Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

被引:6
作者
Allegaert, Karel [1 ,2 ,3 ]
Smits, Anne [1 ,4 ]
机构
[1] Katholieke Univ Leuven, Dept Dev & Regenerat, Herestr 49, B-3000 Leuven, Belgium
[2] Katholieke Univ Leuven, Dept Pharmaceut & Pharmacol Sci, Herestr 49, B-3000 Leuven, Belgium
[3] Erasmus MC, Dept Clin Pharm, Postbus 2040, NL-3000 CA Rotterdam, Netherlands
[4] Univ Hosp UZ Leuven, Neonatal Intens Care Unit, Herestr 49, B-3000 Leuven, Belgium
来源
CHILDREN-BASEL | 2020年 / 7卷 / 06期
关键词
lactation; physiology-based lactation models; drug exposure prediction; fasting; drug safety; newborn; infant; human milk; RAMADAN;
D O I
10.3390/children7060060
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
There are guidelines on lactation following maternal analgo-sedative exposure, but these do not consider the effect of maternal fasting or fluid abstention on human milk macronutrient composition. We therefore performed a structured search (PubMed) on 'human milk composition' and screened title, abstract and full paper on 'fasting' or 'abstention' and 'macronutrient composition' (lactose, protein, fat, solids, triglycerides, cholesterol). This resulted in six papers and one abstract related to religious fasting (n=129 women) and observational studies in lactating women (n=23, healthy volunteers, fasting). These data reflect two different 'fasting' patterns: an acute (18-25 h) model in 71 (healthy volunteers, Yom Kippur/Ninth of Av) women and a chronic repetitive fasting (Ramadan) model in 81 women. Changes were most related to electrolytes and were moderate and mainly in the chronic repetitive fasting model, with no clinical significant changes in macronutrients during acute fasting. We therefore conclude that neither short-term fasting nor fluid abstention (18-25 h) affect human milk macronutrient composition, so that women can be reassured when this topic was raised during consulting. Besides the nutritional relevance, this also matters, as clinical research samples-especially estimating analgo-sedative exposure by lactation-are commonly collected after maternal procedural sedation and maternal fasting. Based on these results, it is reasonable to assume stable human milk composition when such data are used in physiology-based pharmacokinetic (PBPK) models.
引用
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页数:5
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