health. This demonstrates the importance of nutritional intervention during pregnancy.     

上海某医院产妇乳汁中六溴环十二烷水平及新生儿经母乳日摄入量的监测分析

目的 测定上海市某医院产妇乳汁中六溴环十二烷(hexabromocyclododecane,HBCD)含量水平,并估算新生儿每日经母乳HBCD摄人量.方法 于2006年9月至2007年4月在上海市城郊地区某三级甲等医院对分娩后的产妇进行问卷调查,并收集母乳样品48个,产妇均为单胎妊娠,排除高血压、糖尿病、HIV 感染和不良用药史.采用液相色谱-电喷雾离子源-串联三重四极杆质谱法测定α-HBCD,β-HBCD,γ-HBCD 3种非对映异构体的含量,并通过模型估算新生儿经母乳HBCD日摄入量.结果 上海市某医院产妇母乳中总HBCD浓度范围为0.11-37.75 ng/g脂重(lipid weight,1w),中位数为1.42 ng/g 1w,在79%(38/48)的样品中被检出.其中α-HBCD含量最高,浓度中位数为1.24 ng/g 1w,在77%(37/48)的样品中检出;其次为γ-HBCD、β-HBCD,浓度中位数均小于检测限,分别在13%(6/48),17%(7148)的样品中检出.新生儿经母乳总HBCD日摄人为:0.71-243.46 ng/kg.结论 上海市某医院产妇母乳中HBCD含量水平较高,其对婴幼儿健康的影响值得进一步研究.

Abstract：

Objective To explore the level of hexabromocyclododecane(HBCD)in human breast milk of delivery women in a Shanghai hospital.and estimate the daily intake of newborns from breast milk.Methods Forty-eight delivery women in a Shanghai suburb hospital(Class A,Grade 3)were surveyed by questionnaires.and their breast milk samples were collected from September 2006 to April 2007.All the delivery women were singleton pregnancies,excluding high blood pressure,diabetes,HIV infection and adverse medical history.Three diastereoisomers(α-HBCD,β-HBCD,γ-HBCD)were measured by the liquid chromatography-electrospmy ion source-tandem mass spectrometry.and then esitmated the daily intake of the newborns from the breast milk.Results The total HBCD concentration of breast milk,which was detected in 79%(38/48)of samples,ranged from 0.11 ng/g lipid weight(1w)to 37.75 ng/g 1w,with the median at 1.42 ng/g 1w.The most abundant diastereoisomer was α-HBCD which detected in 77%(37/48)of samples,with a median of 1.24,g/g 1w;followed by γ-HBCD and β-HBCD,detected in 13%(6/48)and 17%(8/48)of samples respectively,whose median were both under the limit of detection (LOD).The daily intake of the newborns from the breast milk ranged from 0.71 ng/kg to 243.46 ng/kg.Conclusion The concentrations of HBCD in breast milk of delivery women in a Shanghai hospital have been in a high level.and the influence on newborns'health need to be further studied.     

The effect of milk and skim milk intake on serum lipids and apoproteins in postmenopausal females.

The effects of milk and skim milk intake on serum lipids, apoprotein levels and fatty acid composition were investigated in postmenopausal females. After a 25-day intake of 200 ml/day of whole milk, the milk group had increased HDL and LDL cholesterol levels, with a slight decrease in the proportion of 18:0 fatty acids in the phospholipid fraction. The skim milk group, which had consumed 20 g/day of skim milk for 25 days, showed no changes. After intake of 400 ml/day of whole milk for 29 days, LDL, HDL and total cholesterol concentrations were even more increased and the VLDL-phospholipid concentration was decreased, with significant increases in apoA-I, apoA-II and apoB concentrations. In the skim milk group, consuming 40 g of skim milk per day for 29 days, total cholesterol, atherogenic index, HDL-triglyceride concentrations were decreased and HDL-phospholipid, apoA-I and apoA-II concentrations were increased. Daily skim milk consumption, which is effective in preventing osteoporosis, and careful selection of foods should be recommended for Japanese postmenopausal women who consume more than 200 ml/day of whole milk.     

A longitudinal study of the nutritional and immunological composition of human milk

Eleven healthy women, who were 25–35 years of age, primipara, fullterm and had had normal delivery, were included in this study. Breast milk was estimated for protein, non-protein nitrogen, lipids, lactose, sIgA, IgM, IgG and total and differential cell counts. In the first 3–5 days post-partum, protein concentration (chiefly immunoglobulins sIgA, IgM, IgG) was very high but decreased rapidly by day 5 and remained rather stable afterwards. The contents of fat and lactose were low in the first few days and increased gradually later. Neutrophils, lymphocytes, colostral cells and macrophages were all found in the breast milk.     

人乳和牛乳中有机物种类及邻苯二甲酸二丁酯水平的比较

目的 比较人乳和牛乳中有机物种类及邻苯二甲酸二丁酯(DBP)的污染水平.方法 选取40名健康产妇,年龄(27.44±3.43)岁.分别采集每名产妇乳汁5 ml.采用简单随机抽样的方法选取市售常见4种不同品牌鲜牛奶和1种品牌的奶粉,每种品牌的牛奶制品分别抽取3个样品,共取样15份(其中鲜牛奶12份,奶粉3份).应用气相色谱-质谱(GC-MS)联用法分别对样品中有机物种类进行定性分析及DBP的定量测定.结果 在40份人乳中共检出有机物176种,平均(10.58±4.16)种;12份鲜牛奶中共检出有机物37种,平均为(8.67±1.61)种;3份奶粉中共检出有机物31种,平均(12.67±0.58)种.奶粉中的有机物检出种类数高于人乳和鲜牛奶(t值分别为2.09、4.00,P值均<0.05).在人乳与牛乳中检出率均较高的有机物主要是9-十八烯酸,人乳中检出率为45.00%(18/40),牛乳中检出率为53.33%(8/15).人乳中DBP的含量为(57.78±35.42)μg/L,鲜牛奶中DBP的含量为(20.76±6.60)μg/L,奶粉中DBP的含量为(0.45±0.05)mg/kg[相当于浓度值为(66.78±7.60)μg/L].鲜牛奶中DBP含量低于人乳和奶粉(t值分别为37.02、46.02,P值均<0.05).结论 人乳与牛乳中均含有多种环境有机污染物,部分污染物具有生殖和发育毒性.

Abstract：

Objective To explore types of organic components and pollution level of di-n-butyl phthalate (DBP) between human milk and cow milk products. Methods Forty healthy postpartum women with an average age of (27.44 ± 3.43) years old were selected, and a 5 ml sample of breast milk were collected. Four different brands of fresh cow milk and 1 brand of milk powder were randomly selected in the market. A total of 15 samples were collected with 3 from each brand,and the qualitative analysis of types of organic components and quantitative analysis of DBP were conducted by gas-chromatography and massspectrometry(GC/MS) method. Results A total of 176 different types of organic components were detected in 40 samples of human milk (averaged at (10. 58 ± 4. 16) types per sample); 37 different types were detected in 12 samples of fresh cow milk (averaged at (8.67 ± 1.61) types per sample); while 31 types of organic components were detected in 3 samples of milk powder (averaged at (12. 67 ± 0. 58) types per sample). It was obvious that the types of organic components in milk powder were significantly higher than the other two groups (t =2. 09,4. 00, P < 0. 05). The most frequent organic component in human milk and cow milk was 9-octadecenoic acid (45.00% (18/40) in human milk; 53. 33% (8/15) in cow milk). DBP concentrations were (57.78 ± 35.42) μg/L, (20. 76 ± 6. 60) μg/L and (0. 45 ± 0. 05) mg/kg (equal to (66.78 ± 7.60) μg/L) in human milk, fresh cow milk and milk powder, respectively. The DBP concentration in fresh cow milk was significantly lower than those in human milk and milk powder (t =37.02,46. 02,P <0. 05). Conclusion Both human milk and cow milk contain different types of organic pollutants, some of which have toxic effects on reproduction and human development.     

Macronutrient composition of human milk from Korean mothers of full term infants born at 37-42 gestational weeks

BACKGROUND/OBJECTIVESBreast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women.SUBJECTS/METHODSMilk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 ± 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2.RESULTSThe mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk.CONCLUSIONSThese results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.     

Release of 19-nor-testosterone type of contraceptive steroids through different drug delivery systems into serum and breast milk of lactating women

The release of contraceptive steroids through different drug delivery systems into serum and breast milk was investigated in a group of lactating women. Four women in each group were taking either a low dosage progestogen compound like norethisterone (NET) 350 μg or d-norgestrel (d-Ng) 50 μg alone or low dosage combination pills containing NET 1 mg or d-Ng 150 μg with 30 μg ethinyl estradiol (EE₂) or a biodegradable implant containing 25 mg NET or d-Ng. Peak levels in plasma and milk were seen in oral contraceptive users around 2 hours. Of the two low dosage progestogen compounds, d-Ng was below the detection limit in milk within 4 hours whereas NET was still detectable at the 24-hour interval. In contrast to this, because of the larger quantity of steroids in the combination pills, the NET/d-Ng levels in serum as well as in milk were high throughout the 24-hour period. With the subdermal route because of the sustained low release of the drug from the biodegradable implants, the levels in milk were below the detection limit within a day with d-Ng and within a week with NET.     

Copper,zinc, magnesium and cadmium levels of breast milk of Indian women

One hundred and seventy eight milk samples from healthy Indian women who had term delivery were analysed for Cu, Zn, Mg and Cd contents by wet digestion with Atomic Absorption Spectrophotometer (AAS). Cu level in colostrum was 0·72 ± 0·23 μg/ml, in transitional milk 0·62 ± 0·16 μg/ml and in mature milk 0·39 ± 0·09 to 0·21 ± 0·07 μg/ml. Zn level in colostrum was 9·32 ± 1·63 μg/ml, in transitional milk 6·71 ± 1·21 μg/ml and in mature milk 2·90 ± 0·47 to 2·16 ± 0·38 μg/ml. Mg level in colostrum was 46·22 ± 15·77 μg/ml, in transitional milk 40·71 ± 13·29 μg/ml and in mature milk 38·18 ± 14·21 to 39·66 ± 12·90 μg/ml. Cd level in colostrum was 2·0 ± 0·71 μg/dl, in transitional milk 1·5 ± 0·43 μg/dl, and in mature milk 1·6 ± 0·19 to 1·7 ± 0·13 μg/dl. Cu and Zn showed a significant fall in their levels from colostrum to transitional and mature milk. Mg level showed a slight fall in transitional milk and then remained stationary. Cd level showed no significant fall in its level from colostrum to mature milk.     

Norethisterone concentration in breast milk and infant and maternal plasma during ethynodiol diacetate administration

Twelve women with established lactation of 4–8 weeks duration were given a low-dose progestogen-only contraceptive, ethynodiol diacetate 0.5 mg (Femulen) daily. On the seventh and eighth day of the study, prior to the mother's taking the pill, a blood sample was taken from her and from the infant. Further blood samples were collected from the mother 4 and 12 hours later. Breast milk samples were collected at every feed on day 7 and day 8.

Ethynodiol diacetate is rapidly metabolised in humans, changing into the metabolite norethisterone which is found in both blood and milk. Hence, norethisterone concentrations were estimated.

On day 7 and day 8, four hours after ingestion of the pill, the median norethisterone maternal plasma concentration was 1.60 ng/ml and it fell to a median level of 0.30 ng/ml prior to the next dose of the pill. At this time the median infant concentration was 0.10 ng/ml but the maximum observed level was 0.50 ng/ml.

In the breast milk the norethisterone concentration appears to peak at around 4–8 hours following the ingestion of the pill. The maximum observed concentration in breast milk was 0.84 ng/ml. The amount of norethisterone ingested by the infant averaged 0.02% (6.65 μg) of the dose of ethynodiol diacetate ingested by the mother. The maximum observed on any one day was 0.07% (27.52 μg).

The above results indicate that the amount of progestogen ingested by the infant from its mother's milk is small and is unlikely to pose a risk to the infant.     

Human milk banking I. Effects of container upon immunologic factors in mature milk

The effects of the type of storage container and the duration of storage upon the concentrations of lactoferrin, lysozyme, secretory IgA (SIgA), total IgA, and SIgA antibodies to E.coli somatic antigens and upon the numbers and functions of macrophages, neutrophils and lymphocytes in mature human milk were examined. Milk samples collected during the fourth week of lactation from women aged 20–35 years were kept in pyrex and polypropylene or polyethylene containers at 4°C for 4 and 24 hours. The concentrations of lactoferrin and lysozyme fell by 30% and 40%, respectively, after storage for 24 hours in pyrex and polypropylene containers. The concentration of SIgA antibodies to E.coli O antigens did not change with time in samples stored in pyrex or polypropylene containers but fell by 60% in samples stored in polyethylene. The numbers of macrophages and neutrophils were similar in all containers after 4 hours of storage but increased after 24 hours, particularly after storage in pyrex containers. A similar pattern was found in respect to the number of lymphocytes. The uptake of ³H-thymidine by phytohemagglutinin stimulated milk lymphocytes decreased significantly after 24 hours of storage. These findings indicate that the storage of mature milk at 4°C for comparatively brief periods induces significant changes in the concentrations and/or functions of key immunological components.     

早产儿生后早期母乳营养成分变化分析

目的 分析早产儿生后早期母乳各大营养成分变化的特点,初步探讨提供早产儿个性化营养支持的必要性。 方法 收集2017年1-12月在南京医科大学附属常州妇幼保健院分娩产妇70人的母乳140份,用MIRIS母乳分析仪检测母乳中宏量营养成分及能量,比较不同早产儿性别、乳母年龄和不同分娩方式初乳和过渡乳母乳营养成分的差异及随着出生天数所发生的变化。 结果 1)早产母乳中初乳蛋白质含量大于过渡乳(P<0.01);初乳的脂肪、碳水化合物和能量低于过渡乳(P<0.05)。2)≤ 30周早产初乳蛋白质含量最高,与30⁺¹~33⁺⁶周组和≥34周组比较差异有统计学意义(P<0.05);≤ 30周早产初乳能量显著低于30⁺¹~33⁺⁶周(P<0.05),而脂肪、碳水化合物差异无统计学意义(P>0.05);3)不同胎龄的三组过渡乳中蛋白质、脂肪、能量差异均无统计学意义(P>0.05);碳水化合物分别为(6.28±0.57)、(6.61±0.43)、(6.36±0.81) g/100 ml,随着孕周增加而增加,差异有统计学意义(P＝0.04)。4)母乳营养成分含量在孕母生育年龄、分娩方式、婴儿性别、出生体重方面差异均无统计学意义。5)线性拟合后发现母乳中蛋白质在生后持续下降,其折点天数在第11天,同时,线性拟合发现脂肪、糖类和能量含量呈增长趋势,脂肪变化的折点在出生后第9天,而糖类以及能量在出生14 d内呈近似线性增长关系。结论 早产初乳、过渡乳营养成分差异显著,母乳营养成分含量与孕母生育年龄、分娩方式、婴儿性别、出生体重无相关性。早产儿早期蛋白质累计缺乏以及蛋白质/热卡比例较低,且早产母亲母乳成分的个体差异较大,应该对母乳中蛋白质含量和热卡密度进行“目标性”强化,对母乳添加剂添加需进一步研究。     

不同分娩方式产妇产后血清催乳素水平、自评泌乳量及初乳中生长因子浓度

目的:比较自然分娩与剖宫产产妇产后2～5天自评泌乳量、产后6～24h血清中催乳素(PRL)以及初乳中胰岛素样生长因子-1(IGF-1)、表皮生长因子(EGF)浓度的差异。方法:在医院产科对招募的志愿者收集产后6～24h的血清及产后2～5天的初乳。采用化学发光免疫分析法测定自然分娩组与剖宫产组PRL的含量,采用生物素-亲和素酶联免疫吸附试验测定两组初乳中IGF-1和EGF的浓度。结果:自然分娩组产后血清PRL浓度为(361.67±80.74)ng/ml,剖宫产组为(221.94±90.82)ng/ml,两组之间差异有统计学意义(P0.05)。产后2～3天,剖宫产组初乳中IGF-1浓度高于自然分娩组(P0.05),而自评泌乳量低于自然分娩组(P0.05)。产后4～5天,两组IGF-1浓度及自评泌乳量差异无统计学意义(P0.05)。产后2～5天,剖宫产组EGF浓度略高于自然分娩组,但两组差异无统计学意义(P0.05)。结论:剖宫产组产妇早期初乳中较高的IGF-1以及血清中较低的PRL水平与泌乳延迟和泌乳量相关,建议剖宫产后产妇仍应坚持早接触、早吸吮,提倡早期母乳喂养。     

Infant intake of fatty acids from human milk over the first year of lactation

Despite the importance of human milk fatty acids for infant growth and development, there are few reports describing infant intakes of individual fatty acids. We have measured volume, fat content and fatty acid composition of milk from each breast at each feed over a 24 h period to determine the mean daily amounts of each fatty acid delivered to the infant from breast milk at 1, 2, 4, 6, 9 and 12 months of lactation in five women. Daily (24 h) milk production was 336.60 (SEM 26.21) and 414.49 (SEM 28.39) ml and milk fat content was 36.06 (SEM 1.37) and 34.97 (SEM 1.50) g/l for left and right breasts respectively over the course of the first year of lactation. Fatty acid composition varied over the course of the day (mean CV 14.3 (SD 7.7) %), but did not follow a circadian rhythm. The proportions (g/100 g total fatty acids) of fatty acids differed significantly between mothers (P<0.05) and over the first year of lactation (P<0.05). However, amounts (g) of most fatty acids delivered to the infant over 24 h did not differ during the first year of lactation and only the amounts of 18:3n-3, 22:5n-3 and 22:6n-3 delivered differed between mothers (P<0.05). Mean amounts of 18:2n-6, 18:3n-3, 20:4n-6 and 22:6n-3 delivered to the infant per 24 h over the first year of lactation were 2.380 (SD 0.980), 0.194 (SD 0.074), 0.093 (SD 0.031) and 0.049 (SD 0.021) g respectively. These results suggest that variation in proportions of fatty acids may not translate to variation in the amount delivered and that milk production and fat content need to be considered.     

分娩方式的不同对母婴身心健康的影响分析

目的:探讨不同分娩方式对产妇产后出血量、母乳时间以及围生儿体质的影响,为选择对母婴身心健康伤害程度最低的分娩方式提供依据。方法:选择该院自2011年收治的行剖宫产手术分娩的初产妇120例,作为对照组,选择同一时期阴道顺产分娩的初产妇120例作为观察组,对两种分娩方式对产妇产后出血量、母乳时间以及围生儿体质的影响进行统计分析。结果:观察组与对照组产妇的产后出血量分别为(112.5±45.8)ml、(233.2±67.8)ml,两组比较有统计学差异(t=3.437,P<0.05);对照组母乳开始时间为(49.89±6.87)h,明显晚于观察组(36.52±5.75)h的母乳时间(t=3.587,P<0.05);阴道顺产组产妇产后并发症的发生率明显低于剖宫产组(P<0.05),新生儿胆红素指数及Apgar评分的发生率低于剖宫产组(P<0.01)。结论:剖宫产对母婴造成的健康危害远远大于阴道顺产方式,医护人员应谨慎选择产妇分娩方式,建议产妇选择对自身及婴儿健康程度损伤性小的分娩方式,从而利于母婴的健康。     

Changes in human milk vitamin E and total lipids during the first twelve days of lactation

Our previous study showed vitamin E deficiency in newborns (69.7%) and mothers at term (85.9%) when the ratio between serum vitamin E in mg/dl and total lipids in g/dl was used as an indicator of vitamin E status. This study was conducted to determine the human milk content of vitamin E. During the first 12 days of lactation milk vitamin E levels remained almost constant (day 1, 0.68 mg/dl; day 12, 0.65 mg/dl), milk total lipid levels increased daily (day 1, 1.11 g/dl; day 12, 3.60 g/dl), and the ratio between milk vitamin E and total lipids dropped steadily (day 1, 1.3; day 12, 0.2). In spite of this drop in vitamin E status, it is unlikely that vitamin E availability will be affected in neonates, because normal neonates absorb milk fats well and this ability increases with age.     

Association between fat content of breast milk and maternal nutritional status and infants' weight in tabriz, iran

The aim of this study was to investigate the relationship between breast milk fat content with maternal anthropometric status, energy and macronutrient intake and weight for age Z-score of exclusively breastfed infants. Breast milk samples and information on energy and macronutrients intake (using 24-hour recall method for 3 days) were collected from 182 lactating women. Weight and height of mothers and infants were measured and the body mass index (BMI) and weight for age Z-score (WAZ) were calculated. The fat content of the milk samples was measured by the Gerber method. The mean daily energy intake was 2390 ± 405 kcal which was lower than the recommended values for mothers. The mean fat content of the milk samples was 3.52 ± 1.41 g/dl, which was significantly associated with dietary carbohydrate consumption (β= 0.39, P<0.004) and BMI (β= 0.28, P<0.02). A significant association between the WAZ of infants and maternal BMI (β= 0.36, P<0.001) was recorded. The WAZ of infants whose mothers' breast milk lipid content was more than 3 g/dl was significantly higher than those whose mothers had lower breast milk lipid content (P<0.031). Further studies need to be done on the effect of fat content of breast milk on infant's weight and how maternal factors regulate the composition of breast milk.     

Length of gestation and nutritional composition of human milk

A comparative analysis of the composition of milk produced during the first 14 days of lactation by mothers who deliver prematurely and those who deliver at term is described and these values are contrasted with the composition of donor milk specimens. Twenty-four-hour milk collections (days 3, 7, and 14 postpartum) were obtained from nine mothers delivered between 37 to 42 wk gestation (term) and from 14 mothers who delivered between 28 to 36 wk gestation (preterm). A single spot milk collection was obtained from nine mothers who were 6 to 10 months postpartum (donor). Term and preterm milk was compared on specific postpartum days using an analysis of covariance controlling for 24-h milk volume. The protein, carbohydrate, fat, and energy content varied in a similar fashion in term and preterm milk over the 14 postpartum days studied. Furthermore, there was no significant difference between the two milk groups on any single postpartum day evaluated in terms of protein, carbohydrate, fat, or energy concentration. The milk volumes were significantly greater from the mothers delivered at term on days 7 and 14 (p less than 0.01) and the protein content of both term and preterm milk was negatively correlated with milk volume (r = -0.6 or more on each day studied). The nutrient and energy composition of spot donor milk was highly variable and frequently quite different from either term or preterm 24-h milk collections. These data indicate that milk from mothers who deliver prematurely does not contain significantly different concentrations of nutrients or energy than milk from mothers delivered at term and suggest that the differences previously noted between the two groups may be related to 24-h milk volume.