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Providing perspectives on recent research into vitamins and nutritionals


Change is Constant: Even Breast Milk Varies with Dietary Intake

By Michael McBurney

Experts recommend that babies should be exclusively breastfed for the first 6 months of life. Breast milk has antibodies to help defend against infections and prevent allergies. WebMD suggests breast feeding may even raise a child’s intelligence. Accumulating evidence suggests that breast milk composition is not a ‘gold standard’; composition actually reflects the mother’s diet. Better maternal nutrition yields better infant nutrition.

Sherry and colleagues measured the lutein and zeaxanthin content in breast milk of nursing mothers and the plasma of their babies at 2-3 months of age. Lactating women were randomized to placebo or supplements providing lutein (6 or 12 mg/d) and docosahexaenoic acid (DHA, 200 or 400 mg/d). Breast milk samples were collected weekly for the next 6 weeks and infant blood samples were analyzed at beginning and end of the study. Fatty acid data is not reported. Unfortunate. Stay tuned for another paper on the same cohort.

Breast milk carotenoid concentrations were significantly correlated with plasma carotenoids at baseline. Nursing women had plasma lutein and zeaxanthin levels averaging ~ 15-17 µg/dL. Low- and high-dose lutein supplementation increased maternal plasma lutein and zeaxanthin concentrations 170 and 250%, respectively. Breast milk concentrations increased similarly and infant plasma concentrations followed an almost identical change (180 and 330% increase).  Clearly, maternal lutein and zeaxanthin intake changes breast milk composition and infant nutritional status. Breast milk is not standard. The nutritional value of breast milk is a reflection of the mother’s diet.

If a woman chooses not to breastfeed, an infant formula with lutein and zeaxanthin should be chosen. Plasma lutein concentrations in infants fed lutein-fortified formula increase in a dose-dependent manner (Bettler et al, 2010). Approximately  4 times more lutein is needed in infant formula to achieve similar blood levels in formula-fed as breastfed children.  Fortification is effective. Supplementation in pre-term infants increases plasma lutein concentrations and biomarkers of retinal health and maturation.

Lutein and zeaxanthin have to be obtained from the diet. Yesterday we discussed the importance of adequate dietary lutein and zeaxanthin intake to increase macular pigment density (MPOD) correlated with vision and brain function in adults. The Institute of Medicine and other authoritative bodies may not have defined an Adequate Intake for lutein or zeaxanthin but  eyes and brain need these nutrients.

Today, we learn that breast milk composition and the nutrients a nursing infant ingests are a function of maternal diet. An infant has no choice than to depend upon those feeding it.

Caregivers have choices. Choose foods rich in lutein and zeaxanthin or use a dietary supplement.

Main Citation

Sherry CL, Oliver JS, Renzi LM, Marriage BJ. Lutein supplementation increases breast milk and plasma lutein concentrations in lactating women and in infant plasma concentrations but does not affect other carotenoids. 2014 J Nutr doi: 10.3945/jn.114.192914

Other Citations

Bettler J, Zimmer JP, Neuringer M, DeRusso PA. Serum lutein concentrations in healthy longterm infants fed human milk or infant formula with lutein. 2010 Eur J Nutr doi: 10.1007/s00394-009-0047-5

 Rubin LP, Chan GM, Barrett-Reis BM, Fulton AB, Hansen RM, Ashmeade TL, Oliver JS, Mackey AD, Dimmit RA, Hartmann EE, Adamkin DH. Effect of carotenoid supplementation on plasma carotenoids, inflammation and visual development in preterm infants. 2012 J Perinatol doi: 10.1038/jp.2011.87