Article

Dietary supplements for the lactating adolescent mother: Influence on plasma micronutrients

Department of Nutrition and Dietetics, Federal Fluminense University, Rio de Janeiro, Brazil.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral (Impact Factor: 1.04). 03/2011; 26(2):392-8. DOI: 10.1590/S0212-16112011000200022
Source: PubMed

ABSTRACT

The nutritional status of micronutrients in lactating adolescent women is crucial to guarantee an adequate secretion of these in breast milk and, consequently, an adequate nutritional status of children. Hence, more attention should be given to micronutrient status of adolescent mother who breastfeed. This study aimed to evaluate the influence of multimicronutrients supplementation upon nutritional status of iron, copper, zinc and calcium of lactating adolescent mother from low socioeconomic status in Rio de Janeiro/Brazil.
We conducted a randomized, placebo-controlled trial. During 60 days, 36 adolescents were allocated into two groups: supplemented group (SG) with 17 volunteers, receiving daily multimicronutrients supplement and the placebo group (PG) with 19 volunteers, receiving an inert compound. Plasma iron, copper, zinc and calcium and hemoglobin were determined at 7, 11 and 15 of the postpartum weeks (PPW). The effect of supplementation was analyzed by analysis of variance, comparing the differences between groups and within groups.
The average age of volunteers was 17.1 ± 0.8 for the supplemented group and 16.3 ± 1.4 for the placebo group. We observed an increase in the mean concentration of zinc (p < 0.05) and hemoglobin (p < 0.05) in the SG during the study (60 days), while the PG showed reduction (p < 0.05) in the mean concentration of copper between the 7th and 11t h PPW.
The results of this study show that supplementation with multimicronutrientes exerted positive effect on hemoglobin, copper and zinc.

Download full-text

Full-text

Available from: André Manoel Correia-Santos, May 01, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: to evaluate changes in the nutritional status of lactating adolescents in different postpartum weeks. this is an analytical, observational, longitudinal study. Lactating adolescents were followed-up from the 5th to the 15th postpartum week (PPW). The nutritional status was evaluated in the 5th, 10th and 15th PPW by the Body Mass Index (BMI/age). A colorimetric method was used to determine hemoglobin level and microcentrifugation to define hematocrit. ANOVA with repeated measures was used to compare means, followed by the Tukey post-test. The level of significance was 5%. modification in nutritional status was observed from the pregestational period to the 15th PPW, with a reduction in the frequency of lactating adolescents with low weight (from 21% to 9%) and a rise in the frequency of overweight (21% to 27%) and eutrophic (58% to 64%) adolescents. Although mean hemoglobin (12.3 ± 1.7 g/dL) and hematocrit (39.0 ± 4.0%) levels were normal, a high frequency of anemia (30%) was observed throughout the study period. the present results show that the body weight of lactating adolescents rises during the lactation period and could lead to a higher frequency of obesity among adolescents. Anemia is still a nutritional problem, not only during pregnancy, but also during the postpartum period. It is necessary to prevent and treat probable subclinical nutritional deficiencies at this biological time.
    Full-text · Article · Apr 2011 · Revista brasileira de ginecologia e obstetrićia: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study was conducted to evaluate the impact of a food aid program (Plan Más Vida, PMV) on the micronutrient nutritional condition of lactating mothers 1 year after its implementation. The food program provided supplementary diets (wheat- and maize-fortified flour, rice or sugar, and fortified soup) to low-income families from the province of Buenos Aires, Argentina. A prospective, non-experimental study was carried out to evaluate the micronutrient nutritional status of lactating mothers (n = 178 at baseline and n = 151 after 1 year). Biochemical tests (hemoglobin, ferritin, zinc, vitamin A, and folic acid), anthropometric assessments (weight and height) and dietary surveys (24-h recall) were performed. We found no significant changes in anthropometric values 1 year after the intervention. The risk for vitamin A (retinol 20-30 μg/dl) and folate deficiency significantly decreased 1 year after PMV implementation (56.3 vs. 29.9 and 50.3 vs. 3.4 %, respectively; p < 0.001). Anemia was seen in 25.8 % of lactating mothers at baseline, without statistically significant differences 1 year after (p = 0.439). The nutritional data obtained after assessing the early impact of PMV actions may be useful to provincial health authorities to perform periodic evaluations in the future.
    No preview · Article · Nov 2012 · Biological trace element research
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The days and weeks following childbirth – the postnatal period – is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. Yet, this is the most neglected period for the provision of quality care. WHO’s Postpartum care of the mother and newborn: a practical guide (WHO/RHT/MSM/98.3) was published in 1998. Guidance from this document was included in the WHO guideline Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice, published in 2004 (http://whqlibdoc.who.int/publications/2006/924159084X_eng.pdf). In keeping with the WHO Handbook on development of guidelines, these documents needed to be updated to include current best evidence-based practices. To initiate the guidelines update process, WHO convened a technical consultation in October 2008. At this consultation, existing WHO and other agency guidelines related to postnatal care were reviewed for best practices and supporting evidence. Areas were identified where guidance was non-existent or conflicting, and these were prioritized for further work. The process of evidence review synthesis and establishment of a Steering Group and Guidelines Development Group (GDG) was taken up during 2011–2. Systematic reviews were commissioned to address the timing and content of postnatal care and contacts for the mother and newborn following normal childbirth. The GDG consultation to formulate recommendations was held in Geneva from 3–5 September 2012. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. These health professionals include physicians, midwives, nurses and auxiliary nurse-midwives providing primary health care in facilities and at home. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services. The information in these guidelines will be included in job aids and tools for both pre- and in-service training of health professionals to improve their knowledge, skills and performance in postnatal care. The guidelines focus on postnatal care of mothers and newborns in resource-limited settings in low- and middle-income countries. The critical maternal health outcome considered was maternal morbidity (including haemorrhage, infections, anaemia and depression). The two critical neonatal outcomes were neonatal mortality and morbidity. Other important outcomes included growth, cognitive development and breastfeeding status. The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The guidelines include assessment of mothers and newborns to detect problems or complications, but the management of these conditions is addressed in other WHO documents (e.g. management of a mother with postpartum haemorrhage – PPH – or infection, care of a preterm or low-birth-weight newborn or a newborn with infection). Through 2011–12, the Department of Maternal, Newborn, Child and Adolescent Health coordinated efforts to review and synthesize the evidence on the priority questions. The process included targeted systematic reviews of relevant literature, preparation of GRADE1 profiles, and analysis of the benefits and risks, values and preferences, and costs of implementation. The systematic reviews, meta-analyses and GRADE profiles were conducted by different expert groups using the methodology recommended by the Guidelines Review Committee. In drafting the recommendations, the WHO Steering Group used the summaries of evidence for the critical outcomes, quality of evidence, risks and benefits of implementing the recommendations, values and preferences and costs. The draft recommendations, evidence summaries, GRADE tables and information on benefits and risks, values and preferences, and costs were presented to the GDG at its meeting held at WHO headquarters in Geneva, Switzerland, in September 2012. The GDG reviewed and discussed this information to finalize the recommendations. Individual members of the GDG filled in a worksheet to comment on the quality of evidence and the draft and strength of the recommendation before discussing these as a group. Where the GDG determined that there was insufficient evidence, consensus within the group was used as the basis of the recommendation. The decisions on the final recommendations and their strengths were made by consensus or, where necessary, by vote. The recommendations for postnatal care of mothers and newborns are summarized in the table below. These recommendations will be regularly updated as more evidence is collated and analysed on a continuous basis, with major reviews and updates at least every five years. The next major update will be considered in 2018 under the oversight of the WHO Guidelines Review Committee. Full text can be accessed at http://apps.who.int/iris/bitstream/10665/97603/1/9789241506649_eng.pdf.
    Full-text · Technical Report · Oct 2013
Show more