Brown K H, Akhtar N A, Robertson A D, Ahmed M G
Pediatrics. 1986 Nov;78(5):909-19.
Longitudinal studies of the nutritional status of 60 lactating Bangladeshi mothers from an underprivileged, periurban community and of the quantity and composition of their milk were completed to determine the relationships between maternal nutritional status and lactational capacity. Daily milk production was estimated by 24-hour test-weighing; the nitrogen, fat, lactose, and total energy concentrations of extracted milk samples were analyzed at various stages of lactation to estimate total milk nutrient production. Although the mothers were poorly nourished compared with international reference populations, their lactational capacity was not severely impaired. Average milk production peaked at 750 g/d when the infants were between 5 and 7 months of age. Nitrogen and fat concentrations declined with (log) infant age; lactose concentration increased with (log) infant age (P less than .001). Average concentrations of milk nutrients when the infants were 3 months of age were: nitrogen, 0.161 g/dL; fat, 2.804 g/dL; lactose, 7.92 g/dL; energy, 61.0 kcal/dL. Fat and energy concentrations were significantly greater, and fat and energy amounts tended to be greater, for mothers with larger triceps skinfold thickness or arm circumference. Changes in nutritional status within individual women were also significantly related to the amount and composition of their milk: within-woman increases in triceps skinfold thickness were associated with increases in fat and energy concentrations (P less than .01) and within-woman increases in body weight were associated with increases in the amounts of milk and all major nutrients (P less than .01). Milk production declined significantly during certain months of the year, just before the major harvest period. The findings suggest that, despite their remarkably good lactational capacity, the mothers' milk production was limited to some extent by their nutritional status and may, therefore, be further increased with nutritional improvement.
对来自贫困城郊社区的60名孟加拉国哺乳期母亲的营养状况及其乳汁的数量和成分进行了纵向研究，以确定母亲营养状况与泌乳能力之间的关系。通过24小时称重法估算每日乳汁产量；在泌乳的不同阶段分析提取的乳汁样本中的氮、脂肪、乳糖和总能量浓度，以估算乳汁中总营养成分的产量。尽管与国际参考人群相比，这些母亲的营养状况较差，但她们的泌乳能力并未受到严重损害。当婴儿5至7个月大时，平均乳汁产量达到峰值，为750克/天。氮和脂肪浓度随（对数）婴儿年龄下降；乳糖浓度随（对数）婴儿年龄增加（P小于0.001）。婴儿3个月大时，乳汁营养成分的平均浓度为：氮，0.161克/分升；脂肪，2.804克/分升；乳糖，7.92克/分升；能量，61.0千卡/分升。三头肌皮褶厚度或臂围较大的母亲，其脂肪和能量浓度显著更高，脂肪和能量含量也往往更高。个体女性营养状况的变化也与她们乳汁的数量和成分显著相关：女性三头肌皮褶厚度的增加与脂肪和能量浓度的增加相关（P小于0.01），女性体重的增加与乳汁量和所有主要营养成分的增加相关（P小于0.01）。在一年中的某些月份，就在主要收获期之前不久，乳汁产量显著下降。研究结果表明，尽管这些母亲的泌乳能力非常好，但她们的乳汁产量在一定程度上受到营养状况的限制，因此，营养改善可能会进一步提高乳汁产量。
