Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant

Kathleen Copp; Emily A. DeFranco; Jeanne Kleiman; Lynette K. Rogers; Ardythe L. Morrow; Christina J. Valentine

doi:10.1002/ncp.10071

Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant

Kathleen Copp
, Emily A. DeFranco
, Jeanne Kleiman
, Lynette K. Rogers
, Ardythe L. Morrow
, Christina J. Valentine

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

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	https://doi.org/10.1002/ncp.10071
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 Institutes of Health (NIH)
Mead Johnson Nutrition
National Center for Advancing Translational Sciences (NCATS)	KL2TR000078, UL1TR000077
National Institute of Diabetes and Digestive and Kidney Diseases	P30DK078392, T35DK060444
Office of Dietary Supplements	KL2TR000078, UL1 TR000077-04, R01AT006880-01
March of Dimes Research Foundation	22-FY14-470
National Center for Complementary and Integrative Health	R01AT006880
University of Cincinnati University Research Council	T35DK060444
Fogarty International Center	T37TW000078

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

diet
human milk
infant
maternal nutritional physiological phenomena
maternal-child nursing
mothers

ASJC Scopus subject areas

Medicine (miscellaneous)
Nutrition and Dietetics

Access to Document

10.1002/ncp.10071

Cite this

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title = "Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant",

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{\textquoteright} 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.",

keywords = "diet, human milk, infant, maternal nutritional physiological phenomena, maternal-child nursing, mothers",

author = "Kathleen Copp and DeFranco, \{Emily A.\} and Jeanne Kleiman and Rogers, \{Lynette K.\} and Morrow, \{Ardythe L.\} and Valentine, \{Christina J.\}",

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month = oct,

doi = "10.1002/ncp.10071",

language = "English",

volume = "33",

pages = "687--693",

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AU - Rogers, Lynette K.

AU - Morrow, Ardythe L.

AU - Valentine, Christina J.

PY - 2018/10

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Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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