Abstract
Background: Human milk feeding is encouraged for all infants; however, the mammary gland depends on maternal dietary intake of vitamins A, B1, B2, B6, B12, D, docosahexaenoic acid (DHA), choline, and iodine. Nutrition support team knowledge of maternal feeding guidelines for these nutrient sources can therefore impact infant intake. We hypothesized that these key nutrients for lactation in the mother's diet would be less than the dietary guidelines in the United States. Methods: This was a secondary analysis of nutrition data collected during a randomized, controlled trial. Dietary records were analyzed from 16 mothers (13 with singleton and 3 with multiple births) completing the study. Mean dietary intakes of selected nutrients were calculated and compared with the current dietary reference intakes. Results: Mean maternal dietary intake for singletons was significantly (P <.05) lower than the dietary reference intakes for (vitamin A (58%), vitamin D (44%), and choline (58%);) DHA comprised only 5% of the current expert recommendation. Based on singleton recommendations, mothers to twins consumed an adequate intake except for DHA. Conclusions: Women providing breast milk for singleton preterm infants did not consume dietary reference intakes for key nutrients. Twin mothers’ diets were adequate except for DHA, but these guidelines are based on singleton pregnancies and remain poorly understood for twin needs. The nutrition support team can have a unique role in maternal dietary education to impact human milk nutrient delivery to the infant.
| Original language | English |
|---|---|
| Pages (from-to) | 687-693 |
| Number of pages | 7 |
| Journal | Nutrition in Clinical Practice |
| Volume | 33 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 2018 |
Bibliographical note
Publisher Copyright:© 2018 American Society for Parenteral and Enteral Nutrition
Funding
We performed a secondary analysis of nutrition data collected from women who participated in a randomized control trial conducted through the Neonatal intensive care unit (National Clinical Trial number 01732874, Institutional review board number 2012-0329, Food and Drug Administration number 108241). In this trial, after informed consent, mothers of preterm infants born at <29 weeks of gestational age who planned to provide human milk to their newborns were randomized to dietary supplementation of docosahexaenoic acid (DHA) at either the standard dose of 200 mg/d or 1000 mg/d by the investigational pharmacy. The original trial was designed to determine serum cytokine differences at 4 weeks after DHA supplementation with a power of 0.8. We performed a secondary analysis of nutrition data collected from women who participated in a randomized control trial conducted through the Neonatal intensive care unit (National Clinical Trial number 01732874, Institutional review board number 2012-0329, Food and Drug Administration number 108241). Conflicts of interests: C.J.V. is the medical director of Mead Johnson Nutrition currently but was not employed by Mead Johnson Nutrition during the design and conduct of the trial. The supplement Expecta used in the randomized controlled trial was supported by an in-kind grant Mead Johnson Nutrition; however, this reports on maternal intake and was not analyzed nor reviewed by Mead Johnson Nutrition. Financial disclosure: K.C. received research funding from an educational grant from the Medical Student Summer Research Program at The University of Cincinnati T35DK060444. C.J.V. and L.K.R. received funding from National Institute of Health, Office of Dietary Supplementation R01AT006880-01, KL2TR000078, and UL1 TR000077-04. E.A.D. received research funding from the March of Dimes 22-FY14-470. National Clinical Trial number 01732874.
| Funders | Funder number |
|---|---|
| National Institute of Health National Institute of Minority and Health Disparities Loan Repayment Program | |
| Office of Dietary Supplementation | KL2TR000078, UL1 TR000077-04 |
| National Institutes of Health (NIH) | R01AT006880-01 |
| National Institutes of Health (NIH) | |
| Fogarty International Center Panama International Cooperative Biodiversity | T37TW000078 |
| Fogarty International Center Panama International Cooperative Biodiversity | |
| March of Dimes Research Foundation | 22-FY14-470 |
| March of Dimes Research Foundation | |
| Mead Johnson Nutrition | |
| University of Cincinnati University Research Council | T35DK060444 |
| University of Cincinnati University Research Council |
Keywords
- diet
- human milk
- infant
- maternal nutritional physiological phenomena
- maternal-child nursing
- mothers
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics
