Nutrient Intake from Diet and Micronutrient Supplements among Breastfeeding Women: Comparison to Nutrient Recommendations ^†

Abstract

An optimal nutrient intake is required for the health of both breastfeeding women and their infants. This study aims to assess the nutrient adequacy of breastfeeding women living in New Zealand. A cohort of breastfeeding women residing in the Palmerston North area was enrolled in the longitudinal follow-up Mother and Infant Nutrition Investigation study. Seventy-six women completed a weighed four-day diet diary, including supplement use at three months postpartum. Maternal demographic information was collected via a self-administered online questionnaire. Dietary data were analysed using Foodworks 9 Professional (Xyris Software, Australia) using the dataset from New Zealand Foodfiles 2016. Nutrient intakes from food were compared to the nutrient reference values for Australia and New Zealand (2006) to assess dietary adequacy. Considering food only, the median (Q1, Q3) energy intake was 9706 (8143, 10,952) kJ. Median intakes of macronutrients as a percentage of energy were 16.6% for protein, 37.8% for total fat, 15.5% for saturated/trans-fat and 40.0% for carbohydrates. Many participant intakes were above the acceptable macronutrient distribution range (AMDR) for total fat (68%) and saturated/trans-fat (88%) and below the AMDR for carbohydrates (80%). The median fibre intake was 29 (21, 34) g with 55% below the estimated average requirement (EAR) of 30g. Many participants had intakes below the EAR or adequate intake and were at risk of dietary inadequacy for micronutrients, including thiamin (26%), folate (42%), vitamin A (38%), vitamin E (61%), calcium (36%), selenium (59%) and zinc (32%). Considering both food and supplements, some participants had intakes above the upper level of intake (UL), including iron (12%, 45 mg/day) and folic acid (3%, 1000 mcg/day). This research suggests a high-fat, low-carbohydrate intake coupled with micronutrient inadequacy among breastfeeding women. Some women had high intakes of micronutrients from supplements. Research is required to determine whether such deviations from recommendations have detrimental effects on mothers and infants.