Lactation, diabetes, and nutrition recommendations

Current Diabetes Reports - Tập 4 - Trang 370-376 - 2004
Diane Reader1, Marion J. Franz1
1Nutrition Concepts by Franz, Inc., Minneapolis, USA

Tóm tắt

Human milk is recommended for infants throughout at least the first year of life. Breastfeeding is also recommended for infants of women with preexisting diabetes or gestational diabetes. Dietary Reference Intakes (DRIs) 2002 provides recommendations for energy and macronutrients for all ages and for pregnancy and lactation. During the first 6 months, infants receive an average of 500 kcal/d from human milk, and during the second 6 months 400 kcal/d. To cover this need for the first 6 months of lactation, women need an additional energy intake of 330 kcal/d plus the approximately 170 kcal/d that is supplied by the women's tissue stores, and for the second 6 months 400 kcal/d. The DRIs also set recommended levels for both the infant and mother for carbohydrate, protein, and fats. Women with type 1 diabetes may have problems initiating breastfeeding, and with hypo- and hyperglycemia during lactation. Breastfeeding may have long-term beneficial effects on glycemia in women with gestational diabetes. More research is needed on all aspects of lactation in women with diabetes.

Tài liệu tham khảo

Institute of Medicine: Nutrition During Lactation. Washington, DC: National Academy Press; 1991. Franz MJ, Bantle JP, Beebe CA, et al.: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications (technical review). Diabetes Care 2002, 25:148–198. American Diabetes Association: Gestational diabetes mellitus (position statement). Diabetes Care 2004, 27(suppl1):S88-S93. Lawrence R: Breastfeeding—A Guide for the Medical Professional. St. Louis, MO: Mosby; 1999. Hartmann P, Creagan M: Lactogenesis and the effects of insulin-dependent diabetes mellitus and prematurity. J Nutr 2001, 11:301S-320S. Murtaugh MA, Ferris AM, Capacchione CM, Feese EA: Energy intake and glycemia in lactating women with type 1 diabetes. J Am Diet Assoc 1998, 98:642–648. Institute of Medicine of the National Academies: Dietary Reference Intakes. Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press; 2002. Extensive review and updated recommendations for energy and macronutrient needs for infants and during pregnancy and lactation. Allen JC, Keller RP, Archer P, Neville MC: Studies in human lactation: milk composition and daily secretion rates of macronutrients in the first year of lactation. Am J Clin Nutr 1991, 54:69–80. Heinig MJ, Nommsen LA, Peerson JM, et al.: Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING Study. Am J Clin Nutr 1993, 58:152–161. Institute of Medicine, Food and Nutrition Board: Nutrition During Pregnancy, Part I and II. Washington, DC: National Academy Press; 1990. Butte NF, Hopkinson JM: Body composition changes during lactation are highly variable among women. J Nutr 1998, 128:381S-385S. Dewey KG: Growth characteristics of breast-fed compared to formula-fed infants. Biol Neonate 1998, 74:94–105. Dusdieker LB, Hemingway DL, Stumbo PG: Is milk production impaired by dieting during lactation? Am J Clin Nutr 1994, 59:833–848. Dewey KG, Heining MJ, Nommsen LA: Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr 1993, 58:162–166. Dewey KG, McCrory MA: Effects of dieting and physical activity on pregnancy and lactation. Am J Clin Nutr 1994, 59(suppl):446S-452S. Gibbon A: Solving the brain's energy crisis. Science 1998, 280:1345–1347. Lönnerdal B: Effects of maternal nutrition in human lactation. In Human Lactation 2: Maternal and Environmental Factors. Edited by Hamosh M, Goldman AS. New York, NY: Plenum Press; 1986:301–323. Motil KJ, Davis TA, Montandon CM, et al.: Whole-body protein turnover in the fed state is reduced in response to dietary protein restriction in lactating women. J Clin Nutr 1996, 64:32–39. Francois CA, Connor SL, Wander RC, Connor WE: Acute effects of dietary fatty acids on the fatty acids of human milk. Am J Clin Nutr 1998, 67:301–308. Birch EE, Hoffman DR, Castaneda YS, et al.: A randomized controlled trial of long-chain polyunsaturated fatty acid supplementation of formula in term infants after weaning at 6 weeks of age. Am J Clin Nutr 2002, 75:570–580. Ferris AM, Dalidowitz CK, Ingardia CM, et al.: Lactation outcome in insulin-dependent diabetic women. J Am Diet Assoc 1988, 88:317–322. Ferris AM, Neubauer SH, Bendel RB, et al.: Perinatal lactation protocol and outcome in mothers with and without insulindependent diabetes mellitus. Am J Clin Nutr 1993, 58:43–48. Kerssen A, Evers IM, deValk HW, Visser GHA: Effect of breast milk of diabetic mothers on bodyweight of the offspring in the first year of life. Eur J Clin Nutr 2004, 10:1038–1041. There were no significant differences in weight and BMI in breast-, formula-, or mixed-fed infants at 1 year of age. Kjos SL, Henry O, Lee RM, et al.: The effect of lactation on glucose and lipid metabolism in women with recent gestational diabetes. Obstet Gynecol 1993, 82:451–455. McManus RM, Cunningham I, Watson A, et al.: Beta-cell function and visceral fat in lactating women with a history of gestational diabetes. Metabolism 2001, 50:715–719. Three months of breastfeeding in women with gestational diabetes was associated with a slight improvement in β-cell function, but with no differences in measures in visceral or subcutaneous fat compared with nonbreastfeeding women.