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Community and International Nutrition

An Overlap of Breastfeeding during Late Pregnancy Is Associated with Subsequent Changes in Colostrum Composition and Morbidity Rates among Peruvian Infants and Their Mothers

Grace S. Marquis³, Mary E. Penny^*, J. Paul Zimmer, Judith M. Díaz^* and R. Margot Marín^*

Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011; ^* Instituto de Investigación Nutricional, Apartado 18–0191, Lima, Peru; and Wyeth Nutrition, Philadelphia, PA 19101

³To whom correspondence should be addressed. E-mail: gmarquis{at}iastate.edu.

An overlap of breast-feeding and late pregnancy is associated with decreased intake of human milk and reduced infant growth. We evaluated the association of an overlap with macronutrient and immunological components of milk, infant urinary IgA, and infant and maternal morbidity. On d 2 and 1 mo postpartum, staff measured 24-h intake of breast milk and collected samples from 133 Peruvian women; 68 had breast-fed during the last trimester of pregnancy (BFP) and 65 had not breast-fed during pregnancy (NBFP). Data on maternal and infant anthropometry and health were collected for 1 mo. On d 2, lactose and lysozyme concentrations were higher, total lysozyme intake was higher and concentration and total intake of lactoferrin were lower in the BFP than the NBFP group (P < 0.05). The total 1-mo IgA intake was lower among BFP than NBFP infants (P = 0.01). Urinary IgA concentration was correlated with breast milk IgA concentration (r = 0.29; P = 0.01) but not with breast-feeding during pregnancy. An overlap was not associated with diarrhea but BFP infants were 5 times as likely to have a cough for at least 7 d than NBFP infants (P < 0.05). Reported mastitis was rare and occurred only in the NBFP group (P = 0.05). An overlap of breast-feeding and late pregnancy was associated with changes in milk composition, an increased frequency in symptoms of infant respiratory illness but decreased reported mastitis. Further in-depth studies are warranted to determine the cumulative effects associated with a breast-feeding/pregnancy overlap on infant and maternal outcomes.

KEY WORDS: • breast-feeding • pregnancy • breast milk composition • immunology • respiratory illness

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