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ARS Home » Pacific West Area » Davis, California » Western Human Nutrition Research Center » Obesity and Metabolism Research » Research » Publications at this Location » Publication #342465
Title: Vitamin concentrations in human milk vary with time within feed, circadian rhythm, and single-dose supplementation

Author
item HAMPEL, DANIELA - University Of California
item Shahab-Ferdows, Setti
item ISLAM, MUNIRUL - International Centre For Diarrhoeal Disease Research
item PEERSON, JANET - University Of California
item Allen, Lindsay - A

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/17/2017
Publication Date: 2/15/2017
Citation: Hampel, D., Shahab-Ferdows, S., Islam, M., Peerson, J.M., Allen, L.H. 2017. Vitamin concentrations in human milk vary with time within feed, circadian rhythm, and single-dose supplementation. Journal of Nutrition. 147(4):603-611. doi: 10.3945/jn.116.242941.

Interpretive Summary: While human milk samples have been collected in many studies, there is no sample collection protocol established. We evaluated the influence of the timing of the collection within a feed and during the day as well as the effect of acute maternal supplementation on breast milk vitamin concentrations (vitamin B1, B2, B3, B6, B12, A, and E) in an observational intervention in Dhaka, Bangladesh. 18 healthy women at 2-4mo lactation participated in a 3-d supplementation study. On day 1, no supplements were given; on days 2 and 3, participants received ~1x and 2x of the Recommended Dietary Allowances for vitamins early morning. Milk was collected during every feed from the same breast over 24h. The first 2min of expressed milk (A) was collected separately from the remainder (B); a third aliquot (C) was saved by combining (A) and (B). We found that the differences among aliquots within a feed and circadian variance are significant but small. Samples collected in the afternoon/evening are most representative to the daily median. Maternal supplementation was reflected in milk B1, B2, B6, and A concentrations 2-4h after the supplement was taken with 0.1-6.17% of dose passing into milk. Supplementation was reflected in fasted samples for vitamins B2 and B6, collected 24h post-dose. Thus, the timing of maternal supplementation acutely affects breast milk MN concentrations.

Technical Abstract: Importance: Human milk is the subject of many nutrition studies but methods for representative sample collection are not established. Our recently improved, validated methods for analyzing micronutrients in human milk now enable systematic study of factors affecting their concentration. Objective: To evaluate effects of sample collection protocols, circadian and subject-variability variation, and acute maternal micronutrient supplementation on vitamin concentrations in milk. Design, Setting, and Participants: The Breast Milk Quality (BMQ) Study was an observational intervention conducted October 2013-February 2014 in Dhaka, Bangladesh. We recruited 18 healthy women (18-26y) at 2-4mo lactation for a 3-d supplementation study. Intervention: On day 1, no supplements were given; on days 2 and 3, participants received ~1x and 2x of the Recommended Dietary Allowances (RDA) for vitamins early morning. Milk was collected during every feed from the same breast over 24h. The first 2min of expressed milk (A) was collected separately from the remainder (B); a third aliquot (C) was saved by combining (A) and (B). Main Outcome and Measure: Vitamins B1, B2, B3, B6, B12, A, E, and fat, were assessed at each feed and aliquot. Results: Significant but relatively small differences among aliquots were found for all vitamins except B6 and B12. The circadian variance was significant for all but A and E when adjusted for fat, with higher contribution to the total variance when supplements were taken. Subject-variability accounted for the majority of the total variance. Afternoon and evening sample collection showed the best agreement with the daily median for all study days. Acute supplementation effects were found for B1, B2, B6, and A at 2-4h post-dose with 0.1-6.17% of dose passing into milk. Supplementation was reflected in fasted samples, collected 24h post-dose, for B2 and B6. Maximum amounts of dose-responding vitamins provided in one feed ranged from 4.7-21.8 (d2) and 8.2-35.0% (d3) of the AI. Conclusions and Relevance: Differences among aliquots within a feed and circadian variance are significant but small. Afternoon/evening collection provides best representative samples; however, the timing of maternal supplementation acutely affects breast milk MN concentrations.