Relationship between Delivery Mode and Macronutrient Content of Breast Milk

Abstract

Abstract: Background and purpose: Human milk considered as the best source of nutrition for newborns and has incredible advantages for mothers, neonates, and the community at large. It contains nutritive and active non-nutritive factors, caused to optimizing newborns' health. Macronutrients of breast milk including carbohydrate, protein, and fat are essential nutritional sources in the first few months of a newborn’s life. The aim of this study was to assess the effect of delivery mode on the macronutrients of human milk. Methods: This was an analytical descriptive study conducted on 102 women who gave birth by cesarean section or vaginal delivery in Tabriz. The participants were requested to express their milk day 15±1 after childbirth. Milk samples were gathered on day 15±1 postpartum between 9-10 am after feeding of the infants. Obtained milk was stored in special boxes and sent to laboratory within one hour. For analysis of macronutrients content, we used Lactoscan. The participants were matched according to the mother's age, education level, income status and current body mass index (BMI). For each participant daily intake of calories, protein, fat, and carbohydrate in both groups were calculated using a 3-day food record questionnaire. To assess the amount of energy and nutrients received, each food and beverage was coded and entered into the Nutritionist Ⅳ modified nutrition software for Iranian foods. The average three-day energy, macronutrients and micronutrients intakes were determined for every one for both groups. Results: Demographic results in the two groups were not statistically significant (P >0.05). The mean dietary intake of carbohydrates (P = 0.695), fat (P = 0.421), protein (P = 0.494) and energy (P = 0.660) in the participating mothers in both groups was almost the same and there were no statistically significant differences between them. Milk protein content in cesarean delivery group was 2.21 mg / dl and in vaginal delivery group was 2.31 mg / dl (P = 0.181), milk fat content in the cesarean section was 2.67 mg / dl and in the vaginal delivery group was 2.49 mg / dl (P = 0.234), the energy level of breast milk in the cesarean delivery group was 68.53 kcal / ml and in the vaginal delivery group was 68.83 kcal / ml (P = 0.936), none of these macronutrients were significantly different between the two groups. Milk lactose content in the cesarean delivery group was 6.61 mg / dl and in the vaginal delivery group was 7.98 mg / dl, which was statistically significant (P = 0.039). The results of this study showed that the lactose level was significantly higher in women who gave birth by vaginal delivery than in women who had a cesarean delivery [adjusted mean difference, 1.2 (95% CI 0.02- 1.82)]. Conclusion: Lactose has a vital role in providing energy for the brain development of the newborn. The results of this study showed that the lactose level in the milk of women with VD was significantly higher than those with CS on day 15 after birth. Considering the study design, vaginal delivery could be a probable factor for increasing the lactose level of human milk. It is suggested that a study be performed on the effect of type of delivery on breast milk micronutrients with milk samples collected in 24 hours in two groups to have a higher predictive power.