No abstract

After validation of test-weighing procedures milk volumes produced by 13 multiparous Caucasian women were followed longitudinally through the first year of lactation. All practiced exclusive breast-feeding for at least 5 mo. Milk transfer to the infant was low on days 1 and 2 and increased rapidly to 498 +/- 129 g/d (means +/- SD) on day 5 and then more slowly to 753 +/- 89 g/d during months 3-5. There was a characteristic milk volume for each mother-infant pair that was significantly related neither to milk yield on days 4-6 nor to birth weight. It was, however, strongly related to infant weight at 1 mo, suggesting that infant and/or maternal factors coming into play during the first month of life are strong determinants of subsequent milk transfer to the infant.

Concentrations and secretion rates of macronutrients and major ions in human milk during lactogenesis (birth to 8 d) and late lactation (greater than 6 mo postpartum) are reported. Postpartum changes in lactose, sodium, and chloride concentrations signalled closure of the paracellular pathway during days 1-2. From days 2 to 4 postpartum, initiation of copious milk secretion was accompanied by significant increases in citrate, free phosphate, glucose, and calcium concentrations and a decrease in pH. During weaning, significant changes in milk protein, lactose, chloride, and sodium concentrations were observed only when milk volume fell below 400 mL/d; more than one feed per day was necessary to maintain milk secretion. Temporal changes in the concentration of other milk components, except glucose and magnesium, were not different in weaning and non-weaning women. Differences between the relation of milk volume and composition during lactogenesis and weaning suggest that volume is differently regulated in the two periods.

Within-feed and between-breast differences in the concentrations of sodium, potassium, chloride, calcium, magnesium, lipid, protein, lactose, glucose, urea nitrogen, creatinine, zinc, and copper were examined in milk samples from 10 women. The average lipid content doubled in the interval from the beginning of the feed to the end. The composition of the aqueous phase of milk, as determined by the major osmotically active constituents, did not vary significantly within the feed. For these components as well as for lipid a small mid-feed sample of milk gave the same mean composition as the pooled, pumped contents of one breast suggesting that such a sample is adequate for determination of milk composition in population studies. Sporadic, inconsistent differences in the composition of the milk from the right and left breasts were observed. It is suggested that mastitis may contribute to these differences. It is recommended that samples routinely be taken from both breasts and analyzed for sodium and chloride to rule out episodes of mastitis or other local phenomena which sporadically alter milk composition.