Mineral and trace element content of human transitory milk indentified with inductively coupled plasma atomic emission spectrometry

Selenium and breast-feeding

The objective of the present review is to discuss Se nutrition during breast-feeding, encompassing environmental and maternal constitutional factors affecting breast-milk-Se metabolism and secretion. A literature search of Medline and Webofscience was used to retrieve and select papers dealing with Se and breast milk. Although Se in natural foods occurs only in organic form, breast milk responds to organic and inorganic Se in supplements. Inorganic Se (selenite, selenate), which is largely used in maternal supplements, is not detectable in breast milk. The mammary-gland regulating mechanism controls the synthesis and secretion of seleno-compounds throughout lactation, with a high total Se level in colostrum that decreases as lactation progresses. Se appears in breast milk as a component of specific seleno-proteins and seleno-amino-acids in milk proteins that are well tolerated by breast-fed infants even in high amounts. Se in breast milk occurs as glutathione peroxidase (4-32 % total Se) > selenocystamine > selenocystine > selenomethionine. The wide range of breast-milk Se concentrations depends on Se consumed in natural foods, which reflects the Se content of the soils where they are grown. Se prophylaxis, either through soil Se fertilization or maternal supplements, is effective in raising breast-milk Se concentration. In spite of wide variation, the median Se concentration from studies worldwide are 26, 18, 15, and 17 microg/l in colostrum (0-5 d), transitional milk (6-21 d), mature milk (1-3 months) and late lactation (>5 months) respectively. Se recommendations for infants are presently not achieved in 30 % of the reported breast-milk Se concentrations; nevertheless Se status is greater in breast-fed than in formula-fed infants.

Magnesium in human milk

Reported concentrations for magnesium in breast milk vary over a wide range (15 to 64 mg/L) with a median value of 31 mg/L and 75% of reported mean concentrations below 35 mg/L. Constitutional variables such as adolescent motherhood, gestation length, maternal undernutrition, metabolic disorders (diabetes, galactosemia), race, stage of lactation, sampling techniques (foremilk and hindmilk), as well as environmental variables such as socio-cultural diversity, smoking habits, dietary calcium and magnesium (including supplementation), vegetarianism, calciotropic agents (immunoreactive calcitonin, vitamin D), medication (hormonal contraceptives, magnesium sulfate) are critically reviewed in relation to changes in milk magnesium concentrations. Magnesium secretion into breast milk does not seem to be affected by the studied variables.

Iron and copper in human milk

The reported concentrations of iron and copper in breast milk show a wide variation. Research published over the past 50 y has reported median values of 0.47 and 0.32 mg/L for iron and copper, respectively. The levels of both metals decrease with the progress of lactation. The calculated iron-to-copper ratio of reported means differs from 0.25 to 6.29 (median = 1.18). Maternal constitutional variables such as undernutrition, iron and copper body reserves, stage of lactation, adolescent motherhood, gestation length, and infection and environmental variables such as iron and copper dietary intake, in addition to supplementation, smoking, vegetarianism, and prolonged use of hormonal contraceptives before and during lactation did not consistently affect the concentrations of iron and copper in breast milk. Extreme cases of either low or high levels of body metal availability or altered metabolism due to chelating therapy or illnesses such as Wilson's disease and infections did not affect metal transfer from blood serum to breast milk. There is no clinical or scientific support for the need of extra iron or copper, besides the quantities provided by milk in the full-term breast-fed infant, at least during the first 6 mo.

Changes in the concentrations of trace elements in human milk during lactation

Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine 18 trace elements (Ba, Be, Bi, Cd, Co, Cs, Cu, La, Li, Mn, Mo, Pb, Rb, Sb, Sn, Sr, Tl, and Zn) in 55 human milk samples from 46 healthy mothers collected during lactation periods extending to 293 days after birth. Se was quantified by hydride generation atomic absorption spectrometry (HG-AAS). To test the accuracy and the precision of the analytical procedure, milk powder reference materials (BCR 063 and BCR 150) were analyzed. The results obtained by ICP-MS and HG-AAS showed good agreement with the certified values. Whenever available, trace element concentrations determined in the human milk samples were compared to reliable literature data. The concentrations of Be (< 0.05 to 0.9 microgram/kg), Bi (< 0.09 to 2.0 micrograms/kg), Cs (1.7 to 7.7 micrograms/kg), La (< 0.05 to 3.7 micrograms/kg), Rb (440 to 1,620 micrograms/kg), and Tl (< 0.08 to 0.5 microgram/kg) are the first to be reported for human milk. The concentrations of the essential trace elements Cu (p < 0.005), Mn (p < 0.05), Mo (p < 0.0005), Se (p < 0.001), and Zn (p < 0.0005) significantly decreased and the concentrations of cobalt significantly increased (p < 0.005) in human milk during the course of lactation. All concentrations for the essential trace element tin in the human milk samples were below the method detection limit of 0.3 microgram/kg. Among the not essential and toxic elements-with the exception of Ba, Pb, and Tl-the trend toward lower concentrations with continuing lactation is much less pronounced than for the essential trace elements. With the exception of Se, the daily intakes of essential trace elements of fully breast-fed infants are considerably lower than dietary recommendations.