NEW METHOD FOR MEASURING MILK INTAKES IN BREAST-FED BABIES

doi:10.1016/S0140-6736(79)90177-6

The Lancet

Volume 314, Issue 8132, 7 July 1979, Pages 13-14

https://doi.org/10.1016/S0140-6736(79)90177-6 Get rights and content

Abstract

A method for the measurement of milk intake in young breast-fed babies is described in which heavy water (²H₂O) enrichment in saliva is measured on only two occasions after a single oral dose of ²H₂O. Values obtained by this method are compared with those obtained by test-weighing. This new method is ideal for routine surveys since it does not interfere with feeding habits and maternal life style, and no technical expertise is required of the mother.

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Cited by (80)

Exclusive Breastfeeding Measured by Deuterium-Oxide Turnover Method is Associated with Motor Development in Rural Senegalese Infants
2023, Journal of Nutrition
The findings on the relationship between breastfeeding and children’s motor development are very poor, particularly in low and middle income countries, because of the use of inadequate measures of breastfeeding practices.
To assess the relationship between exclusive breastfeeding, measured by the deuterium-oxide turnover method (DTM), and the acquisition of motor development in a cohort of Senegalese children.
One hundred forty mother-infant (4–5 mo) pairs were recruited and monitored up to 18 mo. Breast milk intake and breastfeeding practices were measured by DTM. Six stages of motor development were assessed: “sitting without support,” “hands-and-knees crawling,” “standing with assistance,” “walking with assistance,” “standing alone,” and “walking alone.” Acquisition age of motor milestones between exclusively breastfed (EBF) and not exclusively breastfed (non-EBF) infants was compared using Student’s and Wilcoxon’s tests. Mixed linear regression, adjusted with confounding factors, was used to determine the association between EBF and motor development.
Overall, 32.9% of infants were EBF at the enrollment at 4–5 mo of age. Breast milk intake of EBF infants was significantly higher than that of non-EBF infants (1039 ± 193 g/d compared with 915 ± 211 g/d; P < 0.01). At 4–5 mo of age, only “sitting without support” (67.4% compared with 47.9%, P = 0.02) and “hands-and-knees crawling” (17.4% compared with 4.3%, P = 0.01) were completed significantly in the EBF group. At 18 mo, all children had completed all 6 motor developmental milestones. However, their acquisition age was significantly earlier in the EBF group after adjustment. Non-EBF infants had a delay of 0.4 to 0.5 mo on the acquisition of the first 5 stages compared to EBF infants. For “walking alone,” no difference was found after adjustment.
Motor skill acquisition is earlier in EBF infants compared to non-EBF infants. This finding highlights the need to strengthen the advocacy for EBF up to 6 mo.
Comparative phylogenetic analysis of milk output at peak lactation
2021, Comparative Biochemistry and Physiology -Part A : Molecular and Integrative Physiology
A large body of literature exists on the comparative aspects of milk nutrient concentrations of numerous species. However, in the last three decades little attention has been given to the comparative aspects of quantitative milk output and the related nutrient outputs at peak lactation, one of the most energy demanding times for the lactating female. Therefore, the purpose of the present study was to investigate milk output, milk energy output (MEO) and milk nutrient outputs in mammals at peak lactation using the phylogenetic generalized least squares approach to account for the potential lack of independence among species. Milk output, MEO and output of milk nutrients (solids, fat, protein and sugar) at peak lactation for 47 mammalian species were evaluated for the present analysis to derive phylogenetically controlled allometric relationships for all species available and separately for species with single young and for species with multiple young. A strong (P < 0.001) positive relationship exists between the response variables (milk output, MEO, milk nutrient outputs) and maternal body mass whether calculated for all mammals or separately for species with single or multiple young. The results revealed that milk output and MEO scaled identically to the power of 0.74 ± 0.05 of maternal body mass and thus confirming the quarter-power scaling exponent for milk output and MEO. For most allometric relationships the phylogenetic signal lambda was intermediate (0 < λ < 1) and thus required phylogenetic correction with the exception for the relationships between milk nutrient outputs and maternal body mass for species with multiple young.
Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth
2013, Fertility and Sterility
Citation Excerpt :
Maternal D2O intake has been used in other studies mainly to assess infant breast milk intake (13–17), but many of those studies on breastfeeding did not use NMR to quantify D2O (17, 18). Since 1979 (20) D2O has been used as a noninvasive test for tracking milk transfer from breastfeeding mothers to infants and the common method for assessment was Fourier-transform infrared spectroscopy (21, 22). Nevertheless, this method requires sample preparation with specialized analytical manipulations, in contrast to NMR which is a more workable approach (18).
To measure infants' breast milk intake and infant growth when their mothers initiated either combined oral contraceptive (COC), levonorgestrel-releasing intrauterine system, or etonogestrel-releasing implant, or copper intrauterine device (IUD) as a reference group.
Prospective trial.
University-based hospital.
On postpartum day 42, 40 women initiated a contraceptive method according to their choice.
Deuterium (D₂O; 0.5 g/kg mother's weight) was ingested by mothers on postpartum days 42, 52, and 63 as a marker of total body fluid.
Infants' milk intake from 42 to 63 postpartum days was assessed by measurement of D₂O levels in infants' saliva and infant growth by measuring their body weight, height, and tibia length. Women recorded all infant feed and changes of diapers wet with urine. Breastfeeding continuation was assessed at 6 months postpartum.
Infant mean milk intake, mean growth increase, mean number of breastfeeding episodes, daily wet diaper changes, and mean duration of exclusively breastfeeding (∼5 months) were similar in the four groups.
Use of a COC, the two progestin-only contraceptives, or copper IUD did not affect the amount of infant milk intake and growth up to 9 weeks of age. The incidence of full breastfeeding and breastfeeding continuation was similar with contraceptive hormonal use and no use.
NCT01388582.
Short communication: Milk output in llamas (Lama glama) in relation to energy intake and water turnover measured by an isotope dilution technique
2013, Journal of Dairy Science
Citation Excerpt :
Mineral feed (HG MIN 13, Raiffeisen-Agravis AG, Minden Westfalen, Germany) was offered for ad libitum consumption. Milk output was measured in 5 dams by using an isotope dilution technique (Coward et al., 1979; Haisma et al., 2003; Riek and Gerken, 2009). The method depends on measuring the transfer of deuterium (2H)-labeled water from the mother to the young via milk.
Despite the fact that llamas have become increasingly popular as companion and farm animals in both Europe and North America, scientific knowledge on their nutrient requirements is scarce. Compared with other livestock species, relatively little is known especially about the nutrient and energy requirements for lactating llamas. Therefore, we aimed to measure milk output in llama dams using an isotope dilution technique and relate it to energy intakes at different stages of lactation. We also validated the dilution technique by measuring total water turnover (TWT) directly and comparing it with values estimated by the isotope dilution technique. Our study involved 5 lactating llama dams and their suckling young. Milk output and TWT were measured at 4 stages of lactation (wk 3, 10, 18, and 26 postpartum). The method involved the application of the stable hydrogen isotope deuterium (²H) to the lactating dam. Drinking water intake and TWT decreased significantly with lactation stage, whether estimated by the isotope dilution technique or calculated from drinking water and water ingested from feeds. In contrast, lactation stage had no effect on dry matter intake, metabolizable energy (ME) intake, or the milk water fraction (i.e., the ratio between milk water excreted and TWT). The ratios between TWT measured and TWT estimated (by isotope dilution) did not differ with lactation stage and were close to 100% in all measurement weeks, indicating that the D₂O dilution technique estimated TWT with high accuracy and only small variations. Calculating the required ME intakes for lactation from milk output data and gross energy content of milk revealed that, with increasing lactation stage, ME requirements per day for lactation decreased but remained constant per kilogram of milk output. Total measured ME intakes at different stages of lactation were similar to calculated ME intakes from published recommendation models for llamas.
High Prevalence of Vitamin A Deficiency Is Detected by the Modified Relative Dose-Response Test in Six-Month-Old Senegalese Breast-Fed Infants<sup>1,2</sup>
2012, Journal of Nutrition
To alleviate vitamin A (VA) deficiency (VAD) in Senegal, understanding the relationship between VA status of lactating women and their 6-mo-old infants is important. This study measured 6-mo-old infants' VA intake from human milk and assessed the VA status of mothers and infants. A comprehensive study was undertaken in 34 mother-infant pairs. Nonpregnant lactating women and their infants were included. None of the infants had received a VA supplement. Mothers were grouped as supplemented with 2 doses of 200,000 IU (60,000 μg; 210 μmol) retinol as retinyl palmitate (n = 13) or nonsupplemented (n = 19) after delivery. Breast milk intake was measured by the deuterium dilution technique. Plasma and breast milk retinol concentrations were measured by HPLC. Infants' VA liver stores were assessed by the modified relative dose-response (MRDR) test. Plasma retinol detected 15% VAD among infants and the MRDR test (≥0.06) indicated 73.5% with low VA liver stores. Infants' milk VA intakes were close to estimated requirements (375 μg/d). No correlation was found between infants' plasma retinol and MRDR value. Infants' MRDR value was lower in the group from supplemented mothers (0.055 ± 0.017 vs. 0.073 ± 0.017; P = 0.009), but no difference was observed between plasma retinol concentrations of both groups of mothers; 8.8% of mothers were VA deficient based on plasma retinol (≤0.7 μmol/L). Low VA liver stores were prevalent among Senegalese infants at the beginning of the complementary feeding period. Postpartum VA-supplemented mothers significantly enhanced their infants' VA liver stores.
Allometry of milk intake at peak lactation
2011, Mammalian Biology
Much attention has been given to the scaling of milk output and lactational strategies across species. However developed allometric equations for milk output in adult animals cannot be used for suckling young. Therefore, the purpose of the present study was to investigate milk intake and intake of milk nutrients in suckling mammalian young at peak lactation using phylogenetic independent contrasts in order to derive allometric relationships corrected for phylogeny. Milk intake and intake of milk nutrients (solid, fat, protein and sugar) at peak lactation for 40 mammalian species were evaluated for the present analysis to derive allometric relationships for suckling young. K^* -values were calculated in order to detect phylogenetic signals across traits. Phylogenetic signals were high and significant for all traits examined, thus phylogenetically independent contrasts were calculated for log₁₀ transformed milk intake and intake of milk nutrients, body mass and average daily gain to eliminate the potential lack of independence between species, because of their shared evolutionary history. The phylogeny for the species used in the present study was derived from a recently published mammalian Supertree with branch lengths derived from dated estimates of divergence times. Thirty allometric equations were calculated using phylogenetically independent contrasts. A strong (P < 0.001) positive relationship exists between neonate body mass and the response variables (milk intake, intake of milk nutrients), whether calculated for all mammals or separately for artiodactyls and carnivores, with the exception of sugar intake in carnivores. However, large deviations for some species and few outliers were found. The present equations could be used to predict values for species similar to those included in the present study that have not been studied, providing that the body mass falls inside the range of masses used to derive the equations. However, predicting values for missing species should be done with caution as they are not included in the phylogenetic tree that was used to derive the phylogenetically corrected equations.

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Preliminary CommunicationNEW METHOD FOR MEASURING MILK INTAKES IN BREAST-FED BABIES

Abstract

Am J Clin Nutr

J Nutr

J Nutr

Lancet

J Pediatr

Am J Clin Nutr

Am J Clin Nutr

Preliminary Communication
NEW METHOD FOR MEASURING MILK INTAKES IN BREAST-FED BABIES