On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition of healthy mothers and the outcomes of lactation. Of widest interest are the committee's clear-cut recommendations for mothers and health care providers This review aims to assess the effectiveness of infant and young child feeding (IYCF) interventions. We searched . Undernutrition is associated with 45% of total infant deaths, totalling million globally per year. The vast majority of the burden is felt in low- and middle-income countries (LMICs).Cited by: 13 May 14, · In this context, the purpose of this systematic literature review is to assess the scientific evidence of bioactive compounds present in infant formulas (α-lactalbumin, lactoferrin, taurine, milk fat globule membrane, folates, polyamines, long-chain polyunsaturated fatty acids, prebiotics, and probiotics) and their effects on infant nutrition and health. Through previously Author: Cristine Couto Almeida, Cristine Couto Almeida, Bianca Figueiredo Mendonça Pereira, Katia Christina
Not a MyNAP member yet? Register for a free account to start saving and receiving special member only perks. During the past decade, the benefits of breastfeeding have been emphasized by many authorities and organizations in the United States.
Federal agencies have set specific objectives to increase the incidence and duration of breastfeeding DHHS,literature review infant nutrition,and the Surgeon General has held workshops on breastfeeding and human lactation DHHS, At the federal and state levels, the Special Supplemental Food Program for Women, Infants, and Children WIC has produced materials designed to promote breastfeeding e.
Furthermore, the Office of Maternal and Child Health has sponsored breastfeeding projects e. However, less attention has been given to two general topics: 1 the effects of breastfeeding on the nutritional status and long-term health of the mother and 2 the effects of the mother's nutritional status on the volume and composition of her milk and on the potential subsequent effects of those changes on infant health. The present report was designed to address these topics. This literature review infant nutrition briefly describes the origin of this effort and the process; provides key definitions; reviews what was learned about who is breastfeeding in the United States and if those women are well nourished; discusses nutritional influences on milk volume or composition; and describes how breastfeeding may affect infant growth, nutrition, and health, as well as maternal health.
It then presents major conclusions, clinical recommendations, and the research recommendations most directly related to the nutrition of lactating women in the United States. This study was undertaken at the request of the Maternal and Child Health Program Title V, Social Security Act of the Health Resources and Services Administration, U. Department of Health and Human Services. In response to that request, the Food and Nutrition Board's Committee on Nutritional Status During Pregnancy and Lactation and its Subcommittee on Nutrition During Lactation were asked to evaluate current scientific evidence and formulate recommendations pertaining to the nutritional needs of lactating women, literature review infant nutrition, giving special attention to the needs of lactating adolescents; women over age 35; and women of black, Hispanic, or Southeast Asian origin.
Part of this task included consideration of the effects of maternal dietary intake and nutritional status on the volume and composition of human milk, the appropriateness of various anthropometric methods for assessing nutritional status during lactation, and the effects of lactation both on maternal literature review infant nutrition infant health and on the nutritional status of both the mother and the infant.
The study was limited to consideration of healthy U. women and their healthy, full-term infants. The Subcommittee on Nutrition During Lactation conducted an extensive literature review, consulted with a variety of experts, and met as a group seven times to discuss the data and draw conclusions from them.
The Committee on Nutritional Status During Pregnancy and Lactation the advisory committee reviewed and commented on the work of the subcommittee and helped establish appropriate linkages between this literature review infant nutrition and the reports on weight gain and nutrient supplements during pregnancy contained in Nutrition During Pregnancy —a report prepared by two other subcommittees of this advisory committee IOM, Compared with earlier reports from the National Research Council, Nutrition During Pregnancy recommended a higher range of weight gain In addition, it advised routine low-dose iron supplementation during pregnancy, but supplements of other vitamins or minerals were recommended only under special circumstances.
In examining the nutritional needs of lactating women, priority was given to energy and to those nutrients believed to be consumed in amounts lower than Recommended Dietary Allowances RDAs by many women in the United States. These nutrients include calcium, magnesium, literature review infant nutrition, iron, zinc, folate, and vitamin B 6. Careful attention was given to the effects of lactation on various indicators of nutritional status, such as measurements of levels of biochemical compounds; functions related to specific nutrients; nutrient levels in specific body compartments; and height, weight, or other indicators of body size or.
The subcommittee took into consideration that weight gain recommendations for pregnant women have been raised see Nutrition During Pregnancy [IOM, ] and that average weight gains of U, literature review infant nutrition. women during pregnancy have risen over the past two decades, literature review infant nutrition. When possible, a distinction was made between exclusive breastfeeding, defined as the consumption of human milk as the sole source of energy, literature review infant nutrition, and partial breastfeeding, defined as the consumption of human milk in combination with formula or literature review infant nutrition foods, or both, literature review infant nutrition.
The nutritional demands imposed by lactation were estimated from data on volume and composition of milk produced by healthy, successfully lactating women, as done in Recommended Dietary Allowances NRC, literature review infant nutrition When it was feasible, evidence relating to possible depletion of maternal stores or to a decrease in the specific nutrient content of milk resulting from low maternal intake of the nutrient was also addressed.
Because of the complex relationships between the nutrition of the mother and infant, the subcommittee examined the nutrition and growth of the breastfed infant. The terms maternal health and infant health were interpreted in a broad sense, literature review infant nutrition. Consideration was given to both beneficial and adverse consequences for the health of the mother and her offspring, both during lactation and long after breastfeeding has been discontinued.
For the mother, there was a search for evidence of differences in outcome related to whether or not she had breastfed. For the infant, evidence was sought for differences in outcome related to the method of feeding breast compared with bottle. The possible influences of breastfeeding on prevention or promotion of chronic disease were addressed. To the extent possible, this report includes detailed coverage of published evidence linking maternal nutrition, breastfeeding, and maternal and infant health.
Because breastfeeding is encouraged primarily as a method for promoting the health of infants, considerable attention is also directed toward infant health even when there is no established relationship to maternal nutritional status. Recognizing the serious gaps in knowledge of nutrition during lactation, literature review infant nutrition, the subcommittee gave much thought to establishing directions for research, literature review infant nutrition.
The members of the subcommittee realized that nutrition is not the sole determinant of successful breastfeeding. A network of overlapping social factors including access to maternal leave, instructions concerning breastfeeding, availability of prenatal care, the length of hospital stay following delivery, infant care in the workplace, and the public attitudes toward breastfeeding are important.
Given the goals of this report, the subcommittee did not specifically address those factors, but it recognizes that they should be considered in depth by public health groups that are attempting to improve rates of breastfeeding in this and other countries. The incidence and duration of breastfeeding changed markedly during the twentieth century—first declining, then rising, and, from the early s, declining once again.
Currently, women who choose to breastfeed tend to be well educated, older, and white. Data on the incidence and duration of breastfeeding in the United States are especially limited for mothers who are economically disadvantaged and for those who are members of ethnic minority groups.
The best data for any minority groups are for black women. Their rates of breastfeeding are substantially lower than those for white women, but factors that distinguish breastfeeding from nonbreastfeeding women tend to be similar among black and white women. Social, cultural, economic, and literature review infant nutrition factors that influence infant feeding choices by adolescent mothers are not well understood. In the United States, literature review infant nutrition, where few employers provide paid maternity leave, return to work outside the home is associated with a shorter duration of breastfeeding, but little else is known about when mothers discontinue either exclusive or partial breastfeeding.
Such data are needed to estimate the total nutrient demands of lactation. The few lactating women who have been studied in the United States have been characterized as well nourished, but this observation cannot be generalized since these subjects were principally white women with some college education. Women from less advantaged, less well studied populations may be at higher risk of nutritional problems but tend not to breastfeed.
To determine whether women are adequately nourished, investigators use biochemical or anthropometric methods, or both. For lactating women, however, there are serious gaps and limitations in the data literature review infant nutrition with these methods. Consequently, there is no scientific basis for determining whether poor nutritional status is a problem among certain groups of these women.
To identify the nutrients likely to be consumed in inadequate amounts by lactating women, the subcommittee used an approach involving nutrient densities nutrient intakes per 1, kcal calculated from typical diets of nonlactating U. That is, they made the assumption that the average nutrient densities of the diets of lactating women would be the same as those of nonlactating women but that lactating women would have higher total energy intake and therefore higher nutrient intake.
Using this approach, the nutrients most likely to be consumed in amounts lower than the RDAs for lactating women are calcium, zinc, magnesium, vitamin B 6and folate. Data for U.
women indicate that successful lactation occurs regardless of whether a woman is thin, of normal weight, literature review infant nutrition, or obese.
Anthropometric measurements such as weight, weight for height, literature review infant nutrition, and skinfold thickness have not been useful for predicting the success of lactation among the few U. women who have been studied. The predictive ability is not known for anthropometric measurements that fall outside the ranges observed in these limited samples.
Lactating women eating self-selected diets typically lose weight at the rate of 0. Such weight loss is probably physiologic. During the same period, values for subscapular and suprailiac skinfold thickness also decrease; triceps skinfold thickness does not. Biochemical data for lactating women have been obtained only literature review infant nutrition small, select samples.
Such data are of limited use in the clinical situation because there are no norms for lactating women, and the norms for nonpregnant, literature review infant nutrition, nonlactating women may not be applicable to breastfeeding women. For example, there appear to be changes in plasma volume post partum, and there are changes in blood nutrient values over the course of lactation that are unrelated to changes in plasma volume.
Literature review infant nutrition mean volume of milk literature review infant nutrition by healthy U. The major determinant of milk production is the infant's demand for milk, literature review infant nutrition, which in turn may be influenced by the size, age, health, and other characteristics of the infant as well as by his literature review infant nutrition her intake of supplemental foods.
The potential for milk production may be considerably higher than that actually produced, literature review infant nutrition, as evidenced by findings that the milk volumes produced by women nursing twins or triplets are much higher than those produced by women nursing a single infant. Studies of healthy women in industrialized countries demonstrate that milk volume is not related to maternal weight or height or indices of fatness.
In developing countries, there is conflicting evidence about whether thin women produce less milk than do women with higher weight for height. Increased maternal energy intake has not been linked with increased milk production, at least among well-nourished women in industrialized countries.
Nutritional supplementation of lactating women in developing countries where undernutrition may be a problem has generally been reported to have little. or no impact on milk volume, but most studies have been too small to test the hypothesis adequately and lacked the design needed for causal inference. Studies of animals indicate that there may be a threshold below which energy intake is insufficient to support normal milk production, but it is likely that most studies in humans have been conducted on women with intakes well above this postulated threshold, literature review infant nutrition.
The weight loss ordinarily experienced by lactating women has no apparent deleterious effects on milk production. Although lactating women typically lose 0. Regular exercise appears to be compatible with production of an adequate volume of milk. The influence of maternal intake of specific nutrients on milk volume has not been investigated satisfactorily. Early studies in developing countries suggest a positive association of protein intake with milk volume, but those studies remain inconclusive.
Fluids consumed in excess of thirst do not increase milk volume. The composition of human milk is distinct from the milk of other mammals and from infant literature review infant nutrition ordinarily derived from them. A number of generalizations can be made about the effects of maternal nutrition on the composition of milk see also Table :.
Even if the usual dietary intake of a macronutrient is less than that recommended in Recommended Dietary Allowances NRC,there will be little or no effect on the total amount of that nutrient in the milk.
However, the proportions of the different fatty acids in human milk literature review infant nutrition with maternal dietary intake. The concentrations of major minerals calcium, phosphorus, magnesium, sodium, and potassium in human milk are not affected by the diet, literature review infant nutrition.
Maternal intakes of selenium and iodine are positively related to their concentrations in human milk, but there is no convincing evidence that the concentrations of other trace elements in human milk are affected by maternal diet. The vitamin content of human milk is literature review infant nutrition upon the mother's current vitamin intake and her vitamin stores, but the strength of the relationships varies with the vitamin.
Chronically low maternal intake of vitamins may result in milk that contains low amounts of these essential nutrients. TABLE Possible Influences of Maternal Intake on the Nutrient Composition of Human Milk and Nutrients for Which Clinical Deficiency Is Recognizable in Infants. Effect of Maternal Intake on Milk Composition a. The magnitude of the effect varies widely among nutrients. o denotes no known effect of intake on nutrient content of the milk.
b Evidence is not sufficiently conclusive to categorize as ''No, literature review infant nutrition. c Effect appears to be on type of fatty acids present but not on total content of triglycerides or cholesterol in the milk. e Maternal intake is not the primary determinant of the infant's vitamin K status.
The content of at least some nutrients in human milk may be maintained at a satisfactory level at the expense of maternal stores. This applies particularly to folate and calcium, literature review infant nutrition.
Maternal, Infant and Early Childhood Nutrition — The Thousand Day Window of Opportunity
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The literature review for the Infant Feeding Guidelines was co-funded by the Australian Government Department of Health and Ageing. Relevant contributions were provided by the Nutrition Section of the Population Health Division. The NHMRC commissioned Curtin University to undertake this literature review. The Curtin University team included May 14, · In this context, the purpose of this systematic literature review is to assess the scientific evidence of bioactive compounds present in infant formulas (α-lactalbumin, lactoferrin, taurine, milk fat globule membrane, folates, polyamines, long-chain polyunsaturated fatty acids, prebiotics, and probiotics) and their effects on infant nutrition and health. Through previously Author: Cristine Couto Almeida, Cristine Couto Almeida, Bianca Figueiredo Mendonça Pereira, Katia Christina extent to which variations in infant nutrition affect growth, development and long-term function. Many Many studies have compared breast and formula feedi ng in infancy, Estimated Reading Time: 7 mins
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