Breast milk tocopherol content during the first six months in exclusively breastfeeding Greek women

Purpose  

To determine tocopherol and fat content of Greek mother’s milk during the first 6 months of exclusive breastfeeding and correlate with maternal diet characteristics.     

Growth pattern of exclusively breast-fed infants during the first six months of life in Ile-Ife,Osun State,Nigeria

Several studies to determine the growth pattern of exclusively breast fed infants have provided varying conclusions as to the sufficiency of breast milk alone to support adequate growth for the first six months of life. Disagreement exists concerning the optimal timing of introduction of complementary foods to exclusively breast fed infants. This prospective study thus examined the adequacy of breast milk alone to support normal growth during the first six months of life in our environment. The overall objective was to propose a scientifically sound national recommendation on the appropriate timing for the introduction of complementary feeding in Nigeria. Three hundred and fifty-two mother/infant pairs were serially recruited into the study; all babies were aged 14 days or less and weighed 2.5 kg and above. Three hundred and forty-five (98%) were successfully followed up till the infants were six months old. By six months, 264 (76.5%) were exclusively breast-fed, while 81 (23.5%) had commenced complementary feeding. Growth curves of exclusively breast-fed infants showed increasing weight from birth to six months. Although the 50th percentile birth weight for both boys and girls were the same (3.2 kg), boys gained weight faster than the girls from the age of one month to six months and were heavier at six months. Additionally, the 50th percentile curves of these infants (both genders) for the first six months were above the 50th percentile curve of the World Health Organisation and National Centre for Health Statistics (WHO/NCHS) reference currently used on our national "road to health" (growth monitoring) cards. It was concluded that exclusive breast-feeding supported adequate growth during the first six months of life for most of the children studied and that our national recommendation that infants be introduced to complementary feeding at six months is appropriate.     

Breast milk composition: fat content and fatty acid composition in vegetarians and non-vegetarians

Milk from vegetarians contained a lower proportion of fatty acids derived from animal fat and a higher proportion of polyunsaturated fatty acids derived from dietary vegetable fat. No significant differences were observed between dietary groups in percent fat in the milk or in proportions of fatty acids synthesized de novo in the mammary gland. Among women consuming less than 35 g animal fat per day, percent milk fat was significantly correlated with animal fat intake. Among women consuming greater than 35 g animal fat, percent fat in milk was positively correlated with percent of C10:0, C12:0, and C18:3 and negatively correlated with percent of C16:0 and C18:0 in the milk fat. These findings suggest that there is a maximum amount of C16:0 and C18:0 that can be taken up from the blood and subsequently secreted into the milk.     

Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation

OBJECTIVE: To investigate the relation between maternal smoking habits, plasma lipids and milk fatty acid (FA) content and composition. DESIGN: Breastfeeding mothers who gave birth to healthy, full-term infants were recruited. Mothers were interviewed on smoking habits, being defined smokers (S) when usually smoking at least five cigarettes per day before pregnancy. SETTING: Department of Pediatrics, San Paolo Hospital, Milan, Italy. SUBJECTS: In total, 92 mothers: 61 non-S (NS) and 31 S. INTERVENTIONS: Pooled hindmilk was collected at the first raise of milk (colostrum stage), 1, 3 and 6 months, and total lipid (TL) content and fatty acid (FA) composition were evaluated. Maternal dietary habits were assessed by a food-frequency questionnaire. Two subsamples (16 NS, 6 S) were investigated after delivery and at 3 months for serum lipids and FA status. At 6 months after delivery, the number of mothers still breastfeeding decreased to 30. Variables were compared using nonparametric tests. RESULTS: In smoking mothers serum levels of triglycerides, cholesterol and low-density lipoproteins were higher, while those of high-density lipoproteins were lower. TL content in breast milk was similar in the two groups just after delivery but higher in milk from NS at 1 month. TL content and FA absolute amounts of linoleic, arachidonic, alpha-linolenic and docosahexaenoic (DHA) acid in breast milk were lower in S vs NS 1 month after delivery. Also 3 months after delivery, the breast milk of smoking mothers contained less DHA than the breast milk of nonsmoking mothers. CONCLUSIONS: Maternal cigarette smoking in early pregnancy is associated with higher plasma lipid levels and lower milk TL and DHA content in the first months of lactation.     

Boron concentrations in milk from mothers of exclusively breast-fed healthy full-term infants are stable during the first four months of lactation

Because boron is a bioactive element that satisfies several of the criteria for essentiality in humans, the aim of the present work was to determine the profile of boron metabolism in human milk during the first 4 mo of lactation. The concentration of boron and other minerals was determined in archived milk collected (1980-84) 1 time/mo for 4 mo from lactating mothers of full-term, exclusively breast-fed infants living in Houston, TX. A linear model (treating month as a continuous variable) indicated that B concentrations were stable (P = 0.14) between mo 1 [3.88 +/- 0.6 mumol (42 +/- 6.5 microg)/L milk] and 4 [3.24 +/- 0.6 micromol (35 +/- 6.5 microg)/L milk, mean +/- SEM]. Mg concentrations increased slightly over time (1.18 +/- 0.09 to 1.36 +/- 0.09 mmol/L, P < 0.0001), whereas Ca concentrations decreased slightly (7.01 +/- 0.29 to 6.68 +/- 0.29 mmol/L milk, P < 0.02) and Zn decreased substantially (0.04 +/- 0.004 to 0.02 +/- 0.004 mmol/L milk, P < 0.0001). Similarities in findings reported here and earlier (from samples collected in St. John's, Newfoundland) provide further evidence that boron may be metabolically regulated. Future investigations of boron regulatory mechanisms should focus on metabolism of bone as the major storage site of B and kidney excretion, the major excretory route for B.     

Breast milk fatty acid composition differs between overweight and normal weight women: the STEPS Study

Objective

We studied differences in breast milk fatty acid (FA) composition between overweight and normal weight women and the effect of FA composition on children’s cholesterol concentrations at 13 months and growth from birth to 13 months.

Methods

Samples were collected from lactating women (n = 100) participating in STEPS study at infant’s age of 3 months, and FA composition was analyzed with gas chromatography. Diet of mother was studied with Index of Diet Quality at third trimester of pregnancy and with food frequency questionnaire on sampling day. The children’s weights and heights were collected from hospital records at birth and during study visits at 13 months.

Results

Overweight women’s breast milk compared to normal weight women’s breast milk contained higher amount of saturated FAs (46.3 vs. 43.6 %, P = 0.012), lower amount of n-3FAs (2.2 vs. 2.7 %, P = 0.010), lower ratio of unsaturated to saturated FAs (1.1 vs. 1.3, P = 0.008), and higher ratio of n-6 to n-3 FAs (5.7 vs. 4.9, P = 0.031) than those of normal weight women even after adjusting for maternal diet (P < 0.05 for all). Normal weight women adhered more to dietary recommendations during pregnancy, whereas no differences were found in diet at sampling 3 months postpartum. The children’s weight gains correlated with saturated FAs (R = 0.22, P = 0.04) and the ratio of unsaturated to saturated FAs (R = ?0.23, P = 0.038) in milk; however, effects diminished after adjusting for total duration of breastfeeding. Milk FA composition was not associated with children’s cholesterol concentrations at 13 months.

Conclusions

Breast milk FA composition differed between overweight and normal weight women.     

Arsenic in breast milk during the first 3 months of lactation

Increased concentrations of arsenic were found in soil and ground water from a military training area in Munster, Lower Saxony, Germany, where chemical weapons were dumped after World War II. In order to assess the possible impact of this contamination for nursing new-borns and infants, samples from breast milk of 36 women were analysed with respect to arsenic content. Study participants came from three different regions: the city of Hamburg, the rural area of Soltau, Lower Saxony, and from Munster, the potentially contaminated area. Breast milk samples were collected immediately before and after nursing on days 2, 5, 15, 30, 45, 60, 75, and 90 post partum. At least 10 ml were required for measurements of arsenic, and 187 samples were of that volume. Samples were analysed with a Perkin-Elmer Type 403 hydride-generation atomic absorption spectrometer, equipped with an arsenic EDL-lamp. Arsenic was not detectable, i.e. below 0.3 microgram/l, in 154 of 187 samples. The highest concentration of 2.8 micrograms/l was measured in a sample from the rural area of Soltau. Geometric means of arsenic concentrations were comparable in the three regions. Concentrations did neither differ in samples obtained before and after nursing nor with respect to age of the infant. The calculated daily intake of arsenic was in the range of 0.02 to 0.06 microgram per kg body weight, which is far below the lower limit of daily permissible intake for adults (WHO/JECFA recommendation 1993) of 15 micrograms/kg/wk. In conclusion, we found concentrations of arsenic in breast milk within the reported safety limits. This was also true for samples from women living in a region which has previously been shown to be contaminated with arsenic from chemical weapons.     

Breast milk sodium content in rural Gambian women: between‐ and within‐women variation in the first 6 months after delivery

Richards AA, Darboe MK, Tilling K, Smith GD, Prentice AM, Lawlor DA. Breast milk sodium content in rural Gambian women: between‐ and within‐women variation in the first 6 months after delivery. Paediatric and Perinatal Epidemiology 2010; 24 : 255–261. It has been suggested that infancy is a particularly sensitive period with respect to the effect of dietary sodium on future risk of hypertension. One difficulty of researching the effects of early sodium intake on later health is accurately measuring sodium intake from breast milk. In observational studies, sodium content has been calculated by estimating breast milk volume consumed and assuming a fixed sodium concentration for all women at all times (a standardised measure). The objectives of this study were to investigate the variation in breast milk sodium concentration in the first 6 months postpartum within women and test whether the pattern of change in sodium concentration differs between women. The study population was 197 rural Gambian women. Multilevel models were used to investigate whether the sodium content of breast milk changed over time within and between women. Fractional polynomials were used to identify the best‐fitting functions of age to be included in the within and between variance functions. Sodium levels decreased with time; the reduction was initially rapid (levels decreasing by 17.7% between 30 and 60 days after delivery). Immediately after birth, there was substantial variation in breast milk sodium content between women but this reduced with time. Our results suggest that it is not appropriate to use a standardised measure of breast milk sodium content when direct measurement is possible – particularly when there is a research interest in measuring sodium intake in very early infancy.     

Salmon consumption during pregnancy alters fatty acid composition and secretory IgA concentration in human breast milk

Fish oil supplementation during pregnancy alters breast milk composition, but there is little information about the impact of oily fish consumption. We determined whether increased salmon consumption during pregnancy alters breast milk fatty acid composition and immune factors. Women (n = 123) who rarely ate oily fish were randomly assigned to consume their habitual diet or to consume 2 portions of farmed salmon per week from 20 wk of pregnancy until delivery. The salmon provided 3.45 g long-chain (LC) (n-3) PUFA/wk. Breast milk fatty acid composition and immune factors [soluble CD14, transforming growth factor-β (TGFβ)1, TGFβ2, and secretory IgA] were analyzed at 1, 5, 14, and 28 d postpartum (PP). Breast milk from the salmon group had higher proportions of EPA (80%), docosapentaenoic acid (30%), and DHA (90%) on d 5 PP compared with controls (P < 0.01). The LC (n-6) PUFA:LC (n-3) PUFA ratio was lower for the salmon group on all days of PP sampling (P ≤ 0.004), although individual (n-6) PUFA proportions, including arachidonic acid, did not differ. All breast milk immune factors decreased between d 1 and 28 PP (P < 0.001). Breast milk secretory IgA (sIgA) was lower in the salmon group (d 1-28 PP; P = 0.006). Salmon consumption during pregnancy, at the current recommended intakes, increases the LC (n-3) PUFA concentration of breast milk in early lactation, thus improving the supply of these important fatty acids to the breast-fed neonate. The consequence of the lower breast milk concentration of sIgA in the salmon group is not clear.     

Patterns of infant feeding in the first six months

A quasi-experimental six months longitudinal study of women planning to breastfeed was carried out in Vancouver, B.C., Canada. The purpose was to increase breastfeeding duration through the provision of nursing support, and information about breastfeeding. This paper reports on the patterns of infant feeding by 131 mothers for six months postpartum. Included are data on initiation of breastfeeding, feeding intervals, supplementation, initiating semi-solids and duration of breastfeeding. Unsupplemented breastfeeding declined from 90.8% at the time of discharge from hospital to 65% at one month, 45% at three months and 3.9% at six months. For some infants, semi-solids were introduced at one month and by three months 11.4% were being fed semi-solids. The implications for health care professionals caring for breastfeeding women are outlined.     

Trace element compositional changes in human milk during the first four months of lactation

The aims of this paper were to evaluate changes in specific oligoelements in human milk during the first four months of lactation and to correlate such changes with total antioxidant status (TAS) and other parameters, such as the mother’s age, primipara versus multipara, and supplement intake. Milk samples were collected from 31 lactating women following 1, 4, 8, 12 and 16 weeks after birth. Trace levels of 13 elements were measured by inductively coupled plasma-mass spectrometry (ICP-MS). The results obtained for the oligoelements exhibited a decrease in concentration from 7 days to 4 months of breast-feeding, with exceptions. Correlations were found between TAS and Co, V, Rb and Tl. Between primipara and multipara, differences were found for Ni and Rb. Regarding the mother’s age, correlation was found for Rb and Ba (increased for mothers older than 30 years). Increased amounts of Rb, Mo and Tl at any lactation period appeared in women who took supplements.     

Conjugated linoleic acids alter milk fatty acid composition and inhibit milk fat secretion in dairy cows.

Conjugated linoleic acids (CLA) have positive health effects in experimental models. Our objective was to determine the effect of CLA supplementation on milk of dairy cows. A commercial source of CLA was infused abomasally to by-pass rumen fermentation. The supplement contained 61.2% CLA; the major CLA isomers were cis/trans 8,10, cis/trans 9,11, cis/trans 10,12 and cis/trans 11,13. Four Holstein cows were used in a 4 x 4 Latin square design. Treatments were 5-d infusions of 0, 50, 100 and 150 g/d of CLA supplement. Infusion increased milk fat content of CLA from 6.8 mg/g fat (zero dose) to 63.6 mg/g fat (highest dose). All of the major CLA isomers in the supplement were transferred to milk fat in a dose-dependent manner. Apparent efficiency of transfer to milk fat was 22.5, 22.5, 10.2 and 26.3% for cis/trans 8,10, cis/trans 9,11, cis/trans 10,12 and cis/trans 11,13, respectively. CLA infusion had no effect on milk protein and little effect on milk yield (21.5, 20.4, 20.9 and 18.3 kg/d for 0, 50, 100 and 150 g/d CLA supplement, respectively). However, CLA infusion dramatically reduced milk fat. On average, the content and yield of milk fat were reduced by 52 and 55%, respectively. The role of specific CLA isomers and mechanism(s) for the reduction in milk fat have not been established, although the pattern of milk fatty acids demonstrated effects were most pronounced on de novo fatty acid synthesis and the desaturation process. Overall, dietary supplemention of CLA increased milk fat content of CLA, altered milk fatty acid composition and markedly reduced the content and yield of milk fat.     

Delayed excess mortality after exposure to measles during the first six months of life

In an urban area of Guinea-Bissau, 71 children exposed to measles before age 6 months had a mortality risk of 34% (95% confidence interval (Cl) 24-47) between 6 and 60 months of age. The mortality risk for the 205 other children of the same birth cohort who had not been exposed to or developed measles was 11% (95% Cl 9-15), a significant difference compared with exposed children. With a version of the Cox regression model, maternal education was found to be the only background factor with a significant effect on mortality. When background factors were controlled for, the mortality of children exposed to measles was significantly higher than that of controls in each of the age intervals 6-11, 12-23, and 24-35 months. For the large subgroup of children of mothers without any formal education, exposed children had 5.7 times (95% Cl 2.7-12.0) higher mortality than did the control children in the age interval 6-35 months. Diarrhea deaths were particularly common among exposed children. Of 22 children who had been exposed before age 6 months during a subsequent epidemic and had a blood test taken, there was a significantly higher mortality risk (27%) between 6 months and 5 years than in the 26 controls who had a blood test (0%). Children who had elevated antibody titers to measles after exposure had a particularly high mortality compared with controls. These results suggest that later childhood mortality may be related to infectious experiences during the first months of life. The possible long-term health consequences of exposure to measles virus should be considered when assessing the value of measles control programs.     

Molybdenum content of term and preterm human milk during the first 2 months of lactation

To assess the molybdenum supply and requirements of preterm infants, Mo concentration was determined in milk from mothers of 6 term and 11 preterm newborns; no difference was found between fore- and hindmilk and no diurnal variations were found during 24-h collections. Respective values (means +/- SD) of term and preterm milks were 10.2 +/- 3.7 and 4.0 +/- 3.7 micrograms/L (106.2 +/- 38.5 and 41.7 +/- 38.5 nmol/L) at 3-5 d of lactation, 4.8 +/- 3.9 and 3.7 +/- 3.8 micrograms/L (50.0 +/- 4.6 and 38.5 +/- 39.6 nmol/L) at 7-10 d, 1.5 +/- 1.4 and 1.4 +/- 0.9 micrograms/L (15.6 +/- 14.6 and 14.6 +/- 9.6 nmol/L) at 14 d, 2.6 +/- 2.2 and 1.9 +/- 1.4 micrograms/L (27.1 +/- 22.9 and 19.8 +/- 14.6 nmol/L) at 1 mo, and 0.2 and 1.2 +/- 0.5 micrograms/L (2.1 and 12.5 +/- 5.2 nmol/L) at 2 mo. A statistical difference was found between term and preterm milk at 3-5 d of lactation. During lactation significant changes were found between the periods 3-5 d and 7-10 d, 14 d, 1 mo (p less than 0.01) and 2 mo (p less than 0.05) of lactation and between 7-10 d and 14 d (p less than 0.05). According to the requirements of the preterm infant, a supplementation of 2-3 micrograms.kg-1.d-1 by enteral route is suggested.