Breast Milk Iron Concentrations may be Lower than Previously Reported: Implications for Exclusively Breastfed Infants

SV, Harding

doi:10.4172/2472-1182.1000104

Matern Pediatr Nutr

2016

DOI: 10.4172/2472-1182.1000104

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Breast Milk Iron Concentrations may be Lower than Previously Reported: Implications for Exclusively Breastfed Infants

Harding SV¹

Abstract: Objective: Atomic Absorption Spectrophotometry (AAS) is the most common technique for detecting iron in human milk. Quantifying the iron in human milk is essential for determining the amount of dietary iron available to the exclusively breastfed infant. To determine whether more sensitive procedures for iron analyses would yield different values than those obtained using the AAS, flame atomic absorption, we investigated and compared three different analytical techniques using AAS. Methods:The present experimen… Show more

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Cited by 4 publications

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“…Human breast milk has little iron (0.4 mg/L) (5). Since breast milk is designed for humans by humans, we assume what is in breast milk is optimal for developing infants.…”

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confidence: 99%

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There Is No Iron in Human Milk

Friel¹

2017

J. pediatr. gastroenterol. nutr.

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in children. Only 41% of the cohort were on daily preoperative narcotics, so this cohort had less opioid dependence than is seen in adolescent and adults (6). Despite this relatively low rate of daily narcotic use preoperatively, patients required a median of 2 months to wean off of narcotics. At our center, we have had similar experience that younger children, with shorter duration of disease, often wean off of narcotics more quickly and recover from their chronic pain more easily.Regardless of opioid dependence, all of these children suffer from chronic pain before TP-IAT. Chronic pancreatitis significantly impairs quality of life in pediatric patients and in their parents (6). In our experience, psychiatric issues including anxiety, depression, and conversion disorder are common in older children and teenagers experiencing chronic pancreatitis; whether early intervention might alleviate or even prevent these serious morbidities is not known. Close collaboration with pediatric pain specialists is crucial for postoperative pharmacologic and nonpharmacologic pain management, and coping skills. The long-term psychological impact of severe chronic pain, missed school days, disruption of family life has not been systematically studied but should be in the future for these children. Adult studies have shown significant improvements in quality of life after TP-IAT that are independent of insulin dependence; this balance will be important to investigate in children (7).Despite the severity of these children's pancreatitis, they had excellent islet yields-with almost all exceeding the 5000 islet equivalents per kilogram body mass that has been associated with high prevalence of insulin independence in previous reports (8). The relatively short duration of disease and Minnesota's decades of experience with islet isolation are both key components of these islet yields.Following with the high islet yields, insulin independence rates were high-and seemed to be sustained over the reported follow-up period. Reported postsurgical follow-up time was relatively short, with most less than 5 years. Longer-term follow-up of this and other pediatric TP-IAT cohorts will be crucial, particularly in evaluating the sustainability of islets and insulin independence. Even over the relatively short follow-up period, it appears that 3 of the 14 patients that attained temporary insulin independence had to resume insulin. Two of 7 patients that had more than 3 years of follow-up had to restart insulin, and 1 of those 7 never came off of insulin (1).Continued monitoring of glucose tolerance, even in those off of insulin, is key for children who undergo TP-IAT. In Bellin et al's cohort, hemoglobin A1c was elevated in 2 patients and borderline elevated in 75% of the cohort. Given their early onset of severe disease, these children would likely have progressed to insulindependent diabetes eventually without the TP-IAT. And even their insulin-dependent patients had some islet function, indicated by their C-peptide, which likely gave them some prot...

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“…Human breast milk has little iron (0.4 mg/L) (5). Since breast milk is designed for humans by humans, we assume what is in breast milk is optimal for developing infants.…”

mentioning

confidence: 99%

“…The total intracellular iron content of human milk is estimated to be 0.58 to 0.65 mg/L. The total iron content in human milk between 1 and 3 months is about 0.27 to 0.45 mg/L (5). Thus, intracellular iron accounts for a large proportion if not all of the total iron content in human milk.…”

mentioning

confidence: 99%

There Is No Iron in Human Milk

Friel¹

2017

J. pediatr. gastroenterol. nutr.

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Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases

et al. 2023

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Micronutritional deficiencies are common in atopic children suffering from atopic dermatitis, food allergy, rhinitis, and asthma. A lack of iron, in particular, may impact immune activation with prolonged deficiencies of iron, zinc, vitamin A, and vitamin D associated with a Th2 signature, maturation of macrophages and dendritic cells (DCs), and the generation of IgE antibodies. In contrast, the sufficiency of these micronutrients establishes immune resilience, promotion of regulatory cells, and tolerance induction. As micronutritional deficiencies mimic an infection, the body’s innate response is to limit access to these nutrients and also impede their dietary uptake. Here, we summarize our current understanding of the physiological function of iron, zinc, and vitamins A and D in relation to immune cells and the clinical consequences of deficiencies in these important nutrients, especially in the perinatal period. Improved dietary uptake of iron is achieved by vitamin C, vitamin A, and whey compounds, whereas zinc bioavailability improves through citrates and proteins. The addition of oil is essential for the dietary uptake of beta-carotene and vitamin D. As for vitamin D, the major source comes via sun exposure and only a small amount is consumed via diet, which should be factored into clinical nutritional studies. We summarize the prevalence of micronutritional deficiencies of iron, zinc, and vitamins in the pediatric population as well as nutritional intervention studies on atopic diseases with whole food, food components, and micronutrients. Dietary uptake via the lymphatic route seems promising and is associated with a lower atopy risk and symptom amelioration. This review provides useful information for clinical studies and concludes/emphasizes that a healthy, varied diet containing dairy products, fish, nuts, fruits, and vegetables as well as supplementing foods or supplementation with micronutrients as needed is essential to combat the atopic march.

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Effects of iron deficiency and iron supplementation at the host-microbiota interface: Could a piglet model unravel complexities of the underlying mechanisms?

et al. 2022

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Iron deficiency is the most prevalent human micronutrient deficiency, disrupting the physiological development of millions of infants and children. Oral iron supplementation is used to address iron-deficiency anemia and reduce associated stunting but can promote infection risk since restriction of iron availability serves as an innate immune mechanism against invading pathogens. Raised iron availability is associated with an increase in enteric pathogens, especially Enterobacteriaceae species, accompanied by reductions in beneficial bacteria such as Bifidobacteria and lactobacilli and may skew the pattern of gut microbiota development. Since the gut microbiota is the primary driver of immune development, deviations from normal patterns of bacterial succession in early life can have long-term implications for immune functionality. There is a paucity of knowledge regarding how both iron deficiency and luminal iron availability affect gut microbiota development, or the subsequent impact on immunity, which are likely to be contributors to the increased risk of infection. Piglets are naturally iron deficient. This is largely due to their low iron endowments at birth (primarily due to large litter sizes), and their rapid growth combined with the low iron levels in sow milk. Thus, piglets consistently become iron deficient within days of birth which rapidly progresses to anemia in the absence of iron supplementation. Moreover, like humans, pigs are omnivorous and share many characteristics of human gut physiology, microbiota and immunity. In addition, their precocial nature permits early maternal separation, individual housing, and tight control of nutritional intake. Here, we highlight the advantages of piglets as valuable and highly relevant models for human infants in promoting understanding of how early iron status impacts physiological development. We also indicate how piglets offer potential to unravel the complexities of microbiota-immune responses during iron deficiency and in response to iron supplementation, and the link between these and increased risk of infectious disease.

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Breast Milk Iron Concentrations may be Lower than Previously Reported: Implications for Exclusively Breastfed Infants

Cited by 4 publications

References 27 publications

There Is No Iron in Human Milk

There Is No Iron in Human Milk

Lack of iron, zinc, and vitamins as a contributor to the etiology of atopic diseases

Effects of iron deficiency and iron supplementation at the host-microbiota interface: Could a piglet model unravel complexities of the underlying mechanisms?

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