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Healthy diet of breastfeeding mother and composition of human milk

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Healthy diet of breastfeeding mother and composition of human milk

The diet of the breastfeeding mother has a certain impact on the composition of the milk. The most fundamental aspect is the intake of adequate amounts of high-quality fatty acids. Even during fetal life, the child can develop its taste preferences – which underscores all the more how crucial it is that the diet during lactation be varied.

Table of Contents

1. Maternal diet during breastfeeding

According to the 2020 nutrition standards for the population of Poland, women during the breastfeeding period should consume slightly more nutrients, some vitamins and minerals than women of the same age but not in the lactation period. Comparison of the recommended intake of nutrients, vitamins and minerals for breastfeeding mothers and women who are neither pregnant nor breastfeeding.

2. The composition of human breast milk

The composition of human breast milk is influenced by numerous factors, including the lactation period, environmental factors, and diet. During the initial phase, a few days following childbirth, colostrum is produced, which is rich in immunological components such as IgA antibodies, lactoferrin, and leukocytes. It contains less lactose compared to milk produced in the subsequent weeks. Over time, the ratio of sodium to potassium in milk decreases, and the lactose content increases. In the subsequent stages, the milk becomes increasingly more nutritious to provide an adequate supply of nutrients required for the rapidly developing newborn. After 4-6 weeks postpartum, the milk reaches full maturity. The average composition of macronutrients in mature human milk (based on O. Ballard, A. L. Morrow 2013) is as follows. L. A. Nommsen et al. have demonstrated that the macronutrient content in milk may be related to maternal body weight, protein intake, return of menstruation, and breastfeeding frequency. It is worth noting that even during a single feeding, the composition of milk changes. Initially, it is more watery and less nutritious to quench the baby's thirst. Subsequently, it becomes denser and richer in macronutrients, including energy. The amount of vitamins and micronutrients in milk meets most of the infant's needs. Exceptions are vitamins D and K, which must be given as a supplement. Human milk also contains many other bioactive components that are essential for the baby's proper development, such as IGF (insulin-like growth factor) and erythropoietin (which plays a significant role in the production of red blood cells). Human milk contains oligosaccharides, which are not nutritional components but function as probiotics that promote the growth of beneficial bacteria.

3. The mother's diet and the fatty acids in breast milk

A portion of long-chain fatty acids (LCPUFA) is synthesized in the mammary glands of the mother, but they do not originate from endogenous synthesis, rather they enter the milk through the mother's diet. The LCPUFA content is usually low in the diet of women in developed countries, hence supplementation is recommended. Trans fatty acids are produced as a result of partial hydrogenation/hardening of vegetable oils. Their primary source is diet, particularly sweets, fast food, and confectioneries. The presence of trans fatty acids in the milk is mainly due to their intake through the diet. They may have a negative impact on the infant and affect the metabolism of LCPUFA, hence they should be reduced in the diet of the breastfeeding mother. L. Aumeistere and colleagues evaluated the frequency of consumption of various food groups and the composition of milk in women in Lithuania. Most of the women rarely consumed cereal flakes and whole grain products. Milk and dairy products were consumed in the majority of cases only twice a week. The respondents consumed fish less frequently than once a week. A correlation was observed between the frequency of fish consumption and the DHA content in the milk (the more often a woman consumed fish, the more DHA was found in the milk). Furthermore, the higher the consumption of nuts and seeds, the higher the linoleic acid content (a polyunsaturated fatty acid of the omega-6 group) in the milk. A lower concentration of trans fatty acids was observed in a subgroup of the respondents who consumed whole grain products more frequently. A systematic review by F. Bravi and colleagues confirms the above findings.

4. Mother's diet and its impact on milk microbiota

Mother's milk contains not only nutrients, but also microorganisms. Although their number is not large, they are highly diverse. These microorganisms likely colonize the digestive tract of the breastfed baby. In an article by M. D. Seferovic and colleagues, published in the journal "Nature", the results of several studies were presented that showed that the microbiota in the stool of breastfed infants differs from that of children fed with modified milk. These same bacteria and the previously mentioned oligosaccharides (natural prebiotics) present in mother's milk have a significant impact on the process of colonization of the neonatal digestive tract. Oligosaccharides are complex structures composed of 2-10 monomers, in this case simple sugars (e.g. glucose, fructose). Oligosaccharides are not digested in the digestive tract, but support the growth of beneficial bacteria. According to the results of the above-mentioned studies, mother's diet has an impact on the amount and type of oligosaccharides in milk. Furthermore, it has been shown that the composition of milk in terms of the content of these components changes in response to dietary modifications, but there is currently insufficient data to formulate definitive recommendations.

5. The mother's diet during lactation and its impact on the child's taste preferences later on

A study by J. P. Beckerman, E. Slade, and A. K. Ventura found that both the duration of lactation and the mother's vegetable intake during this period were linked to higher vegetable consumption by children as young as 6 years old. It is possible that this is due to the fact that during lactation, the child is exposed to the flavors of the mother's diet, which may shape future taste preferences. However, indirect evidence for this may also be the fact that studies of children as old as 2-13 years old who were breastfed during the first period of life have shown that more vegetables and fruits are eaten in the early stages of breastfeeding than newborn babies. Such correlations have been found in various geographic latitudes. Undoubtedly, what the mother eats has an impact on the taste of milk. H. Hausner and his team showed that volatile compounds pass into food to varying degrees and at different rates. Pregnant women in the lactation period were given several volatile compounds, such as isoamyl acetate, which has a fruity aroma, or L-menthol. Subsequently, the concentration of these compounds in milk was checked. Volatile compounds pass into milk selectively and in small quantities. There are no direct evidence that the child automatically likes what the mother eats. However, a great advantage is that children already during breastfeeding experience a variety of flavors and get used to them. This may help them in later life better tolerate new foods. Undoubtedly, other important factors, such as the mother's pregnancy diet, the way the infant's diet is expanded, or the diversity of the diet in early childhood, also have an impact on the child's taste preferences.

6. Exclusion diets

There are instances where we opt to remove gas-producing products (such as cauliflower, Brussels sprouts, cabbage) from our diet due to concerns about the occurrence of bloating in the infant. However, this step is not required. The compounds responsible for gas formation in the intestines do not pass into milk and are unable to cause similar symptoms in the child. It is also not advisable to exclude products that may cause an allergic reaction to prevent the development of food allergy in the infant. Only for diagnostic purposes, when a child is suspected of having a cow's milk protein allergy, the mother should discontinue the intake of dairy products for a certain period to ascertain if they are the cause of the child's discomfort. There is no need for complete caffeine abstinence during breastfeeding as only 1% of this substance is transferred into milk. However, the daily caffeine intake should not exceed the equivalent of 1-2 cups of coffee.
Source

Aumeistere L. et al., Impact of Maternal Diet on Human Milk Composition Among Lactating Women in Latvia, „Medicina” 2019, 55(5), 173.
Ballard O., Morrow A.L., Human milk composition: nutrients and bioactive factors, „Pediatric Clinics of North America” 2013, 60(1), 49–74.
Beckerman J.P., Slade E., Ventura A.K., Maternal diet during lactation and breast-feeding practices have synergistic association with child diet at 6 years, „Public Health Nutrition” 2020, 23(2), 286–294.
Bravi F. et al., Impact of maternal nutrition on breast-milk composition: a systematic review, „American Journal of Clinical Nutrition” 2016, 104(3), 646–662.
Butts C.A. et al., Human Milk Composition and Dietary Intakes of Breastfeeding Women of Different Ethnicity from the Manawatu-Wanganui Region of New Zealand, „Nutrients” 2018, 10(9), 1231.
Hausner H. et al., Differential transfer of dietary flavour compounds into human breast milk, „Physiology & Behavior” 2008, 95(1–2), 118–124.
Jeong G. et al., Maternal food restrictions during breastfeeding, „Korean Journal of Pediatrics” 2017, 60(3), 70–76.
Nommsen L.A. et al., Determinants of energy, protein, lipid, and lactose concentrations in human milk during the first 12 mo of lactation: the DARLING Study, „American Journal of Clinical Nutrition” 1991, 53(2), 457–465.
Normy żywienia dla populacji Polski i ich zastosowanie, pod red. Jarosza M. et al., Warszawa 2020.
Seferovic M.D. et al., Maternal diet alters human milk oligosaccharide composition with implications for the milk metagenome, „Scientific Reports” 2020, 10(1), 22092.