Department of Women and Children's Health, King's College London, London SE1 7EH, UK.
Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Banjul P.O. Box 273, The Gambia.
Nutrients. 2021 Oct 28;13(11):3848. doi: 10.3390/nu13113848.
Micronutrients are fundamental for healthy brain development and deficiencies during early development can have a severe and lasting impact on cognitive outcomes. Evidence indicates that undernourished lactating individuals may produce breast milk containing lower concentrations of certain vitamins and minerals. Exclusively breastfed infants born to mothers deficient in micronutrients may therefore be at risk of micronutrient deficiencies, with potential implications for neurodevelopment. This systematic review aims to consider current knowledge on the effects of breast milk micronutrients on the developmental outcomes of infants. The databases Medline, Global Health, PsychInfo, Open Grey, and the Web of Science were searched for papers published before February 2021. Studies were included if they measured micronutrients in breast milk and their association with the neurodevelopmental outcomes of exclusively breastfed infants. Also, randomised control trials investigating neurocognitive outcomes following maternal supplementation during lactation were sought. From 5477 initial results, three observational studies were eligible for inclusion. These investigated associations between breast milk levels of vitamin B6, carotenoids, or selenium and infant development. Results presented suggest that pyroxidal, β-carotene, and lycopene are associated with infant neurodevelopmental outcomes. Limited eligible literature and heterogeneity between included papers prevented quantitative synthesis. Insufficient evidence was identified, precluding any conclusions on the relationship between breast milk micronutrients and infant developmental outcomes. Further, the evidence available was limited by a high risk of bias. This highlights the need for further research in this area to understand the long-term influence of micronutrients in breast milk, the role of other breast milk micronutrients in infant neurodevelopmental outcomes, and the impact of possible lactational interventions.
微量营养素对大脑健康发育至关重要，早期发育过程中的微量营养素缺乏会对认知结果产生严重且持久的影响。有证据表明，营养不足的哺乳期妇女所分泌的母乳中可能含有较低浓度的某些维生素和矿物质。因此，出生于微量营养素缺乏的母亲的纯母乳喂养婴儿可能面临微量营养素缺乏的风险，这可能对神经发育产生影响。本系统评价旨在评估母乳中微量营养素对婴儿发育结果的影响。检索了 Medline、Global Health、PsychInfo、Open Grey 和 Web of Science 数据库，以获取截至 2021 年 2 月前发表的论文。如果研究测量了母乳中的微量营养素及其与纯母乳喂养婴儿神经发育结果的关系，则纳入研究。此外，还寻找了调查哺乳期母亲补充营养后神经认知结果的随机对照试验。从 5477 项初始结果中，有三项观察性研究符合纳入标准。这些研究调查了母乳中维生素 B6、类胡萝卜素或硒水平与婴儿发育之间的关系。研究结果表明，吡哆醛、β-胡萝卜素和番茄红素与婴儿神经发育结果相关。纳入的文献数量有限且存在异质性，因此无法进行定量综合分析。由于证据不足，无法得出母乳微量营养素与婴儿发育结果之间关系的结论。此外，现有证据还受到偏倚风险高的限制。这突显了在该领域进一步研究的必要性，以了解母乳中微量营养素对婴儿发育的长期影响、母乳中其他微量营养素在婴儿神经发育结果中的作用，以及可能的哺乳期干预措施的影响。
