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Date: | Wed, 7 Jan 2009 15:09:55 -0500 |
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Dear all:
Of the articles I could access:
Del Prado Martha et al Contribution of dietary and newly formed arachidonic acid to
human milk lipids in women eating a low-fat diet. Am J Clin Nutr 2001;74:242-67.
Prentice AM, Roberts SB, Prentice A, et al.: "Dietary supplementation of lactation in
Gambian women. Effect on breast milk volume and quality". Hum Nutr Clin Nutr 37C: 53-
64, 1983
Siber H, Hachey D, Schanler R, et al. Manipulation of maternal diet to alter fatty acid
composition of human milk intended for premature infants." Am J Clin Nutr 47: 810-814,
1988 (not 1989 as was posted!)
None of the above came anywhere close to proving any functional impact of low fat
content, imbalanced fatty acid ratios or lactose overload on an infant's behavior.
The Del Prado article basically showed that the fatty acid composition of the milk is
influenced by fat stores, not intestinal absorption among women on a low fat diet. This
article would ONLY be relevant to women on low fat diets and says nothing about what
happens to the infant with different fatty acid ratios.
The Prentice article is very familiar and was long ago discarded from my filing cabinet
due to the issue of space in a small Manhattan apartment. This article was among
marginally malnourished women who were supplemented with biscuits and there was
quite a bit of disturbance to the diet ordinarily consumed at home. At lot of the impact
was merely what we call income transfer. Free food enabled these families to have more
income because they didn't have to spend as much money buying or as much energy
acquiring food. I couldn't access the methods section, but I do have a vague memory of
some methodology issues that could come into play if you were really trying to
investigate lactose overload. The results were no significant change in milk volume, nor
in fat content. There was a significant and small increase in lactose. Now, what is not
proven in this is whether the change in lactose was a "lactose overload". These women
were likely offering the breast 20x day if they followed practices I know in other West
African countries and switch nursing frequently. There was no research done on an
"increase in fussiness due to lactose overload". So it would be a wild leap to extrapolate
these results out to women in developed countries that highly schedule their infants to
feed far less frequently than in many areas of Africa.
The Siber article shows what we already know, that the fatty acid composition changes
with changes in maternal diet of the mother. The sample size was ludicrously small -- 10
infants. Again, this article did not provide any evidence of "deficiency" or even
"imbalances" and the impact on the infant --- it merely reported on "differences". The
functional impact of these findings was not established in this article.
The other two articles were not possible for me to access even an abstract from the
internet. By the title of the first --- it does not sound like it makes the leap to infant
behavior. By the title of the second --- it does not appear to be a true "trial" to
determine what happens on a population basis when you implement an intervention. If
anyone has better luck than I in finding these articles, please let me know.
Abakada AO, Hartmann PE: "Maternal Dietary Intake and Human Milk
Composition." Breastfeeding Review 13: 43-45, 1988
Hatherly,Patricia A The Manipulation Of Maternal Diet And Its Effect On The Infant With
Particular Reference To Gastrointestinal Disturbance: A Series Of Case Studies. Journal of
Australasian College of Nutritional & Environmental Medicine Vol. 13 No. 2; December
1994: pp. 5-12
Still unconvinced about foremilk hindmilk imbalance as anything other than an unproven
theory except for those who overpump to feed the freezer.
Susan Burger
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