BREASTFEEDING MEDICINE

Volume 12, Number 9, 2017 Reviews

ª Mary Ann Liebert, Inc.
DOI: 10.1089/bfm.2017.0048

Macro- and Micronutrients of Human Milk Composition:

Are They Related to Maternal Diet?
A Comprehensive Systematic Review

Mojtaba Keikha,1 Maryam Bahreynian,2 Mohammad Saleki,3 and Roya Kelishadi2

Abstract
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Background: This study aims at systematically reviewing the observational and interventional studies on the
association of maternal macro- and micronutrient intake with breast milk content.
Methods: We systematically searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till October
2016 with the following search strategy: (‘‘human milk’’ OR ‘‘breast milk’’ OR ‘‘breast milk composition’’ OR
‘‘human breast milk composition’’ OR ‘‘composition breast milk’’ OR ‘‘mother milk’’ OR ‘‘human breast milk’’)
AND (‘‘maternal diet’’ OR ‘‘maternal nutrition’’). We also searched Google scholar for increasing the sensitivity of
our search. The search was not limited to title and abstract due to the possibility that the desired outcome might have
been considered a secondary aim. We excluded conference papers, editorials, letters, commentary, short survey, and
notes. The search was refined to English language, and we did not consider any time limitation. To increase the
sensitivity and to select more studies, the reference list of the published studies was checked as well.
Results: This review included 59 observational and 43 interventional studies on maternal diet related to breast
milk composition. Different studies determined the associations and effects of some maternal dietary intake of
micro and macronutrients and its reflection in human milk.
Conclusion: Maternal dietary intake, particularly fatty acids, and some micronutrients, including fat soluble
vitamins, vitamin B1, and vitamin C, was related to their content in breast milk composition.

Keywords: maternal diet, human milk, macronutrients, micronutrients, breast milk composition

Introduction Therefore, it is essential to investigate human milk content

and the factors contributing to its composition to improve the

B reast milk is considered the best nutrition for normal

infants. Milk fat is the main source to supply energy for
newborns such that it comprises *50% of the energy that
they need.1
Infants’ optimal growth can be ensured only when the food
and water they consume contain all the essential elements in
recommended doses.2
Milk lipids provide essential nutrients, which are needed,
as structural elements, for all cell membranes and, as integral
constituents of neural tissues, for rapidly growing infants2–4
Human milk supplies all the essential nutrients that infants
need in the early stages of their life after birth.5
Accordingly, the World Health Organization recommends
breastfeeding as the exclusive nutrition for infants until at
least 6 months after birth.6
growth and development of infants’ breastfeeding and to
determine lactating mothers’ nutritional requirements.
The health benefits of breastfeeding for infants include
reduced morbidity and mortality due to infectious diseases7
and improved cognitive and physical development.8,9 In ad-
dition, increasing evidence shows that breastfeeding has an
association with better health outcomes for infants in the long
term, such as a reduced risk of developing obesity, diabetes,
cardiovascular disease (CVD), and other metabolic diseases
of adulthood.10–14
In many countries or societies, there are many women who
encountered lack of macro and micronutrients in their
milk.15–19 Also, they do not supplement with any supplement
material such as supplemented food or nutritional supple-
ments.

1
Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
2
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-
communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
3
Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

517
 518
In this area, there are some questions about the composi-
tion of human milk and its related factors. Many mothers or
lactating mothers, when referred (attend) to a pediatric clinic,
often ask, ‘‘Does my diet have any effect on my milk?’’
In recent years, many researchers have studied the effect of
mothers’ diets on milk composition. Some studies show a
positive effect of maternal diet on breast milk composition,20
but there are some studies with the opposite theme.21
Further, many researchers have investigated the effect of
supplemented food or diet on maternal milk composition,
such as vitamins and fatty acids (FAs).22,23
In this systematic review, we aimed at summarizing and
accumulating the result of related studies that work on ma-
ternal diet and breast milk composition or any study that has
worked toward investigating the effect of prescribing sup-
plemented food or diet on breast milk composition. In total,
we want to understand as to whether micro- or macronutrients
of the maternal diet pass from mothers into their milk.
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Methods
Literature search
We systematically searched the Medline via PubMed,
Scopus, and ISI Web of Knowledge till October 3, 2016 with
following search strategy: (‘‘human milk’’ OR ‘‘breast milk’’
OR ‘‘breast milk composition’’ OR ‘‘human breast milk
composition’’ OR ‘‘composition breast milk’’ OR ‘‘mother
milk’’ OR ‘‘human breast milk’’) AND (‘‘maternal diet’’ OR
‘‘maternal nutrition’’).
Also, we searched Google scholar for increasing the sen-
sitivity of our search. Ethical approval was not required as
this was a secondary data analysis.
The search was conducted on human studies, but it was not
limited to title and abstract because our desired results or
outcomes might have been considered a secondary aim of the
studies. Limitations were applied to exclude conference pa-
pers, editorials, letters, commentary, short survey, and note.
The search was refined to the English language, and we did
not consider any time limitation.
Hand searching
To increase the sensitivity and to select more studies, the
reference list of the published studies was checked as well.
Selection criteria
Studies identified from the literature search were selected
on the basis of the predefined selection criteria presented
later:
Inclusion criteria
1. All observational studies (cross-sectional studies,
case–control studies, cohort studies)
2. All interventional studies (clinical trial studies, cross-
over trial studies, experimental studies)
3. Studies investigating the associations between mater-
nal diet and breast milk composition
4. Studies with an exact method reported for assessing
the maternal dietary habits
KEIKHA ET AL.
Exclusion criteria
1. Conference papers, editorials, letters, commentary,
short survey, and note
2. Animal studies
3. Laboratory studies
Data extraction and abstraction
We used EndNote program for managing and handling ex-
tracted references that were searched from databases. Dupli-
cates were removed and entered into a duplicate library. Titles
and abstracts of papers were screened, and relevant papers were
selected. Then, full texts of relevant papers were read, and
findings were rescreened. Two independent reviewers (M.S.
and M.K.) screened the titles and abstracts of papers, which
were identified by the literature search, for their potential rel-
evance or assessed the full text for inclusion in the review.
In the case of disagreement, the discrepancy was resolved
in consultation with an expert investigator (R.K.).
Two reviewers abstracted the data independently (M.K.
and M.S.). The required information that was extracted from
all eligible papers was as follows: data on first author’s family
name, year of publication, country of the study, title of study,
type of supplement or food, population studied, type of study,
method of nutritional status assessment, aim, type of nutrients
evaluated in milk, and main findings of studies.
Study selection strategy
In the systematic search, 1,030 unique references were
identified (Fig. 1). Of them, 468 were excluded on the basis of
the title and abstract. For the remaining 277 articles, the full
text was retrieved and critically reviewed. After the selection
process, 102 papers were included.
Results
Observational studies
In total, 59 articles were extracted as observational studies.
The summary of association between maternal dietary intake
of macro- and micronutrients and breast milk content is pre-
sented in Supplementary Table S1 (Supplementary data
are available online at http://www.liebertpub.com/bfm). We
mention some findings in brief here.
Fatty acids, trans fatty acids,
and polyunsaturated fatty acids
Most studies showed a positive association of FA com-
position in maternal diet and its reflection in breast milk.24–40
In contrast, some other studies have reported no associa-
tion.41,42 No association between trans fatty acid (TFA)
consumption and TFA levels of human milk was docu-
mented,43 whereas other studies showed that mothers with a
higher intake of TFA in their diet had higher levels of trans
isomers in breast milk.44,45
Another study conducted in North Carolina showed no re-
lationship between breast milk and dietary intake of poly un-
saturated fatty acids (PUFAs). In multiple regression models,
dietary intake and body fat percentage were not considered
predictors of FA concentrations in human milk.46
Iranpour et al.41 found no correlation between docosahex-
aenoic acid (DHA) and arachidonic acid (AA) content of
 MATERNAL DIET AND HUMAN MILK COMPOSITION
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FIG. 1. Papers search and review flow-
chart for selection of primary studies.
human milk in mothers of preterm and full-term newborns.
Another study revealed that the mean protein intake of Filipino
women was a determinant of DHA levels in breast milk.47
Another study conducted in Iran found no association of breast
milk fat content and daily energy intake, carbohydrate, protein,
linoleic acid (LA), linolenic acid, PUFA, saturated fatty acid
(SFA), mono-unsaturated fatty acid (MUFA), and cholesterol
of maternal diet. Only AA and fat content of human milk were
correlated with eicosapentaenoic acid (EPA) and DHA of
maternal dietary intake.42 TFAs of human milk were known as
indicators of different sources of TFA in maternal diet.48
Another study found that only EPA content of breast milk was
not a predictor of maternal fat intake.35
Fish
Frequency of fish intake was correlated positively with
DHA content of human milk in Denmark.49 Another study
showed that mercury levels were moderately associated with
519
fish consumption, and maternal concentration of omega-3
PUFA had a poor correlation with fish intake.50
Tocopherol
Tocopherol intake of breast milk was associated with
maternal total fat and SFA intake, and not to tocopherol
intake,51 whereas another cross-sectional study found no
significant correlation between dietary intake of vitamin E
and its concentration in breast milk.52
Vitamin C
The content of vitamin C of human milk was related to the
maternal intake.53
Vitamin B12
Vitamin B12 concentration was associated with both ma-
ternal intake of B12 and maternal serum B12.54 Another study
 520
found that serum and milk B12 levels were significantly lower
in lacto-ovo-vegetarians compared with the control group.63
Lipophilic vitamins
Intake of vitamins A and E was correlated to their content
in human milk.64 Another study found that breast milk retinol
was significantly correlated with frequency intake of vitamin
A-rich foods, including sweet potato.65
Vitamin B1
Higher intake of vitamin B1 was significantly related to
increased levels of B1 in mature milk.66
Zinc, copper, and iron
Dietary intake of zinc, copper, and iron during pregnancy
had no effect on zinc, copper, and iron concentrations of
milk.67 Mahdavi et al.68 found no significant association of
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maternal intake of zinc, copper, and iron with their levels in
human milk. This finding was also documented in another
study that showed that breast milk levels of iron, zinc, and
copper were not related to dietary intake.69
Calcium and copper
Calcium and copper levels of breast milk were influenced
by maternal dietary intake.70
Selenium
Among foods consumed during pregnancy, only egg intake
showed a weak positive correlation with selenium levels of
breast milk.71
Lead (Pb) and mercury (Hg)
Fish intake was significantly associated with milk Pb,
whereas milk Hg was not affected by dietary intake of fish.72
Another study found that eating fish (‡2 times/week) during
pregnancy did not affect Hg levels in second-month breast
milk.73 Yalçin et al.74 found that fish consumption had no
effect on Hg content of breast milk.
Chromium (Cr)
Chromium intake had no correlation with Cr levels of milk
in lactating mothers.75
Arsenic, cadmium, lead, and aluminum
Canned-food intake had no correlation with cadmium
content of colostrum.76
Sugar, protein, and amino acids
Maternal diet or body fat percentages were not associated
with milk composition, except of modest, inverse correlation
between maternal adiposity and sugar content of milk. Ma-
ternal dietary energy or calorie sources were not significant
predictors of milk macronutrients in Filipino mothers.77
Another study found that protein quality and quantity was
related to casein:whey protein ratio. This proportion had a
positive relationship with maternal protein intake.78 Total
protein and lactoferrin levels of breast milk could be pre-
KEIKHA ET AL.
dicted by maternal daily energy and fat intake. A linear
correlation was also found between total protein concentra-
tion in human milk and maternal daily energy intake.79 An-
other study revealed no association of maternal dietary intake
and milk protein and fat composition.80
Docosahexaenoic acid
Milk DHA had a positive dose-dependent association with
maternal fish consumption. Milk DHA was positively related
to protein intake, reflecting the relationship between fish and
protein intake.81 Another study showed that frequency of fish
consumption was positively associated with DHA levels of
human milk.49
Interventional studies
In total, 43 articles were extracted as interventional stud-
ies. The effects of maternal dietary intake on macro- and
micronutrients of milk content are presented in Supplemen-
tary Table S2. We mention some findings in brief here.
Fatty acids
Most studies showed a positive association between FA
composition in maternal diet and its effect on FAs of breast
milk.82–84
Interventional studies have demonstrated that maternal
diet rich in full-fat dairy products resulted in a significant
difference in milk lipids compared with low-fat dairy
products.85 This effect was documented in another previ-
ous study.86 Other studies have also shown an increase in
alpha-linolenic acid (ALA) and total omega-3 FAs in the
intervention group.87 Imhoff-Kunsch et al.88 found that
prenatal DHA supplementation from 18 to 22 weeks of
gestation to parturition increased DHA and ALA levels
of breast milk at 1 month postpartum. Another study re-
vealed that higher consumption of stearic acid and ALA in
a high-fat diet could significantly increase the proportion
of these FAs in breast milk within 4 days.89 Mothers taking
virgin coconut oil had an increase in the medium-chain
FA (lauric acid, caprylic acid, and capric acid) content of
breast milk.90
Fish-oil supplements
Most of the studies that used fish-oil supplements showed a
significant effect on the DHA and EPA content of human
milk.91 Supplementation with fish oil in a randomized con-
trolled trial resulted in significantly higher levels of DHA and
EPA.92 Similarly, fish-oil supplements had an effect on the
increased levels of long-chain PUFA of breast milk compared
with the control group.93,94 Consistent with these results,
women who received fish-oil supplementation showed pro-
portionately increased levels of DHA and EPA at 3 and 6
weeks after delivery, but it was continued till 6 months. Fish-
oil supplementation during pregnancy was associated with
higher levels of long-chain PUFAs in breast milk, particu-
larly in early lactation.95
Fat-soluble vitamins and pro-vitamins
Maternal diet that contained red palm oil increased the pro-
vitamin A carotenoids in breast milk.96 Another study found
 MATERNAL DIET AND HUMAN MILK COMPOSITION
that the group with cod-liver-oil supplementation had sig-
nificantly lower levels of gamma-tocopherol in breast milk,
whereas other fat-soluble vitamins were not affected by
supplementation.23
A direct association was observed between mother and
infant levels of 25-hydroxy vitamin D, suggesting that ma-
ternal vitamin D intake directly appears in human milk.101
A clinical trial of short-term daily intake of bio-fortified
maize did not increase the retinol level of milk in lactating
Zambian women102; whereas in another study, maternal
supplementation with a single dose of retinylpalmitate in-
creased the retinol level in the intervention group.103 Simi-
larly, supplementing women with fat from mild to late
pregnancy till 6 months postpartum increased the retinol
content of breast milk at 3 months postpartum than the con-
trol group.104
A significant difference was observed between lower and
higher doses of supplementation: A higher dose of vitamin
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D supplements resulted in higher vitamin D levels (2,000
IU/day) in human milk 2 months postpartum, compared
with lower doses (1,000 IU/day) or with the placebo
group.105 The effect of higher dose supplementation has
been examined in several trials, showing that a high dose of
vitamin D3 (6,400 IU/day) safely and significantly resulted
in higher maternal circulating 25-hydroxy-D levels.106 Si-
milarly, a higher dose (4,000 IU) of vitamin D-calcium
supplementation was more effective and increased both
maternal and infant serum levels and breast milk compared
with lower amounts (2,000 IU).107 Another clinical trial
found that phylloquinone content of breast milk increased
in a dose-dependent manner.108
Another study found that maternal supplementation of
vitamin A resulted in higher colostrum retinol content.109
Lutein, zeaxanthin, and b-carotene content of breast milk
increased after maternal supplementation of Chlorella.110
Higher levels of breast milk retinol were documented after
vitamin A supplementation, and the rising level remained
significantly higher for 4 months.111 Red palm oil supple-
ments (rich in vitamin A) resulted in a higher b-carotene level
of both plasma and breast milk.112 In another study, maternal
vitamin A or b-carotene supplementation improved the vi-
tamin A content of both mothers and infants, but it did not
prevent sub-clinical deficiency among lactating Bangladeshi
mothers.113
Choline
Higher choline intake during lactation improved human
milk choline content.114 Another study revealed that dietary
intake of choline (not supplement) was related to the breast
milk phosphatidyl choline and plasma choline level.115
Multiple supplements
Daily supplementation with multiple micronutrients (zn,
vitamin A, and folate) during pregnancy did not change their
content in breast milk or cod liver at 1 month postpartum even
after adjustment for body mass index.116 Another study
showed that weekly vitamin A and iron supplementation
during pregnancy resulted in increased vitamin A content of
human milk 4 months postpartum, but not iron status of breast
milk in Indonesian lactating women.117 An insignificant in-
521
crease of zinc, copper, iron, magnesium, and calcium in hu-
man milk was observed after synbiotic supplementation.118
Selenium
Supplementation of HIV-infected Malawian women was
not related to a change in plasma or breast milk selenium
level.119
Iron
Iron supplementation resulted in significantly improved
hematocrit and transferrin receptor levels, but it had no ef-
fect on maternal folate status or breast milk folate and iron
level.120
Calcium
Calcium supplements had no effect on breast milk calcium
or maternal bone mineral content.121
Ovalbumin
Maternal dietary egg intake increased ovalbumin level in
human milk.22
Protein
Reduced protein intake was associated with decreased
nonprotein nitrogen and total free amino acid content in
breast milk. Reduction of dietary protein did not affect the
quantity of human milk, as well as the amount of protein
nitrogen, protein-bound amino acid, and lactoferrin con-
tent.122
Tyrosin
Oral tyrosin had no effect on the total tyrosin content of
breast milk.123
Discussion
This study systematically reviewed the macro- and mi-
cronutrient content of breast milk in relation to maternal diet.
We assessed different observational and interventional
studies that had indicated the possible role of maternal nu-
trition in breast milk composition.
Previous research had mostly focused on the FA content of
maternal dietary intake and breast milk, whereas some few
studies evaluated the association of micronutrient consump-
tion, including vitamins and/or minerals, during pregnancy
and its reflection in human milk.
Fat is considered one of the most important nutrients of
human milk and is used to provide energy for the breastfed
infant.124 Among studies conducted on the FA composition
of maternal diet and breast milk, observational studies mostly
demonstrated a positive association of FA composition, in-
cluding DHA, LA, oleic acid, EPA, and PUFA, in maternal
diet and, subsequently, in breast milk.24–28 Moreover, several
clinical trials found a significant improvement in fat-soluble
vitamins and fat content of breast milk after maternal sup-
plementation.23,82–86,100,101
On the contrary, lack of an effect of maternal diet is evident
in both observational41–43,46 and some interventional
 522
studies,102 in which nutritional FA supplements were indi-
cated to result in minimal or minor changes in FA milk
composition.
It has been shown that human milk composition dose
varies significantly during a single feeding,125 throughout a
day,125,126 and even between mammary glands.127 Differ-
ences in sampling methods might also be possible; it has been
suggested that also milk fat composition is independent of
nursing frequency, and it is associated with time of day. For
instance, morning milk samples have lower total fat con-
tent.126 Instead, pooled 24-hour milk samples are considered
gold standards for collection; however, they are not appro-
priate for field use due to some factors, including nutritional
impact and difficulties in normal breastfeeding behaviors.126
In addition, milk samples collected in the morning (6–8 AM)
have been proposed as valid single-sample estimates of milk
content, especially for fat and energy.127 Some increase in fat
content of human milk with infant age might be due to the
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changes in feeding behavior, and milk fat has been shown to
be related with feeding practices and feeding duration.125,126
Previous research indicated that feeding frequency was an
inverse predictor of total energy, reflecting a decrease in milk
fat content with a higher feeding frequency.69,126
The weak or lack of association between most milk mac-
ronutrients, including fat and proteins, and maternal diet in
some studies is consistent with the hypothesis that milk
content might be buffered against variations in maternal di-
etary intake and nutritional status.128 For instance, some
previous studies found that milk macronutrient content tends
to be independent of maternal nutritional status, even in
malnourished mothers.129 Short-term fasting or being on a
diet in lactating women has not been associated with milk
macronutrient content.130 Some compensatory physiological
mechanisms are proposed to be responsible for the relatively
stable milk macronutrient composition in nutritional varia-
tions of maternal diet.131
Previous studies indicated that inadequate intake of LA
and ALA might be the cause of low essential fatty acid (EFA)
levels in the human milk of Filipino and Pakistani moth-
ers.132,133 Differences between intake and breast milk con-
centration of EFAs might be explained by regulatory
mechanisms with an important role to determine DHA and
AA content in human milk. Several up- and/or down-
regulations may control breast milk PUFA content, including
release of FAs from lipoproteins, transportation of FAs from
blood into the mammary glands, and milk triglyceride syn-
thesis.134
In addition to PUFA, MUFA, and SFA, TFA is also an-
other FA contributing toward the fat content of breast milk.
TFA consumption of lactating mothers could be rapidly
transferred to human milk. Therefore, breast milk is consid-
ered a biomarker of TFA intake. Trans fat levels of human
milk are important, because higher intakes of TFA could
affect the infant cognitive behavior. Moreover, trans fat ac-
cumulation, 3 g per day, might reduce breast milk fat by more
than 20%.43
Lack of association between TFA content of maternal in-
take and breast milk suggests that different isomers of dif-
ferent TFA food sources might have diverse favorable and/or
opposing effects. For instance, TFA isomers produced in the
food industry, including elaidic acid and lino-elaidic acid,
may increase the risk of CVD. By contrast, TFA of natural
KEIKHA ET AL.
sources such as vaccenic acid showed beneficial effects in
diabetes and CVD.43
In addition, TFA content of foods might also be under-
reported. The food preparation method and the portion size
consumed by mothers were also not determined in previous
studies.43 Previous studies have also found that lactating
women with smaller fat stores might have a less substrate to
move and utilize as the fat content of breast milk. Thus, the
fat content of milk was less affected by TFA dietary intake in
mothers who had relatively high body fat.43
Another possible explanation for no association between
TFA dietary intake and breast milk might refer to the rela-
tively low intake of main food sources of partially hydroge-
nated fat. Moreover, the TFA formation in the food industry
might be precluded because of the naturally solid structure of
palm oil, and, thus, the amount of TFA in foods is low.43
It has been indicated that only maternal diet in the third
trimester of pregnancy was associated with EPA and DHA
content of breast milk. It might be partly explained by weight
gain and body fat storage during late pregnancy.135 Studies
have shown that 25% and 33% of variation in EPA and DHA
content of breast milk would be explained by the dietary
content of these FAs in late pregnancy (third trimester), re-
spectively.26 These findings suggest the role of other factors
contributing to the FA composition of breast milk, such as
level of breast milk maturation, gestational length, and ma-
ternal nutritional status.136,137
Clinical trials demonstrated an increase in DHA content of
human milk, after DHA or fish-oil supplementation in preg-
nant women or during the postpartum period.91–94 However,
the effect of supplementation on EPA and ALA concentration
remains controversial.88,95 Such inconsistent results might be
due to the type of administered supplement (algae or fish oil
as a source of DHA) and the amount of DHA (400 mg or 2 g).
Moreover, vegetable oils are considered the main source of
omega-6 in diet and it is not possible to estimate their true
intake, due to the difficulties in estimation of the amount of
omega-6 used in food preparation. Results of previous studies
suggest that LA and AA are not presented directly in mam-
mary glands after intestinal absorption. They are stored in
body fat and then appear in the blood stream, demonstrating
that maternal body storage is the main source of omega-6.138
A wide variation in milk iron and other micronutrient
content might possibly be due to supplementation. Previous
studies also indicated that these differences might be partly
explained by geographical and nutritional variations,59,139 as
well as by different sampling methods.59 Moreover, nutri-
tional assessment through a limited number of 24-hour die-
tary recalls could attenuate the associations, particularly
because the main dietary sources of EPA, DHA (fish), and
some other micronutrients are not eaten on a regular daily
basis.26 In addition, it is important to mention that some
genetic variants might affect the FA composition of breast
milk.140
Because of this large heterogeneity between studies, we
could not conduct a meta-analysis; however, this compre-
hensive review provides sufficient information of both ob-
servational and interventional studies conducted on the
reflection of macro- and micronutrients of maternal diet in
breast milk, with more evidence on the effect of maternal FA
supplementation and higher levels of fat and fat-soluble vi-
tamin in human milk.
 MATERNAL DIET AND HUMAN MILK COMPOSITION
Some other underlying factors, for instance, using different
tools for maternal dietary assessment, including 24-hour re-
call, dietary record, food frequency questionnaire, the va-
lidity of these questionnaires among different ethnicities and
populations, considerable individual variation in diet, dietary
data analysis, over- and/or underestimation of dietary intake,
food preparation methods, milk sample collection method,
different doses and forms of supplementations, ethnicity,
postpartum milk sampling, and duration of breastfeeding,
might partly explain the large variation between different
study results.26,95,141
In conclusion, maternal dietary intake, particularly FAs,
and some micronutrients, including fat-soluble vitamins, vi-
tamin B1, and vitamin C, was related to their content in breast
milk composition.
Disclosure Statement
The study was conducted as a thesis funded by Isfahan
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University of Medical Sciences. No competing financial in-
terests exist.
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Address correspondence to:
Roya Kelishadi, MD
Department of Pediatrics
Child Growth and Development Research Center
Research Institute for Primordial Prevention
of Non-communicable Disease
Isfahan University of Medical Sciences
Hezar Jerib Avenue
Isfahan 81676-36954
Iran
E-mail: roya.kelishadi@gmail.com; kroya@aap.net
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