Feeding for breastfeeding (II)

Most mothers who moderately increase their intakes of energy, proteins, healthy fatty acids and complex carbohydrates following a balanced diet, manage to meet the demands of vitamins and minerals; however, some suffer from deficiencies of certain nutrients for different reasons; having to produce milk at the expense of their own reserves, which can harm their health status in the short, medium and long term.

In this presentation we will learn about the important role that some micronutrients play in the mother's diet to preserve her health and maintain the optimal quality of breast milk, in order to enhance the physical, emotional and cognitive development of the baby.

Vitamin requirements

The concentration of most vitamins in breast milk depends on their levels in the mother's body, so that a maternal insufficiency would lead to a deficiency in the infant. For this reason, intakes during lactation should be higher than at any other stage in a woman's life.

Liposoluble vitamins

Vitamin A: It is recommended that the mother should receive 1300 µg/day (micrograms per day) of vitamin A during lactation; this amount is considerably higher than that recommended for any other stage of a woman's life.

Vitamin A is essential for good vision and the maintenance of the immune system; it is involved in the protection of epithelial tissue - skin, nails, respiratory mucous membranes, etc. - and is involved in the production of enzymes in the liver and hormones. Carotenes (provitamin A) are a powerful antioxidant.

Vitamin A deficiencies in infants cause immunological alterations, increasing the risk of respiratory and diarrheal infections; more serious deficiencies can cause blindness.

Vitamin D: The vitamin D content of breast milk is low. Vitamin D deficiencies are frequent in breastfeeding mothers as its levels depend mainly on exposure to sunlight. It is recommended that the mother should receive 15 µg/day (micrograms per day) of vitamin D during lactation.

Vitamin D is essential for the health of the skeletal system, as it promotes bone mineralization. Deficiencies in infants can retard growth.

Vitamin E: High levels of vitamin E in breast milk are mainly related to high contents of polyunsaturated fatty acids in the mother's diet. It is recommended that the mother receive 17 mg/day (milligrams/day) of vitamin E during lactation; this amount is higher than that recommended for any other stage of a woman's life.

The main function of vitamin E is to act as an antioxidant in cells, facilitating proper nutrition and tissue regeneration; it also intervenes in the synthesis of enzyme systems that modulate hemoglobin formation.

Vitamin E deficiencies in infants can cause destruction of red blood cells, anemia and muscle degeneration.

B group vitamins

The nutritional recommendations for the breastfeeding mother of the main vitamins of the B group are shown in the following table.

Within this group, the following stand out for their importance:

• Vitamin B6 (pyridoxine): severe deficiencies of this vitamin in the mother and infant can cause different dermatitis and neurological abnormalities, which may include peripheral neuritis.
• Vitamin B9 (folic acid): Involved in the formation of blood cells, it is considered an anti-anemic element. Deficiencies may cause malabsorption of nutrients, digestive disorders and anemia.
• Vitamin B12 (cobalamin): Severe deficiencies of this vitamin in infants can cause anemia and neurological disorders in the short and long term. Cobalamin concentrations in strictly vegetarian women -vegans- are generally low since this vitamin only exists in foods of animal origin.

Vitamin C and choline

Vitamin C (ascorbic acid): It has antioxidant properties, favors iron absorption, contributes to the maintenance of tissues, collagen, cartilage, bones, teeth and gums and is involved in wound healing and the functioning of the immune system.

The concentration of vitamin C in the milk of smoking and diabetic mothers may be reduced, so their diet should prioritize the consumption of citrus fruits. It is recommended that the mother receives 85 mg/day (milligrams/day) of vitamin C during lactation, this amount is higher than that recommended for any other stage of a woman's life.

Choline: It is recommended that the mother receive 550 mg/day (milligrams/day) of choline during lactation; this amount is higher than that recommended for any other stage of a woman's life.

Choline is necessary to form the membranes that surround the body's cells. It also plays an important role in the development of the brain and nervous system, being involved in the regulation of memory, mood, and muscle control among other functions.

Mineral needs

Calcium: During lactation, the mother's calcium needs remain high and a deficient intake of this mineral would compromise the mother's bone tissue. During lactation the role of calcium is fundamental for the development of the child's bone tissue. It is recommended that the mother receive 1300 mg/day (milligrams/day) of calcium during lactation, the same amount recommended during pregnancy.

To meet maternal calcium needs, 4 to 5 servings per day of dairy products, such as skim milk, skim cheese and yogurt, are recommended.

Iron: Breastfeeding favors the delay of menstruation and therefore contributes to increase the availability of iron in the mother's body. It is recommended that the mother receives 18 mg/day (milligrams/day) of iron during lactation, the same value recommended during pregnancy.

Iron deficiencies during breastfeeding cause anemia and affect the mother's immune function.

Iodine: The amount of iodine present in breast milk is directly related to maternal intake. The mother's iodine requirements during breastfeeding are considerably higher than at any other stage of life, since iodine is necessary for the synthesis of thyroid hormones in the mother and the infant; it is also involved in the brain development of the child. It is recommended that the mother receives 155 µg/day (micrograms/day) of iodine during lactation; this amount is higher than that recommended for any other stage of a woman's life.

Zinc: Zinc concentrations in breast milk are not high, however, they are sufficient to cover the infant's needs due to its high bioavailability. It is recommended that the mother receive 25 mg/day (milligrams/day) of zinc during lactation; this amount is higher than that recommended for any other stage of a woman's life.

Zinc is essential for growth, cellular immunity and for the formation of enzymes; it is involved in the sense of taste, smell and vision.

Selenium: The amount of selenium present in breast milk is closely related to maternal intake. It is recommended that the mother receives 75 µg/day (micrograms/day) of selenium during lactation; this amount is considerably higher than that recommended for any other stage of a woman's life.

Selenium acts as an antioxidant, stimulates the formation of antibodies in the mother and infant and reduces the toxic effects of metals in their bodies.