Breast Milk intake measured by deuterium kinetics in mother-infant pairs in Addis Ababa

Abstract

The accurate determination of breast-milk intake of infants is essential in order to estimate energy intake and nutrient requirement during infancy and lactation. The deuterium dilution technique was employed for measuring breast-milk intake in exclusively breast-fed Ethiopian infants. This method is convenient for field conditions rather than the commonly used test-weighing procedure. In addition, the feasibility of using the less specialised, more efficient and considerably cheaper instrument, Fourier Transform Infrared (FTIR), was evaluated in the Ethiopian setting. The results obtained were compared to that of Isotope Ratio Mass Spectrometer (IRMS). Ten mother-infant pairs were recruited from two government subsidised health centres, namely Ledeta and Semen. Mothers received a pre-weighed 30g oral dose of D2O. Maternal and infant saliva samples, and breast milk samples were collected over a 14-day period following dose administration. Anthropometric data were also collected. Saliva and deffated milk samples were analysed for deuterium enrichment by Infrared Spectroscopy and Mass Spectrometry and the data were fitted into two-compartment model. Infant weights were compared with a 12 months breastfed infant-pooled data set. Comparison of these infants with 12 months breast-fed pooled data set showed that weight for age Z-scores were below the mean. There was no significant difference between initial and final Z-scores (p>0.05) during the experimental period although all of the infants showed some catch-up growth. Mean ± SD breast milk intake was 850±120ml/day and 880±120ml/day measured using FTIR and IRMS, respectively. The study has demonstrated that it is feasible to measure breast milk intake using deuterium dilution technique in the Ethiopian setting and Infrared spectroscopy could be used for the purpose. It also confirmed that Ethiopian mothers have comparable or higher milk output than privileged communities. These findings have important implications for future research.