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Macronutrient composition of human milk from Korean mothers of full term infants born at 37-42 gestational weeks

  • Chang, Namsoo (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Jung, Ji A (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Kim, Hyesook (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Jo, Ara (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Kang, Sujeong (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Lee, Si-Won (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Yi, Hyunju (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Kim, Jihee (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Yim, Jong-Gap (Maeil Human Milk R & D Center, Maeil Dairies Co.) ;
  • Jung, Byung-Moon (Maeil Human Milk R & D Center, Maeil Dairies Co.)
  • Received : 2015.01.10
  • Accepted : 2015.06.10
  • Published : 2015.08.01

Abstract

BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; $32.0{\pm}3.3years$), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.

Acknowledgement

Grant : 식품영양기반 창의적 미래 건강전문인재 양성팀

References

  1. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am 2013;60:49-74. https://doi.org/10.1016/j.pcl.2012.10.002
  2. Isaacs EB, Fischl BR, Quinn BT, Chong WK, Gadian DG, Lucas A. Impact of breast milk on intelligence quotient, brain size, and white matter development. Pediatr Res 2010;67:357-62. https://doi.org/10.1203/PDR.0b013e3181d026da
  3. Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, Igumnov S, Fombonne E, Bogdanovich N, Ducruet T, Collet JP, Chalmers B, Hodnett E, Davidovsky S, Skugarevsky O, Trofimovich O, Kozlova L, Shapiro S; Promotion of Breastfeeding Intervention Trial (PROBIT) Study Group. Breastfeeding and child cognitive development: new evidence from a large randomized trial. Arch Gen Psychiatry 2008;65:578-84. https://doi.org/10.1001/archpsyc.65.5.578
  4. World Health Organization (CH); Unicef (US). Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization; 2003.
  5. Unicef (US). Infant and young child feeding [Internet]. New York (NY): Unicef; 2014 [cited 2015 June 1]. Available from: http://www.unicef.org/nutrition/index_breastfeeding.html.
  6. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:e827-41. https://doi.org/10.1542/peds.2011-3552
  7. Department of Health (GB). Infant feeding recommendation [Internet]. London: Department of Health; 2003 [cited 2015 June 1]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4096999.pdf.
  8. Ministry of Health and Welfare, Korea Center for Disease Prevention and Control; National Health Insurance Service. Manual of Pediatric Physical Examination 2015. Cheongju: Korea Center for Disease Prevention and Control; 2015.
  9. Kim SG, Kim YK, Kim HR, Park JS, Son CK, Choi YJ, Kim YW, Lee GE, Yoon AR. The status of breast-feeding. In: The 2012 National Survey on Fertility, Family Health & Welfare in Korea. Seoul: Korea Institute for Health and Social Affairs; 2012. p.415-41.
  10. Lee WS, Cho J, Choi YS, Chung SH, Bae CW, Jung JA. Breastfeeding rate in below 6 months infants during recent 6-year in Korea based on childcare database. Neonatal Med 2013;20:221-7. https://doi.org/10.5385/nm.2013.20.2.221
  11. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey [KNHANES VI-1]. Cheongju: Korea Centers for Disease Control and Prevention; 2014.
  12. Yang T, Zhang Y, Ning Y, You L, Ma D, Zheng Y, Yang X, Li W, Wang J, Wang P. Breast milk macronutrient composition and the associated factors in urban Chinese mothers. Chin Med J (Engl) 2014;127:1721-5.
  13. Abranches AD, Soares FV, Junior SC, Moreira ME. Freezing and thawing effects on fat, protein, and lactose levels of human natural milk administered by gavage and continuous infusion. J Pediatr (Rio J) 2014;90:384-8. https://doi.org/10.1016/j.jped.2013.11.001
  14. 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. https://doi.org/10.1002/ajhb.22266
  15. Thakkar SK, Giuffrida F, Cristina CH, De Castro CA, Mukherjee R, Tran LA, Steenhout P, Lee le Y, Destaillats F. Dynamics of human milk nutrient composition of women from Singapore with a special focus on lipids. Am J Hum Biol 2013;25:770-9. https://doi.org/10.1002/ajhb.22446
  16. Lee JS. Changes in specific gravity, total solid and protein contents of human milk during the course of lactation in Korean women. Korean J Nutr 1988;21:129-33.
  17. Lee SG, Chung TH. Lipid content of breast milk in Korean women. J Korean Pediatr Soc 1985;28:977-88.
  18. Kim SK, Ra CS. Quantitative determination of lipids in breast milk of Korean woman. J Korean Pediatr Soc 1986;29:67-74.
  19. Song SW, Moon SJ, Ahn HS. Ecological study of the changes in the components of human milk during the breast feeding and the relationships between the dietary behavior of lactating women and the growth of breastfed infants: I. A study on the nitrogen content in human milk. Korean J Nutr 1990;23:179-86.
  20. Choi MH, Moon SJ, Ahn HS. An ecological study of changes in the components of human milk during the breast feeding and the relationships between the dietary behavior of lactating women and the growth of breast-fed infants: II. A study on the lipids content in human milk. Korean J Nutr 1991;24:77-86.
  21. Moon SJ, Lee MJ, Kim JH, Kang JS, Ahn HS, Song SW, Choi MH. A longitudinal study of the total nitrogen, total lipid, and lactose contents in human milk and energy intake of breast-fed infants. Korean J Nutr 1992;25:233-47.
  22. Michaelsen KF, Pedersen SB, Skafte L, Jaeger P, Peitersen B. Infrared analysis for determining macronutrients in human milk. J Pediatr Gastroenterol Nutr 1988;7:229-35. https://doi.org/10.1097/00005176-198803000-00013
  23. de Halleux V, Close A, Stalport S, Studzinski F, Habibi F, Rigo J. Advantages of individualized fortification of human milk for preterm infants. Arch Pediatr 2007;14 Suppl 1:S5-10. https://doi.org/10.1016/S0929-693X(07)80004-2
  24. Min KB, Lee SM, Eun HS, Park MS, Park KI, Namgung R, Lee C. Analysis of the macronutrient composition of breast milk from Korean women and growth of infants. Korean J Perinatol 2012;23: 259-65.
  25. Corvaglia L, Battistini B, Paoletti V, Aceti A, Capretti MG, Faldella G. Near-infrared reflectance analysis to evaluate the nitrogen and fat content of human milk in neonatal intensive care units. Arch Dis Child Fetal Neonatal Ed 2008;93:F372-5. https://doi.org/10.1136/adc.2007.133280
  26. Casadio YS, Williams TM, Lai CT, Olsson SE, Hepworth AR, Hartmann PE. Evaluation of a mid-infrared analyzer for the determination of the macronutrient composition of human milk. J Hum Lact 2010;26:376-83. https://doi.org/10.1177/0890334410376948
  27. Menjo A, Mizuno K, Murase M, Nishida Y, Taki M, Itabashi K, Shimono T, Namba K. Bedside analysis of human milk for adjustable nutrition strategy. Acta Paediatr 2009;98:380-4. https://doi.org/10.1111/j.1651-2227.2008.01042.x
  28. Lonnerdal B, Forsum E, Gebre-Medhin M, Hambraeus L. Breast milk composition in Ethiopian and Swedish mothers. II. Lactose, nitrogen, and protein contents. Am J Clin Nutr 1976;29:1134-41. https://doi.org/10.1093/ajcn/29.10.1134
  29. Ding M, Li W, Zhang Y, Wang X, Zhao A, Zhao X, Wang P, Sheng QH. Amino acid composition of lactating mothers' milk and confinement diet in rural North China. Asia Pac J Clin Nutr 2010;19: 344-9.
  30. Morita A, Yoshiike N, Takimoto H, Tsubota-Utsugi M, Kodama H, Shimizu T, Sugiyama T, Tabata I, Tamai H, Tsutsumi C, Hirahara F, Kuzuya M, Gomi I, Nakamura K, Yoshida H, Nakamura M. Dietary reference intakes for Japanese 2010: lifestage. J Nutr Sci Vitaminol (Tokyo) 2013;59 Suppl:S103-9.
  31. Nommsen LA, Lovelady CA, Heinig MJ, Lonnerdal B, Dewey KG. Determinants of energy, protein, lipid, and lactose concentrations in human milk during the first 12 mo of lactation: the DARLING Study. Am J Clin Nutr 1991;53:457-65. https://doi.org/10.1093/ajcn/53.2.457
  32. Prentice AM, Goldberg GR, Prentice A. Body mass index and lactation performance. Eur J Clin Nutr 1994;48 Suppl 3:S78-86.
  33. Innis SM. Human milk and formula fatty acids. J Pediatr 1992;120: S56-61. https://doi.org/10.1016/S0022-3476(05)81237-5
  34. 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.
  35. Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics 2006;117: e387-95. https://doi.org/10.1542/peds.2005-1417
  36. Chang YC, Chen CH, Lin MC. The macronutrients in human milk change after storage in various containers. Pediatr Neonatol 2012;53:205-9. https://doi.org/10.1016/j.pedneo.2012.04.009
  37. 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. https://doi.org/10.1002/ajhb.22334
  38. Picciano MF. Comparative lactation - humans [Internet]. Champaign (IL): Lactation Resource Library; 2009 [cited 2015 June 1]. Available from: http://ansci.illinois.edu/static/ansc438/Lactation/humans.html.
  39. Koletzko B, Baker S, Cleghorn G, Neto UF, Gopalan S, Hernell O, Hock QS, Jirapinyo P, Lonnerdal B, Pencharz P, Pzyrembel H, Ramirez-Mayans J, Shamir R, Turck D, Yamashiro Y, Zong-Yi D. Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated international expert group. J Pediatr Gastroenterol Nutr 2005;41:584-99. https://doi.org/10.1097/01.mpg.0000187817.38836.42
  40. Butte NF, Lopez-Alarcon MG, Garza C. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. Geneva: World Health Organization; 2002.
  41. Wijnhoven TM, Bollars C, Tabacchi G, Hermoso M. Collate and review data on the composition and volume and intake of breast milk: results from a systematic literature review [Internet]. Brussels: EURopean micronutrient RECommendations Aligned; [cited 2015 June 1]. Available from: http://www.eurreca.org/downloadattachment/8565/9807/Report%20on%20the%20composition,%20volume%20and%20intake%20of%20breast%20milk.pdf.
  42. Chung SH, Kim HR, Choi YS, Bae CW. Trends of breastfeeding rate in Korea (1994-2012): comparison with OECD and other countries. J Korean Med Sci 2013;28:1573-80. https://doi.org/10.3346/jkms.2013.28.11.1573
  43. Kim HR. Trends of breastfeeding in Korea and other nations: strategic policy for improving breastfeeing in Korea. Issue Focus 2011;86:1-8.
  44. Pei X, Tandon A, Alldrick A, Giorgi L, Huang W, Yang R. The China melamine milk scandal and its implications for food safety regulation. Food Policy 2011;36:412-20. https://doi.org/10.1016/j.foodpol.2011.03.008
  45. Mitternacht M. Botulism threat to infant milk formula [Internet]. [place unknown]: Sun Herald; 2013 [cited 2015 June 1]. Available from: http://newsstore.fairfax.com.au/apps/viewDocument.ac?page=1&sy=nstore&kw=botulism+threat+AND+infant&pb=all_ffx&dt=selectRange&dr=entire&so=relevance&sf=text&sf=headline&rc=10&rm=200&sp=nrm&clsPage=1&docID=SHD130804DI7L638LA9H.
  46. Ministry of Health and Welfare. National Health Plan 2020. Seoul: Ministry of Health and Welfare; 2011.
  47. Kim JY, Hwang SJ, Park HK, Lee HB, Kim NS. Analysis of online breast-feeding consultation on the website of the Korean Pediatric Society. Korean J Pediatr 2008;51:1152-7. https://doi.org/10.3345/kjp.2008.51.11.1152

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