Nutrition During Lactation (1991) / Chapter Skim
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9 Meeting Maternal Nutrient Needs During Lactation
9 Meeting Maternal Nutrient Needs During Lactation
Pages 213-235
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From page 213... ...
Table 9-1 provides the estimated daily output of various nutrients in human mild compared with the increments in nutrient intakes for lactating women as specified in the Recommended Dietary Allowances (RDAs)
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From page 214... ...
The absolute values in the 1989 RDAs represent the RDAs for nonpregnant, nonlactating women aged 25 to 50 plus increments, which are shown in Table 9-1. For many nutrients, it is evident that the RDA increments were designed to exceed the estimated daily output during lactation.
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From page 218... ...
To illustrate the possible impact of inadequate intake on the mother, Table 9-2 lists the estimated total body content of protein, calcium, and folate; the average amounts of iron and vitamin A stored by women; and the estimated outputs during partial or exclusive breastfeeding for various durations. Energy output in milk is not listed: changes in maternal body stores cannot be easily computed since energy-supplying nutrients could originate in either fat or lean tissue.
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From page 219... ...
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From page 220... ...
Table 9-3 provides nutrient densities for protein, minerals, and vitamins as determined from nationally representative samples of U.S. women aged 19 to 50 and the total nutrient intakes that would be predicted from those densities at three different levels of energy intake (nutrient density x kcal of energy = total intake)
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From page 222... ...
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From page 223... ...
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From page 224... ...
There is no evidence that the same nutrient intakes would pertain to breastfeeding women in less affluent or less educated groups. Keeping these cautions in mind, this subcommittee attempted to determine which nutrients are most likely to be in short supply in the diets of lactating women, relative to the RDAs, and the consequences of any such shortfalls.
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From page 225... ...
The difference between the RDA increment and estimated zinc secretion is especially large during the second 6 months of lactation, when zinc concentrations in mink decline substantially, regardless of the woman's zinc intake (Krebs et al., 19851. Low intakes are not generally reflected in low zinc concentrations in milk, and no major health risks have been associated with zinc intakes lower than the RDA.
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From page 226... ...
, but the RDA increment for lactation appears generous even if based on the vitamin B6 content of the milk of supplemented women. On the other hand, protein intakes by lactating women in the United States are high (average predicted intakes range from 111 to 166% of the RDA; Table 9-3J; thus, the RDA increment allows for the increase in vitamin B6 requirement that accompanies increases in protein intake.
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From page 227... ...
The predicted average thiamin intakes shown in Table 9-3 are less than the RDA only at lower than recommended energy intakes, suggesting that low thiamin intake is seldom a problem. Low maternal thiamin intake can result in low thiamin levels in milk, however.
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From page 228... ...
indicate that maternal reserves of folate may be depleted to maintain folate levels in milk. If dietary intake and maternal reserves of folate have been chronically low, milk folate levels will increase in response to increased folate intake (see Chapter 6~.
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From page 229... ...
This applies to those whose total food and energy intake is low (unless nutrient density is unusually high) and to those who avoid foods that are major sources of nutrients, such as calcium-rich dairy products, vitamin D-fortified milk, animal foods (for vitamin Bit)
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From page 230... ...
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From page 231... ...
women. If nutrient intake is lower than the total demand for both maternal maintenance needs and milk production (because of low energy intake, low nutrient density of the diet, or both)
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From page 232... ...
These include groups with restricted eating patterns (such as complete vegetarians, women who diet to lose weight, and those who avoid dairy products) , adolescents, and low-income women.
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From page 233... ...
The evidence does not warrant recommending routine vitamin-mineral supplementation of lactating women. · If dietary evaluation suggests that one or more nutrients may be provided in lower than recommended amounts by the diet of an individual woman, promote selection and consumption of more food choices that are rich in these nutrients.
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From page 234... ...
1983. Dietary zinc intake and zinc concentrations of plasma, erythrocytes, and breast milk in antepartum and postpartum lactating and nonlactating women: a longitudinal study.
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From page 235... ...
1980. Human milk folate and folate status in lactating mothers and their infants.
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