乳母膳食和乳汁成分与婴儿生长发育的关系分析

Analysis on relationships between diet,breast milk compositions of lactating mothers and infant growth

目的:调查吉林省长春市乳母膳食、乳汁成分和婴儿生长发育情况,探讨母乳营养水平与婴儿生长发育的关系,为促进婴儿健康发育提供理论依据。方法:募集138例健康乳母,在产后40~45 d面对面调查研究对象基本信息及婴儿生长发育信息,并采用“二十四小时膳食回顾法”调查乳母膳食情况。提供标准食物图片估算研究对象的膳食品种及数量。应用《金钥匙营养专家系统软件-孕产妇版》分析乳母膳食摄入的能量和营养素水平,并与《中国孕期哺乳期妇女0~6岁儿童膳食指南(2007)》和《中国居民膳食营养素参考摄入量(2013版)》比较,评价乳母的膳食摄入水平。收集母乳并测量婴儿的生长发育指标,采用乳汁成分分析仪测定乳汁宏量营养素水平。分析乳母膳食、乳汁成分与婴儿生长发育之间的关系。结果:乳母平均能量摄入为(1 698.74 ±406.23) kcal·d^-1 ,蛋白质、脂类和碳水化合物提供的能量比例分别为14.06%、33.83%和52.09%。乳汁平均能量为(61.18±13.04)kcal·100 g^-1 ,蛋白质含量为(0.94±0.19)g·100 g^-1 ,脂类含量为(3.55±1.27)g·100 g^-1 ,乳糖含量为(6.38±0.82)g·100 g^-1 。乳母膳食蛋白质摄入量与乳汁蛋白质含量有关联(r=0.203,P=0.017)。控制喂养方式、乳汁能量、婴儿性别和婴儿年龄的影响,偏相关分析显示乳汁各成分与婴儿身长增量和体质量增量之间均无关联(P>0.05)。结论:乳母膳食营养素摄入量存在不足及不均衡现象;乳母膳食蛋白质摄入量会影响乳汁蛋白质含量,乳汁脂类和乳糖含量与乳母膳食营养素之间无关联,且母乳成分与婴儿生长发育之间也无关联。

Objective:To investigate the diet of lactating mothers,breast milk components and the growth of infants in Changchun City,Jilin Province and explore the relationships between the nutritional status of breast milk and the growth of infants,and to provide the theoretical basis for the development of the infant health.Methods: A total of 138 healthy nursing mothers were selected.Within 40-45 d after the delivery,face-to-face investigations were conducted to obtain the basic information of the subjects and the growth and development information of the infants.The 24-hour dietary review method was adopted to investigate the dietary status of the lactating mothers,the standard food pictures were provided to estimate the dietary variety and the quantities of the subjects.Golden key maternal nutrition expert system software was applied to analyze the energy and nutrients of dietary intake,and they were compared with Dietary Guidelines of Pregnant,Lactating Women and 0-6 Years Old Children in China (2007) and Chinese Dietary Reference Intake of Nutrients (2013);the diet intake level of the lactating mothers was evaluated.The breast milk was collected and the infant growth and development indicators were measured.The compositions of breast milk were analyzed by milk composition analyzer.The relationships between the lactating mother’ s diet,the breast milk composition and the infant growth and development were analyzed.Results: The average energy intake of the lactating mothers was (1 698.7±406.23) kcal·d^-1 ,and the energy proportions of proteins,lipids,and carbohydrates were 14.06%,33.83%,and 52.09%,respectively.The average energy content of breast milk was (61.18±13.04) kcal·100 g^-1 ,the average protein content was (0.94±0.19) g·100 g^-1 ,the average lipid content was (3.55±1.27) g·100 g^-1 ,and the average lactose content was (6.38±0.82) g·100 g^-1 .The dietary protein intake was associated with the protein content of breast milk (r=0.203,P=0.017).When the influence of feeding patterns,energy of breast milk,infant gender,and age were controlled,the partial correlation analysis result showed that the breast milk composition had no correlations with the increases in body lengths and weights of the infants (P >0.05).Conclusion:There are insufficience and imbalance in the general dietary intakes in the lactating mothers.The dietary protein intake of lactating mothers may influence the protein content of breast milk.The lipid and carbohydrate contents in milk have no significant correlations with the dietary nutrients of the lactating mothers.The breast milk compositions of lactating mothers have no effects on the growth and development of infants.