Longitudinal Changes of Human Milk Nutrient Content in the First 6 Months of Lactation

Kiboi Willy^1, , Kimiywe Judith¹ and Chege Peter¹

¹Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya

Cite this paper:
Kiboi Willy, Kimiywe Judith and Chege Peter. Longitudinal Changes of Human Milk Nutrient Content in the First 6 Months of Lactation. World Journal of Nutrition and Health. 2020; 8(1):1-6. doi: 10.12691/jnh-8-1-1

Abstract

Human milk is considered to be the optimal source of nutrition during the first six months of a child’s life. Since the milk is the only source of nutrition for the first six months of an infant’s life, understanding its composition remains a matter of public health concern. Further, few studies have determined the breast milk composition of lactating mothers in African countries. The aim of this research was to assess longitudinal changes of human milk nutrient content in the first 6 months of lactation. A longitudinal descriptive study with repeated measures was adopted by the study. Breast milk nutrient composition was assessed among lactating mothers at the 1^st and the 5^th month of lactation. The milk energy, lactose, protein, lipids, vitamin A, calcium, magnesium, zinc and iron was assessed at the two time points of lactation (first and fifth month). A total of 104 mature breast human milk samples were collected and analysed for energy and the selected nutrients at the two stages of lactation. Significant differences in the mean nutrient content of proteins (p value = 0.029), vitamin A (p value = 0.004) and iron (p value = 0.015) was observed between the first and the fifth month of lactation. A downward trend in the mean nutrient content for protein was observed while an upward trend was observed for both vitamin A (retinol) and iron between the 1^st and 5^th month of lactation. Human milk nutrient content varies longitudinally in the first six months of lactation. Studies investigating the causes of the variations are critical in improving the quality of human breast milk and ultimately the growth and development of a child.

Keywords:
human milk lactating mother infant nutrient composition

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Ballard, O., & Morrow, A. L. Human Milk Composition: Nutrients and Bioactive Factors. Pediatric Clinics of North America, 2013, 60 (1), 49-74.
[2]	World Health Organization. Infant and young child feeding: A tool for assessing national practices, policies and programmes. World Health Organization, Geneva, 2003.
[3]	Aumeistere, L., Ciproviča, I., Zavadska, D., Bavrins, K., & Borisova, A. Zinc Content in Breast Milk and Its Association with Maternal Diet. Nutrients, 2018, 10(10).
[4]	Isaacs, E. B., Fischl, B. R., Quinn, B. T., Chong, W. K., Gadian, D. G., & Lucas, A. (2010). Impact of breast milk on intelligence quotient, brain size, and white matter development. Pediatric Research, 2010, 67(4), 357-362.
[5]	Horta, B. L., Hartwig, F. P., & Victora, C. G. Breastfeeding and intelligence in adulthood: Due to genetic confounding? The Lancet Global Health, 2018, 6(12), e1276-e1277.
[6]	Martin, C. R., Ling, P.-R., & Blackburn, G. L. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients, 2016, 8(5).
[7]	Motee, A., & Jeewon, R. Importance of Exclusive Breastfeeding and Complementary Feeding among Infants. Current Research in Nutrition and Food Science Journal, 2014, 2(2), 56-72.
[8]	Savino, F., Benetti, S., Liguori, S. A., Sorrenti, M., & Cordero Di Montezemolo, L. Advances on human milk hormones and protection against obesity. Cellular and Molecular Biology (Noisy-Le-Grand, France), 2013, 59(1), 89-98.
[9]	Bai, Y. K., Middlestadt, S. E., Joanne Peng, C.-Y., & Fly, A. D. Psychosocial factors underlying the mother’s decision to continue exclusive breastfeeding for 6 months: An elicitation study. Journal of Human Nutrition and Dietetics: The Official Journal of the British Dietetic Association, 2009, 22(2), 134-140.
[10]	World Health Organization (WHO), United Nations International Children's Fund (UNICEF). Worldwide breastfeeding scorecard. Tracking progress for breastfeeding policies and programmes, 2017.
[11]	Andreas, N. J., Kampmann, B., & Mehring Le-Doare, K. Human breast milk: A review on its composition and bioactivity. Early Human Development, 2015, 91(11), 629-635.
[12]	Wu, X., Jackson, R. T., Khan, S. A., Ahuja, J., & Pehrsson, P. R. Human Milk Nutrient Composition in the United States: Current Knowledge, Challenges, and Research Needs. Current Developments in Nutrition, 2018, 2(7).
[13]	FAO. Food energy: Methods of analysis and conversion factors: report of a technical workshop, Rome, 3-6 December 2002. Rome: Food and Agriculture Organization of the United Nations, 2003.
[14]	AOAC. Official methods of analysis 16th ed. Association of Official Analytical Chemists, Arlington, VA, 2005.
[15]	Zahar, M. & Smith, D. E. Vitamin A quantification in fluid dairy products: Rapid method for vitamin A extraction for high performance liquid chromatography. Journal of Dairy Science (USA), 1990.
[16]	AOAC. Official methods of analysis 16th Ed. Association of official analytical chemists. Washington DC, USA, 1995.
[17]	Mosca, F., & Giannì, M. L. Human milk: Composition and health benefits. La Pediatria Medica e Chirurgica, 2017, 39(2).
[18]	Chang, N., Jung, J. A., Kim, H., Jo, A., Kang, S., Lee, S.-W., … Jung, B.-M. Macronutrient composition of human milk from Korean mothers of full-term infants born at 37-42 gestational weeks. Nutrition Research and Practice, 2015, 9(4), 433-438.
[19]	Kent, J. C., Mitoulas, L. R., Cregan, M. D., Ramsay, D. T., Doherty, D. A., & Hartmann, P. E. Volume and frequency of breastfeeding and fat content of breast milk throughout the day. Pediatrics, 2006, 117(3), e387-395.
[20]	Yang, T., Zhang, Y., Ning, Y., You, L., Ma, D., Zheng, Y., … Wang, P. Breast milk macronutrient composition and the associated factors in urban Chinese mothers. Chinese Medical Journal, 2014, 127(9), 1721-1725.
[21]	Miller, E. M., Aiello, M. O., Fujita, M., Hinde, K., Milligan, L., & Quinn, E. A. Field and laboratory methods in human milk research. American Journal of Human Biology: The Official Journal of the Human Biology Council, 2013, 25(1), 1-11.
[22]	Khan, S., Prime, D. K., Hepworth, A. R., Lai, C. T., Trengove, N. J., & Hartmann, P. E. Investigation of short-term variations in term breast milk composition during repeated breast expression sessions. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 2013, 29(2), 196-204.
[23]	Bauer, J., & Gerss, J. Longitudinal analysis of macronutrients and minerals in human milk produced by mothers of preterm infants. Clinical Nutrition (Edinburgh, Scotland), 2011, 30(2), 215-220.
[24]	Grote, V., Verduci, E., Scaglioni, S., Vecchi, F., Contarini, G., Giovannini, M., … European Childhood Obesity Project. Breast milk composition and infant nutrient intakes during the first 12 months of life. European Journal of Clinical Nutrition, 2016, 70(2), 250-256.
[25]	Butts, C. A., Hedderley, D. I., Herath, T. D., Paturi, G., Glyn-Jones, S., Wiens, F., … Gopal, P. Human Milk Composition and Dietary Intakes of Breastfeeding Women of Different Ethnicity from the Manawatu-Wanganui Region of New Zealand. Nutrients, 2018, 10(9).
[26]	Bzikowska, A., Czerwonogrodzka-Senczyna, A., Weker, H., & Wesołowska, A. Correlation between human milk composition and maternal nutritional status. Roczniki Państwowego Zakładu Higieny, 2018, 69 (4), 363-367.
[27]	Léké, A., Grognet, S., Deforceville, M., Goudjil, S., Chazal, C., Kongolo, G., … Biendo, M. Macronutrient composition in human milk from mothers of preterm and term neonates is highly variable during the lactation period. Clinical Nutrition Experimental, 2019, 26, 59-72.
[28]	Wojcik, K. Y., Rechtman, D. J., Lee, M. L., Montoya, A., & Medo, E. T. Macronutrient analysis of a nationwide sample of donor breast milk. Journal of the American Dietetic Association, 2009, 109(1), 137-140.
[29]	Morita, A., Yoshiike, N., Takimoto, H., Tsubota-Utsugi, M., Kodama, H., Shimizu, T., … Nakamura, M. Dietary Reference Intakes for Japanese 2010: Lifestage. Journal of Nutritional Science and Vitaminology, 2012, 59(Supplement), S103-S109.
[30]	Keikha, M., Bahreynian, M., Saleki, M., & Kelishadi, R. Macro- and Micronutrients of Human Milk Composition: Are They Related to Maternal Diet? A Comprehensive Systematic Review. Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine, 2017, 12(9), 517-527.
[31]	Mitoulas, L. R., Kent, J. C., Cox, D. B., Owens, R. A., Sherriff, J. L., & Hartmann, P. E. Variation in fat, lactose and protein in human milk over 24 h and throughout the first year of lactation. The British Journal of Nutrition, 2002, 88(1), 29-37.
[32]	Zielinska, M. A., Hamulka, J., & Wesolowska, A. Carotenoid Content in Breastmilk in the 3rd and 6th Month of Lactation and Its Associations with Maternal Dietary Intake and Anthropometric Characteristics. Nutrients, 2019, 11(1).
[33]	Czosnykowska-Łukacka, M., Królak-Olejnik, B., & Orczyk-Pawiłowicz, M. Breast Milk Macronutrient Components in Prolonged Lactation. Nutrients, 2018, 10(12).
[34]	Abranches, A. D., Soares, F. V. M., Junior, S.-C. G., & Moreira, M. E. L. Freezing and thawing effects on fat, protein, and lactose levels of human natural milk administered by gavage and continuous infusion. Jornal de Pediatria, 2014, 90(4), 384-388.
[35]	Cooper, A. R., Barnett, D., Gentles, E., Cairns, L., & Simpson, J. H. Macronutrient content of donor human breast milk. Archives of Disease in Childhood - Fetal and Neonatal Edition, 2013, 98(6), F539-F541.
[36]	Vieira, A. A., Soares, F. V. M., Pimenta, H. P., Abranches, A. D., & Moreira, M. E. L. Analysis of the influence of pasteurization, freezing/thawing, and offer processes on human milk’s macronutrient concentrations. Early Human Development, 2011, 87(8), 577-580.
[37]	Kim, H., Jung, B.-M., Lee, B.-N., Kim, Y.-J., Jung, J. A., & Chang, N. Retinol, α-tocopherol, and selected minerals in breast milk of lactating women with full-term infants in South Korea. Nutrition Research and Practice, 2017, 11(1), 64-69.
[38]	Daniels, L., Gibson, R. S., Diana, A., Haszard, J. J., Rahmannia, S., Luftimas, D. E., … Houghton, L. A. Micronutrient intakes of lactating mothers and their association with breast milk concentrations and micronutrient adequacy of exclusively breastfed Indonesian infants. The American Journal of Clinical Nutrition, 2019, 110(2), 391-400.
[39]	Duda, Grazyna, Malgorzata, N.-K., Wanda, K., Bogumila, K., & Eleonora, L.-S. Influence of the Lactating Women Diet on the Concentration of the Lipophilic Vitamins in Human Milk. Pakistan Journal of Nutrition, 2009, 8, 629-634.
[40]	Tokuşoğlu, O., Tansuğ, N., Akşit, S., Dinç, G., Kasirga, E., & Ozcan, C. Retinol and alpha-tocopherol concentrations in breast milk of Turkish lactating mothers under different socio-economic status. International Journal of Food Sciences and Nutrition, 2008, 59(2), 166-174.
[41]	Hailu, T., Abuye, C., Abebe, H., & Whiting, S. J. Correlation of Iron, Zinc, and Vitamin a Maternal Plasma Levels with Breast Milk Composition in Rural Southern Ethiopia. Ethiopian Journal of Public Health Nutrition, 2016.
[42]	Vítolo, M. R., Valente Soares, L. M., Carvalho, E. B., & Cardoso, C. B. Calcium and magnesium concentrations in mature human milk: Influence of calcium intake, age and socioeconomic level. Archivos Latinoamericanos de Nutrición, 2004, 54(1), 118-122.
[43]	Mastroeni, S. S. B. S., Okada, I. A., Rondó, P. H. C., Duran, M. C., Paiva, A. A., & Neto, J. M. Concentrations of Fe, K, Na, Ca, P, Zn and Mg in Maternal Colostrum and Mature Milk. Journal of Tropical Pediatrics, 2006, 52(4), 272-275.
[44]	Yalcin, S. S., Yalcin, S., & Gucus, A. I. Zinc and Copper Concentrations in Breast Milk During the First Nine Months of Lactation: A Longitudinal Study. Pediatrics, 2015, 135(Supplement 1), S13-S14.
[45]	Khaghani, S., Ezzatpanah, H., Mazhari, N., Givianrad, M. H., Mirmiranpour, H., & Sadrabadi, F. S. Zinc and Copper Concentrations in Human Milk and Infant Formulas. Iranian Journal of Pediatrics, 2010, 20(1), 53-57.
[46]	Taravati Javad, M., Vahidinia, A., Samiee, F., Elaridi, J., Leili, M., Faradmal, J., & Rahmani, A. Analysis of aluminum, minerals and trace elements in the milk samples from lactating mothers in Hamadan, Iran. Journal of Trace Elements in Medicine and Biology, 2018, 50, 8-15.
[47]	Soetan, K. O., Olaiya, C. O., & Oyewole, O. E. The importance of mineral elements for humans, domestic animals and plants: A review. 2010, 23.
[48]	Winiarska-Mieczan, A. Cadmium, Lead, Copper and Zinc in Breast Milk in Poland. Biological Trace Element Research, 2014, 157(1), 36-44.
[49]	Ejezie, F., Nwagha, U., Ikekpeazu, E., Ozoemena, O., & Onwusi, E. Assessment of Iron Content of Breast Milk in Preterm and Term Mothers in Enugu Urban. Annals of Medical and Health Sciences Research, 2011, 1(1), 85-90.
[50]	C, C., & Sv, H. Breast Milk Iron Concentrations may be Lower than Previously Reported: Implications for Exclusively Breastfed Infants. Maternal and Pediatric Nutrition, 2016, 2(1).
[51]	Fernández-Sánchez, M. L., de la Flor St. Remy, R. R., Iglesias, H. G., López-Sastre, J. B., Fernández-Colomer, B., Pérez-Solís, D., & Sanz-Medel, A. Iron content and its speciation in human milk from mothers of preterm and full-term infants at early stages of lactation: A comparison with commercial infant milk formulas. Microchemical Journal, 2012, 105, 108-114.
[52]	Silvestre, D., Martìnez-Costa, C., Lagarda, M. J., Brines, J., Farré, R., & Clemente, G. Copper, iron, and Zinc contents in human milk during the first three months of lactation. Biological Trace Element Research, 2001, 80(1), 1-11.
[53]	Hampel, D., Shahab-Ferdows, S., Gertz, E., Flax, V. L., Adair, L. S., Bentley, M. E., … Allen, L. H. The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV-infected Malawian mothers and associations with maternal and infant biomarkers. Maternal & Child Nutrition, 2018, 14(2), e12503.