Lactancia materna exclusiva en Castellón: repercusión materno-infantil. Estudio preliminar
Starting from the key role that breastfeeding plays, both from the point of view of public health for infants and mothers and from a psychosocial point of view, this thesis aims to expand the set of studies carried out in this area that help the doctors to know the nutritional trends and nutritional status of mothers during the periods of pregnancy and lactation and the possible repercussions on the nutritional composition of the milk produced and on the growth percentiles of infants. The general objective of this doctoral thesis is to study whether there is a relationship between the nutritional quality / bacteriological presence of human milk with food and the nutritional status of breastfeeding mothers, as well as its implication in the growth curve of fed children with human milk studied. For this, the following specific objectives are proposed: • Assess the nutritional status, as well as study the habits and dietary intake of breastfeeding mothers. • Carry out a descriptive study of the composition of breast milk in terms of its content in macronutrients, calcium and mesophilic aerobic bacteria. • Study the growth percentiles of exclusively breastfed infants. Methodology To carry out the study there are: • Cards for the collection of personal and clinical-obstetric data of the participating mothers as well as the anthropometric parameters. • Questionnaire on the eating habits of mothers during pregnancy. • Validated Food Consumption Frequency Questionnaire. • Three-day food record that will be used to calibrate maternal diets with the DIAL version 1.10 software (ALCE Ingeniería, Madrid, Spain). • Pediatric follow-up cards established by the Valencian Community Health Department. • Analysis of breast milk samples in an accredited laboratory (ENAC accreditation tests No. 221 / LE451). The analysis includes energy content in Kcal / Kjul, determination of gerber fat and profile of fatty acids, proteins, lactose, dry extract and moisture, ash, calcium and mesophilic aerobic bacteria. • SPSS statistical package (Statistical Package for Social Sciences) in its version 15.0 for Windows for data processing. Conclusions: • The mothers participating in the study present anthropometric values that are mostly within normal parameters as well as a weight gain during pregnancy adjusted to the established recommendations. • During pregnancy the mothers participating in the study show a frequency of food consumption far from the patterns of the Mediterranean diet. • The calibrated diet of mothers during the lactation period is quite close to the recommendations regarding energy intake and parameters included in the nutritional objectives of the SENC 2011. Regarding the vitamin-mineral content of the diet, the deficit of calcium, iodine, vitamin D, E, and folic acid. • The bacteriological quality of the analyzed milk is acceptable following the established safety standards (NICE clinical Guidelines 2010) and the nutritional composition is practically within the reference standard values. • Milk samples show a distribution of the lipid profile shifted towards the SFA and PUFA to the detriment of the AGMI. However, and in accordance with the standard values, oleic acid is the major fatty acid followed by palmitic acid and linoleic acid. • Although no effect of maternal age is observed, the composition of breast milk may undergo modifications based on the anthropometric characteristics of the mother. • The effect of diet on the lipid fraction of breast milk is confirmed, which reaches its maximum exponent in the analysis of the effect of LC-PUFA. And this effect not only reflects the intake of the previous days but also in a significant way the long-term feeding that conditions the maternal fat reserve mobilized to a lesser or greater degree during lactation. • The growth percentiles in weight, height and head circumference of the breastfed children who participated in the study are completely within the growth percentiles established by the WHO. • The only factor affecting the weight percentiles that have been established in the present study is the mother's age, which, on the other hand, does not affect the nutritional composition of breast milk.