Day-to-Day Fluctuation in Micronutrient Content in Human Milk Relative to Maternal Diet

Abstract

Background/objectives: The impact of daily variations in habitual maternal intake on human milk (HM) composition has been poorly studied. We aimed to investigate the associations between day-to-day fluctuation in the micronutrient concentration in HM and daily maternal diet.

Methods: To this end, an observational longitudinal study was carried out. A total of 143 lactating women each compiled a five-day weighed dietary record and concomitantly expressed milk for four successive days. Maternal daily intakes of micronutrients and food groups were analyzed. Free thiamine, free riboflavin, nicotinamide, pantothenic acid, pyridoxal, folic acid, cobalamin, ascorbic and dehydroascorbic acids, retinol, alpha- and gamma-tocopherol, cholecalciferol, and calcidiol in HM were determined for each of the four investigated days. A longitudinal data analysis with generalized estimating equation models was performed.

Results: For each daily serving of meat, fish, and eggs, total vitamin D₃ levels increased by 243.2 pg/mL (p = 0.027) and selenium levels increased by 0.16 ppb (p = 0.031) in HM. For every 1 mg/day of riboflavin supplementation, free riboflavin levels in HM increased by 28.6 mcg/L (p = 0.019). Pyridoxal levels in HM increased by 6.3 mcg/L per 1 mg/day of vitamin B₆ supplementation (p = 0.001), and by 2 mcg/L per daily fruit ration (p = 0.016).

Conclusions: In conclusion, we were able to quantify the impact of the usual day-to-day variations in the diet and in the intake of commonly used supplements on the fluctuation of vitamin D, free riboflavin, pyridoxal, and selenium concentration in the milk of lactating women.

Keywords: breast milk; generalized estimating equations; intake; lactating women; minerals; pyridoxal; riboflavin; selenium; vitamin D; vitamins.

Figure 1

Protocol for completion of the dietary record and collection of milk samples over time.

Figure 2

Distribution of participants (n = 143) by group. Abbreviations: D, human milk donors; P, mothers of preterm infants less than 32 weeks gestational age admitted to the neonatal service; V, vegetarian or vegan mothers. Number of total human milk donors = 113 (108 + 2 + 3). Number of total mothers of preterm infants less than 32 weeks of gestational age admitted to the neonatal service = 15 (12 + 3). Number of total vegetarian or vegan mothers = 20 (18 + 2).