Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
J Nutr. 2021 Mar 11;151(3):705-715. doi: 10.1093/jn/nxaa381.
When maternal micronutrient intakes and statuses are compromised, reductions in micronutrient concentrations in neonatal stores and human milk may result in suboptimal micronutrient intakes, statuses, and functional outcomes of breastfed infants during the critical first 6-month period.
We compared the adequacy of micronutrient intakes and statuses at 2 and/or 5 months and morbidity and growth faltering at 2, 5, and 12 months in a cohort of exclusively breastfed (EBF) and partially breastfed (PBF) infants from low-resource Indonesian households.
At 2 and 5 months, the breastfeeding status and human milk intake of 212 infants were determined using the deuterium oxide dose-to-mother technique, and intakes were calculated from milk micronutrient concentrations and 3-d weighed food intakes. At 5 months, five infant micronutrient biomarkers, hemoglobin, C-reactive protein, and α-1-acid-glycoprotein were measured. Infant morbidity, weight, and length were measured at 2, 5, and 12 months. Means, medians, or proportions were reported for each group and differences between groups were statistically determined.
Median intakes of iron, thiamin, niacin, and vitamin B-12 were higher in PBF than EBF infants at 5 months (all P values < 0.05), but intakes in all infants were below adequate intakes. At 5 months, anemia was <20% in both groups, although fewer PBF versus EBF infants had vitamin B-12 deficiency (11.5% vs. 28.6%, respectively; P = 0.011). The mean ± SD length-for-age z-scores for EBF versus PBF infants at 2 months were 0.7 ± 0.9 versus -0.5 ± 1.1, respectively (P = 0.158), declining to -1.4 ± 0.9 versus -1.1 ± 1.2, respectively, at 12 months (P = 0.059). Reported morbidity rates were generally low, with no evidence of a difference between infant groups (all P values > 0.126).
Irrespective of exclusive or partial breastfeeding status, micronutrient intakes of infants were low, statuses were compromised, and growth faltering during the critical 6 months period of early infancy was present. The findings highlight the importance of improving maternal nutritional statuses and evaluating their impacts on infant outcomes.
当母体微量营养素的摄入量和状况受损时，新生儿储存和人乳中的微量营养素浓度可能会降低，从而导致母乳喂养婴儿在关键的头 6 个月内的微量营养素摄入量、状况和功能结果不理想。
我们比较了来自资源匮乏的印度尼西亚家庭的纯母乳喂养（EBF）和部分母乳喂养（PBF）婴儿队列在 2 个月和/或 5 个月时的微量营养素摄入量和状况的充足性，以及在 2、5 和 12 个月时的发病率和生长迟缓。
在 2 和 5 个月时，使用氘水剂量到母亲技术确定 212 名婴儿的母乳喂养状况和人乳摄入量，并根据人乳微量营养素浓度和 3 天称重食物摄入量计算摄入量。在 5 个月时，测量了 5 名婴儿的微量营养素生物标志物，血红蛋白、C 反应蛋白和α-1-酸性糖蛋白。在 2、5 和 12 个月时测量了婴儿的发病率、体重和长度。报告了每组的平均值、中位数或比例，并通过统计学方法确定了组间差异。
在 5 个月时，PBF 婴儿的铁、硫胺素、烟酸和维生素 B-12 的摄入量高于 EBF 婴儿（所有 P 值均<0.05），但所有婴儿的摄入量均低于充足摄入量。在 5 个月时，两组的贫血均<20%，尽管 PBF 婴儿中维生素 B-12 缺乏症的比例低于 EBF 婴儿（分别为 11.5%和 28.6%；P=0.011）。在 2 个月时，EBF 与 PBF 婴儿的长度年龄 Z 评分均值分别为 0.7±0.9 和-0.5±1.1（P=0.158），到 12 个月时分别下降至-1.4±0.9 和-1.1±1.2（P=0.059）。报告的发病率普遍较低，两组婴儿之间没有差异的证据（所有 P 值均>0.126）。
无论婴儿是纯母乳喂养还是部分母乳喂养，微量营养素的摄入量都较低，状况受损，在婴儿早期的关键 6 个月期间生长迟缓。这些发现强调了改善产妇营养状况及其对婴儿结局影响的重要性。
