Nutritional supplements and mother's milk composition: a systematic review of interventional studies

BackgroundThis study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk.MethodsWe systematically searched electronic databases including Medline via PubMed, Scopus and ISI Web of Science till May 24, 2018. The following terms were used systematically in all mentioned databases: (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 OR maternal milk) AND (vitamin a OR retinol OR retinal OR retinoic acid OR beta-carotene OR beta carotene OR ascorbic acid OR l-ascorbic acid OR l ascorbic acid OR vitamin c OR vitamin d OR cholecalciferol OR ergocalciferol OR calciferol OR vitamin e OR tocopherol OR tocotrienol OR alpha-tocopherol OR alpha tocopherol OR alpha -tocopherol OR alpha tocopherol OR vitamin k OR vitamin b OR vitamin b complex OR zinc OR iron OR copper Or selenium OR manganese OR magnesium) and we searched Medline via Medical subject Headings (MeSH) terms. We searched Google Scholar for to increase the sensitivity of our search. The search was conducted on human studies, but it was not limited to the title and abstract. Methodological quality and risk of bias of included studies were evaluated by Jadad scale and Cochrane risk of bias tools, respectively.ResultsThis review included papers on three minerals (zinc, iron, selenium) and 6 vitamins (vitamin A, B, D, C, E and K) in addition to multi-vitamin supplements. Although studies had different designs, e.g. not using random allocation and/or blinding, our findings suggest that maternal use of some dietary supplements, including vitamin A, D, vitamin B1, B2 and vitamin C might be reflected in human milk. Vitamin supplements had agreater effect on breast milk composition compared to minerals. Higher doses of supplements showed higher effects and they were reflected more in colostrum than in the mature milk.ConclusionMaternal dietary vitamin and/or mineral supplementation, particularly fat- soluble vitamins, vitamin B1, B2 and C might be reflected in the breast milk composition. No difference was found between mega dose and single dose administration of minerals.

Automated summary

This study found that maternal dietary vitamin and/or mineral supplementation, especially fat-soluble vitamins, vitamin B1, B2, and C, may have an impact on the composition of breast milk. Higher doses of supplements had a greater effect, particularly in colostrum, compared to minerals.