| dc.description.abstract | Background:
Exclusive breastfeeding is recommended for the first six months of life. Breast milk intake and
composition not only vary between populations and individuals, but also within feeds, within
days and between days. Very limited information is currently available on the breast milk intake
of exclusively breastfed infants, as well as on the energy and fat composition of breast milk from
lactating women in South African.
Aim:
The aim of this study was to assess breast milk intakes, as well as energy and fat concentration
of breast milk in a convenience sample of exclusively breastfed infants and their mothers from
Potchefstroom in South Africa. Furthermore, the study determined within-feed, diurnal and
between-day variations in energy and fat concentration of breast milk.
Methodology:
Twenty-four healthy mothers and their exclusively breastfed two to five-month old infants were
recruited to stay at the metabolic unit of the North-West University in South Africa for a period of
five days. The first 24 hours served as a run-in period and the remaining four days (96 hours)
served as the actual test weighing period. Infants were weighed (± 1 g accuracy) before and
after each feed to determine breast milk intake. A foremilk sample was collected before each
feed to determine energy and fat concentration of the milk using the creamatocrit method.
Additional mid-feed and hind-milk samples were collected from the first feed each day.
Results:
Mean breast milk intake was low (369 ± 98 g/day), and infants consumed 52 ± 15 g of milk at
each feed. Mean breastfeeding frequency was 7 ± 1 feeds/day. Mean fat and energy
concentrations of sampled foremilk were 25.7 ± 7.3 g/L and 2544.5 ± 255.9 KJ/L, respectively.
Mean daily fat and energy intake calculated from the measured milk intake was 14 ± 4g and
1096 ± 302 KJ, respectively. Fat concentrations of fore- (26.8 ± 8.2 g/L), mid- (37.6 ± 7.0g/L)
and hind-feed- (50.2±10.4 g/L) milk differed significantly (P<0.001). Consequently, energy
concentrations of fore- (2522.9 ± 323.2 KJ/L), mid- (2947.1 ± 275.3 KJ/L) and hind-feed (3463.5
± 409.6 KJ/L) milk differed (P<0.001). Milk fat concentration was significantly lower at night than
the evening (P=0.015).Milk energy concentration was significantly lower at night than the
morning, day and the evening (P<0.05). There were no differences in breast milk intake (grams)
between the four days (P=0.371). However, breast milk fat and energy concentration was significantly lower at day 4 than at days 1 and 3 (P<0.05). Prevalence of stunting, underweight
and wasting amongst the infants were 39.1%, 13.6% and 4.8%, respectively.
Conclusion
Breast milk and consequently energy intakes were low in this small sample of exclusively
breastfed South African infants. This may explain the high prevalence of stunting. However, the
change of environment and feeding pattern during the study could have affected milk production
or intake. Furthermore, test weighing may not be a well-suited method for establishing milk
intake in this population. Our results further confirm significant within-feed differences in breast
milk fat and energy concentration | en_US |
