Vitamin K1 content of maternal milk: influence of the stage of lactation, lipid composition, and vitamin K1 supplements given to the mother

Using a sensitive electrochemical assay for vitamin K1 and standardized techniques for breast-milk collection, we studied the vitamin K1 content of human milk during the first 5 wk of lactation with respect to 1) individual and interindividual differences, 2) the relationship of vitamin K1 to other lipids, and 3) the influence of oral supplements of vitamin K1 on breast milk concentrations. Comparison of fore and hind milk from the mothers revealed higher vitamin K1 concentrations in hindmilks, suggesting that the lipid content influences the vitamin K1 concentration in maternal milk. Samples of maternal milk from nine mothers collected from day 1 to day 36 of lactation showed significantly higher vitamin K1 concentrations in colostral milk than in mature milk. For colostral milk there was a significant correlation of vitamin K1 to cholesterol (r = 0.62) but not to total lipid or phospholipid suggesting a role for cholesterol in the secretion of vitamin K1 into colostral milk. For mature milk correlation coefficients of vitamin K1 with all lipids were low (r = 0.29-0.37) suggesting that at later stages of lactation dietary fluctuations of vitamin K1 may be a more important determinant of the vitamin K1 content of breast milk than the lipid composition. To test the influence of diet, mothers were given oral supplements of vitamin K1.(ABSTRACT TRUNCATED AT 250 WORDS)     

人乳质和量的非疾病性母源影响因素

人乳是新生婴儿最天然、最健康的食物.人乳研究发现乳汁分泌量和许多成分的含量存在明显个体差异;但对于同一个体而言,某些乳汁成分不受环境及母体本身各种因素的影响,如蛋白质、乳糖,而另一些成分易波动,如脂肪、干物质等浓度随各种条件的变化而变化.母体疾病可影响乳汁质和量,乳母膳食、心情、生活习惯等也可使乳汁中脂肪酸、干物质、细胞因子等发生变化.为帮助哺乳母亲为婴儿提供更优质的乳汁,更好地实现人乳喂养,该文对人乳各成分的变化特点及非疾病性的母源性影响因素作一综述.     

Lipid and trace element composition of human milk

The recent work on lipids and trace elements in human milk has been reviewed. Lipids in human milk are specially important for the development of the central nervous system of the infant, in addition to being a source of nutrients. Recent studies revealed that the concentration of total lipids was low in milk samples from Indian women belonging to the low socio-economic group: linoleic acid constituted a high percent of the fatty acids. The bile-stimulated lipase activity of milk was higher in Ethiopian than in Swedish milk samples. Vitamin D sulphate, the water soluble conjugate of vitamin D, was present in higher concentrations than that reported for vitamin D in lipid fraction; however, the antirachitic activity of vitamin D sulphate is yet to be studies. Copper, zinc, and magnesium concentrations were high in sampled obtained during the first month of lactation. Copper and zinc levels continued to fall gradually till the end of one year lactation. The mean concentrations of zinc and copper in mature milk samples from Indian mothers were similar to those in American samples, though both the samples showed wide variation. A high proportion of zinc in milk was bound to proteins.     

Proximate principle and energy content of human milk in well-nourished urban mother

Milk samples from 54 well-nourished urban mothers between the age of 18-36 years were studied. The birth weight of infants ranged between 2.5 to 3.9 kg at full term. The mean (g or Cal/100 ml) lactose (6.51), protein (1.08), fat (4.48) and energy contents (74.83) of milk was on par with the well-nourished mothers of developed countries. The milk fat content observed was higher than that reported in under nourished mothers from developing countries.     

Energy and respiratory metabolism in cystic fibrosis: the influence of carbohydrate content of nutritional supplements

The basal energy expenditure (BEE) in a group of adolescent and young adult patients with cystic fibrosis (CF) with mild lung disease was 97 +/- 6% of that predicted by the Harris-Benedict equation (which estimates BEE by age, sex, height, and weight). The BEE of a group with more severe lung disease was 117 +/- 5% of that predicted by the Harris-Benedict equation, due primarily to a 14% greater oxygen consumption (VO2) and 24% greater CO2 production (VCO2) compared with milder lung disease (p less than 0.05). The measured BEE in the patients with mild lung disease correlated well with the predicted BEE, but variably underestimated that of patients with more advanced lung disease. The influence of low carbohydrate (Pulmocare) and higher carbohydrate (Instant Breakfast) nutritional supplements on the energy and pulmonary metabolism was compared in 10 malnourished CF patients with moderate to severe lung disease. Their BEE before ingesting the supplements was 120% of that predicted by the Harris-Benedict equation. Their VCO2 increased 9-19% for the 3 h after ingesting 500 kcal/M2 of Pulmocare, and 25-30% after ingesting Instant Breakfast (p less than 0.05). The respiratory quotient (RQ) was significantly greater for Instant Breakfast than Pulmocare. The minute ventilation (VE) rose 10-13% for the 3 h after ingesting Pulmocare, versus 27-31% after ingesting Instant Breakfast, but the difference was not significant. The metabolic expenditure rose 13-16% for the 3 h after ingesting both formulas. We concluded that CF patients have increasing difficulty maintaining their nutrition as their pulmonary disease progresses, in part because of a 17-20% increase in their BEE.(ABSTRACT TRUNCATED AT 250 WORDS)     

Experimental milk formulae with reduced protein content and desialylated milk proteins: influence on the faecal flora and the growth of term newborn infants

We have assessed the growth, tolerance and the faecal flora composition in healthy infants on different feeding regimens. Four groups of infants were fed exclusively on mother's milk, a standard formula and two experimental formulae. The first experimental formula consisted of a milk with a reduced protein content (1.2 g/100 ml), the second in a formula with the same protein content and with milk proteins desialylated by mild acid hydrolysis. The aim of the study was to test whether lowering the protein content and/or modifying the proteins by desialylation would favour the development of a bifidus flora. A bifidus flora was detected in 60% of breastfed infants at 1 month of life. All formulae employed during the study failed to induce a prevalence of colonization with bifidobacteria at 1 month of age. The two experimental milk formulae were well tolerated, but the infant growth rate was slightly lower as compared to the breastfed infants and the infants fed the standard formula. The presence in milk formulae of pre-digested and desialylated proteins can offer some advantages in term of digestibility and mimic a physiological intestinal mechanism of the infant.     

Prenatal, intrapartum, and postpartum support of the lactating mother

Physicians must continue to improve their knowledge regarding lactation. Improved education will allow for alterations in standard practices that may deter breastfeeding. Presently known influences on successful breastfeeding should direct changes in clinic and hospital practices. Continued research into various aspects of care in and out of the hospital must be pursued to improve maternal-infant care and breastfeeding.     

Evaluation of the trace metal supplements for a synthetic low lactose diet.

A trace element supplement used with a synthetic low lactose milk (Galactomins 17 and 18) has been evaluated by means of metabolic balance studies in 4 infants with dissacharide intolerances. The supplement was considered satisfactory for iron and manganese but increases in its zinc and copper content are probably necessary to ensure adequate retentions of these metals.     

Labor pain effects on colostral milk beta-endorphin concentrations of lactating mothers

beta-Endorphin (beta-EP) levels of colostral milk are approximately two-fold higher than in plasma of lactating women, in who concentrations peak at term, after the first and second stages of labor. We investigated the effect of labor pain and vaginal parturition on colostral beta-EP concentrations (beta-endorphin (125)I RIA, Incstar Corp., Stillwater, Minn., USA) of at-term nursing mother, in comparison to those having undergone elective cesarean section. Our results show that colostral milk beta-EP concentrations of mothers who delivered vaginally are significantly higher on the 4th postpartum day (6.0 +/- 0.5 vs. 4.3 +/- 0.4 pmol/l, respectively; p < 0.01) than colostral levels of mothers who underwent cesarean section. These data indicate the important influence of the labor process on the colostral opioid galactopoiesis. It is suggested that labor and parturition pain may increase colostral milk beta-EP concentrations of lactating mothers in order to help the newborn overcome the stressful perinatal events of natural labor and delivery.     

The effect of food supplements on the bioavailability of breast milk for premature infants--fecal fat and carbohydrate excretion

Faecal excretion of fat and carbohydrates was studied in 14 preterm infants fed on raw mother's milk (group I) or banked fortified human milk (group II) at days 7, 14, 21 and 28 of postnatal life: group I: n = 5; 31.0 +/- 2.0 weeks; 1954 +/- 441 g; group II: n = 9; 32.0 +/- 1.0 weeks; 1806 +/- 176 g. Mixtures of amino acids, peptides, minerals, dextrine and maltose were designed for fortifying banked human milk. There were no significant differences between faecal excretion of fat and carbohydrates in both feeding groups. The investigated human milk fortifier helps to realize the protein-energy ratio needed in preterm infants with well tolerable volumes of feeding and without stressing their limited digestive capacity.     

The influence of a slow-release multi-trace element ruminal bolus on trace element status,number of ovarian follicles and pregnancy outcomes in synchronized Afshari ewes

Published data on the effects of ruminal bolus on the number of ovulatory follicles in ewes does not exist. The present study determined the effects of a ruminal bolus on trace element status, follicular dynamics and reproductive performance in ewes. Eighty Afshari cycling ewes were synchronized during breeding season using CIDR for 14 days and assigned to 4 groups (n=20); group 1 received a single Ferrobloc bolus four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 2 received two boluses four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 3 received only 400 IU eCG on CIDR removal and group 4 (control) received no bolus and no eCG. Transrectal ultrasonography was done to monitor the ovarian follicles on the day of CIDR removal and a day later. Results showed that boluses increased the status of copper, selenium and iodine on mating day and days 90 to 100 of gestation. Ruminal bolus did not significantly increase the number of different classes of ovarian follicles in ewes fed a diet meeting all trace mineral requirements. All ewes eventually became pregnant with 1 or 2 boluses but the multiple births rate (80%) was higher (P<0.05) after 2 boluses compared to the other groups.Key Words: Reproductive performance, Ruminal bolus, Follicle, Trace elements, Afshari ewe     

Effect of water supplementation of full-term newborns on arrival of milk in the nursing mother

It has been suggested that water supplementation of breast-fed newborns may delay the arrival of true milk. A total of 136 healthy term neonates were divided into two groups. Seventy-eight nursed exclusively on demand, and 58 received in addition supplemental water ad lib. Mean time for arrival of milk in the unsupplemented group was 54.9 hours and in the supplemented group 56.6 hours. This difference was not significant, indicating that water supplementation to the normal term newborn does not affect or disrupt the establishment of lactation.     

Storage of human milk and the influence of procedures on immunological components of human milk

The storage of human milk for use later by the mother's own infant or an unrelated recipient has an impact on its constituents. These effects involve the storage container, heating, cooling and freezing the milk. Overall, glass is the least destructive container. Milk can be safely refrigerated for 72 h with little change. Freezing destroys cellular activity and reduces vitamins B₆ and C. Boiling, in addition, destroys lipase and reduces the effect of immunoglobulin A and secretory immunoglobulin A. The nutrient value of human milk is essentially unchanged, but the immunological properties are reduced by various storage techniques.