Adequacy of vitamin A and fat in the breast milk of lactating women in south Sri Lanka

Abstract

Objective: To determine vitamin A (retinol) and fat concentrations in breast milk during early lactation. Methods: Healthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method. Results: Subjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0?10 to 2?46 mmol/l, with a mean of 0?50 mmol/l, and correlated positively with parity (Pearson correlation coefficient, r 5 0?307; P 5 0?01) and negatively with period of lactation (r 5 20?209; P 5 0?05). The fat content of breast milk ranged between 5?09 and 56?46 g/l with a mean of 26?95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r 5 0?274; P 5 0?01) and height (r 5 0?328; P , 0?001) of the mothers. Conclusions: In this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92?0 %) were not providing the minimum daily requirement (1?05 mmol/l) of retinol to their babies. Keywords Breast milk fat and retinolLactating women Period of lactation Breast milk is a natural source of vitamin A and its close association with maternal vitamin A intake is well established (1) . Vitamin A-deficient lactating mothers may not have enough vitamin A in breast milk to maintain and build body reserves in their rapidly growing infants (2) . Vitamin A intake and status during the third trimester of pregnancy affect the retinol concentration in breast milk (3) .Vitamin A in breast milk is found almost exclusively in fat; thus factors that can affect breast milk fat concentration may affect the vitamin A concentration as well (4) . Fat is the macronutrient in milk that varies most in concentration and has been shown to be higher in well-nourished mothers than in their poorly nourished counterparts (5) . Fat concentration is higher in mature milk than in colostrum, and somewhat higher in breast milk of mothers from affluent compared with poor societies (6) .In Sri Lanka, no data are available on breast milk quality. The present study was therefore designed to assess the vitamin A (retinol) and fat concentrations of breast milk during 3-7 months of lactation and to determine any variation in the levels among women living in different geographical settings. We hypothesized that the economic and nutritional status of the subjects would be different in different settings of the study population and that the contents of vitamin A and fatty acids of breast milk would show differences according to the stratum to which the lactating mother belonged. Sample and methods SampleT...

Early Initiation of Breastfeeding and Vitamin A supplementation with Nutritional Status of Children under Five years (6-59 Months)

“…Finally, promotion of warmth and protection may reduce the risk of death from hypothermia during day 1, especially in preterm infants. 7,8 Growth of infants with body length indicator have a significant influence in increasing the infant's length and early breastfeeding initiation. This is in line with the assertion that the implementation of early initiation breastfeeding is one way to optimize the growth and health of the infant.…”

“…Vitamin A in breast milk is exclusively found almost in fat, thus factors that can affect breast milk fat concentration may affect the vitamin A concentration as well. 7 Deficiency of vitamin A affects protein synthesis, so it also affects cell growth. Therefore, children with vitamin A deficiency will experience growth failure.…”

“…A total of 22% of newborn mortality can be prevented by breastfeeding within one hour after birth. 7 Breast milk can reduce morbidity and mortality because in addition to high nutritional value, it also contains immunological substances that protect infants and toddlers from various infections. Exclusive breastfeeding accounts for 13% in reducing child mortality.…”

Nutritional, inflammatory, and ecological correlates of maternal retinol allocation to breast milk in agro‐pastoral Ariaal communities of northern Kenya

“…Still, parity has been reported in many studies as one of the major factors of the concentrations of many human milk components, including retinol (Liyanage et al, 2008; Newman, 1993), carotenoids (in the colostrum, Patton, 1990), iron (Silvestre et al, 2000), and copper (Arnaud and Favier, 1995). Yet, in this literature as well, some studies report parity to have no relationship with human milk retinol (Panpanich et al, 2002) or copper (Feely et al, 1983).…”

High dose vitamin A capsules – Rusty bullets?

“…In well-nourished populations, breast milk is sufficient to meet this demand and build infant stores (Humphrey, et al, 2000). However, since breast milk vitamin A reflects the vitamin A status of the mother (Stoltzfus, et al, 1995;Semba, et al, 2000), the quantity in breast milk in most mothers in low income countries, while not resulting in deficiency, is insufficient to provide infants with liver stores (Humphrey, et al, 2000;Liyanage, et al, 2008). Thus, there have been efforts to extend the expected benefit of HDVAC to children below the age of 6 months.…”