Laktasyonun ilk dört ayında anne sütünde demir ve çinko düzeyleri
Date
2000
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Anne sütü, zamanında doğan bebekler için hayatın ilk aylarında doğal bir besindir. Anne sütündeki birçok mineralin biyoyararlılığı, inek sütü ve formülalara kıyasla daha fazladır. Anne sütünde demir (Fe), çinko (Zn) ve bakır (Cu) dışında çoğu minerallerin düzeyi laktasyon boyunca oldukça sabit seyreder. Bu mineraller, doğumdan hemen sonra yüksek düzeyde iken sonraki aylarda, giderek azalır. Bu çalışmada, 27 Türk kadınında, anne sütünde Fe ve Zn düzeyleri, laktasyonun 0. (kolostrum, 1-5 gün),1. ve 4. aylarında izlendi. Bu annelerin bebekleri anne sütü alanlar (grup l) ve karma beslenenler (grup II: anne sütü ve formüla) olarak iki gruba ayrıldı. Laktasyonun 0.,1. ve 4. aylarında, Fe ve Zn açısından, annelerin serum ve süt düzeyleri karşılaştırıldı. Bebeklerde ise 4. ayda bu elementlerin serum düzeyleri, annelerin serum ve süt düzeyleri ile karşılaştırıldı. Ayrıca her iki gruptaki bebeklerin Fe ve Zn düzeyleri karşılaştırıldı. Fe eksikliği anemisi açısından anneler doğumdan sonra, bebekler ise 4. ayda değerlendirildi. Serum Fe ve Zn düzeylerinin, anne sütü ve karma beslenmenin hücresel immünite üzerine olan etkisi, 16 anne sütü ve 11 karma beslenen bebekte 4. ayda, annelerde ise bu elementlerin hücresel immünite üzerine olan etkisi doğumdan sonra değerlendirildi. Fe düzeyi, kolostrumda 0,42±0,15, Layda 0,39±0,13, 4.ayda 0,37±0,13 mg/L; Zn düzeyi kolostrumda 4,6±1, Layda 2,73±1,25, 4.ayda 1,57±1,06 mg/L bulundu. Fe ve Zn düzeyleri açısından anne sütü, anne serumu ve bebek serumları arasında ilişki saptanmadı. Anne sütü ile beslenen bebeklerde (% 37,5) Fe eksikliği anemisin prevalansı karma beslenen bebeklerden (% 27) daha yüksek bulundu. Çalışmaya katılan annelerde Fe eksikliği anemisin prevalansı ise % 40,7 olarak saptandı. Anne sütü alan bebeklerde aneminin yüksek prevalansı anne sütündeki Fe'in düşük düzeyi ile ilişkiliydi. Annelerde ise kötü prenatal takip ve gebelikte Fe ilavesinin yapılmaması aneminin yüksek prevalansından sorumlu faktörlerdi. Bebeklerde beslenme şeklinin ve Fe eksikliğinin, annelerde ise Fe eksikliğinin hücresel immünite üzerine etkisi gözlenmedi. Hem bebeklerin hem de annelerin T hücre alt grupları ve NK hücre yüzdeleri normal sınırlar içinde bulundu. Teknik yetersizlik nedeni ile T hücre fonksiyonları değerlendirilemedi. Her iki gruptaki bebeklerin büyüme hızları farklı bulunmadı ve Fe eksikliğinin büyüme üzerine olumsuz etkisi gözlenmedi. Sonuç olarak, anne sütünün, düşük Fe içeriği nedeni ile anne sütü alan bebekler Fe eksikliği anemisi açısından yüksek riske sahiptir. Anne sütü ile beslenen bebeklerde Fe eksikliği anemisi açısından taramaya ihtiyaç vardır. Bu bebeklere hayatın 4. ayından sonra Fe ilavesi başlanmalıdır. Annelerde gebeliğin erken dönemlerinde anemi teşhis edilmeli ve tedavi verilmelidir.
Breast milk is the natural food for full term infants during the first months of life. The bioavailability of most minerals in the breast milk is much higher than cows milk or infant formula. The concentrations of most minerals in the breast milk remain fairly constant throughout the course of lactation. The exceptions are zinc (Zn), copper (Cu) and iron (Fe). These minerals have their highest concentrations immediately after parturition, and fall for several months thereafter. In this study, the contents of iron and zinc were determined in human milk samples from 27 Turkish women longitudinally for four months of lactation. These mother's infants were grouped according to breast feeding (group I) or mixed feeding (group II: breast milk and formula). The concentrations of Zn and Fe in maternal serum and breast milk at 0, 1 and 4months of lactation were compared with each other. These parameters were also correlated with the mineral concentrations in the serum of infants at 4 months of age. Fe deficiency was evaluated in postpartum mothers and infants at 4 months of age. The effects of serum Fe and Zn concentrations on cellular immunity were examined in postpartum mothers and breast fed (16) and mixed feeding infants (11) fed infants at 4 months of age. Milk samples was collected at three stages of lactation: colostrum, first month and fourth month. Fe and Zn contents were 0 42±0 15 and 4 6±1 mg/L in colostrum; 0,39±0,13 and 2,73±1,25 mg/L at 1 month; 0,37±0,13 and 1,57±1,06 mg/L at 4 months, respectively. Zn concentration decreased significantly throughout the course of lactation but Fe showed no difference significantly throughout the course of lactation but Fe showed no difference. There was no correlation found amoung the mineral concentrations in maternal serum breast milk and serum of infants. The prevalance of iron deficiency anemia was higher in infants fed breast milk (37,5 %) than those who received mixed feeding (27 %). Iron deficiency anemia was observed in 40,7 % of all the mothers. In infants who were breast fed, higher prevalance of anemia were associated with low iron content of human milk. Poor prenatal care and lack of iron supplementation were responsible for anemia in mothers. No effect of iron deficiency anemia or feeding regym in infants on cellular immunity could be discerned. Similarly no effect of iron deficiency on cellular immunity in mothers were observed.T cell subset and NK cells percentages were found in normal range in both breast and mixed feeding infants and mothers. T cell functions could not be evaluated because of technical insufficiency. Both groups of infants growth patterns were found similar and no effect of iron deficiency on growth rate was detected. In conclusion, the iron content of human milk is low and infants receiving exclusively breast milk have high risk for iron deficiency anemia. There is a need for screening for iron deficiency anemia in breast fed infants and supplemental iron should be given after four months of age. Iron deficiency anemia must be diagnosed and treated early in pregnancy.
Breast milk is the natural food for full term infants during the first months of life. The bioavailability of most minerals in the breast milk is much higher than cows milk or infant formula. The concentrations of most minerals in the breast milk remain fairly constant throughout the course of lactation. The exceptions are zinc (Zn), copper (Cu) and iron (Fe). These minerals have their highest concentrations immediately after parturition, and fall for several months thereafter. In this study, the contents of iron and zinc were determined in human milk samples from 27 Turkish women longitudinally for four months of lactation. These mother's infants were grouped according to breast feeding (group I) or mixed feeding (group II: breast milk and formula). The concentrations of Zn and Fe in maternal serum and breast milk at 0, 1 and 4months of lactation were compared with each other. These parameters were also correlated with the mineral concentrations in the serum of infants at 4 months of age. Fe deficiency was evaluated in postpartum mothers and infants at 4 months of age. The effects of serum Fe and Zn concentrations on cellular immunity were examined in postpartum mothers and breast fed (16) and mixed feeding infants (11) fed infants at 4 months of age. Milk samples was collected at three stages of lactation: colostrum, first month and fourth month. Fe and Zn contents were 0 42±0 15 and 4 6±1 mg/L in colostrum; 0,39±0,13 and 2,73±1,25 mg/L at 1 month; 0,37±0,13 and 1,57±1,06 mg/L at 4 months, respectively. Zn concentration decreased significantly throughout the course of lactation but Fe showed no difference significantly throughout the course of lactation but Fe showed no difference. There was no correlation found amoung the mineral concentrations in maternal serum breast milk and serum of infants. The prevalance of iron deficiency anemia was higher in infants fed breast milk (37,5 %) than those who received mixed feeding (27 %). Iron deficiency anemia was observed in 40,7 % of all the mothers. In infants who were breast fed, higher prevalance of anemia were associated with low iron content of human milk. Poor prenatal care and lack of iron supplementation were responsible for anemia in mothers. No effect of iron deficiency anemia or feeding regym in infants on cellular immunity could be discerned. Similarly no effect of iron deficiency on cellular immunity in mothers were observed.T cell subset and NK cells percentages were found in normal range in both breast and mixed feeding infants and mothers. T cell functions could not be evaluated because of technical insufficiency. Both groups of infants growth patterns were found similar and no effect of iron deficiency on growth rate was detected. In conclusion, the iron content of human milk is low and infants receiving exclusively breast milk have high risk for iron deficiency anemia. There is a need for screening for iron deficiency anemia in breast fed infants and supplemental iron should be given after four months of age. Iron deficiency anemia must be diagnosed and treated early in pregnancy.
Description
Keywords
Emzirme, Bileşim, Anne sütü, Laktasyon, Çinko düzeyleri
Citation
Göçet, N. (2000). Laktasyonun ilk dört ayında anne sütünde demir ve çinko düzeyleri. Yayınlanmamış tıpta uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.