Global Landscape of Nutrition Challenges in Infants and Children

93rd Nestlé Nutrition Institute Workshop, Kolkata, March 2019

Editor(s): Michaelsen, Kim F. (Copenhagen)
Neufeld, Lynnette M. (Geneva)
Prentice, Andrew M. (Banjul)

Role of Milk in Early Life

Human Milk as the First Source of Micronutrients

Allen L.H.a,b · Hampel D.a,b

Author affiliations

aUSDA, ARS Western Human Nutrition Research Center, Davis, CA, USA
bDepartment of Nutrition, University of California, Davis, CA, USA

Related Articles for ""
Michaelsen KF, Neufeld LM, Prentice AM (eds): Global Landscape of Nutrition Challenges in Infants and Children. Nestlé Nutr Inst Workshop Ser. Nestlé Nutrition Institute, Switzerland/S. Karger AG., Basel, © 2020, vol 93, pp 67–76
https://doi.org/10.1159/000503359

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Article / Publication Details

Received: August 27, 2019
Accepted: August 27, 2019
Published online: January 28, 2020
Cover Date: 2019

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 2

ISBN: 978-3-318-06648-7 (Print)
eISBN: 978-3-318-06649-4 (Online)

Abstract

Well-nourished mothers are assumed to produce adequate concentrations of nutrients in their milk for optimal infant growth and development and infants should be exclusively breastfed during the first 6 months. It is important to know the nutrient content of human milk as this information is used to set recommended adequate intakes (AIs) for infants. Our review of existing information reveals that the AI recommendations are based on poor data. The milk content of a few nutrients may not be adequate to provide requirements for 6 months even in well-nourished mothers. Importantly, the concentrations of many micronutrients in milk are low when the mother consumes a poor quality diet. Our new efficient methods for milk nutrient analysis have enabled us to illuminate the large differences in milk micronutrient concentrations across populations, to examine the effects of milk collection protocols on nutrient concentrations, and to study the effects of maternal supplementation in pregnancy and/or lactation on milk micronutrient and infant status. The ongoing Mothers, Infants and Lactation Quality study proposes to answer some of these uncertainties. Two hundred and fifty healthy, well-nourished, unsupplemented mother–infant dyads in each of the 4 countries are being studied. The range of milk nutrient concentrations across the first 9 months postpartum will provide “Reference Values” against which other studies and surveys can evaluate the quality of milk and possibly target nutrients for treatment with supplements or fortification.

© 2020 Nestlé Nutrition Institute, Switzerland/S. Karger AG, Basel



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References

  1. World Health Organization: The Optimal Duration of Exclusive Breastfeeding. Report of an Expert Consultation. Geneva, World Health Organization, 2001.
  2. World Health Organization: Daily Iron Supplementation in Infants and Children. Geneva, World Health Organization, 2016.
  3. Paganini D, Zimmermann MB: The effects of iron fortification and supplementation on the gut microbiome and diarrhea in infants and children: a review. Am J Clin Nutr 2017;106(suppl 6):1688S–1693S.
  4. Thomas TA: Zinc supplementation in diarrhea: summary of Cochrane database review. Curr Med Issue 2017;15:142–143.
  5. Krebs NF: Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metab 2013;62:19–29.
  6. Hollis BW, Wagner CL, Howard CR, et al: Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics 2015;136:625–634.
  7. Bouhouch RR, Bouhouch S, Cherkaoui M, et al: Direct iodine supplementation of infants versus supplementation of their breastfeeding mothers: a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2014;2:197–209.
  8. Andersson M, Aeberli I, Wust N, et al: The Swiss iodized salt program provides adequate iodine for school children and pregnant women, but weaning infants not receiving iodine-containing complementary foods as well as their mothers are iodine deficient. J Clin Endocrinol Metab 2010;95:5217–5224.
  9. Dror DK, Allen LH: Vitamin B-12 in human milk: a systematic review. Adv Nutr 2018;9(suppl 1):358S–366S.
  10. Greibe E, Lildballe DL, Streym S, et al: Cobalamin and haptocorrin in human milk and cobalamin-related variables in mother and child: a 9-mo longitudinal study. Am J Clin Nutr 2013;98:389–395.
  11. Hay G, Johnston C, Whitelaw A, et al: Folate and cobalamin status in relation to breastfeeding and weaning in healthy infants. Am J Clin Nutr 2008;88:105–114.
  12. Bjørke Monsen AL, Ueland PM: Homocysteine and methylmalonic acid in diagnosis and risk assessment from infancy to adolescence. Am J Clin Nutr 2003;78:7–21.
  13. Dror DK, Allen LH: Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 2008;66:250–255.
  14. Allen LH: Maternal micronutrient malnutrition: effects on breast milk and infant nutrition, and priorities for intervention. SCN News 1994;11:21–24.
  15. Hampel D, York ER, Allen LH: Ultra-performance liquid chromatography tandem mass-spectrometry (UPLC-MS/MS) for the rapid, simultaneous analysis of thiamin, riboflavin, flavin adenine dinucleotide, nicotinamide and pyridoxal in human milk. J Chromatogr B Analyt Technol Biomed Life Sci 2012;903:7–13.
  16. Hampel D, Dror DK, Allen LH: Micronutrients in human milk: analytical methods. Adv Nutr 2018;9(suppl 1):313S–331S.
  17. Hampel D, Shahab-Ferdows S, Adair LS, et al: Thiamin and riboflavin in human milk: effects of lipid-based nutrient supplementation and stage of lactation on vitamer secretion and contributions to total vitamin content. PloS one 2016;11:e0149479.
  18. Lildballe DL, Hardlei TF, Allen LH, et al: High concentrations of haptocorrin interfere with routine measurement of cobalamins in human serum and milk. A problem and its solution. Clin Chem Lab Med 2009;47:182–187.
  19. Hampel D, Shahab-Ferdows S, Domek JM, et al: Competitive chemiluminescent enzyme immunoassay for vitamin B12 analysis in human milk. Food Chem 2014;153:60–65.
  20. Hampel D, Shahab-Ferdows S, Islam MM, et al: Vitamin concentrations in human milk vary with time within feed, circadian rhythm, and single-dose supplementation. J Nutr 2017;147:603–611.
  21. Allen LH, Dror DK: Introduction to current knowledge on micronutrients in human milk: adequacy, analysis, and need for research. Adv Nutr 2018;9(suppl 1):275S–277S.
  22. Allen LH, Hampel D: Water-soluble vitamins in human milk: factors affecting their concentration and their physiological significance; in Donovan SM, German JB, Lönnerdal B, Lucas A (eds): Human Milk: Composition, Clinical Benefits and Future Opportunities, Karger Publishers 2019;90:69–81.
  23. Whitfield KC, Smith G, Chamnan C, et al: High prevalence of thiamine (vitamin B1) deficiency in early childhood among a nationally representative sample of Cambodian women of childbearing age and their children. PLoS Negl Trop Dis 2017;11:e0005814.
  24. Coats D, Frank EL, Reid JM, et al: Thiamine pharmacokinetics in Cambodian mothers and their breastfed infants. Am J Clin Nutr 2013;98:839–844.
  25. Whitfield KC, Karakochuk CD, Kroeun H, et al: Perinatal consumption of thiamine-fortified fish sauce in rural Cambodia: a randomized clinical trial. JAMA Pediatr 2016;170: e162065.
  26. Allen LH, Graham JM: Assuring micronutrient adequacy in the diets of young infants; in Delange FM, West KP (eds): Micronutrient Deficiencies in the First Months of Life. Nestec Ltd; Vevey/S. Basel, Karger AG, 2003, vol 52, pp 55–88.
  27. Powers HJ, Hill MH, Mushtaq S, et al: Correcting a marginal riboflavin deficiency improves hematologic status in young women in the United Kingdom (RIBOFEM). Am J Clin Nutr 2011;93:1274–1284.
  28. Kehoe L, Walton J, Hopkins S, et al: Intake, status and dietary sources of riboflavin in a representative sample of Irish adults aged 18–90 years. Proc Nutr Soc 2018;77:E66.
  29. McCullough AL, Kirksey A, Wachs TD: Vitamin B-6 status of Egyptian mothers: relation to infant behavior and maternal-infant interactions. Am J Clin Nutr 1990;51:1067–1074.
  30. Allen LH, Miller JW, de Groot L, et al: Biomarkers of nutrition for development (BOND): vitamin B-12 review. J Nutr 2018;148(suppl 4):1995S–2027S.
  31. Dror DK, Allen LH: Retinol-to-fat ratio and retinol concentration in human milk show similar time trends and associations with maternal factors at the population level: a systematic review and meta-analysis. Adv Nutr 2018;9(suppl 1):332S–346S.
  32. Allen LH, Hampel D, Shahab-Ferdows S, et al: Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the positive effects of lipid-based nutrient supplements on breast-milk B vitamins. Am J Clin Nutr 2015;102:1468–1474.
  33. Siddiqua TJ, Ahmad SM, Ahsan KB, et al: Vitamin B12 supplementation during pregnancy and postpartum improves B12 status of both mothers and infants but vaccine response in mothers only: a randomized clinical trial in Bangladesh. Eur J Nutr 2016;55:281–293.
  34. Engle-Stone R, Nankap M, Ndjebayi AO, et al: Iron, zinc, folate, and vitamin B-12 status increased among women and children in Yaoundé and Douala, Cameroon, 1 year after introducing fortified wheat flour. J Nutr 2017;147:1426–1436.

Article / Publication Details

Received: August 27, 2019
Accepted: August 27, 2019
Published online: January 28, 2020
Cover Date: 2019

Number of Print Pages: 10
Number of Figures: 1
Number of Tables: 2

ISBN: 978-3-318-06648-7 (Print)
eISBN: 978-3-318-06649-4 (Online)

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