Departments of Human Nutrition.
Faculty of Medicine, Universitas Padjadjaran, West Java, Indonesia.
Am J Clin Nutr. 2019 Aug 1;110(2):391-400. doi: 10.1093/ajcn/nqz047.
Breast milk is the sole source of nutrition for exclusively breastfed infants in the first 6 mo of life, yet few studies have measured micronutrient concentrations in breast milk in light of maternal diet and subsequent infant micronutrient intakes.
We evaluated the adequacy of micronutrient intakes of exclusively breastfed Indonesian infants by measuring milk volume and micronutrient concentrations and assessed maternal micronutrient intakes and their relationship with milk concentrations.
Mother-infant (2-5.3 mo) dyads (n = 113) were recruited for this cross-sectional study. Volume of breast-milk intake via the deuterium dose-to-mother technique over 14 d and analyzed micronutrient concentrations were used to calculate micronutrient intakes of exclusively breastfed infants. Maternal 3-d weighed food records were collected to assess median (IQR) micronutrient intakes. Multivariate regression analyses examined the association of usual maternal micronutrient intakes with milk micronutrient concentrations after adjustment for confounding variables.
Mean ± SD intake of breast-milk volume was 787 ± 148 mL/d. Median daily infant intakes of iron, zinc, selenium, magnesium, sodium, and B-vitamins (thiamin, riboflavin, niacin, pantothenic acid, B-6, and B-12) were below their respective Adequate Intakes. Inadequacies in maternal intakes (as % < estimated average requirements) were >40% for calcium, niacin, and vitamins A, B-6, and B-12. Significant positive associations existed between maternal usual intakes of vitamin A, niacin and riboflavin and milk retinol, nicotinamide, and free riboflavin concentrations in both unadjusted and adjusted (for infant age, milk volume, and parity) analyses (all P < 0.05).
The majority of micronutrient intakes for these exclusively breastfed infants and their mothers fell below recommendations, with associations between maternal intakes and breast-milk concentrations for 3 nutrients. Data on nutrient requirements of exclusively breastfed infants are limited, and a better understanding of the influence of maternal nutritional status on milk nutrient concentrations and its impact on the breastfed infant is needed.
母乳是生命最初 6 个月内纯母乳喂养婴儿的唯一营养来源，但很少有研究根据母亲的饮食和随后婴儿的微量营养素摄入量来测量母乳中的微量营养素浓度。
我们通过测量母乳量和微量营养素浓度来评估纯母乳喂养印度尼西亚婴儿微量营养素摄入量的充足性，并评估母亲的微量营养素摄入量及其与母乳浓度的关系。
这项横断面研究招募了 113 对母婴（2-5.3 月龄）。通过氘剂量-母亲技术在 14 天内测量母乳摄入量，并分析了微量营养素浓度，以计算纯母乳喂养婴儿的微量营养素摄入量。收集了 3 天的称重食物记录，以评估中位数（IQR）的微量营养素摄入量。多元回归分析检查了调整混杂因素后，母亲通常的微量营养素摄入量与母乳中微量营养素浓度之间的关联。
平均（±SD）母乳摄入量为 787±148 毫升/天。婴儿每日铁、锌、硒、镁、钠和 B 族维生素（硫胺素、核黄素、烟酸、泛酸、B-6 和 B-12）的摄入量低于各自的适宜摄入量。母亲摄入不足（以<估计平均需求量的%表示）超过 40%的有钙、烟酸和维生素 A、B-6 和 B-12。未调整和调整（婴儿年龄、母乳量和产次）分析中，母亲的维生素 A、烟酸和核黄素的常规摄入量与母乳视黄醇、烟酰胺和游离核黄素浓度呈显著正相关（均 P<0.05）。
这些纯母乳喂养婴儿及其母亲的大多数微量营养素摄入量低于推荐量，且有 3 种营养素的母亲摄入量与母乳浓度之间存在关联。关于纯母乳喂养婴儿的营养需求数据有限，需要更好地了解母亲营养状况对母乳营养浓度的影响及其对母乳喂养婴儿的影响。
