Maternal Body Composition and Its Relationship to Infant Breast Milk Intake in Rural Pakistan

Nafeesa Nazlee, Rakhshanda Bilal, Zahid Latif, Les Bluck

.

DOI: 10.4236/fns.2011.29127                

Abstract

Some women in rural Pakistan are chronically undernourished, and consequently underweight. Concerns have been expressed that the degree of undernourishment might be sufficiently severe to affect lactation performance. We have obtained data on maternal body composition and infant breast milk intake using stable isotope methods in a group of thirty three mother and infant pairs at approximately six months of age. The maternal body mass index ranged from 16.6 to 29.1 kg·m^-2. In this population we found that exclusive breast-feeding tended to be associated with lower maternal body fat, and that there was no evidence for compromised lactational performance due to malnourishment. Finally we note that when our data is combined with that from other studies there may be a generalised negative correlation between breast milk intake and maternal body fat.

Keywords

Stable Isotopes, Breast Milk Intake, Maternal Body Composition

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	J. S. Garrow and J. Webster, “Quetelet Index (w/h?2) as a Measure of Fatness,” International Journal of Obesity, Vol. 9, No. 2, 1985, pp. 147-153.
[2]	A. S. Jackson, P. R. Stanforth, J. Gagnon, T. Rankinen, A.S. Leon, D. C. Rao, J. S. Skinner, C. Bouchard and J. H. Wilmore, “The Effect of Sex, Age and Race on Estimating Percentage Body Fat from Body Mass Index: The Heritage Family Study,” International Journal of Obesity, Vol. 26, No. 6, 2002, pp. 789-796.
[3]	S. B. Racette, S. S. Deusinger and R. H. Deusinger, “Obesity: Overview of Prevalence, Etiology, and Treatment,” Physical Therapy, Vol. 83, No. 3, 2003, pp. 276- 288.
[4]	S. Meeuwsen, G. W. Horgan and M. Elia, “The Relationship between BMI and Percent Body Fat, Measured by Bioelectrical Impedance, in a Large Adult Sample is Curvilinear and Influenced by Age and Sex,” Clinical Nutrition, Vol. 29, No. 5, 2010, pp. 560-566. doi:10.1016/j.clnu.2009.12.011
[5]	WHO, “Global Strategy for Infant and Young Child Feeding,” World Health Organization, Geneva, 2003.
[6]	G. Jones, R. W. Steketee, R. E. Black, Z. A. Bhutta, S. S. Morris and G. Bellagio, “Child Survival Study, How Many Child Deaths Can We Prevent This Year?” Lancet, Vol. 362, No. 9377, 2003, pp. 65-71. doi:10.1016/S0140-6736(03)13811-1
[7]	A. M. Prentice, A. A. Paul, A. Prentice, A. Black and T. J. Cole, “Cross-Cultural Differences in Lactaional Performance, in Human Lactation 2: Maternal and Environmental Factors,” M. Hamosh and A. S. Goldman, Eds., Planum, New York, 1986, pp. 13-44.
[8]	G. A. Ettyang, W. D. V. Lichtenbelt, F. Esamai, W. H. M. Saris and K. R. Westerterp, “Assessment of Body Composition and Breast Milk Volume in Lactating Mothers in Pastoral Communities in Pokot, Kenya, Using Deuterium Oxide,” Annals of Nutrition and Metabolism, Vol. 49, No. 2, 2005, pp. 110-117. doi:10.1159/000084744
[9]	S. M. Imong, D. A. Jackson, L. Wongsawasdii, S. Ruckphaophunt, A. Tansuhaj, P. Chiowanich, M. W. Woolridge, R. F. Drewett, J. D. Baum and K. Amatayakul, “Predictors of Breast-Milk Intake in Rural Northern Thailand,” Journal of Pediatric Gastroenterology Nutrition, Vol. 8, No. 3, 1989. pp. 359-370. doi:10.1097/00005176-198904000-00017
[10]	W. A. Coward, T. J. Cole, M. B. Sawyer, A. M. Prentice and A. K. Orrewing, “Breast-Milk Intake Measurement in Mixed-Fed Infants by Administration of Deuterium-Oxide to Their Mothers,” Human Nutrition-Clinical Nutrition, Vol. 36, No. 2, 1982, pp. 141-148.
[11]	C. Kendall and T. B. Coplen, “Multisample Conversion of Water to Hydrogen by Zinc for Stable Isotope Determination,” Analytical Chemistry, Vol. 57, No. 7, 1985, pp. 1437-1440. doi:10.1021/ac00284a058
[12]	J. C. K. Wells, R. Bilal, K. A. Abbass, Z. Latif, S. Roohi and A. Hafeez, “Breast-Milk Intake in Exclusively Breastfed Pakistani Infants: An Estimation by Deuterium Dilution Method,” Pakistan Paediatric Journal, Vol. 31, No. 3, 2007, pp. 111-119.
[13]	H. Haisma, W. A. Coward, E. Albernaz, G. H. Visser, J. C. K. Wells, A. Wright and C. G. Victoria, “Breast Milk and Energy Intake in Exclusively, Predominantly, and Partially Breast-Fed Infants,” European Journal of Clinical Nutrition, Vol. 57, No. 12, 2003, pp. 1633-1642. doi:10.1038/sj.ejcn.1601735
[14]	WHO, “WHO Child Growth Standards,” World Health Organization, Geneva, 2006.
[15]	S. F. Villalpando, N. F. Butte, W. W. Wong, S. Floreshuerta, M. D. Hernandezbeltran, E. O. Smith and C. Garza, “Lactation Performance of Rural Mesoamerindians,” European Journal of Clinical Nutrition, Vol. 46, No. 5, 1992, pp. 337-348.
[16]	L. Galpin, C. Thakwalakwa, J. Phuka, P. Ashorn, K. Maleta, W. W. Wong and M. J. Manary, “Breast Milk Intake Is Not Reduced More by the Introduction of Energy Dense Complementary Food than by Typical Infant Porridge,” Journal of Nutrition, Vol. 137, No. 7, 2007, pp. 1828-1833.
[17]	N. C. de Bruin, H. J. Degenhart, S. Gal, K. R. Westerterp, T. Stijnen and H. K. A. Visser, “Energy Utilization and Growth in Breast-Fed and Formula-Fed Infants Measured Prospectively during the First Year of Life,” American Journal of Clinical Nutrition, Vol. 67, No, 5, 1998, pp. 885-896.
[18]	SACN, “SACN Energy Requirements Working Group Draft Report,” 2010. http://www.sacn.gov.uk/pdfs/5nov_sacn_energy_drafting_group_draft.pdf
[19]	A. K. Orr-Ewing, P. F. Heywood and W. A. Coward, “Longitudinal Measurements of Breast-Milk Output by a H2(2)-O Tracer Technique in Rural Papua-New-Guinean Women,” Human Nutrition-Clinical Nutrition, Vol. 40C, No. 6, 1986, pp. 451-467.
[20]	Z. Getahun, R. Elsom, H. Gsellasie, L. J. C. Bluck, Y. Taffese, A. Wright and G. Jennings, “Breast Milk Intake Measured by Deuterium Kinetics in Mother-Infant Pairs in Addis Ababa,” Ethiopia Journal Health and Development, Vol. 13, No. 3, 1999, pp. 271-280.
[21]	L. Barbosa, N. F. Butte, S. Villalpando, W. W. Wong and E. O. Smith, “Maternal Energy Balance and Lactation Performance of Mesoamerindians as a Function of Body Mass Index,” American Journal of Clinical Nutrition, Vol. 66, No. 3, 1997, pp. 575-583.
[22]	S. E. Moore, A. M. Prentice, W. A. Coward, A. Wright, E. A. Frongillo, A. J. C. Fulford, A. P. Mander, L. A. Persson, S. E. Arifeen and I. Kabir, “Use of Stable-Isotope Techniques to Validate Infant Feeding Practices Reported by Bangladeshi Women Receiving Breastfeeding Counseling,” American Journal of Clinical Nutrition, Vol. 85, No. 4, 2007, pp. 1075-1082.
[23]	A. M. Prentice, R. G. Whitehead, S. B. Roberts and A. A. Paul, “Long-Term Energy-Balance in Childbearing Gambian Women,” American Journal of Clinical Nutrition, Vol. 34, No. 12, 1981, pp. 2790-2799.
[24]	R. G. Whitehead, A. A. Paul, A. E. Black and S. J. Wiles, “Recommended Dietary Amounts of Energy for Pregnancy and Lactation in the United Kingdom,” Food and Nutrition Bulletin, Supplement 5, 1981, pp. 259-265.