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Falize C, Savage M, Jeanes YM, Dyall SC. Evaluating the relationship between the nutrient intake of lactating women and their breast milk nutritional profile: a systematic review and narrative synthesis. Br J Nutr 2024; 131:1196-1224. [PMID: 38053371 PMCID: PMC10918524 DOI: 10.1017/s0007114523002775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/05/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023]
Abstract
Maternal diet influences breast milk nutritional profile; however, it is unclear which nutrients and contaminants are particularly responsive to short- and long-term changes in maternal intake, and the impact of specific exclusion diets, such as vegan or vegetarian. This study systematically reviewed the literature on the effects of maternal nutrient intake, including exclusion diets, on both the nutrient and contaminant content of breast milk. The electronic databases, PubMed, CENTRAL, Web of Science and CINALH were systematically searched until 4 June 2023, with additionally searches of reference lists (PROSPERO, CRD42020221577). The quality of the studies was examined using Cochrane Risk of Bias tool and Newcastle-Ottawa scale. Eighty-eight studies (n 6577) met the search criteria. Due to high heterogeneity, meta-analysis was not possible. There was strong evidence of response to maternal intakes for DHA and EPA, vitamins A, E and K, iodine and Se in breast milk composition, some evidence of response for α-linolenic acid, B vitamins, vitamin C and D, ovalbumin, tyrosine and contaminants, and insufficient evidence to identify the effects arachidonic acid, Cu, Fe, Zn and choline. The paucity of evidence and high heterogeneity among studies reflects the need for more high-quality trials. However, this review identified the importance of maternal intake in the nutritional content of breast milk for a wide range of nutrients and supports the recommendation for supplementation of DHA and vitamin B12 for those on restrictive diets.
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Affiliation(s)
- Coralie Falize
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - M. Savage
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Yvonne M. Jeanes
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Simon C. Dyall
- School of Life and Health Sciences, University of Roehampton, London, UK
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Kumar PSS, Gupta A, Desu SS, Reddy B V, Shaik YN, Kakkar R, Aravindakshan R. Alarming levels of inadequate intake of B group vitamins in tribal lactating women from South India. J Public Health Res 2024; 13:22799036241234036. [PMID: 38476323 PMCID: PMC10929043 DOI: 10.1177/22799036241234036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/03/2024] [Indexed: 03/14/2024] Open
Abstract
Background Micronutrients are necessary for proper growth and development of the human body, though required in small amounts. Dietary intake of these micronutrients by lactating women is essential for their own health as well as children's overall growth and development. objective of present study is to assess the adequacy of dietary B-group vitamins intake during lactation and to find out the factors associated with their inadequate intake. Design and methods It was a analysis of data from prospective cohort study for 10 months carried out among 340 Scheduled Tribes mothers in 10 clusters in Guntur district, Andhra Pradesh, India. Data collection was done using a 24 h dietary recall questionnaire. A p-value less than 0.05 was considered to be statistically significant. Results All the mothers (n = 340) were not having adequate intake of Thiamine, Riboflavin, Niacin, Pyridoxine, Pantothenic acid, Biotin and Folic acid. Methyl cobalamin intake was inadequate in 37.5% mothers (n = 136). The mean intake of Vitamin B12 was 40.98 + 42.8 (SD) µg/day. Age at marriage, location and parity were significantly associated with inadequate intake of Vitamin B12. Conclusions The current diet pattern of mothers of vulnerable groups might affect the growth and development of the infant. We strongly recommend for supplementation of B-group vitamins to pregnant and lactating women in India.
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Affiliation(s)
- Pentapati Siva Santosh Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - Arti Gupta
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - Sai Subhakar Desu
- Ex Medical Officer, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - Venkatashiva Reddy B
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - Yusuf Noorani Shaik
- Ex-Assistant Child Development Project Officer, ICDS Project, Mangalagiri, Guntur, Andhra Pradesh, India
| | - Rakesh Kakkar
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Punjab, India
| | - Rajeev Aravindakshan
- Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
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Mukomafhedzi N, Tshitangano TG, Tshivhase SE, Olaniyi FC. Protocol to develop a framework addressing barriers to utilization of elimination of mother- to -child transmission of HIV services among pregnant women and lactating mothers in Gauteng province. MethodsX 2023; 11:102351. [PMID: 37830000 PMCID: PMC10565866 DOI: 10.1016/j.mex.2023.102351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/26/2023] [Indexed: 10/14/2023] Open
Abstract
Mother-to-child transmission of HIV remains the primary contributor to HIV infections in children, globally. Despite the progress made to reduce new HIV infections in children, barriers to utilization of the Elimination of Mother-to-Child Transmission service remain the bottleneck that affects the program's effectiveness. This study aims to develop a framework to address barriers to the utilization of the Elimination of Mother-to-Child Transmission of HIV services among pregnant women and lactating mothers in Gauteng province. A convergent parallel mixed methods design will be employed in phases. Phase 1(a) quantitative will be collected from pregnant women and lactating mothers to describe barriers associated with poor utilization of elimination of mother-to-child transmission services and a potential strategy to facilitate EMTCT utilization; phase 1(b) qualitative data will be collected to explore reasons for poor utilization of EMTCT services and perceived strategy to enhance women's utilization of elimination of mother-to-child transmission services. Quantitative data will be analyzed using Stata software version 14.0 and qualitative data will be analyzed thematically and then results will be integrated. Phase 2: will focus on the development of a framework; Phase 3: will validate the developed framework. The conclusion and recommendations will be based on the findings of the study.
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Affiliation(s)
- Ndivhuwo Mukomafhedzi
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Takalani G. Tshitangano
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Shonisani E. Tshivhase
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Foluke C. Olaniyi
- Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa
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Ahmad N, Muhammad A, Zafar R, Afzal U, Aslam M. Assessment of lead, cadmium, and mercury levels in the breast milk in Pakistani women. Environ Sci Pollut Res Int 2023; 30:85903-85909. [PMID: 37395883 DOI: 10.1007/s11356-023-28517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 06/26/2023] [Indexed: 07/04/2023]
Abstract
The concentrations of potentially toxic metals like lead (Pb), cadmium (Cd), and mercury (Hg) in healthy lactating mothers of Lahore city were estimated during 2020-2021 with the help of a flame atomic absorption spectrometer (FAAS). Seventy samples of breast milk were collected from two different age groups, namely, G-1 (25-30 years) and G-2 (31-40 years). The results showed that Cd contents were below the detection limit of the measuring instrument; however, the Pb and Hg contents were detected with great ease. The mean concentrations of Pb and Hg in the G-1 corresponding to the age between 25 and 30 years were observed to be 1.914 ± 0.493 μg/L and 10.432 ± 3.249 μg/L, respectively. For the G-2 with an age limit between 31 and 40 years, the concentrations of Pb and Hg were estimated to be 2.045 ± 0.502 μg/L and 11.527 ± 3.231 μg/L, respectively. The T-test analysis of concentrations of these toxic metals indicated a significant correlation between the content levels of Pb and Hg (p < 0.05). The observed values of toxic metals were significantly more frequent than those suggested by WHO (World Health Organization). An increase in the concentrations of Pb and Hg is directly associated with the location of the target population. As a result, it is turned out that the majority of the lactating woman with significantly high levels of Pb and Hg belongs to industrial areas of Lahore. To avoid such conditions, residential areas must be at larger distances, in addition, to strictly abiding by the environmental policies of the government.
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Affiliation(s)
- Naveed Ahmad
- Department of Physics, Division of Science and Technology, University of Education, Lahore, 54000, Pakistan
| | - Abbas Muhammad
- Department of Physics, Division of Science and Technology, University of Education, Lahore, 54000, Pakistan
| | - Ramna Zafar
- Department of Physics, Division of Science and Technology, University of Education, Lahore, 54000, Pakistan
| | - Usama Afzal
- Department of Physics, Division of Science and Technology, University of Education, Lahore, 54000, Pakistan.
- School of Microelectronics, Tianjin University, Tianjin, 300072, China.
| | - Muhammad Aslam
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, 21551, Saudi Arabia
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Karbasi S, Mohamadian M, Naseri M, Yahya Hanafi-Bojd M, Khorasanchi Z, Morovatdar N, Zarban A, Bahrami A, Ferns GA. The association of maternal food quality score (FQS) with breast milk nutrient content and antioxidant content of infant urine: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:126. [PMID: 36829155 PMCID: PMC9951474 DOI: 10.1186/s12884-023-05400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/20/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Breast milk (BM) is a complex fluid with a variable composition within women over time and between women in the population. The BM compositional differences are likely to be partly due to maternal dietary patterns. This study aimed to evaluate food quality score (FQS) in lactating mothers and its association with quality indicators of BM and antioxidant content of infant urine. METHODS This cross-sectional study was undertaken in 350 lactating women aged 20 to 35 years. Data on dietary intake was collected using a validated food frequency questionnaire (FFQ) containing 65 food items. The FQS was calculated by integrating the scores obtained from healthy and unhealthy food groups. Subjects were categorized according to FQS adherence, with the greatest adherence being allocated to the third tertile and those with the lowest FQS in the first tertile. Antioxidant activity of the BM and infant urine samples was assessed using the Ferric reducing antioxidant power (FRAP), 2, 2'-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Ellman's assay. The total content of BM protein, calcium, and triglyceride was measured using standard biochemical kits. RESULTS BM from mothers from the third tertile of FQS contained significantly higher DPPH, thiol, calcium, and protein levels compared to BM from those in the lowest tertile (p˂0.05). Infant urinary DPPH and FRAP was also significantly higher in the highest tertile vs. the lowest tertile (p˂0.05). CONCLUSION High maternal adherence to the FQS was associated with a high BM quality and antioxidant content of infant urine.
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Affiliation(s)
- Samira Karbasi
- grid.411701.20000 0004 0417 4622Department of Molecular Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Malihe Mohamadian
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Naseri
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Yahya Hanafi-Bojd
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran ,grid.411701.20000 0004 0417 4622Department of Pharmaceutics and Pharmaceutical Nanotechnology. School of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Khorasanchi
- grid.411583.a0000 0001 2198 6209Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Morovatdar
- grid.411583.a0000 0001 2198 6209Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asghar Zarban
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. .,Clinical Biochemistry Department, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
| | - Afsane Bahrami
- Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. .,Clinical Research Development Unit of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Gordon A. Ferns
- grid.414601.60000 0000 8853 076XBrighton and Sussex Medical School, Division of Medical Education, Falmer, Brighton, BN1 9PH Sussex UK
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Shaun MMA, Nizum MWR, Shuvo MA, Fayeza F, Faruk MO, Alam MF, Hawlader MDH, Mali SK. Determinants of minimum dietary diversity of lactating mothers in rural northern region of Bangladesh: A community-based cross-sectional study. Heliyon 2022; 9:e12776. [PMID: 36632115 PMCID: PMC9826838 DOI: 10.1016/j.heliyon.2022.e12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023] Open
Abstract
Background Breastfeeding requires additional diversified foods for the nutritional requirements of mothers and children, especially in preventing micronutrient deficiencies. The minimum dietary diversity for women (MDD-W) is a proxy indicator of micronutrient adequacy for women. Objectives This study aimed to identify the determinants associated with MDD in lactating women. Methods A community-based cross-sectional study was conducted among lactating mothers having at least one live birth in last three years from two districts of Bangladesh between 31st May 2021 and 9th June 2021. Dietary and socio-demographic information was obtained using a single 24-h recall and socio-economic status questionnaires. MDD was defined as at least four food groups consumed in the last 24 hours. In binary logistic regression, adjusted models were used to assess the relationship between MDD and socio-economic factors. Results The mean Dietary Diversity Score (DDS) was 3.9 ± 1.2. The MDD was met by 29.7% of women. Respondent's ages 20-24 years [Adjusted Odds Ratio (AOR) = 0.5; 95% CI: 0.3-0.9], 25-34 years [AOR = 0.5; 95% CI: 0.3-0.8], and 35-49 years [AOR = 0.5; 95% CI: 0.2-0.9], husband's academic qualifications more than 12 years [AOR = 1.9; 95% CI: 1.0-3.7], family income more than 15000 BDT per month [AOR = 2.3; 95% CI: 1.2-4.3], and husband's profession as a day labor [AOR = 0.5; 95% CI: 0.3-0.7] were significant factors to have MDD. Conclusions DDS and MDD were very poor among the mothers, whereas women's age, husband's education, and the family's monthly income were independent determinants of MDD. Special interventions may be needed to improve MDD.
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Affiliation(s)
- Md Mahbubul Alam Shaun
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, 8602, Patuakhali, Bangladesh
- Corresponding author.
| | - Md Wahidur Rahman Nizum
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, 1229, Bangladesh
| | - Md Asaduzzaman Shuvo
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, 1229, Bangladesh
| | - Fahmida Fayeza
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, 8602, Patuakhali, Bangladesh
| | - Md Omar Faruk
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, 8602, Patuakhali, Bangladesh
| | - Md Fakrul Alam
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, 8602, Patuakhali, Bangladesh
| | | | - Sujan Kanti Mali
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, 8602, Patuakhali, Bangladesh
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Shumayla S, Irfan EM, Kathuria N, Rathi SK, Srivastava S, Mehra S. Minimum dietary diversity and associated factors among lactating mothers in Haryana, India: a community based cross-sectional study. BMC Pediatr 2022; 22:525. [PMID: 36057585 PMCID: PMC9440519 DOI: 10.1186/s12887-022-03588-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Food adequacy and dietary quality in the lactation period are fundamental for maternal and child health. Lactating mothers are vulnerable to malnutrition because of increased physiological demand, monotonous diet, lactogenesis process, and increased nutrient requirements. The micronutrient adequacy especially among women is not ensured in Indian diet. The dual course of gender bias and poverty, along with lack of knowledge about diet quality are significant impediments in maintaining minimum dietary diversity among Indian women. The study aimed to assess the prevalence of minimum dietary diversity and associated factors among lactating women. METHODOLOGY A community-based cross-sectional study was conducted among 1236 lactating women through a multistage sampling procedure in Haryana state, India. Data were collected in Computer-assisted personal interviewing (CAPI) using a pretested structured interview schedule. Minimum Dietary Diversity for Women by Food and Agriculture Organization (FAO) was used to calculate the minimum dietary diversity. RESULTS The mean dietary diversity score among lactating women from the ten food groups was 6.35 ± 2.57 and the prevalence of minimum dietary diversity was 77.1%. The complete model revealed that both individual and household factors can explain the variation in dietary diversity intake. Furthermore, the result of model 2 explained that women aged 31 to 35 years (AOR 5.92,95% (1.87-18.77), graduation and above qualified women (AOR 1.98, 95% (0.96-4.09) and lactating women with high knowledge on nutrition (AOR 2.00, 95% (1.34-4.57) were the significant factors promoting minimum dietary diversity. CONCLUSION Three-fourths of the lactating women reached adequate minimum dietary diversity. Younger age, low educational level, and poor nutritional knowledge were significant constraints to achieving minimum dietary diversity. Further improvement in the minimum dietary diversity among lactating women is very much required. It is also advised that exiting platforms dispersing awareness on nutrition should be supported and strengthened.
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Affiliation(s)
- Shumayla Shumayla
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - E M Irfan
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Nishtha Kathuria
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Suresh Kumar Rathi
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India.
| | - Shobhit Srivastava
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Sunil Mehra
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
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Girma B, Nigussie J, Molla A, Mareg M. Under-Nutrition and Associated Factors Among Lactating Mothers in Ethiopia: A Systematic Review and Meta-analysis. Matern Child Health J 2022. [PMID: 36040618 DOI: 10.1007/s10995-022-03467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Under-nutrition (body mass index < 18.5 kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. METHODS To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. RESULTS The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. CONCLUSION The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.
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Kumera M, Haidar J. Level of exclusive breastfeeding and its enabling factors among lactating women who delivered in health facilities of Asosa town, Ethiopia: a cross sectional study. BMC Womens Health 2021; 21:432. [PMID: 34961489 PMCID: PMC8714435 DOI: 10.1186/s12905-021-01580-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants, the practice of exclusive breastfeeding is globally low. In sub-Saharan Africa and Ethiopia, the prevalence of EBF stands at 35% and 59%, respectively. The low EBF practice in Ethiopia as well as in the studied region calls for further study and thus we studied the EBF practice in the study area since little is known about its current magnitude and factors influencing its practice for some programmatic improvements. METHODS A facility based cross-sectional study linked to a community was conducted from June-July 2019 among 412 mothers who had antenatal follow-up and delivered in health facilities of Asosa town over a period of one year prior to the study. Data on socio demographic characteristics and other important variables were collected through face to face interview while gestational age in weeks was recorded from their medical chart by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were then cleaned and entered into Epi-data software version 3.02. Analysis was done by SPSS version 20. Binary and multivariate logistic regression were performed to identify the contributing factors. P-value of less than 0.05 and 95% confidence interval was considered to determine statistical significance. RESULTS Of the 412 respondents, the majority (88.1%) were multi-gravida and above. Slightly higher than a quarter (26.0%) and over half (55.4%) had neither received antenatal nor postnatal care. The proportion of mothers who exclusively breastfed their children was 76.0% and the overall aggregated good practice of EBF score was 64.1%. Mothers who completed primary school [AOR = 4.5; 95% CI = 1.1,18.2], had four or more ANC [AOR = 1.8;95CI = 0.79-0.98], and postnatal follow-up [AOR = 0.21;95% CI = 0.07-0.67], and had male infants [AOR = 2.3; 95% CI = 1.0-4.95] were among the factors influencing the exclusive breastfeeding practice score. CONCLUSION While three in four mothers exclusively breastfed their newborns and about two-thirds had good EBF score, the observed women's retention on the continuum of the maternal care pathway is low with one in four had no antenatal and over half had no postnatal care which are important derivers for EBF practice. To improve the EBF score and narrow the observed maternal and child health disparities, it is essential to promote maternal education and increase the recomended coverage of antenatal and postnatal care for mothers.
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Affiliation(s)
| | - Jemal Haidar
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Ruiz P, Dualde P, Coscollà C, Fernández SF, Carbonell E, Yusà V. Biomonitoring of glyphosate and AMPA in the urine of Spanish lactating mothers. Sci Total Environ 2021; 801:149688. [PMID: 34425442 DOI: 10.1016/j.scitotenv.2021.149688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 05/21/2023]
Abstract
The objectives of this study were to evaluate the urinary levels of Glyphosate (Gly) and its metabolite aminomethylphosphonic acid (AMPA) in Spanish breastfeeding mothers (n = 97), to identify the main predictors of exposure and to perform a risk assessment. Urine samples were analyzed using a method based on solid phase extraction and liquid chromatography tandem mass spectrometry (LC-MS/MS) determination. The developed method showed limits of quantification of 0.1 μg/L for both analytes. The detection frequencies (DFs) were 54% for Gly and 60% for AMPA, with geometric means (GMs) of 0.12 μg/L and 0.14 μg/L, respectively. In the statistical analysis, no relationship was found between the urinary levels of Gly and AMPA. Multiple regression analysis showed a significant relationship between the intake of eggs and fruits and Gly levels in urine. Estimated daily intakes (EDIs), hazard quotients (HQs), and a hazard index (HI) were calculated to analyze the obtained data from a health risk perspective. The GMs of the EDIs were 0.31 and 0.37 μg/kg of body weight (BW)/day for Gly and AMPA, respectively. The HQs were calculated considering 0.5 mg/kg BW/day as an acceptable daily intake (ADI), which EFSA has established as a health-based reference value for both analytes. The values obtained were lower than 1, and thus, low health risk due to Gly and AMPA exposure was expected for the population under study.
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Affiliation(s)
- Pablo Ruiz
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020 Valencia, Spain
| | - Pablo Dualde
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020 Valencia, Spain
| | - Clara Coscollà
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020 Valencia, Spain.
| | - Sandra F Fernández
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020 Valencia, Spain; Analytical Chemistry Department, University of Valencia, Edifici Jeroni Muñoz, 46100 Burjassot, Spain
| | - Elvira Carbonell
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020 Valencia, Spain
| | - Vicent Yusà
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020 Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020 Valencia, Spain; Analytical Chemistry Department, University of Valencia, Edifici Jeroni Muñoz, 46100 Burjassot, Spain.
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11
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Safayi BL, Assimamaw NT, Kassie DG. Breastfeeding technique and associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia: observational method. Ital J Pediatr 2021; 47:206. [PMID: 34641916 PMCID: PMC8507121 DOI: 10.1186/s13052-021-01158-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/21/2021] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The breastfeeding technique is explained positioning, attachment, and suckling during breastfeeding. Ineffective breast feeding technique is one of the factors leading to premature discontinuation of breastfeeding and malnutrition. There is a limited study on the assessments of BFT and associated factors among lactating mothers in the study area. Therefore, the study aimed to assess breastfeeding technique and the associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted from February 20 to March 20, 2020. An observational checklist and structured interviewer-administered questionnaire were applied to collect the data. The data were entered into Epi-Data 4.6 version and transferred to analyzed using SPSS version 20. Bi-variable and multivariable logistic regressions were performed to identify the association. The strength of association was identified using odds ratio with a 95% confidence interval (), and a p-value of 0.05 was declare as statistically significant. RESULTS The proportion of effective BFT was 48% (95%, CI: 43.0-53.0%). The likelihood of applying proper BFT among age group of 18-20 years was 70% lower than (AOR = 0.3; 95% CI: 0.11-0.83) age group > 30 years. The odds of effective BFT in primipara mothers were 49% (AOR = 0.51; 95% CI: 0.32-0.82) lower compared to multiparous mothers. Likewise, the provability of effective BFT was 55% (AOR = 0.45; 95% CI: 0.29-0.70) times lower in women who had no counseling immediately after delivery compared to their counterparts. Moreover, effective breast feeding technique mothers who have breast problem was 78% lower than (AOR = 0.22; 95% CI: 0.07-0.68) mothers who have no breast problem. And mothers who had counselling of BFT during ANC follow up was 55% (AOR = 0.45; 95% CI: 0.29, 0.70) lower than mothers who had no counseling. CONCLUSION Just under half of the women in the study area applied proper breast feeding technique Younger and primipara mothers poorly performed to effective BFT. But women having counseling during antenatal care follow-up and immediately after delivery and not having breast problems applied BFT effectively. Hence, special emphasis have to give for younger and primipara mothers. Besides, educate the mother for preventing breast problems and working on enhancing counseling at postnatal clinic.
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Affiliation(s)
- Boko Loka Safayi
- Nursing Department, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, School of Nursing, University of Gondar, P.O .Box:196, Gondar, Ethiopia
| | - Destaye Guadie Kassie
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, School of Nursing, University of Gondar, P.O .Box:196, Gondar, Ethiopia
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Wang D, Thielecke F, Fleith M, Afeiche MC, De Castro CA, Martínez-Costa C, Haaland K, Marchini G, Agosti M, Domellöf M, Costeira MJ, Billeaud C, Vanapee M, Picaud JC, Samuel TM. Analysis of dietary patterns and nutritional adequacy in lactating women: a multicentre European cohort (ATLAS study). J Nutr Sci 2021; 10:e17. [PMID: 33889400 PMCID: PMC8057516 DOI: 10.1017/jns.2021.7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 01/26/2021] [Indexed: 01/13/2023] Open
Abstract
Eating habits of lactating women can influence the nutrient composition of human milk, which in turn influences nutrient intake of breastfed infants. The aim of the present study was to identify food patterns and nutritional adequacy among lactating women in Europe. Data from a multicentre European longitudinal cohort (ATLAS study) were analysed to identify dietary patterns using cluster analysis. Dietary information from 180 lactating women was obtained using 3-d food diaries over the first 4 months of lactation. Four dietary patterns were identified: 'vege-oils', 'fish-poultry', 'confectionery-salads' and 'mixed dishes'. Nutrition adequacy was not significantly different between clusters, but the 'vege-oils' cluster tended to yield the highest nutrition adequacy measured by Mean Adequacy Ratio. Compared with European dietary reference values (DRVs) for lactating women, women in all clusters had inadequate intakes of energy, pantothenic acid, folate, vitamin C, vitamin A, vitamin D, zinc, iodine, potassium and linoleic acid. Adequate intake for fibre and α-linolenic acid was only achieved in the 'vege-oils' cluster. Overall, fat intake was above DRVs. The present study showed that various dietary patterns do not adequately supply all nutrients, indicating a need to promote overall healthy dietary habits for European lactating women.
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Affiliation(s)
- Dantong Wang
- Nestlé Research, Vers-chez-les-Blanc, P.O. Box 44, 1000Lausanne 26, Switzerland
| | - Frank Thielecke
- Swiss Distance University of Applied Sciences, Regensdorf-Zurich, Switzerland
- T2 Bene Ltd, Bettenstrasse 60a, 4123Allschwil, Switzerland
| | - Mathilde Fleith
- Nestlé Research, Vers-chez-les-Blanc, P.O. Box 44, 1000Lausanne 26, Switzerland
| | - Myriam C. Afeiche
- Nestlé Research, Vers-chez-les-Blanc, P.O. Box 44, 1000Lausanne 26, Switzerland
| | - Carlos A. De Castro
- Nestlé Research, Vers-chez-les-Blanc, P.O. Box 44, 1000Lausanne 26, Switzerland
| | | | | | | | | | - Magnus Domellöf
- Department of Clinical Sciences, Umeå University, SE90185Umeå, Sweden
| | | | | | - Mireille Vanapee
- Astrid Lindgren Children's Hospital, Karolinska University Hospital/Karolinska Institutet, Stockholm, Sweden
| | | | - Tinu Mary Samuel
- Nestlé Research, Vers-chez-les-Blanc, P.O. Box 44, 1000Lausanne 26, Switzerland
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13
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Ding Y, Li F, Hu P, Ye M, Xu F, Jiang W, Yang Y, Fu Y, Zhu Y, Lu X, Liu Y, Xie Z, Wang Z. Reproducibility and relative validity of a semi-quantitative food frequency questionnaire for the Chinese lactating mothers. Nutr J 2021; 20:20. [PMID: 33658024 PMCID: PMC7931348 DOI: 10.1186/s12937-021-00678-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/19/2021] [Indexed: 12/13/2022] Open
Abstract
Background The dietary nutritional status of the lactating mothers is related to maternal health and has a significant impact on the growth and development of infants through the secretion of breast milk. The food frequency questionnaire (FFQ) is the most cost-effective dietary assessment method that can help obtain information on the usual dietary pattern of participants. Until now, the FFQs have been used for different populations in China, but there are few FFQs available for the lactating mothers. We aimed to develop a semi-quantitative, 156-item FFQ for the Chinese lactating mothers, and evaluate its reproducibility and relative validity. Methods A total of 112 lactating mothers completed two FFQs and one 3-d dietary record (3DR). The first FFQ (FFQ1) was conducted during postpartum at 60–65 days and the second FFQ (FFQ2) during subsequent follow-up at 5 weeks. The 3DR was completed with portion sizes assessed using photographs taken by the respondent before and after eating (instant photography) 1 week after FFQ1. Results For reproducibility, the Spearman’s correlation coefficients for food ranged from 0.34 to 0.68, and for nutrients from 0.25 to 0.61. Meanwhile, the intra-class correlation coefficients for food ranged from 0.48 to 0.87, and for nutrients from 0.27 to 0.70. For relative validity, the Spearman’s correlation coefficients for food ranged from 0.32 to 0.56, and for nutrients from 0.23 to 0.72. The energy-adjusted coefficients for food ranged from 0.26 to 0.55, and for nutrients from 0.22 to 0.47. Moreover, the de-attenuation coefficients for food ranged from 0.34 to 0.67, and for nutrients from 0.28 to 0.77. The Bland-Altman plots also showed reasonably acceptable agreement between the two methods. Conclusions This FFQ is a reasonably reproducible and a relative valid tool for assessing dietary intake of the Chinese lactating mothers.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Fang Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Ping Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Mei Ye
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing, Jiangsu, 211100, People's Republic of China
| | - Fangping Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Wei Jiang
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing, Jiangsu, 211100, People's Republic of China
| | - Yue Yang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Youjuan Fu
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing, Jiangsu, 211100, People's Republic of China
| | - Yunhua Zhu
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing, Jiangsu, 211100, People's Republic of China
| | - Xiaolong Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Ying Liu
- Nanjing Jiangning District Maternal and Child Health and Family Planning Service Center, Nanjing, Jiangsu, 211100, People's Republic of China
| | - Zhencheng Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China.
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Dualde P, Leon N, Pardo O, Coscollà C, Vento M, Pastor A, Yusà V. Risk assessment of exposure to phthalates in breastfeeding women using human biomonitoring. Chemosphere 2020; 255:127003. [PMID: 32679629 DOI: 10.1016/j.chemosphere.2020.127003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/29/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
In this study, we assessed the presence of 14 phthalate metabolites in the urine of 104 lactating mothers from Valencia (Spain) who took part in the human biomonitoring project BETTERMILK. Nine of the metabolites studied showed detection frequencies >80%, whereas the rest of the metabolites presented low detection frequencies (<5%). The concentrations ranged from <LoQ to 1291 ng/mL with monoethyl phthalate showing the highest concentration, with a geometric mean of 34.90 ng/mL. In general, the phthalate metabolite levels quantified in the present study were lower than the urinary levels found in previous studies that involved lactating mothers. The consumption of packaged juices and the frequency of deodorant usage were predictors of some phthalate metabolite levels in urine. In order to put the biomonitoring data in a risk assessment context, guide values for the different phthalates were used and the respective hazard quotients were calculated, which ranged from 0.0036 (benzylbutyl phthalate) to 0.49 (di-2-ethylhexyl phthalate) at the 95th percentile level. Consequently, no risk was appreciated in the studied population.
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Affiliation(s)
- Pablo Dualde
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020, Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020, Valencia, Spain; Analytical Chemistry Department, University of Valencia, Edifici Jeroni Muñoz, Dr. Moliner 50, 46100, Burjassot, Spain
| | - Nuria Leon
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020, Valencia, Spain
| | - Olga Pardo
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020, Valencia, Spain
| | - Clara Coscollà
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020, Valencia, Spain
| | - Máximo Vento
- Neonatal Division at the University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Agustín Pastor
- Analytical Chemistry Department, University of Valencia, Edifici Jeroni Muñoz, Dr. Moliner 50, 46100, Burjassot, Spain
| | - Vicent Yusà
- Public Health Laboratory of Valencia, 21, Avenida Catalunya, 46020, Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, 21, Avenida Catalunya, 46020, Valencia, Spain; Analytical Chemistry Department, University of Valencia, Edifici Jeroni Muñoz, Dr. Moliner 50, 46100, Burjassot, Spain.
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15
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Ding Y, Indayati W, Basnet TB, Li F, Luo H, Pan H, Wang Z. Dietary intake in lactating mothers in China 2018: report of a survey. Nutr J 2020; 19:72. [PMID: 32664937 PMCID: PMC7362564 DOI: 10.1186/s12937-020-00589-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background The nutritional status of lactating mothers (LMs) is related to their own health and significantly impacts the secretion of breast-milk, and subsequently the growth and development of infants. Due to the influence of regional economy, traditional habits, and lack of nutrition knowledge, the problem of poor dietary nutrition among Chinese LMs is prominent. We aimed to evaluate and compare the dietary and nutrient intakes in LMs from urban and rural areas in China to provide baseline data for the implementation of relevant health guidance and strategies. Methods A multi-stage sampling method was used to recruit urban and rural LMs from 13 provinces and municipalities in China. An online dietary record using food photographs was employed to keep track of what the LMs had eaten in 2 days in the form of face-to-face interview. A total of 954 participants were included in the final analysis. Data expressed as quartiles P50 (P25; P75) were compared using the Mann-Whitney U-test (level of significance: p < 0.05). Results The consumption of staple food was higher in the rural (283.37 g/d) than in the urban areas (263.21 g/d). The consumption of vegetables, fruits, fish, shrimp, and shellfish, milk and dairy products was lower than the recommended amounts in both areas, and the insufficient intake of these food types was more serious in rural areas. While the energy intake of 83.8% of all LMs was lower than the estimated energy reference, it was comparable in the urban and rural areas. The intake of macronutrients (carbohydrates, protein, and fats) in rural areas was lower than in urban areas. The intake of some vitamins (VA, VB1, VB2, VB9 and VC) and minerals (calcium, magnesium, iodine and copper) was not ideal for LMs in both rural and urban areas. Conclusions Overall, the dietary intake in LMs was lower than the recommended levels. Many essential nutrients failed to meet the recommended doses, both in the urban and rural areas. The deficiencies in micronutrients were more prevalent in rural compared to urban areas. Educating LMs about women’s health and appropriate dietary intake is, therefore, essential.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Wiwik Indayati
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Til Bahadur Basnet
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Fang Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Hongliang Luo
- Danone Open Science Research Center for Life-transforming Nutrition, Shanghai, 201204, People's Republic of China
| | - Han Pan
- Danone Open Science Research Center for Life-transforming Nutrition, Shanghai, 201204, People's Republic of China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China.
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16
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Siziba LP, Chimhashu T, Siro SS, Ngounda JO, Jacobs A, Malan L, Smuts CM, Baumgartner J. Breast milk and erythrocyte fatty acid composition of lactating women residing in a peri‑urban South African township. Prostaglandins Leukot Essent Fatty Acids 2020; 156:102027. [PMID: 31740198 DOI: 10.1016/j.plefa.2019.102027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/30/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
Data on breast milk fatty acid (FA) composition in South African lactating women in relation to their FA status, as well as on potential compositional changes within feed, are limited. The aim of this study was to assess the FA composition of breast milk sampled at three time points within feed, and to determine associations with red blood cell (RBC) total phospholipid FA levels in lactating South African mothers of 2-4-month-old breastfed infants. FA composition (% total FAs) was analyzed in RBC total phospholipids, and in fore-, mid-feed and hind-milk samples of lactating mothers (n = 100) of Black African descent living in a peri‑urban township. The mean age of the lactating women was 27.8 ± 6.8 years. Geometric mean (95% CI) breast milk SFA, MUFA and PUFA contents were 37.7 (37.3,38.1), 28.5 (27.9, 28.8), and 23.5 (23.2, 24.5)%, respectively. Breast milk DHA and AA contents were 0.25 (0.24, 3.71) and 0.81 (0.79, 0.83)%, respectively, in fore-, mid- and hind-milk combined. Maternal RBC EPA, DHA and AA levels were 0.37 (0.34, 0.40), 3.8 (3.6, 4.0) and 15.4 (14.8, 16.1)%, respectively. Women who reported to consume fish often (n = 3) had significantly higher RBC EPA levels than women who consumed fish sometimes (n = 56), never (n = 14) or rarely (n = 19). Breast milk DHA positively correlated with maternal RBC DHA, while no correlations were found between breast milk AA and maternal RBC AA. Breast milk ALA and DHA contents were significantly higher in mid-feed [ALA= 0.8 (0.2, 0.2), DHA=0.3 (0.2, 0.3)] and hind-milk [ALA=0.8 (0.8, 0.9), DHA=0.3 (0.3, 0.3)] than foremilk [ALA=0.8 (0.7, 0.9), DHA=0.2 (0.2, 0.3)]. In contrast, LA and AA contents remained constant within feed. In this sample of peri‑urban South African lactating mothers, breast milk was low in DHA and high in AA compared to global means. Breast milk DHA was associated with maternal RBC status, while breast milk AA was not. We further showed that breast milk ALA and DHA increased, while LA and AA remained unchanged within feed. This suggests that n-3 PUFA maybe preferentially transferred to breast milk within feed through biomagnification.
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Affiliation(s)
- Linda P Siziba
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa.
| | - Tsitsi Chimhashu
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa; Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, Netherlands
| | - Sicelosethu S Siro
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa
| | - Jennifer Osei Ngounda
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - Adriaan Jacobs
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, North-West University, Private Bag X6001, 2520 Potchefstroom, South Africa; Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Switzerland
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17
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Adegbeye MJ, Reddy PRK, Chilaka CA, Balogun OB, Elghandour MMMY, Rivas-Caceres RR, Salem AZM. Mycotoxin toxicity and residue in animal products: Prevalence, consumer exposure and reduction strategies - A review. Toxicon 2020; 177:96-108. [PMID: 31972175 DOI: 10.1016/j.toxicon.2020.01.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/27/2019] [Accepted: 01/13/2020] [Indexed: 12/12/2022]
Abstract
Mycotoxin residues are transferred from feed to animal products, yet, less attention has been paid to it in developing countries. There is a need to find alternative alleviation material for reducing the impact of mycotoxin. This review is meant to elucidate different additives that can reduce mycotoxin residue in animal products in the world, especially in developing countries. There is evidence of relationship between mycotoxin residue in breast milk of nursing mothers and mycotoxin exposure through crop and animal product (egg and milk) intake, especially in Asia, Africa, Middle East, Latin America, and some parts of Europe. Younger livestock tends to have more toxin residues in their tissue compared to older ones. Grazing animal are also exposed to mycotoxin intake which corresponds to high level of mycotoxins in their products including meat and milk. This review shows that phytogenic, probiotic, and prebiotic additives can decrease mycotoxin residues in milk, eggs, meat liver and other tissues of livestock. Specifically, bentonites, difructose anhydride III, yeast (Trichosporon mycotoxinivorans), Bacillus spp., or their biodegradable products can reduce mycotoxin residue in animal products. In addition, Ally isothiocyanates from mustard seed were able to mitigate mycotoxins in silo-simulated system. Evidence shows that there are now low-cost, accessible, and eco-friendly additives, which could alleviate the effect of mycotoxin in feed and food. In addition, there is need for aggressive public awareness and farmers' education on the prevalence, and danger caused by mycotoxins, as well as detoxification strategies that can reduce toxin absorption into animal products.
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Fernández SF, Pardo O, Adam-Cervera I, Montesinos L, Corpas-Burgos F, Roca M, Pastor A, Vento M, Cernada M, Yusà V. Biomonitoring of non-persistent pesticides in urine from lactating mothers: Exposure and risk assessment. Sci Total Environ 2020; 699:134385. [PMID: 31678881 DOI: 10.1016/j.scitotenv.2019.134385] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/14/2019] [Accepted: 09/08/2019] [Indexed: 06/10/2023]
Abstract
The aim of the present study was to assess the exposure to pesticides in urine from Spanish lactating mothers (n = 116). Six nonspecific (dialkyl phosphates) and 20 specific metabolites of organophosphate pesticides (OPs), herbicides and pyrethroids were analyzed. The most frequently detected biomarkers were diethyl phosphate, p-nitrophenol, 3,5,6-trichloro-2-pyridinol and 3-phenoxybenzoic acid, whose geometric means were 1.9 ng·mL-1, 0.8 ng·mL-1, 1.5 ng·mL-1 and 1.4 ng·mL-1, respectively. Herbicide metabolites were the least frequently detected biomarkers with detection frequencies between 0% (2,4,5-Trichlorophenoxyacetic acid) and 22% (2,4-Dichlorophenoxyacetic acid). Multiple regression analyses showed that the closeness to a farming activity, the place of residence and the presence of garden/plants at home were some of the most important contributors to urinary levels of pesticide metabolites. Estimated daily intake (EDI), hazard quotient (HQ) and hazard index (HI) were obtained in order to interpret urinary levels of the most frequently detected pesticide metabolites in a risk assessment context. The highest EDIs were obtained for chlorpyrifos (0.40-1.14 μg·kg bw-1·day-1) and deltamethrin (0.34-4.73 μg·kg bw-1·day-1). The calculated HQ for chlorpyrifos, dimethoate, parathion and deltamethrin ranged from 0.01 to 0.47, and HI for OPs ranged from 0.09 to 0.33 showing that apparently there were low health risks due to the exposure to these pesticides in this group of Spanish breastfeeding women.
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Affiliation(s)
- Sandra F Fernández
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, 46020 Valencia, Spain; Public Health Laboratory of Valencia, Av. Cataluña, 21, 46020 Valencia, Spain
| | - Olga Pardo
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, 46020 Valencia, Spain; Public Health Laboratory of Valencia, Av. Cataluña, 21, 46020 Valencia, Spain.
| | - Inés Adam-Cervera
- Institute of Materials Science of the University of Valencia (ICMUV), University of Valencia, Catedrático José Beltrán, 2, 46980 Paterna, Spain
| | - Lidia Montesinos
- Public Health Laboratory of Valencia, Av. Cataluña, 21, 46020 Valencia, Spain
| | - Francisca Corpas-Burgos
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, 46020 Valencia, Spain
| | - Marta Roca
- Analytical Unit, Health Research Institute La Fe, Av. Abril Martorell, 106, 46026 Valencia, Spain
| | - Agustín Pastor
- Department of Analytical Chemistry, University of Valencia, Doctor Moliner 50, 46100, Burjassot, Spain
| | - Máximo Vento
- Neonatal Research Group, Health Research Institute La Fe, Av. Abril Martorell, 106, 46026 Valencia, Spain
| | - María Cernada
- Neonatal Research Group, Health Research Institute La Fe, Av. Abril Martorell, 106, 46026 Valencia, Spain
| | - Vicent Yusà
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya, 21, 46020 Valencia, Spain; Public Health Laboratory of Valencia, Av. Cataluña, 21, 46020 Valencia, Spain; Analytical Unit, Health Research Institute La Fe, Av. Abril Martorell, 106, 46026 Valencia, Spain
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Boke MM, Geremew AB. Low dietary diversity and associated factors among lactating mothers in Angecha districts, Southern Ethiopia: community based cross-sectional study. BMC Res Notes 2018; 11:892. [PMID: 30547839 PMCID: PMC6295037 DOI: 10.1186/s13104-018-4001-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/08/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The objective of the study was to assess prevalence low dietary diversity and associated factors among lactating mother in Angecha district, Southern Ethiopia. RESULTS The magnitude of low dietary diversity was 52.2%, 95% confidence interval (47.4, 57.27). From multivariable logistic analysis mothers were illiterate had 2.5 times more likely to have low dietary diversity than had formal education. Mothers living in the rural area were 3.1 times more likely to have low dietary diversity as compared with living urban area and women who have Household food insecure was 3.4 times more likely to have low dietary diversity as compared to a counterpart. Therefore, health provider could provide nutritional education focusing illiterate and rural women.
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Affiliation(s)
- Moges Muluneh Boke
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, 196, Gondar, Ethiopia
| | - Alehegn Bishaw Geremew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, 196, Gondar, Ethiopia
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Nazeri P, Dalili H, Mehrabi Y, Hedayati M, Mirmiran P, Azizi F. Breast Milk Iodine Concentration Rather than Maternal Urinary Iodine Is a Reliable Indicator for Monitoring Iodine Status of Breastfed Neonates. Biol Trace Elem Res 2018; 185:71-77. [PMID: 29372437 DOI: 10.1007/s12011-018-1246-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
Abstract
There is no scientific consensus on whether breast milk iodine concentration (BMIC) accurately reflects iodine status in lactating mothers and breastfed infants. This study aimed to compare BMIC and maternal urinary iodine concentration (UIC) as indicators of iodine status in breastfed neonates. In this cross-sectional study, 147 lactating mothers and their neonates (3-5 days postpartum) were randomly selected from health care centers. Breast milk and urine samples were collected from each mother and neonate, and a heel-prick blood sample was taken from all neonates as part of a congenital hypothyroidism screening program. According to the World Health Organization criteria, median urinary iodine concentration (UIC) ≥ 100 μg/L in lactating mothers and neonates indicates iodine sufficiency. In areas of iodine sufficiency, median BMIC ≥ 100 μg/L is considered an adequate level. Overall, 129 (89.0%) and 16 (11.0%) mothers had BMICs ≥ 100 and ˂ 100 μg/L, respectively. Median (interquartile range [IQR]) maternal UIC was 70 μg/L (42-144 μg/L) and 37 μg/L (25-100 μg/L) in mothers with breast milk iodine levels ≥ 100 and ˂ 100 μg/L, respectively (P = 0.047); values for UIC of neonates born to mothers with BMICs ≥ 100 and ˂ 100 μg/L were 230 μg/L (114-310 μg/L) and 76 μg/L (41-140 μg/L), respectively (P < 0.001). In the linear regression model, neonate UIC was positively associated with BMIC in both unadjusted (β = 0.558, P < 0.001) and adjusted analysis (β = 0.541, P < 0.001). A similar result was found in logistic regression analysis, indicating that neonates born to mothers with BMIC ≥ 100 μg/L were more likely to have UIC ≥ 100 μg/L compared to those whose mothers had BMIC < 100 μg/L in both unadjusted (OR = 7.93, P < 0.001) and adjusted analysis (OR = 7.29, P = 0.001). The present findings indicate that BMIC is a more sensitive indicator than maternal UIC for assessment of iodine status in breastfed neonates. To address low levels of maternal UIC, further studies on the prescription of supplements containing 150 μg/day iodine during lactation period are warranted.
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Affiliation(s)
- Pantea Nazeri
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Hosein Dalili
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
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Tian HM, Wu YX, Lin YQ, Chen XY, Yu M, Lu T, Xie L. Dietary patterns affect maternal macronutrient intake levels and the fatty acid profile of breast milk in lactating Chinese mothers. Nutrition 2018; 58:83-88. [PMID: 30391695 DOI: 10.1016/j.nut.2018.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/06/2018] [Accepted: 06/23/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Fatty acids (FA) in human milk play an important role in meeting the nutritional demands and promoting the growth and development of breastfeeding infants. Breast milk FA is sensitive to maternal dietary habits, and dietary patterns are better used to explain the effect of diet on FA. Few studies have examined the association between maternal dietary patterns and the FA components of breast milk in developing countries. In this study, we aimed to determine whether dietary patterns affect the FA profile of breast milk in lactating Chinese mothers with the overall goal to optimize the management of infant feeding. METHODS A total of 274 lactating women ranging from 22 d to 6 mo postpartum were included, and samples of their breast milk were collected together with completed questionnaires. Using a principal component analysis, four dietary patterns were identified in a rotated component matrix. FA profiles were detected using capillary gas chromatography and presented as the percentage by weight of total FA. RESULTS Maternal intake of energy, carbohydrates, and proteins showed differences between the different dietary patterns. In addition, there were significant differences in the total proportions of saturated, polyunsaturated, and ω-6 polyunsaturated fatty acids in breast milk among the four patterns (P < 0.001; P = 0.025; P = 0.038, respectively). CONCLUSIONS The results demonstrate that maternal dietary patterns can affect macronutrient intake levels and milk FA profiles in lactating Chinese women. These results are of great significance in understanding how a maternal diet can both improve maternal macronutrient intake and the FA nutritional status of breast milk.
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Affiliation(s)
- Hui-Min Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China
| | - Yi-Xia Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China
| | - Yi-Qi Lin
- Jilin Women and Children Health Hospital, Changchun, P.R. China
| | - Xue-Yan Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China
| | - Miao Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China
| | - Tong Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China
| | - Lin Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, P.R. China.
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Salcedo C, Torrero C, Regalado M, Rubio L, Salas M. Effects of pre- and neonatal undernutrition on the kyphotic response and c-Fos activity in the caudal periaqueductal gray of primiparous lactating Wistar rats. Physiol Behav 2018; 185:87-94. [PMID: 29269226 DOI: 10.1016/j.physbeh.2017.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 12/04/2017] [Accepted: 12/15/2017] [Indexed: 01/16/2023]
Abstract
In rodents, the most representative component of maternal behavior that meets the purpose of newborn nutrition is the kyphotic posture. During this posture, the mother maintains a unique environment for the protection, thermal regulation and breast-feeding of the progeny. The aim of this study was to investigate possible deficiencies in the kyphotic posture of adult lactating dams with pre- and neonatal undernutrition evoked by their own pups suckling in a home-cage situation. Wistar dams that had been previously exposed to perinatal undernutrition were mated at 90days of age, and pregnancy was confirmed by vaginal smears. Before testing if the perinatal underfed dam affected behavior, pups were removed (4h), and both the maternal response and the kyphotic posture were video-recorded (1h) and analyzed at 4 and 12days of lactation. Pre- and post-test litter weight gain was obtained. To immunostain the caudal periaqueductal gray, the litter was separated from their dams 24h before suckling stimulation. The results showed that underfed dams significantly reduced the duration of high kyphosis by choosing unconventional postures (prone and partial kyphosis). The body weight of the F1 offspring was significantly reduced, and the underfed F0 dams showed reduced c-Fos immunostaining at the caudal periaqueductal gray. The findings showed that early underfed dams have deficiencies in the mechanisms underlying the kyphosis, possibly because the pups' cues to evoke this posture were suboptimal and/or because the dam expressed deficient nursing. The results suggest that the abnormal kyphotic posture may affect the mother-litter bonds and have long-term effects on neonatal brain functions.
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Affiliation(s)
- Claudia Salcedo
- Department of Developmental Neurobiology and Neurophysiology, Institute of Neurobiology, National Autonomous University of Mexico, Campus UNAM Juriquilla, Queretaro, Mexico
| | - Carmen Torrero
- Department of Developmental Neurobiology and Neurophysiology, Institute of Neurobiology, National Autonomous University of Mexico, Campus UNAM Juriquilla, Queretaro, Mexico
| | - Mirelta Regalado
- Department of Developmental Neurobiology and Neurophysiology, Institute of Neurobiology, National Autonomous University of Mexico, Campus UNAM Juriquilla, Queretaro, Mexico
| | - Lorena Rubio
- Department of Developmental Neurobiology and Neurophysiology, Institute of Neurobiology, National Autonomous University of Mexico, Campus UNAM Juriquilla, Queretaro, Mexico
| | - Manuel Salas
- Department of Developmental Neurobiology and Neurophysiology, Institute of Neurobiology, National Autonomous University of Mexico, Campus UNAM Juriquilla, Queretaro, Mexico.
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Kim H, Kang S, Jung BM, Yi H, Jung JA, Chang N. Breast milk fatty acid composition and fatty acid intake of lactating mothers in South Korea. Br J Nutr 2017; 117:556-61. [PMID: 28285609 DOI: 10.1017/S0007114517000253] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The aim of this study was to determine the fatty acid (FA) composition of breast milk, and its association with mothers' FA intake. Milk samples were obtained from 238 healthy lactating women who volunteered to participate in the Human Milk Micronutrients Analysis Research. Dietary intake during lactation was assessed using a 3-d food record, and fat content and FA composition of the breast milk samples were analysed by IR spectrometry using MilkoScan FT2 and GC flame ionisation detector, respectively. The fat content was 3·31 (sd 1·41) g/100 ml breast milk. The concentrations of arachidonic acid (20 : 4 n-6), EPA (20 : 5 n-3) and DHA (22 : 6 n-3) in breast milk were 0·48 (sd 0·13), 0·15 (sd 0·12) and 0·67 (sd 0·47) % of total FA, respectively. Fat content and FA composition of breast milk were associated with maternal age, BMI, supplement use and infant age. Dietary intakes of EPA, DHA, n-3 FA, n-6 FA, SFA and PUFA were positively correlated with the corresponding FA in the milk samples. FA levels in breast milk and maternal diet are highly correlated. Further studies are warranted to explore factors that may be associated with changes in FA composition in human milk.
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Nazeri P, Zarghani NH, Mirmiran P, Hedayati M, Mehrabi Y, Azizi F. Iodine Status in Pregnant Women, Lactating Mothers, and Newborns in an Area with More Than Two Decades of Successful Iodine Nutrition. Biol Trace Elem Res 2016; 172:79-85. [PMID: 26631051 DOI: 10.1007/s12011-015-0575-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
Pregnant women, lactating mothers, and their newborns constitute the target population for prevention and control of iodine deficiency. Hence, the aim of this study was to evaluate the iodine nutrition status among these vulnerable groups in an area with more than two decades of successful elimination of iodine deficiency. In this cross-sectional study conducted in health care centers of Tehran, 100 pregnant women and 84 lactating mothers and their newborn were randomly selected. Urinary iodine concentration and iodine content of salts were measured using the Sandell-Kolthoff and titration methods, respectively. Urinary iodine concentration <150 μg/L for pregnant women and <100 μg/L for lactating mothers and newborns was considered as iodine nutrition inadequacy, respectively. Median (interquartile range [IQR]) urinary iodine concentration (UIC) was 103 (59-155) μg/L in pregnant women, 77 (42-194) μg/L in lactating mothers, and 198 (84-260) μg/L in newborns. Median (IQR) iodine content of salt was 26 (21-30) ppm and 25 (18-28) ppm in pregnant women and lactating mothers, respectively (P = 0.462). Iodine content of salt was significantly correlated with UIC of pregnant women (r = 0.24, P = 0.019), but no correlation was found among lactating mothers (r = 0.12, P = 0.316). Neonatal UIC was significantly correlated with iodine content of salt consumed by their mothers (r = 0.49, P = 0.001). Despite suboptimal iodine status among subgroups of Tehranian pregnant and lactating women, iodine nutrition status of newborns was within optimal levels, which may be explained by a compensatory mechanism in the mammary glands.
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Affiliation(s)
- Pantea Nazeri
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Mehrabi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, # 24, Aerabi St., Yaman St., Chamran Exp, P.O. Box: 19395-4763, Tehran, Iran.
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Mogre V, Dery M, Gaa PK. Knowledge, attitudes and determinants of exclusive breastfeeding practice among Ghanaian rural lactating mothers. Int Breastfeed J 2016; 11:12. [PMID: 27190546 PMCID: PMC4869336 DOI: 10.1186/s13006-016-0071-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/09/2016] [Indexed: 11/17/2022] Open
Abstract
Background The practice of exclusive breastfeeding (EBF) is influenced by maternal knowledge and attitudes as well as socio-demographic and cultural factors. This study assessed knowledge, attitudes and practice of EBF among rural lactating mothers with infants aged 0–6 months. Factors associated to the practice of EBF were also investigated. Methods This cross-sectional study was conducted among 190 rural lactating mothers with infants aged 0–6 months seeking postnatal care at a health centre in Ghana. All data was collected using a questionnaire that contained both closed and open ended questions. Results About 26 % (n = 50) of the mothers were unable to correctly define EBF. The majority (92.6 %, n = 176) of the mothers said they felt good to EBF for 6 months, to breastfed on demand (99.5 %, n = 189) and did not have difficulties EBF (90 %, n = 171). Despite the generally positive attitude towards EBF, 42 % (n = 79) of the mothers did not EBF their babies. These mothers did not practice EBF because they misunderstood certain signs of the child to mean wanting to eat food or drink water, regarded breastmilk to be inadequate to meet the nutritional needs of the child and misunderstood healthcare professionals’ EBF advice. Higher maternal education was associated with higher likelihood of EBF (OR 3.5; 95 % CI 1.6, 7.7; p = 0.002). Mothers whose babies were younger than 3 months were more likely to EBF (OR 12.0; 95 % CI 4.4, 32.5; p < 0.001) than those having babies aged ≥ 3 months. Furthermore, higher knowledge of EBF was associated with the likelihood of EBF (OR 5.9; 95 % CI 2.6, 13.3; p < 0.001). Conclusion Mothers’ knowledge and attitudes towards EBF were favourable but practice of EBF was suboptimal. This study adds additional evidence that knowledge of EBF, child’s age and maternal level of education are important determinants of the practice of EBF. Beyond dissemination of health messages, healthcare professionals should pay more counselling attention to less educated mothers, and also older children’s caregivers.
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Affiliation(s)
- Victor Mogre
- Department of Health Professions Education and Innovative Learning, School of Medicine and Health Sciences, University for Development Studies, Box TL 1883, Tamale, Ghana
| | - Michael Dery
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Box TL 1883, Tamale, Ghana
| | - Patience K Gaa
- Nutrition Unit, Lawra District Hospital, Box 19, Upper West Region, Lawra Ghana
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Mahdavi R, Taghipour S, Ostadrahimi A, Nikniaz L, Hezaveh SJG. A pilot study of synbiotic supplementation on breast milk mineral concentrations and growth of exclusively breast fed infants. J Trace Elem Med Biol 2015; 30:25-9. [PMID: 25744506 DOI: 10.1016/j.jtemb.2015.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/04/2015] [Accepted: 01/15/2015] [Indexed: 12/01/2022]
Abstract
Despite the crucial role of breast milk mineral contents for health and growth of the infants, they decrease with the duration of lactation. So, this pilot study aimed to determine the effects of synbiotic supplementation on breast milk mineral composition and infants' growth. In this pilot, randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly divided into two groups to receive a daily supplement of synbiotic (n=30) or a placebo (n=27) for 30 days. Breast milk zinc, copper, Iron, magnesium and, calcium concentrations were determined by flame atomic absorption spectrometry. Weight for age Z-score (WAZ) and height for age Z-score (HAZ) were assessed for infants. Dietary intake was collected from lactating women using the 24-h recall method. Data analyses were carried out using nutritionist IV, Epi Info and SPSS soft wares. Synbiotic supplementation led to an insignificant increase of the mean breast milk levels of zinc (from 2.44±0.65 to 2.55±0.55mgL(-1)), copper (from 0.35±0.24 to 0.40±0.26mgL(-1)), iron (from 0.28±0.42 to 0.31±0.38mgL(-1)), magnesium (from 17.14±1.35 to 17.17±1.09mgL(-1)), and calcium (from 189±25.3 to 189.9±21.7mgL(-1)); whilst in the placebo group, these variables decreased significantly (P=0.001). The observed changes between two groups were statistically significant (P<0.05). Although WAZ and HAZ of infants increased slightly in the supplemented group (from 1.19±0.79 to 1.20±0.69 and 0.36±0.86 to 0.37±0.85 respectively), these two parameters decreased in the placebo group which was significant only for WAZ (P=0.01). Moreover, no significant association was found between mineral intake and breast milk mineral contents. It seems, synbiotic supplementation may have positive effects on breast milk mineral contents.
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Affiliation(s)
- Reza Mahdavi
- Nutrition Research Center, School of Nutrition, Tabriz University of Medical Sciences, Golgasht St, Tabriz, Iran.
| | - Sharare Taghipour
- Student Research Committee, School of Nutrition, Tabriz University of Medical Sciences, Golgasht St, Tabriz, Iran.
| | - Alireza Ostadrahimi
- Nutrition Research Center, School of Nutrition, Tabriz University of Medical Sciences, Golgasht St, Tabriz, Iran.
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tavanir Exit, Valiamr Square, Shafizade Ave, NPMC, Tabriz, Iran.
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Kajale N, Khadilkar A, Chiponkar S, Unni J, Mansukhani N. Effect of traditional food supplements on nutritional status of lactating mothers and growth of their infants. Nutrition 2014; 30:1360-5. [PMID: 25280413 DOI: 10.1016/j.nut.2014.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/26/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES During lactation, traditional food supplements (TFS) are commonly consumed in India to increase lactation performance and health of mothers. TFS are rich in fats, nuts, dry fruits, and sugars and indulging in such supplements for 3 to 6 mo postpartum may put the mother at risk for obesity. The aim of this study was to assess the nutrient quality of TFS and its effect on nutritional status of lactating mothers and infant's weight gain in first 6 mo after delivery. METHODS A random sample of 125 Indian urban lactating mothers (28.9 ± 3.2 y) was assessed within 6 mo postpartum for anthropometry, diet by 24-h recall on 3 random days, along with socioeconomic factors, lactation history, and infant's birth weight and current weight. RESULTS Among 18 different TFS, 50% TFS were rich in calcium, 33% rich in iron, 38% in zinc, and only 13% were good sources of vitamins. Mothers consuming TFS (n = 75) had significantly higher fat intakes than mothers consuming no TFS Supplements (NTS; n = 50). A higher weight gain was seen in TFS mothers (10.5%) than NTS mothers (8.8%) after adjusting for number of days after delivery, parity, mother's age, and breast-feeding practices (P < 0.05). Percent weight gain in infants of TFS mothers (120.7% ± 7.3%) was higher than in infants of NTS mothers (96.2% ± 7.8%; P = 0.024) after adjusting for infant's age and mother's breast-feeding practices. CONCLUSION TFS may be modified to increase its micronutrient quality and to reduce fat contents with the goal of reducing the risk for obesity in mothers, while still benefiting infant growth.
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Affiliation(s)
- Neha Kajale
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | | | - Shashi Chiponkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Jyothi Unni
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Nina Mansukhani
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
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