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Dietary Intake and Milk Micronutrient Levels in Lactating Women with Full and Partial Breastfeeding

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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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References

  • Abdulrazzaq, Y. M., Osman, N., Nagelkerke, N., Kosanovic, M., & Adem, A. (2008). Trace element composition of plasma and breast milk of well-nourished women. Journal of Environmental Science and Health, Part A Toxic/Hazardous Substances and Environtal Engineering, 43(3), 329–334. https://doi.org/10.1080/10934520701792878.

    Article  CAS  Google Scholar 

  • Choi, Y. K., Kim, J. M., Lee, J. E., Cho, M. S., Kang, B. S., Choi, H., & Kim, Y. (2016). Association of maternal diet with zinc, copper, and iron concentrations in transitional human milk produced by Korean mothers. Clinical Nutrition Research, 5(1), 15–25. https://doi.org/10.7762/cnr.2016.5.1.15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Clark, K. M., Li, M., Zhu, B., Liang, F., Shao, J., Zhang, Y., et al. (2017). Breastfeeding, mixed, or formula feeding at 9 months of age and the prevalence of iron deficiency and iron deficiency anemia in two cohorts of infants in China. Journal of Pediatrics, 181, 56–61.

    Article  CAS  Google Scholar 

  • Dempsey, C., McCormick, N. H., Croxford, T. P., Seo, Y. A., Grider, A., & Kelleher, S. L. (2012). Marginal maternal zinc deficiency in lactating mice reduces secretory capacity and alters milk composition. The Journal of Nutrition, 142(4), 655–660. https://doi.org/10.3945/jn.111.150623.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dijkhuizen, M. A., Wieringa, F. T., & West, C. E. (2001). Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia. American Journal of Clinical Nutrition, 73(4), 786–791.

    CAS  Google Scholar 

  • Domellof, M., Lonnerdal, B., Dewey, K. G., Cohen, R. J., & Hernell, O. (2004). Iron, zinc, and copper concentrations in breast milk are independent of maternal mineral status. American Journal of Clinical Nutrition, 79(1), 111–115.

    Article  Google Scholar 

  • Dorea, J. G. (2002). Zinc deficiency in nursing infants. Journal of the American College of Nutrition, 21(2), 84–87.

    Article  CAS  Google Scholar 

  • Dumrongwongsiri, O., Suthutvoravut, U., Chatvutinun, S., Phoonlabdacha, P., Sangcakul, A., Siripinyanond, A., et al. (2015). Maternal zinc status is associated with breast milk zinc concentration and zinc status in breastfed infants aged 4–6 months. Asia Pacific Journal of Clinical Nutrition, 24(2), 273–280. https://doi.org/10.6133/apjcn.2015.24.2.06.

    Article  CAS  PubMed  Google Scholar 

  • Erick, M. (2018). Breast milk is conditionally perfect. Medical Hypotheses, 111, 82–89. https://doi.org/10.1016/j.mehy.2017.12.020.

    Article  CAS  PubMed  Google Scholar 

  • Hannan, M. A., Faraji, B., Tanguma, J., Longoria, N., & Rodriguez, R. C. (2009). Maternal milk concentration of zinc, iron, selenium, and iodine and its relationship to dietary intakes. Biological Trace Element Research, 127(1), 6–15. https://doi.org/10.1007/s12011-008-8221-9.

    Article  CAS  PubMed  Google Scholar 

  • Jarjou, L. M., Goldberg, G. R., Coward, W. A., & Prentice, A. (2012). Calcium intake of rural Gambian infants: a quantitative study of the relative contributions of breast milk and complementary foods at 3 and 12 months of age. European Journal of Clinical Nutrition, 66(6), 673–677. https://doi.org/10.1038/ejcn.2012.7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD003517.pub2.

    Article  Google Scholar 

  • Krebs, N. F., & Westcott, J. (2002). Zinc and breastfed infants: if and when is there a risk of deficiency? Advance in Experimental Medicine and Biology, 503, 69–75.

    Article  CAS  Google Scholar 

  • Leotsinidis, M., Alexopoulos, A., & Kostopoulou-Farri, E. (2005). Toxic and essential trace elements in human milk from Greek lactating women: association with dietary habits and other factors. Chemosphere, 61(2), 238–247. https://doi.org/10.1016/j.chemosphere.2005.01.084.

    Article  CAS  PubMed  Google Scholar 

  • Lonnerdal, B. (2007). Trace element transport in the mammary gland. Annual Review of Nutrition, 27, 165–177. https://doi.org/10.1146/annurev.nutr.27.061406.093809.

    Article  CAS  PubMed  Google Scholar 

  • Maguire, J. L., Salehi, L., Birken, C. S., Carsley, S., Mamdani, M., Thorpe, K. E., et al. (2013). Association between total duration of breastfeeding and iron deficiency. Pediatrics, 131(5), e1530-1537. https://doi.org/10.1542/peds.2012-2465.

    Article  PubMed  Google Scholar 

  • McKinstry, P. J., Indyk, H. E., & Kim, N. D. (1999). The determination of major and minor elements in milk and infant formula by slurry nebulisation and inductively coupled plasma - optical emission spectrometry (ICP-OES). Food Chemistry, 65(2), 245–252. https://doi.org/10.1016/S0308-8146(98)00183-6.

    Article  CAS  Google Scholar 

  • Mello-Neto, J., Rondo, P. H., Oshiiwa, M., Morgano, M. A., Zacari, C. Z., & dos Santos, M. L. (2013). Iron supplementation in pregnancy and breastfeeding and iron, copper and zinc status of lactating women from a human milk bank. Journal of Tropical Pediatrics, 59(2), 140–144. https://doi.org/10.1093/tropej/fms055.

    Article  PubMed  Google Scholar 

  • Montalbetti, N., Dalghi, M. G., Albrecht, C., & Hediger, M. A. (2014). Nutrient transport in the mammary gland: calcium, trace minerals and water soluble vitamins. Journal of Mammary Gland Biology and Neoplasia, 19(1), 73–90. https://doi.org/10.1007/s10911-014-9317-9.

    Article  PubMed  Google Scholar 

  • Moser, P. B., & Reynolds, R. D. (1983). Dietary zinc intake and zinc concentrations of plasma, erythrocytes, and breast milk in antepartum and postpartum lactating and nonlactating women: a longitudinal study. American Journal of Clinical Nutrition, 38(1), 101–108.

    Article  CAS  Google Scholar 

  • Nakamori, M., Ninh, N. X., Isomura, H., Yoshiike, N., Hien, V. T. T., Nhug, B. T., et al. (2009). Nutritional status of lactating mothers and their breast milk concentration of iron, zinc and copper in rural Vietnam. Journal of Nutritional Science and Vitaminology (Tokyo), 55(4), 338–345.

    Article  CAS  Google Scholar 

  • Nikniaz, L., Mahdavi, R., Gargari, B. P., GayemMagami, S. J., & Nikniaz, Z. (2011). Maternal body mass index, dietary intake and socioeconomic status: differential effects on breast milk zinc, copper and iron content. Health Promotion Perspectives, 1(2), 140–146. https://doi.org/10.5681/hpp.2011.015.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ortega, R. M., Andres, P., Martinez, R. M., Lopez-Sobaler, A. M., & Quintas, M. E. (1997). Zinc levels in maternal milk: the influence of nutritional status with respect to zinc during the third trimester of pregnancy. European Journal of Clinical Nutrition, 51(4), 253–258.

    Article  CAS  Google Scholar 

  • Samuel, T. M., Thomas, T., Thankachan, P., Bhat, S., Virtanen, S. M., & Kurpad, A. V. (2014). Breast milk zinc transfer and early post-natal growth among urban South Indian term infants using measures of breast milk volume and breast milk zinc concentrations. Maternal and Child Nutrition, 10(3), 398–409. https://doi.org/10.1111/j.1740-8709.2012.00421.x.

    Article  PubMed  Google Scholar 

  • Severi, C., Hambidge, M., Krebs, N., Alonso, R., & Atalah, E. (2013). Zinc in plasma and breast milk in adolescents and adults in pregnancy and pospartum: a cohort study in Uruguay. NutricionHospitalaria, 28(1), 223–228. https://doi.org/10.3305/nh.2013.28.1.6258.

    Article  CAS  Google Scholar 

  • Silvestre, M. D., Lagarda, M. J., Farre, R., Martinez-Costa, C., Brines, J., Molina, A., & Clemente, G. (2000). A study of factors that may influence the determination of copper, iron, and zinc in human milk during sampling and in sample individuals. Biological Trace Element Research, 76(3), 217–227. https://doi.org/10.1385/bter:76:3:217.

    Article  CAS  PubMed  Google Scholar 

  • Smith, J. C., Jr., Butrimovitz, G. P., & Purdy, W. C. (1979). Direct measurement of zinc in plasma by atomic absorption spectroscopy. Clinical Chemistry, 25(8), 1487–1491.

    Article  CAS  Google Scholar 

  • Stevens, M. D., Mac Kenzie, W. F., & Anand, V. D. (1977). A simplified method for determination of zinc in whole blood, plasma, and erythrocytes by atomic absorption spectrophotometry. Biochemical Medicine, 18(2), 158–163.

    Article  CAS  Google Scholar 

  • Valentine, C. J., & Wagner, C. L. (2013). Nutritional management of the breastfeeding dyad. Pediatric Clinics of North America, 60(1), 261–274. https://doi.org/10.1016/j.pcl.2012.10.008.

    Article  PubMed  Google Scholar 

  • Vuori, E., Makinen, S. M., Kara, R., & Kuitunen, P. (1980). The effects of the dietary intakes of copper, iron, manganese, and zinc on the trace element content of human milk. American Journal of Clinical Nutrition, 33(2), 227–231.

    Article  CAS  Google Scholar 

  • Wasowicz, W., Gromadzinska, J., Szram, K., Rydzynski, K., Cieslak, J., & Pietrzak, Z. (2001). Selenium, zinc, and copper concentrations in the blood and milk of lactating women. Biological Trace Element Research, 79(3), 221–233. https://doi.org/10.1385/bter:79:3:221.

    Article  CAS  PubMed  Google Scholar 

  • Zhao, A., Ning, Y., Zhang, Y., Yang, X., Wang, J., Li, W., & Wang, P. (2014). Mineral compositions in breast milk of healthy Chinese lactating women in urban areas and its associated factors. Chinese Medical Journal (English), 127(14), 2643–2648.

    Google Scholar 

  • Zhao, A., Xue, Y., Zhang, Y., Li, W., Yu, K., & Wang, P. (2016). Nutrition concerns of insufficient and excessive intake of dietary minerals in lactating women: A cross-sectional survey in three cities of China. PLoS ONE, 11(1), e0146483. https://doi.org/10.1371/journal.pone.0146483.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We acknowledge staff at the Well Child Clinic, Faculty of Medicine Ramathibodi Hospital, and express our sincere thanks to all women and their families for participating in our study. This study was financially supported by the Development potential of Thai people project, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

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Authors and Affiliations

  1. Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand

    Oraporn Dumrongwongsiri, Nalinee Chongviriyaphan, Phanphen Phoonlabdacha & Umaporn Suthutvoravut

  2. Pediatrics Nursing Division, Nursing Service Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand

    Suthida Chatvutinun

  3. Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand

    Areeporn Sangcakul

  4. Department of Chemistry and Center of Excellence for Innovation in Chemistry, Faculty of Science, Mahidol University, 272, Rama VI road, Ratchathewi, Bangkok, 10400, Thailand

    Atitaya Siripinyanond

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  1. Oraporn Dumrongwongsiri
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  2. Nalinee Chongviriyaphan
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Correspondence to Oraporn Dumrongwongsiri.

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Dumrongwongsiri, O., Chongviriyaphan, N., Chatvutinun, S. et al. Dietary Intake and Milk Micronutrient Levels in Lactating Women with Full and Partial Breastfeeding. Matern Child Health J 25, 991–997 (2021). https://doi.org/10.1007/s10995-020-03049-4

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  • DOI: https://doi.org/10.1007/s10995-020-03049-4

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