Evaluation of postpartum vitamin E supplementation on the concentration of retinol and alpha-tocopherol in maternal serum and milk

One of the major public health nutritional problems in the world is vitamin A deficiency, especially in developing countries, with the groups considered to be at risk for pregnant women, postpartum women and children in early childhood. Therefore, the main objective of this study was to evaluate the effect of alphatocopherol supplementation in the immediate postpartum on the concentration of retinol and alpha-tocopherol in serum and human milk up to 60 days postpartum. This study was prospective, controlled, randomized, starting with 80 women attended for delivery in two public maternity hospitals in Rio Grande do Norte. In the immediate postpartum period, these women were allocated to the control groups (n = 18) without any intervention; supplemented 1 (n = 16) receiving the dose of 400 IU of RRR-alpha-tocopherol; and supplemented 2 (n = 19) receiving the dose of 800 IU of RRR-alpha-tocopherol. Blood and maternal milk were collected in 4 moments: 1 o (0 hour) before supplementation, 20o, 30o, 60o days postpartum, and maternal milk was also collected in 24 hours and 7 days after the first collection, totaling 6 milk samples. Retinol and alpha-tocopherol were analyzed by High Performance Liquid Chromatography. Supplementation with the 800 IU dose of RRR-alpha-tocopherol guaranteed higher circulating concentrations of retinol up to 30 days postpartum and alpha-tocopherol up to 20 days. The impact of alpha-tocopherol supplementation on the concentration of retinol in breast milk can be observed both in the group receiving the dose of 400 IU of RRR-alpha-tocopherol and the one that received the dose of 800 IU, as it caused an increase in concentration of retinol 24 hours after supplementation. Regarding the analysis of alpha-tocopherol in breast milk, the increase in alpha-tocopherol concentration provided 24 hours after supplementation was high in both supplemented groups, but in group 2 this increase was maintained until the 7th day of the study. Evaluating the supply of breast milk in relation to the daily requirement of vitamin A for infants up to 6 months of age (400 g / day), the supplemented group 1 contemplated the requirement established only in the production of milk up to 24 hours postpartum and supplemented group 2 completed the application by the 20th day after delivery. Thus, it is concluded that if maternal nutritional status reflects retinol and alpha-tocopherol concentrations in maternal serum and milk, vitamin E supplementation was effective for both nutrients during the analyzed period. dose of vitamin E administered.Um dos principais problemas nutricionais de saúde pública no mundo é a deficiência de vitamina A, principalmente em países em desenvolvimento, sendo os grupos considerados de risco as mulheres grávidas, puérperas e crianças na primeira infância. Sendo assim, este estudo tem como objetivo principal avaliar o efeito da suplementação, no pós-parto imediato, com alfa-tocoferol sobre a concentração de retinol e alfa-tocoferol no soro e leite humano até 60 dias após o parto. Este estudo foi prospectivo, controlado, randomizado, tendo iniciado com 80 mulheres atendidas para o parto em duas maternidades públicas no Rio Grande do Norte. No pós-parto imediato, essas mulheres foram alocadas nos grupos: controle (n = 18) sem nenhuma intervenção; suplementado 1 (n = 16) recebendo a dose de 400 UI de RRR-alfa-tocoferol; e suplementado 2 (n = 19) recebendo a dose de 800 UI de RRRalfa-tocoferol. Foram coletados sangue e leite maternos em 4 momentos: 1 o (0 hora) antes da suplementação, 20o , 30o , 60o dias pós-parto, sendo coletado leite materno também em 24 horas e 7 o dia após a primeira coleta, totalizando 6 coletas de leite. O retinol e o alfa-tocoferol foram analisados por Cromatografia Líquida de Alta Eficiência. A suplementação com a dose de 800 UI de RRR-alfa-tocoferol garantiu maiores concentrações circulantes de retinol até 30 dias pós-parto e de alfa-tocoferol até 20 dias. O impacto da suplementação com alfa-tocoferol sobre a concentração de retinol no leite materno pode ser observado tanto no grupo que recebeu a dose de 400 UI de RRR-alfa-tocoferol como o que recebeu a de 800 UI, pois ocasionou um aumento na concentração do retinol 24 horas após a suplementação. Em relação à análise do alfa-tocoferol no leite materno, o aumento da concentração de alfatocoferol proporcionado 24 horas após a suplementação se apresentou elevado em ambos os grupos suplementados, porém no grupo 2 este aumento se manteve até o 7 o dia da pesquisa. Avaliando a oferta de leite materno em relação ao requerimento diário de vitamina A para o lactente até 6 meses de idade (400 g/dia), o grupo suplementado 1 contemplou o requerimento estabelecido somente na produção do leite até 24 horas pós-parto e o grupo suplementado 2 supriu o requerimento até o 20o dia após o parto. Desta forma, conclui-se que se o estado nutricional materno reflete as concentrações de retinol e alfa-tocoferol no soro e leite maternos, a suplementação com vitamina E foi eficaz para os dois nutrientes durante o período analisado, sendo esse aumento maior quanto maior a dose de vitamina E administrada

Evaluation of human milk titratable acidity before and after addition of a nutritional supplement for preterm newborns

Abstract Objective: To evaluate the initial Dornic acidity in raw human milk, after pasteurization and after heating and dilution of a dietary supplement for preterm infants. Methods: A quantitative, descriptive, and experimental study was carried out with a convenience sample at the human milk bank at a Brazilian public maternity, with specialized care for pregnant women and newborns at risk. The eligibility criteria for the study sample included 93 frozen raw human milk in suitable containers with volumes &#8805;100 mL and initial Dornic acidity &#8804;8° Dornic (ºD). Milk acidity of human milk was measured in four stages: in raw human milk (initial); after pasteurization; after the heating of pasteurized milk and dilution of the supplement; and after thirty minutes of supplementation. Results: The initial acidity was 3.8° D ± 1.3 (95% CI: 3.56-4.09) with no significant difference in Dornic acidity in pasteurized milk, which was 3.6° D ± 1.2 (95% CI: 3.36-3.87). The dilution of the supplement in pasteurized milk that was heated significantly increased mean Dornic acidity to 18.6 °D ± 2.2 (95% CI: 18.18-19.11), which remained high after thirty minutes of supplementation at 17.8 °D ± 2.2 (95% CI: 17.36-18.27), considering p < 0.05. Conclusions: The study observed no significant differences in Dornic acidity of raw human milk and pasteurized human milk; however, the dilution of a human milk supplementation caused a significant increase in acidity. Further investigations are necessary on the influence of this finding on the quality of supplemented milk and its consequences on the health of preterm infants

Evaluation of human milk titratable acidity before and after addition of a nutritional supplement for preterm newborns

Abstract Objective: To evaluate the initial Dornic acidity in raw human milk, after pasteurization and after heating and dilution of a dietary supplement for preterm infants. Methods: A quantitative, descriptive, and experimental study was carried out with a convenience sample at the human milk bank at a Brazilian public maternity, with specialized care for pregnant women and newborns at risk. The eligibility criteria for the study sample included 93 frozen raw human milk in suitable containers with volumes ≥100 mL and initial Dornic acidity ≤8° Dornic (ºD). Milk acidity of human milk was measured in four stages: in raw human milk (initial); after pasteurization; after the heating of pasteurized milk and dilution of the supplement; and after thirty minutes of supplementation. Results: The initial acidity was 3.8° D ± 1.3 (95% CI: 3.56-4.09) with no significant difference in Dornic acidity in pasteurized milk, which was 3.6° D ± 1.2 (95% CI: 3.36-3.87). The dilution of the supplement in pasteurized milk that was heated significantly increased mean Dornic acidity to 18.6 °D ± 2.2 (95% CI: 18.18-19.11), which remained high after thirty minutes of supplementation at 17.8 °D ± 2.2 (95% CI: 17.36-18.27), considering p < 0.05. Conclusions: The study observed no significant differences in Dornic acidity of raw human milk and pasteurized human milk; however, the dilution of a human milk supplementation caused a significant increase in acidity. Further investigations are necessary on the influence of this finding on the quality of supplemented milk and its consequences on the health of preterm infants