Impact of maternal nutrition oh breast-milk composition: a systematic review

Background: It is widely reported that maternal diet influences the nutritional composition of breast milk. The amount of variability in human milk attributable to diet remains mostly unknown. Most original studies that reported a dietary influence on breast-milk composition did not assess diet directly, did not quantify its association with milk composition, or both. Objective: To gather the quantitative evidence on this issue, we carried out a systematic PubMed and Medline search of articles published up to January 2015 and filtered the retrieved articles according to predefined criteria. Design: Only studies that provided quantitative information on both maternal diet and milk data, measured in individual healthy mothers of healthy term infants and based on an original observational or experimental design, were included. Exclusion criteria were a focus on supplements, transfer of toxic metals or other contaminants from diet to milk, or on marginally nourished women. Results: Thirty-six publications including data on 1977 lactating women that matched our criteria were identified. Seventeen studies investigated dietary effects on fatty acids in breast milk. The rest included studies that focused on a diverse spectrum of other nutritional properties of breast milk. The largest evidence, in terms of number of articles, for any link between maternal diet and a nutritive property of breast milk came from 3 studies that supported the link between fish consumption and high docosahexaenoic acid in breast milk and 2 studies that reported a positive correlation between dietary vitamin C and milk concentrations of this vitamin. Conclusions: The available information on this topic is scarce and diversified. Most of the evidence currently used in clinical practice to make recommendations is limited to studies that only reported indirect associations.