Association of maternal diet, micronutrient status, and milk volume with milk micronutrient concentrations in Indonesian mothers at 2 and 5 months postpartum. Issue 4 (25th August 2020)

• Record Type: Journal Article
• Authors: Gibson, Rosalind S; Rahmannia, Sofa; Diana, Aly; Leong, Claudia; Haszard, Jillian J; Hampel, Daniela; Reid, Malcolm; Erhardt, Juergen; Suryanto, Aghnia Husnayiani; Sofiah, Wina Nur; Fathonah, Annisha; Shahab-Ferdows, Setareh; Allen, Lindsay H; Houghton, Lisa A
• Is Part Of: American journal of clinical nutrition. Volume 112:Issue 4(2020)
• Page Start: 1039
• Page End: 1050
• Publication Date: 2020-08-25
• Subjects: human milk micronutrient concentrations -- human milk volume -- maternal micronutrient intakes -- maternal micronutrient deficits -- maternal biomarkers -- temporal changes in human milk nutrient concentrations; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqaa200
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Maternal micronutrient deficits during preconception and pregnancy may persist during lactation and compromise human milk composition. Objective: We measured micronutrient concentrations in human milk and investigated their association with maternal micronutrient intakes, status, and milk volume. Methods: Infant milk intake (measured via a deuterium dose-to-mother technique), milk micronutrient and fat concentrations, and maternal micronutrient intakes were assessed at 2 and 5 mo postpartum in 212 Indonesian lactating mother–infant pairs. Maternal hemoglobin, ferritin, transferrin receptors, retinol binding protein (RBP), zinc, selenium, and vitamin B-12 were measured at 5 mo ( n = 163). Multivariate or mixed effects regression examined associations of milk micronutrient concentrations with maternal micronutrient intakes, status, and milk volume. Results: Prevalence of anemia (15%), and iron (15% based on body iron), selenium (2.5%), and vitamin B-12 deficiency (0%) were low compared with deficiencies of zinc (60%) and vitamin A (34%). The prevalence of inadequate intakes was >50% for 7 micronutrients at 2 and 5 mo. Median milk concentrations for most micronutrients were below reference values, and nearly all declined between 2 and 5 mo postpartum and were not associated substantially with milk volume (except for β-carotene, α-carotene, and β-cryptoxanthin). At 5 mo postpartum, associations between maternal micronutrient status and corresponding milk concentrations reported as mean percentage difference in human milk concentration for each unit higher maternal biomarker were significant for hemoglobin (1.9%), iron biomarkers (ranging from 0.4 to 7%), RBP (35%), selenium (70%), and vitamin B-12 (0.1%), yet for maternal intakes only a positive association with β-carotene existed. Conclusions: Most milk micronutrient concentrations declined during lactation, independent of changes in human milk production, and few were associated with maternal micronutrient intakes. The significant associations between maternal biomarkers and milk micronutrient concentrations at 5 mo warrant further study to investigate whether the declines in milk micronutrients are linked to shifts in maternal status.