Department of Clinical Nutrition, Peking University People's Hospital, Beijing 100044, China.
Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing 100191, China.
Nutrients. 2022 Nov 1;14(21):4587. doi: 10.3390/nu14214587.
Breast milk is crucial in the development of late-onset breast milk jaundice (BMJ), possibly due to the composition of breast milk and the lactating mother’s diet. To explore the possible nutritional pathogenesis of late-onset BMJ, we investigated the lactation diet and collected breast milk by following the 42-day postpartum mother−infants pairs in Beijing and a total of 94 pairs were enrolled. The macronutrient content of breast milk was measured, and the epidermal growth factor (EGF) content in breast milk was determined by ELISA. Data on in-hospital and out-of-hospital breastfeeding, infant growth, jaundice-related vaccination, and puerperium diet were collected. The BMJ group received the second dose of hepatitis B vaccine later than the control group, and the difference was statistically significant (p < 0.001). The EGF concentration in breast milk was lower in the BMJ group than in the control group (p = 0.03). When EGF increased by 1 ng/mL, the transcutaneous bilirubin (TcB) value decreased by 0.33 ng/mL and 0.27 ng/mL before and after the adjustment, respectively. A 1 g increase in oil intake led to a 0.38 ng/mL increase in EGF concentration before the adjustment. With a 1 g increase in oil intake, the TcB value decreased by 0.27 ng/mL before the adjustment, and with a 1 g increase in soybean and soybean product intake, the TcB value decreased by 0.34 ng/mL after the adjustment. Collectively, EGF in breast milk may inhibit the occurrence of late-onset BMJ, and the dietary intake of oil in lactating mothers may affect the level of EGF in breast milk, thus affecting the occurrence of late-onset BMJ. Finally, dietary oil intake may be a protective factor for the occurrence of late-onset BMJ by increasing EGF levels in breast milk.
母乳在迟发性母乳性黄疸（BMJ）的发生中起着至关重要的作用，这可能与母乳的成分和哺乳期母亲的饮食有关。为了探讨迟发性 BMJ 的可能营养发病机制，我们对哺乳母亲的饮食进行了调查，并通过随访北京的 42 天产后母婴对，共纳入了 94 对。测量了母乳的宏量营养素含量，并通过 ELISA 法测定了母乳中的表皮生长因子（EGF）含量。收集了住院和院外母乳喂养、婴儿生长、与黄疸相关的疫苗接种和产褥期饮食的数据。BMJ 组接受第二剂乙肝疫苗的时间晚于对照组，差异具有统计学意义（p<0.001）。BMJ 组母乳中的 EGF 浓度低于对照组（p=0.03）。当 EGF 增加 1ng/mL 时，调整前后的经皮胆红素（TcB）值分别降低了 0.33ng/mL 和 0.27ng/mL。油摄入量增加 1g 会导致调整前 EGF 浓度增加 0.38ng/mL。随着油摄入量增加 1g，调整前 TcB 值下降 0.27ng/mL，而大豆及其制品摄入量增加 1g，调整后 TcB 值下降 0.34ng/mL。总之，母乳中的 EGF 可能抑制迟发性 BMJ 的发生，哺乳期母亲的饮食油摄入量可能影响母乳中 EGF 的水平，从而影响迟发性 BMJ 的发生。最后，饮食油摄入可能通过增加母乳中 EGF 水平成为迟发性 BMJ 发生的保护因素。
