Overview of Nutrients in Human Milk

Abstract

The WHO recommends exclusive breastfeeding for the first 6 mo of life to promote optimal infant health and development. Understanding the micro- and macronutrient concentrations of human milk and how each nutrient fluctuates with lactational stage, maternal factors, and supplementation is imperative for supporting good breastfeeding practices. Where maternal undernutrition compromises human milk quality, a thorough awareness of the effectiveness of interventions can direct efforts to achieve both maternal and infant nutrient sufficiency. This review of current knowledge covers trends in nutrient concentrations over the course of lactation and describes the influence of maternal intake, status, supplementation, and other factors on human milk concentrations of each nutrient.

Nutritional and immunological factors in breast milk: A role in the intergenerational transmission from maternal psychopathology to child development

“…The concentration of some water-soluble vitamins, such as thiamin, vitamin B-6 and biotin, increases during the lactation period, while the riboflavin content remains constant. Vitamins A and E are present in high concentrations in colostrum compared to mature milk, while vitamins D and K remain in low quantity in human milk (Coryell et al, 1945;Dror and Allen, 2018). Maternal diet seems to notably influence the vitamin profile in breast milk, resulting, in some cases, in the necessity of dietary supplementation for the mother during the lactation period (Valentine and Wagner, 2013).…”

“…Maternal diet seems to notably influence the vitamin profile in breast milk, resulting, in some cases, in the necessity of dietary supplementation for the mother during the lactation period (Valentine and Wagner, 2013). In contrast, other micronutrients, such as ions and mineral salts, show a constant bioavailability during the course of lactation, with the exception of zinc, copper and iron, which are present in high concentration immediately after childbirth, but decrease in the following months, and seem to be less influenced by maternal diet (Dror and Allen, 2018).…”

Vitamin B12 concentrations in milk from Norwegian women during the six first months of lactation

“…Nevertheless, we may have missed some B12 food sources and therefore underestimated total B12 intake within food groups, which could explain the lack of association between B12 intake and milk concentration. In studies from low-income countries with a higher prevalence of deficient or marginal B12 status, maternal vitamin B12 intake was associated with human milk B12 concentrations at 1, 6, and 12 months postpartum in Kenya [27] and Guatemala [1,2,28].…”

“…Vitamin B12 (B12) is an essential micronutrient for normal growth and cognitive development in infants [1,2]. Infant B12 status depends on both sufficient transfer in utero and sufficient transfer through breast milk, both of which are strongly affected by maternal status [2][3][4].…”

Is natural (6S)-5-methyltetrahydrofolic acid as effective as synthetic folic acid in increasing serum and red blood cell folate concentrations during pregnancy? A proof-of-concept pilot study

“…35,36 Folate binding protein (FBP) in breastmilk has a higher affinity for folic acid than reduced folate forms; after ingestion, folic acid may be less readily released by FBP as it passes through the gastrointestinal tract, reducing subsequent absorption and potentially impacting the infant's folate status. 33 Although total breastmilk folate concentrations are unaffected by maternal folate status (except in cases of severe deficiency) 34,37 , the proportion breastmilk folate as folic acid may be influenced. 33 In a recent retrospective cohort study (n=561), women who reported supplementing with >0.4 mg/day folic acid had proportionally higher UMFA in breastmilk than women who reported 6 supplementing with <0.4 mg/day (50% as compared to 25% respectively).…”