Appendix C

Appendix C presents data from a complete literature survey of data on human milk composition conducted by Margaret C. Neville (University of Colorado Health Sciences Center, personal communication, 1990). References were included if they presented data for milk composition by actual duration of lactation, but the data vary in accuracy. Nutrients included are those analyzed by Dr. Neville and colleagues.



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Nutrition During Lactation Appendix C Appendix C presents data from a complete literature survey of data on human milk composition conducted by Margaret C. Neville (University of Colorado Health Sciences Center, personal communication, 1990). References were included if they presented data for milk composition by actual duration of lactation, but the data vary in accuracy. Nutrients included are those analyzed by Dr. Neville and colleagues.

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Nutrition During Lactation TABLE C-1 Summary of Composition Data for Macronutrients of Human Milk. Data compiled by Neville, University of Colorado, personal communication, 1990   Days Post Partum Reference Nutrient, Analytic Method 21 30 45 60 90 120 150 180   Lactose, mmol/liter NRa 200 200 202 NR NR NR NR NR Hytten, 1954 NR NR 225 NR 222 227 227 227 227 Prentice et al., 1983 ''Agricultural method" NR 199 NR 199 200 203 197 200 Nagra, 1989 Colorimetric NR 223 NR 226 225 232 242 234 Brown et al., 1986 Enzymatic 156 137 NR NR NR NR NR NR Hibberd et al., 1982 Enzymatic, lactase by Somgyi NR 206 NR 211 222 223 223 227 Dewey and Lönnerdal, 1983 β-galactosidase, then glucose NR 205 193 213 234 205 208 213 Morriss et al., 19 86 Folin NR 205 NR 211 225 222 222 222 Kader et al., 1972 Gas chromatography 210 202 196 NR NR NR NR NR Lemons et al., 1982 Hartmann and Kulski, 1978 NR NR NR NR 225 NR NR 206 Saint et al., 1986 HPLCb NR 178 NR NR NR NR NR NR Butte and Calloway, 1981 Method of Conetta on Technicon NR 205 NR NR 214 NR 223 NR Lönnerdal et al., 1976 Technicon NR 208 212 NR NR NR NR NR Gross et al., 1980 Technicon 199 NR NR NR NR NR NR NR Gross et al., 1981 YSI analyzer NR 189 NR 192 194 195 NR NR Butte et al., 1984 YSI analyzer 177 NR 182 NR 188 NR NR 191 Neville, University of Colorado, personal communication, 1990

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Nutrition During Lactation Protein, g/dl NR NR 1.30 NR 1.09 1.05 1.02 1.03 1.04 Prentice et al., 1983 "Agricultural method" NR 1.05 NR 0.99 1.01 0.99 0.98 1.01 Nagra, 1989 BCAc assay with human milk standard 1.20 NR 1.09 NR 0.94 NR NR 1.00 Neville, University of Colorado, personal communication, 1990 Biuret NR 1.30 NR 1.00 1.00 1.30 0.95 0.90 Lauber and Reinhardt, 1979 Kjeldahl 1.23 0.97 0.93 NR NR NR NR NR Hytten, 1954 Kjeldahl NR 0.73 NR NR 0.76 NR 0.71 NR Lönnerdal et al., 1976 Kjeldahl with TCAd precipitation NR 1.52 1.42 NR NR NR NR NR Gross et al., 1980 Kjeldahl with TCA precipitation 1.60 NR NR NR NR NR NR NR Gross et al., 1981 Kjeldahl with TCA precipitation 1.18 1.10 1.22 NR NR NR NR NR Lemons et al., 1982 Kjeldahl with TCA precipitation NR 1.00 NR 0.89 0.84 0.82 NR NR Butte et al., 1984 Microkjeldahl NR 1.03 NR 1.10 0.99 0.88 0.91 0.82 Kader et al., 1972 Lowry 1.51 1.50 NR NR NR NR NR NR Hibberd et al., 1982 Lowry with albumin standard NR 1.44 NR 1.33 1.32 1.30 1.25 1.27 Dewey and Lönnerdal, 1983 Lowry 1.41 NR 1.10 NR NR 0.85 NR NR Duncan et al., 1983 Lowry NR NR NR NR 1.09 NR NR 1.21 Saint et al., 1986 Lipid, g/dl NR 4.0 3.0 3.3 NR NR NR NR NR Hytten, 1954 "Agricultural method" NR 3.6 NR 3.7 3.6 3.7 3.6 3.5 Nagra, 1989 Creamatocrit, Folch extraction NR 4.2 NR 3.7 3.7 3.3 3.3 3.4 Prentice et al., 1983 Creamatocrit NR 3.6 NR NR 3.7 NR 3.2 NR Jackson et al., 1988 Creamatocrit, Folch extraction 4.7 NR 5.3 NR 4.2 NR NR 5.6 Neville, University of Colorado, personal communication, 1990 Modified Folch extraction NR 4.1 NR 4.6 5.2 NR NR NR Clark et al., 1982

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Nutrition During Lactation   Days Post Partum Reference Nutrient, Analytic Method 21 30 45 60 90 120 150 180   Gravimetric NR 3.1 NR 3.0 2.8 2.7 2.6 2.7 Brown et al., 1986 Enzymatic analysis 3.9 4.0 NR NR NR NR NR NR Hibberd et al., 1982 Enzymatic for triglycerides (Worthington) NR 4.0 NR NR NR NR NR NR Butte and Calloway, 1981 Gravimetric NR 2.7 NR 2.5 2.3 2.6 2.5 2.6 Lauber and Reinhardt, 1981 Gravimetric NR 4.0 4.5 4.8 4.2 NR NR NR Butte et al., 1984 Gravimetric NR 3.6 NR 3.4 3.2 3.5 NR NR Butte et al., 1984 Roese-Gottlieb NR 3.9 4.0 NR NR NR NR NR Gross et al., 1980 Roese-Gottlieb 3.0 NR NR NR NR NR NR NR Gross et al., 1981 Sulfuric acid-vanillin 3.0 3.1 3.5 NR NR NR NR NR Lemons et al., 1982 Sulfuric acid-vanillin NR 4.9 NR 4.6 4.6 4.6 4.4 4.3 Dewey and Lönnerdal, 1983 Sodium, mmol/liter Ashed, flame emission NR 10.0 NR NR NR NR NR NR Atkinson et al., 1980 Dry-ash, atomic absorption NR 6.8 6.1 5.4 6.2 NR NR NR Butte et al., 1984 Special ashing, atomic absorption NR 6.6 NR NR 5.3 5.5 NR NR Picciano et al., 1981 Flame emission NR 9.3 NR 10.9 7.6 7.2 6.8 5.5 Dewey and Lönnerdal, 1983 Flame photometry NR 10.8 8.5 NR NR NR NR NR Gross et al., 1980 Flame photometry 10.0 NR NR NR NR NR NR NR Gross et al., 1981 Flame photometry 6.8 7.0 7.1 NR NR NR NR NR Lemons et al., 1982 Flame photometry 7.3 NR NR NR NR NR 4.8 NR Morriss et al., 1986 Ion selective electrode 9.2 NR 7.2 NR 6.3 NR NR 6.0 Neville, University of Colorado, personal communication, 1990 Potassium, mmol/liter Atomic absorption 13.6 13.6 NR NR NR NR NR NR Hibberd et al., 1982 Dry-ash, atomic absorption NR 15.0 NR NR NR NR NR NR Atkinson et al., 1980

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Nutrition During Lactation Special ashing, atomic absorption NR 11.9 NR 10.9 10.4 NR NR NR Picciano et al., 1981 Flame photometry NR 15.8 15.0 NR NR NR NR NR Gross et al., 1980 Flame photometry 14.0 NR NR NR NR NR NR NR Gross et al., 1981 Flame photometry 13.9 13.0 13.6 NR NR NR NR NR Lemons et al., 1982 Flame photometry 17.1 NR NR NR NR NR 12.8 NR Morriss et al., 1986 Flame emission photometry NR 13.2 NR 12.0 11.8 11.6 11.5 10.8 Dewey and Lönnerdal, 1983 Ion selective electrode 16.2 NR 15.1 NR 13.9 NR NR 13.9 Neville, University of Colorado, personal communication, 1990 Chloride, mmol/liter Ashing, then chloride electrode NR 12.0 NR 11.7 11.9 NR NR NR Picciano et al., 1981 Colorimetric NR 15.2 13.1 NR NR NR NR NR Gross et al., 1980 Colorimetric 15.4 NR 13.9 NR 11.6 NR 14.0 NR Neville, University of Colorado, personal communication, 1990 Electrometric titration NR 12.0 NR NR NR NR NR NR Atkinson et al., 1980 Electrometric titration 10.5 10.5 11.3 NR NR NR NR NR Lemons et al., 1982 Electrometric titration 11.8 NR NR NR NR NR 10.5 NR Morriss et al., 1986 Calcium, mmol/liter "Agricultural method" NR 7.50 NR 7.67 7.77 7.60 7.85 8.00 Nagra, 1989 Ashing, atomic absorption NR 6.80 NR NR NR NR NR NR Atkinson et al., 1980 Ashed, atomic absorption 6.63 6.20 NR NR NR NR NR NR Gross et al., 1980 Dry ashing, atomic absorption NR NR 6.40 NR NR 5.88 NR NR Vaughn et al., 1979 Dry ashing, atomic absorption NR 6.33 6.65 6.43 6.48 NR NR NR Butte et al., 1984 Atomic absorption NR 7.24 NR 7.31 7.14 NR NR NR Picciano et al., 1981 Atomic absorption 6.48 NR 6.85 NR 6.72 NR NR 6.23 Greer et al., 1982 Atomic absorption NR 6.50 NR 6.85 6.72 6.35 6.18 6.38 Dewey and Lönnerdal, 1983

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Nutrition During Lactation   Days Post Partum Reference Nutrient, Analytic Method 21 30 45 60 90 120 150 180   Atomic absorption 8.40 NR NR NR NR NR 7.30 NR Morriss et al., 1986 Dilution, atomic absorption NR 6.43 NR 6.53 6.50 6.43 6.28 6.10 Karra et al., 1988 Colorimetric 6.95 6.65 7.82 NR NR NR NR NR Lemons et al., 1982 Colorimetric 7.66 NR 7.53 NR 7.49 NR NR 6.30 Neville, University of Colorado, personal communication, 1990 Orthocresolpthalein 4.46 4.43 NR NR NR NR NR NR Hibberd et al., 1982 Magnesium, mmol/liter "Agricultural method" NR 1.04 NR 1.16 1.08 1.20 0.95 1.00 Nagra, 1989 Ashing, atomic absorption NR 1.20 NR NR NR NR NR NR Atkinson et al., 1980 Ashing, atomic absorption 1.20 1.04 NR NR NR NR NR NR Gross et al., 1980 Dry ashing, atomic absorption NR 1.49 1.66 1.74 1.74 NR NR NR Butte et al., 1984 Atomic absorption NR 1.15 NR 1.27 1.36 NR NR NR Picciano et al., 1981 Atomic absorption 1.21 NR 1.23 NR 1.29 NR NR 1.33 Greer et al., 1982 Atomic absorption 1.44 1.44 NR NR NR NR NR NR Hibberd et al., 1982 Atomic absorption 1.15 1.17 1.51 NR NR NR NR NR Lemons et al., 1982 Atomic absorption NR 1.15 NR 1.34 1.39 1.46 1.40 1.41 Dewey and Lönnerdal, 1983 Atomic absorption 1.30 NR NR NR NR NR 1.25 NR Morriss et al., 1986 Dilution, atomic absorption 1.68 NR NR 1.31 NR NR 1.27 NR Rajalakshmi and Srikantia, 1980 Dilution, atomic absorption NR 1.18 NR 1.33 1.42 1.43 1.45 1.45 Karra et al., 1988 Colorimetric 1.63 NR 1.65 NR 1.77 NR NR 1.63 Neville, University of Colorado, personal communication, 1990 a NR = Not reported. b HPLC = High performance liquid chromatography. c BCA = Bicinchoninic acid. d TCA = Trichloroacetic acid.

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Nutrition During Lactation REFERENCES Atkinson, S.A., I.C. Radde, G.W. Chance, M.H. Bryan, and G.H. Anderson. 1980. Macro-mineral content of milk obtained during early lactation from mothers of premature infants. Early Hum. Dev. 4:5-14. Brown, K.H., N.A. Akhtar, A.D. Robertson, and M.G. Ahmed. 1986. Lactational capacity of marginally nourished mothers: relationships between maternal nutritional status and quantity and proximate composition of milk. Pediatrics 78:909-919. Butte, N.F., and D.H. Calloway. 1981. Evaluation of lactational performance of Navajo women. Am. J. Clin. Nutr. 34:2210-2215. Butte, N.F., C. Garza, C.A. Johnson, E.O. Smith, and B.L. Nichols. 1984. Longitudinal changes in milk composition of mothers delivering preterm and term infants. Early Hum. Dev. 9:153-162. Clark, R.M., A.M. Ferris, M. Fey, P.B. Brown, K.E. Hundreiser, and R.G. Jensen. 1982. Changes in the lipids of human milk from 2 to 16 weeks postpartum . J. Ped. Gastroenterol. Nutr. 1:311-315. Dewey, K.G., and B. Lönnerdal. 1983. Milk and nutrient intake of breastfed infants from 1 to 6 months: Relation to growth and fatness. J. Ped. Gastroenterol. Nutr. 2:497-506. Duncan, M.E., R.R. Samson, J. McGrath, and D.B. McClelland. 1983. Humoral defence factors in the breast milk of Ethiopian women with leprosy and healthy controls. Am. J. Clin Nutr. 38:921-928. Greer, F.R., R.C. Tsang, R.S. Levin, J.E. Searcy, R. Wu, and J.J. Steichen. 1982. Increasing serum calcium and magnesium concentrations in breastfed infants: longitudinal studies of minerals in human milk and in sera of nursing mothers and their infants. J. Pediatr. 100:59-64. Gross, S.J., R.J. David, L. Bauman, and R.M. Tomarelli. 1980. Nutritional composition of milk produced by mothers delivering preterm. J. Pediatr. 96:641-644. Gross, S.J., J. Geller, and R.M. Tomarelli. 1981. Composition of breast milk from mothers of preterm infants. Pediatrics 68:490-493. Hibberd, C.M., O.G. Brooke, N.D. Carter, M. Haug, and G. Harzer. 1982. Variations in the composition of breast milk during the first 5 weeks of lactation: implications for the feeding of preterm infants. Arch. Dis. Child. 57:658-662. Hytten, F.E. 1954. Clinical and chemical studies in human lactation: IV. Trends in milk composition during course of lactation. Br. Med. J.:249-255. Jackson, D.A., S.M. Imong, A. Silprasert, S. Preunglumpoo, P. Leelapat, Y. Yootabootr, Y. Amatayakul, and J.D. Baum. 1988. Estimation of 24 h breast-milk fat concentration and fat intake in rural northern Thailand. Br. J. Nutr. 59:365-371. Kader, M.M., R. Bahgat, M.T. Aziz, F. Hefnawi, M.H. Badraoui, N. Younis, and F. Hassib. 1972. Lactation patterns in Egyptian women. II. Chemical composition of milk during the first year of lactation. J. Biosoc. Sci. 4:403-409. Karra, M.V., A. Kirksey, O. Galal, N.S. Bassily, G.G. Harrison, and N.W. Jerome. 1988. Zinc, calcium and magnesium concentrations in milk from American and Egyptian women throughout the first 6 months of lactation. Am. J. Clin. Nutr. 47:642-648. Lauber, E., and M. Reinhardt. 1979. Studies on the quality of breast milk during 23 months of lactation in a rural community of the Ivory Coast. Am. J. Clin. Nutr. 32:1159-1173. Lemons, J.A., L. Moye, D. Hall, and M. Simmons. 1982. Differences in the composition of preterm and term human milk during early lactation. Pediatr. Nutr. 16:113-117.

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Nutrition During Lactation Lönnerdal, B., E. Forsum, and L. Hambraeus. 1976. Longitudinal study of the protein, nitrogen, and lactose contents of human milk from Swedish well-nourished mothers. Am. J. Clin. Nutr. 29:1127-1133. Morriss, F.H., Jr., E.D. Brewer, S.B. Spedale, L. Riddle, D.M. Temple, R.M. Caprioli, and M.S. West. 1986. Relationship of human milk pH during course of lactation to concentrations of citrate and fatty acids. Pediatrics 78:458-464. Nagra, S.A. 1989. Longitudinal study in biochemical composition of human milk during the first year of lactation . J. Trop. Pediatr. 35:126-128. Picciano, M.F., E.J. Calkins, J.R. Garrick, and R.H. Deering. 1981. Milk and mineral intakes of breastfed infants. Acta Paediatr. Scand. 70:189-194. Prentice, A.M., S.B. Roberts, A. Prentice, A.A. Paul, M. Watkinson, A.A. Watkinson, and R.G. Whitehead. 1983. Dietary supplementation of lactating Gambian women. I. Effect on breast-milk volume and quality. Hum. Nutr.: Clin. Nutr. 37C:53-64. Rajalakshmi, K., and S.G. Srikantia. 1980. Copper, zinc and magnesium content of breast milk of Indian women. Am. J. Clin. Nutr. 33:664-669. Saint, L., P. Maggiore, and P.E. Hartmann. 1986. Yield and nutrient content of milk in eight women breastfeeding twins and one woman breastfeeding triplets. Br. J. Nutr. 56:49-58. Vaughn, L.A., C.W. Weber, and S.R. Kemberling. 1979. Longitudinal changes in the mineral content of human milk. Am. J. Clin. Nutr. 32:2301-2306.