Associations of maternal body composition and nutritional intake with fat content of Indonesian mothers’ breast milk
Abstract
Background Breast milk is the best sole food for infants in their first six months of life. Breast milk fat content accounts for the largest part of infants’ energy and may be influenced by many factors, including maternal factors, which may vary in different settings. So far, there has been no published data about the breast milk fat content of Indonesian mothers, including whether it is affected by their body composition or nutritional intake.
Objective To investigate breast milk fat content of Indonesian mothers and its associations with maternal body composition and nutritional intake.
Method This cross-sectional study was conducted at Budi Kemuliaan Mothers’ and Children’s Hospital. Breast milk specimens were collected from 48 nursing mothers, centrifuged, and tested by creamatocrit for fat content. A 24-hour food recall was performed to evaluate maternal macronutrient intake. Maternal body composition was evaluated by bioelectric impedance analysis. Univariable correlations between breast milk fat content and either energy and macronutrient intake were assessed using the Spearman rho test.
Results All nursing mothers had breast milk fat content within clinically normal range [mean 59.4 (SD 15.9) g/L]. There was no significant correlation between milk fat content and maternal body fat (r = -0.03, P=0.840), total body water (r = 0.09 P=0.509), or muscle mass (r = 0.08, P=0.577). Milk fat content seemed to weakly correlated with maternal fat intake, although it was not statistically significant (r = 0.27, P=0.065).
Conclusion Breast milk fat content at one-month post delivery appears not associated with with maternal body composition. It seems to weakly correlate with maternal fat intake but findings need to be confirmed in larger studies with adjustment for confounding variables.Â
References
Czank C, Mitoulas LR, Hartmann PE. Human milk composition-fat. In: Hartmann PE, editor. Hale & Hartmann’s textbook of human lactation. Amarillo: Hale Pub; 2007. p. 49–63.
Innis SM. Dietary triacylglycerol structure and its role in infant nutrition. Adv Nutr. 2011;2:275–83.
Isaacs J. Infant nutrition. In: Brown JE, editor. Nutrition through the life cycle. Brooks/Cole: Cengage Learning; 2010. p. 222–8.
Pusat data dan informasi kementerian kesehatan RI. Situasi dan analisis ASI eksklusif. Jakarta: Kementerian Kesehatan RI; 2014. p. 2-3
Murtaugh M, Lechtenberg E, Sharbaugh C, Sofka. Nutrition during lactation. In: Brown JE, editor. Nutrition through the life cycle. Brooks/Cole: Cengage Learning; 2010. 160–79.
Hachey DL, Thomas MR, Emken EA, Garza C, Brown-Booth L, Adlof RO, et al. Human lactation: maternal transfer of dietary triglycerides labeled with stable isotopes. J Lipid Res. 1987;28:1185–92.
Francois CA, Connor SL, Wander RC, Connor WE. Acute effects of dietary fatty acids on the fatty acids of human milk. Am J Clin Nutr. 1998;67:301–8.
Mitoulas LR, Kent JC, Cox DB, Owens RA, Sherriff JL, Hartmann PE. Variation in fat, lactose and protein in human milk over 24 h and throughout the first year of lactation. Br J Nutr. 2002;88:29–37.
Hausman Kedem M, Mandel D, Domani KA, Mimouni FB, Shay V, Marom R, et al. The effect of advanced maternal age upon human milk fat content. Breastfeed Med. 2013;8:116–9.
Lawrence RA. Breastfeeding: a guide for the medical profession. Maryland Heights: Mosby/Elsevier; 2011. p. 98–152.
Prentice A. The effect of maternal parity on lactational performance in a rural African community. In: Hamosh M, Goldman AS, editors. Human lactation 2. US: Springer; 1986. p. 165–73.
Osubor CC, Ibadin MO, Asonye CC. Lipid content of breast milk of lactating women in Benin City, Nigeria. Glob J Med Sci. 2004;3:23–7.
Antonakou A, Skenderi KP, Chiou A, Anastasiou CA, Bakoula C, Matalas AL. Breast milk fat concentration and fatty acid pattern during the first six months in exclusively breastfeeding Greek women. Eur J Nutr. 2013;52:963–73.
Neville MC, Picciano MF. Regulation of milk lipid secretion and composition. Annu Rev Nutr. 1997;17:159–83.
Perkumpulan Obstetri dan Ginekologi Indonesia. Konsensus nasional kebutuhan asupan air bagi ibu hamil, melahirkan dan menyusui. Jakarta: POGI; 2013. p. 5–12
Insull W, Hirsch J, James T, Ahrens EH. The fatty acids of human milk. II. Alterations produced by manipulation of caloric balance and exchange of dietary fats. J Clin Invest. 1959;38:443–50.
Wan ZX, Wang XL, Xu L, Geng Q, Zhang Y. Lipid content and fatty acids composition of mature human milk in rural North China. Br J Nutr. 2010;103:913–6.
Nasser R, Stephen AM, Goh YK, Clandinin MT. The effect of a controlled manipulation of maternal dietary fat intake on medium and long chain fatty acids in human breast milk in Saskatoon, Canada. Int Breastfeed J. 2010;5:3.
Mohammad MA, Sunehag AL, Haymond MW. Effect of dietary macronutrient composition under moderate hypocaloric intake on maternal adaptation during lactation. Am J Clin Nutr. 2009;89:1821–7.
Villalpando S, Prado MD. Interrelation among dietary energy and fat intakes, maternal body fatness, and milk total lipid in humans. J Mammary Gland Biol Neoplasia. 1999;4:285–95.
Barbosa L, Butte NF, Villalpando S, Wong WW, Smith EO. Maternal energy balance and lactation performance of Mesoamerindians as a function of body mass index. Am J Clin Nutr. 1997;66:575–83.
Quinn EA, Largado F, Power M, Kuzawa CW. Predictors of breast milk macronutrient composition in Filipino mothers. Am J Hum Biol. 2012;24:533–40.
Ruel MT, Dewey KG, MartÃnez C, Flores R, Brown KH. Validation of single daytime samples of human milk to estimate the 24-h concentration of lipids in urban Guatemalan mothers. Am J Clin Nutr. 1997;65:439–44.
Miller EM, Aiello MO, Fujita M, Hinde K, Milligan L, Quinn EA. Field and laboratory methods in human milk research. Am J Hum Biol. 2013;25:1–11.
Kurniati AM, Sunardi D, SUngkar A. Kadar lemak ASI pada ibu menyusui usia reproduktif. Jurnal Konas XII Perinasia; 2016 Jan 16-20; Banjarmasin, South Borneo. Banjarmasin: Perinasia; 2016. p. 19-23.
Tumbelaka A, Riono P, Sastroasmoro S, Wirjodiarjo M, Pudjiastuti P, Firman K. Pemilihan uji hipotesis. In: Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. Jakarta: CV Sagung Seto; 2011. p. 324–46.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72:694–701.
Depkes RI. Tabel Angka kecukupan gizi yang dianjurkan bagi bangsa Indonesia. 2013 [cited 2014 Sep 30]. Available from: http://gizi.depkes.go.id/download/ Kebijakan%20Gizi/Tabel%20AKG.pdf
Geddes, DT. Gross anatomy of the lactating breast. In: Hartmann PE, editor. Hale & Hartmann’s textbook of human lactation. Amarillo: Hale Pub; 2007. p. 19–31.
Lawrence RA. Breastfeeding: a guide for the medical profession. Maryland Heights: Mosby/Elsevier; 2011. p. 40–61.
Amin W, Indrawan I, Sriwahyuni E. Pengaruh faktor sosial ibu terhadap keberhasilan menyusui pada dua bulan pertama. J Kedokt Brawijaya. 2014;28:146–50.
Ukegbu AU, Ebenebe EU, Ukegbu PO. Breastfeeding pattern, anthropometry and health status of infants attending child welfare clinics of a teaching hospital in Nigeria. S Afr J Clin Nutr. 2010;23:191-6.
Kristiansen AL, Lande B, Øverby NC, Andersen LF. Factors associated with exclusive breast-feeding and breast-feeding in Norway. Public Health Nutr. 2010;13:2087–96.
Al-Sahab B, Lanes A, Feldman M, Tamim H. Prevalence and predictors of 6-month exclusive breastfeeding among Canadian women: a national survey. BMC Pediatr. 2010;10:20.
Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press; 2009. p. 6.
Choua G, El Kari K, El Haloui N, Slater C, Aguenaou H, Mokhtar N. Quantitative assessment of breastfeeding practices and maternal body composition in Moroccan lactating women during six months after birth using stable isotopic dilution technique. Int J Matern Child Health. 2013;1:45-50.
Hopkinson JM. Nutrition in lactation. In: Hartmann PE, editor. Hale & Hartmann’s textbook of human lactation. Amarillo: Hale Pub; 2007. p. 371–83.
Sulistomo A, Sutarina N, Ilyas E. Hidrasi pada aktivitas khusus. In: Status hidrasi pada kondisi umum dan khusus. Jakarta: Badan Penerbit FK UI; 2014. p. 60–81.
Sherwood L. Human physiology: from cells to systems. 6th ed. Independence: Thomson/Brooks/Cole; 2007. p. 257–301.
Depkes RI. Studi diet total: survei makanan individu Indonesia. Jakarta: Balitbangkes; 2014. p. 37-70.
Uauy R, Dangour AD. Fat and fatty acid requirements and recommendations for infants of 0-2 years and children of 2–18 years. Ann Nutr Metab. 2009;55:76–96.
Lawrence RA. Breastfeeding: a guide for the medical profession. Maryland Heights: Mosby/Elsevier; 2011. p. 283–301.
Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeedings
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-12-14
Published 2017-01-09
