Melatonin is the hormone produced by the pineal gland that plays a role in regulating sleep and circadian rhythm as well as a possible role in gut-brain signaling. It is also an antioxidant.[1-3] Melatonin is a normal component of breastmilk, with concentrations higher during nighttime (peak around 3 am) than daytime and possibly higher milk levels following cesarean section.[4-9] Women who work the night shift have lower milk melatonin concentrations during the midnight to 6:30 am period than on days when they are not working, which becomes larger on subsequent days of working the night shift.[10] Elective cesarean section results in higher daytime colostrum levels than with vaginal delivery.[11] Some authors suggest that mothers should nurse in the dark at night in order to avoid reductions in the melatonin content of breastmilk, which could disturb infant sleep patterns.[12] Differentiating milk pumped during the day from milk pumped during darkness has also been suggested for women pumping milk for their infants.[3,4,13] Some studies have attributed longer sleep time in breastfed infant than in formula-fed infants to melatonin in breastmilk.[14,15] Another study found higher colostrum melatonin levels at night which appeared to increase the phagocytic activity of colostral cells against bacteria.[16] A survey of 329 mothers found that infants who consumed mistimed expressed breastmilk took longer to get to sleep compared with infants who were directly breastfed, formula fed, fed timed expressed breast milk and fed breast milk/formula combined. Breastfed infants had more awakenings at night compared with infants who consumed mistimed expressed breastmilk.[17] Melatonin has no specific use during breastfeeding and no data exist on the safety of maternal use of melatonin during breastfeeding. However, doses higher than those expected in breastmilk after maternal supplementation have been used safely in infants.[18] It is unlikely that short-term use of usual doses of melatonin in the evening by a nursing mother would adversely affect her breastfed infant, although some authors recommend against its use in breastfeeding because of the lack of data and a relatively long half-life in preterm neonates.[19,20] Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.
褪黑素是由松果体分泌的一种激素，它在调节睡眠和昼夜节律方面发挥作用，并且可能在肠脑信号传导中也有作用。它还是一种抗氧化剂。[1 - 3] 褪黑素是母乳的正常成分，夜间浓度（凌晨3点左右达到峰值）高于白天，剖宫产术后母乳中的褪黑素水平可能更高。[4 - 9] 上夜班的女性在午夜至凌晨6:30期间的母乳褪黑素浓度低于不上班的日子，且随着后续上夜班天数的增加，这种差异会更大。[10] 择期剖宫产术后初乳的日间水平高于阴道分娩。[11] 一些作者建议母亲夜间应在黑暗中哺乳，以避免母乳中褪黑素含量降低，这可能会扰乱婴儿的睡眠模式。[12] 也有人建议为婴儿挤奶的女性区分白天挤出的奶和在黑暗中挤出的奶。[3,4,13] 一些研究将母乳喂养婴儿比配方奶喂养婴儿睡眠时间更长归因于母乳中的褪黑素。[14,15] 另一项研究发现夜间初乳中褪黑素水平较高，这似乎会增加初乳细胞对细菌的吞噬活性。[16] 一项对329名母亲的调查发现，与直接母乳喂养、配方奶喂养、按时挤奶喂养以及混合喂养的婴儿相比，食用时间不当的挤出母乳的婴儿入睡时间更长。与食用时间不当的挤出母乳的婴儿相比，母乳喂养的婴儿夜间醒来次数更多。[17] 母乳喂养期间褪黑素没有特定用途，也没有关于母亲在母乳喂养期间使用褪黑素安全性的数据。然而，婴儿已安全使用高于母亲补充后母乳中预期剂量的褪黑素。[18] 哺乳期母亲在晚上短期使用常规剂量的褪黑素不太可能对其母乳喂养的婴儿产生不利影响，尽管一些作者因缺乏数据以及早产儿中褪黑素半衰期相对较长而建议不要在母乳喂养期间使用。[19,20] 膳食补充剂不需要美国食品药品监督管理局进行广泛的上市前批准。制造商有责任确保安全，但在膳食补充剂上市前不需要证明其安全性和有效性。膳食补充剂可能含有多种成分，标签上的成分及其含量与实际情况之间往往存在差异。制造商可能会与独立组织签约以核实产品或其成分的质量，但这并不能证明产品的安全性或有效性。由于上述问题，一种产品的临床试验结果可能不适用于其他产品。关于膳食补充剂的更详细信息可在LactMed网站的其他地方获取。
Zotero 插件