脂类营养素补充剂不会减少马拉维婴儿的母乳摄入量。

Lipid-based nutrient supplements do not decrease breast milk intake of Malawian infants.

机构信息

Department of International Health, University of Tampere School of Medicine, Tampere, Finland (CK and PA); the Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA (MJH and KGD); the Department of Nutrition and Public Health Intervention Research, London School of Hygiene and Tropical Medicine, London, United Kingdom (JH); and the Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi (CK and KM).

出版信息

Am J Clin Nutr. 2014 Mar;99(3):617-23. doi: 10.3945/ajcn.113.076588. Epub 2013 Dec 24.

DOI:10.3945/ajcn.113.076588

PMID:24368436

Abstract

BACKGROUND

The potential for small-quantity lipid-based nutrient supplements (LNS) to promote growth and development after 6 mo of age is currently being investigated. Because infants self-regulate energy intake, consumption of LNS may reduce breast milk intake and potentially decrease the beneficial effects of breast milk.

OBJECTIVE

The objective was to test the hypothesis that the breast milk intake of 9- to 10-mo-old rural Malawian infants receiving LNS would not be lower than that of infants receiving no supplementation.

DESIGN

This was a substudy of the International Lipid-based Nutrient Supplements (iLiNS) DOSE trial, in which 6-mo-old infants were randomly assigned to receive 10, 20, or 40 g LNS/d containing 56, 117, or 241 kcal/d, respectively, or no LNS until 18 mo of age. A subset was randomly selected to estimate breast milk intake at 9-10 mo of age with the dose-to-mother deuterium oxide dilution method. The noninferiority margin was <10% of total energy requirements.

RESULTS

Baseline characteristics (n = 376) were similar across groups. The mean (± SD) daily breast milk intake of unsupplemented infants was 730 ± 226 g. The differences (95% CIs) in mean intake of infants provided with 10, 20, or 40 g LNS/d, compared with controls, were +62 (-18, +143), +30 (-40, +99), and +2 (-68, +72) g/d, respectively. Non-breast milk oral water intake did not differ by group (P = 0.39) and was inversely (r = -0.22, P < 0.01) associated with breast milk intake.

CONCLUSION

In this rural Malawian population, breast milk intake at 9-10 mo of age was not reduced by supplementation with complementary foods with 10-40 g LNS/d.

摘要

背景

目前正在研究小剂量脂类基础营养素补充品（LNS）在 6 月龄后促进生长发育的潜力。由于婴儿可以自我调节能量摄入，因此食用 LNS 可能会减少母乳摄入量，并可能降低母乳的有益作用。

目的

本研究旨在检验以下假设，即接受 LNS 的 9-10 月龄农村马拉维婴儿的母乳摄入量不会低于未接受补充的婴儿。

设计

这是国际脂类基础营养素补充剂（iLiNS）剂量试验的子研究，其中 6 月龄婴儿随机分配接受 10、20 或 40 g/d 的 LNS，分别含 56、117 或 241 kcal/d，或在 18 月龄前不接受 LNS。随机选择一部分婴儿使用剂量到母亲氘氧化物稀释法估计 9-10 月龄的母乳摄入量。非劣效性边界为<10%的总能量需求。

结果

基线特征（n=376）在各组间相似。未接受补充的婴儿的平均（±SD）每日母乳摄入量为 730±226 g。与对照组相比，接受 10、20 或 40 g/d LNS 的婴儿的平均摄入量差异（95%CI）分别为+62（-18，+143）、+30（-40，+99）和+2（-68，+72）g/d。各组间非母乳口服水摄入量无差异（P=0.39），且与母乳摄入量呈负相关（r=-0.22，P<0.01）。