A Survey And Study The Dietary Of Lactating Women And The Dynamic Changes Of Nutritional Components In Breast Milk And The Influence Factors Of Infant Growth And Development

Objective To investigate the nutritional components of human breast milk at the different stages of lactation in Jinan, follow up the infant’s growth and development, and analyze the influence factors of infant growth and development, explore the effectiveness of dietary intake to the level of nutrients in breast milk and find the relevant laws between them, so that it guided breast feeding and provided the scientific basis for the development of complementary food and formula and infant growth promotion.Methods Method design was prospective cohort study. Subjects included thirty-five mother-infant pairs from Maternity and Child Health Care Hospital of Shandong Province during December 2012 to February 2013, and follow-up them for one year. With the questionnaire, the general situation of parturient and The dietary status of parturient were investigated. The breast milk samples were collected from lactating women and infant growth level were tracking recorded at 1～5,6～14,20～22, 27-29day and 2,3,4,6,8,9,12 month age in the hospital, but collecte data in maternal home at the top three. The neuropsycological development assessment was completed at 4,6,9months and 1 years of age, using the quantified table of 0-6 years old neuropsycological development.A variety of nutrients intake in maternal diet was calculated using the 2004 Chinese food composition database and the results of dietary were consulted for "nutrient reference intake (DRIs)" which was recommended by Chinese Nutrition Society. The samples were thawed and blended at room temperature and the macronutrients, minerals, energy and so on detected by breast milk analyzer (HMA) come from Sweden. EpiData 3.1 was used for data inputting and SPSS 17.0 was used for data analysis, results record by x±S, one factor analysis such as the analysis of variance: multi factors analysis such as multi variances liner regress was used for data analysis.Result1. Dietary structure of the nursing mothersExcept grains and potato, beans and nutsand, the intake of vegetables, fruit, livestock and poultry meat, fish, eggs, milk and milk products for mothers,which lactation was less than 1 month. The intake of grains and potato, vegetables, fruits, fish and shrimp, milk and dairy products, beans and nuts were less than the recommended values for normal population. Howeve, the intake of eggs, meats for mothers was higher than the recommended values for normal population. There were many imbalance in the general dietary intakes among mothers.2.24 hour dietary assessment of lactating womenThe dietary intake was still not reasonable, which some nutrients were lower than the recommended values for normal population and was on the decline in lactation. The energy (kcal), protein (g), fat (g), carbohydrate(g), vitamin A (ug), vitamin B1 (mg), vitamin C (mg), calcium (mg), iron (mg), zinc (mg), copper (mg), magnesium (mg), selenium(ug) contents of the dietary intake of lactating mothers were respectively 1938.42±713.29、102.46±42.86、62.20±35.63、 251.09±102.83、771.68±531.13、1.09±.38、58.61±40.62、740.66±526.75、 23.94±8.68、13.89±6.26、2.74±3.92、408.18±159.88、88.29±55.50; 1739.61±582.51、81.8±29.32、45.44±20.50、263.20±111.68、 579.41±505.53、.95±.37、58.65±33.83、540.94±279.37、37.36±43.24、 10.98±3.75、1.74±.62、400.65±217.15、66.79±42.50; 1522.15±525.85、 71.96±26.78、38.99±19.42、234.14±83.32、455.81±460.07、.84±.36、 46.61±28.91、.375.57±174.87、17.31±6.77、9.45±3.37、1.44±.85、 276.90±104.06、48.98±19.37; 1365.32±423.57、62.56±21.69、34.14±13.75、 214.04±86.75、279.64±281.76、.78±.34、44.31±26.99、302.50±95.88、 16.78±7.09、8.93±3.25、1.17±.51、243.27±93.90、40.60±12.82 in different period (time:0～1 month,1～3 months,3～6 months and 6～12 months).3. Variation of matemal milk nutrients concentrationThe protein (g/dl) contents respectively were 1.24±.07、1.21±.08、1.20±.07、 1.20±.09、1.18±.06、1.17±.06、1.17±.04、1.13±.06、1.12±.05、 1.14±.06and1.14±.06 in different period.The fat (g/dl) contents of breast milk of lactating mothers were 1.98±.94、3.26±1.11、3.08±1.49、3.48±1.45、3.36±1.69、 3.09±1.86、3.02±1.69、3.31±1.92、3.44±1.60、3.53±2.18and3.83±2.26 in different period (time:the first,second, third and forth week, the second, third,forth, Sixth,nineth, twelveth month). The lactose (g/dl) contents respectively were 7.72±.46、7.54±.47、7.45±.45、7.46±.53、7.31±.36、7.28±.35、7.27±.27、 7.04±.35、6.96±.30、7.09±.35and7.08±.40 in different period. The energy(KJ) respectively were 55.74±9.16、67.00±11.54、64.90±14.44、68.66±14.71、 66.83±16.39、63.50±18.48、63.41±16.60.65.09±18.95、65.94±15.86、 67.36±21.70and70.13±22.25 in differentperiod.The minerals (g/dl) contents respectively were0.22±.01、0.21±.01、0.21±.01、0.21±.02、0.20±.01、0.20±.01、 0.20±.01、0.20±.01、0.19±.01、0.20±.01and0.20±.01 in different period. The density were 1.03±.00 kg/m3 in the whole nursing.4. Influential factors to infant growth and developmentTaking the body weight and length as dependent variables,the continuously variables and assigned categorical variables as independent variables,multiple stepwise regression analysis was applied.Results demonstrated that the dominant influence to the body weight is birth weight and baby gender. Birth body length is the biggest impact of the independent variables about 1～5 days,6～14days,20-22 days and27～29days,3,4,6,12months to the length; Excluding Birth body length is the strongest influence to the length, Baby Gender is the most important factor to the length in the1,3,4,6 and 12 months of age.Conclusion:1. The intake of food is on the decrease during lactation. Except eggs and meats, the intake of food was less than the recommended values for normal population. There were many imbalance in the general dietary intakes among mothers.2. Nurse nutrition intake is less than the dietary reference intake of nutrients (DRIs) in Jinan city. By comparing the energy, three major nutrients, vitamins and the part of minerals in the 0～1,1～3,3～6,6～12 months, found that the nursing nutrients is decreased trend in lactation, which should be paid more attention.3. Nutrients of breast milk presented the dynamic change with prolonged lactation. The protein, lactose, minerals content in human milk decrease in the investigation stage, while the fat and energy content are lowest in colostrum, highest in later milk, and density present a relatively constant level.4. The birth weight and gender was mainly influence factors to baby’s weight, but the length was related to born length and gender.5. Nutrient composition conten in milk were no significant correlation with nurse dietary.6. There was no effects on the growth and development of infants with mother’s dietary intake.