Maternal nutritional status and milk volume and composition in India: an observational study.
Maternal nutritional status and milk volume and composition in India: an observational study.
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DOI：
10.1016/j.ajcnut.2023.02.002
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发表时间：
2023-04
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--
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母乳为婴儿提供必需的营养，其益处是众所周知的。我们缺乏关于中低收入国家孕产妇营养状况对乳汁量和成分影响的数据。我们的目的是 1) 评估印度女性的哺乳表现（母乳量、常量营养素成分和婴儿能量摄入），2) 检查母亲人体测量（BMI、体脂百分比）和哺乳表现之间的关联。我们对印度哈里亚纳邦 232 名产后 2 至 4 个月的母婴进行了一项观察性研究。我们使用氧化氘剂量技术来测量母乳量和母体脂肪百分比，并收集母乳样本以确定常量营养素和能量浓度。调整后的多元线性回归模型用于检查母亲人体测量与哺乳表现之间的关联。母亲的平均 BMI 和体脂百分比分别为 21.7 ± 3.6 kg/m2 和 29.5 ± 7.7。奶量和大量营养素成分与参考值相似（平均值±标准差：奶量，724±184mL/天；中位数（第25、75个百分位）；蛋白质，9.9（8.3，11.7）g/L；脂肪，41.0±15.2g/L；能量密度，0.71±0.14kcal/g；乳糖，65.5 (55.3, 71.3) 克/升)。母亲体重指数和体脂百分比与大量营养素成分没有显着相关。母亲BMI和体脂百分比均与乳汁量呈负相关（分别为-7.0，95% CI：-12.4，-1.6 mL/d；-3.5，95% CI：-6.0，-1.1 mL/d），但调整协变量后对婴儿的总能量摄入没有影响。大多数母亲的体重指数正常，母乳的成分和体积与参考值相似。未来需要对体重不足和/或肥胖负担较大的人群进行研究，以检查母亲身体成分和乳汁量之间的潜在机制。该试验在印度临床试验注册中心注册为 CTRI/2017/01/007636。
Human milk provides essential nutrition for infants, and its benefits are well established. We lack data on the influence of maternal nutritional status on milk volume and composition in low-middle income countries. We aimed to 1) assess lactation performance (human milk volume, macronutrient composition, and infant energy intake) in Indian females and 2) examine the associations between maternal anthropometry (BMI, percentage body fat) and lactation performance. We conducted an observational study among 232 mother-infant dyads, 2 to 4 mo postpartum in Haryana, India. We used deuterium oxide dose-to-mother technique to measure milk volume and maternal percentage body fat and collected human milk samples to determine macronutrient and energy concentrations. Adjusted multiple linear regression models were used to examine the associations between maternal anthropometry and lactation performance. The mean BMI and percentage body fat of mothers were 21.7 ± 3.6 kg/m2 and 29.5 ± 7.7, respectively. Milk volume and macronutrient composition were similar to the reference values (means ± standard deviations: milk volume, 724 ± 184 mL/d; median (25th, 75th percentile); protein, 9.9 (8.3, 11.7) g/L; fat, 41.0 ± 15.2 g/L; energy density, 0.71 ± 0.14 kcal/g; lactose, 65.5 (55.3, 71.3) g/L). Maternal BMI and percentage body fat were not significantly associated with macronutrient composition. Both maternal BMI and percentage body fat were negatively associated with milk volume (-7.0, 95% CI: -12.4, -1.6 mL/d; -3.5, 95% CI: -6.0, -1.1mL/d, respectively) but there were no effects on the total energy intake of infants after adjusting for covariates. Most mothers had a normal BMI and milk of similar composition and volume to reference values. Future work in populations with a greater burden of underweight and/or obesity are needed to examine the underlying mechanisms between maternal body composition and milk volume. This trial was registered at The Clinical Trials Registry- India as CTRI/2017/01/007636.
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