Effect of maternal diet on mother’s own milk pH and preterm infant intestinal inflammation

• Main Author: Overton, Nicolette Erin
• Other Authors: Symes, Karen
• Language: en_US
• Published: 2021
• Subjects: Nutrition; Dietary screener questionnaire; Inflammation; Intestinal fatty acid binding protein; Mother's own milk; Mother-infant dyads; Neonatal ICU
• Online Access: https://hdl.handle.net/2144/43498

BACKGROUND: Quantitative evidence of direct links between dietary intake during pregnancy and maternal and infant outcomes in the preterm population is lacking in the literature. However, studies are starting to investigate relationships between them, and data shows that many of the adverse effects of poor maternal diet are linked to inflammatory response and dysbiosis of the microbiome in both the mother and her offspring. OBJECTIVE: Our objective with this study was to analyze the relationships between sociodemographic factors, maternal diet, pH of breast milk, and infant inflammation. We aimed to assess the dietary pattern of our population of mothers who delivered preterm in comparison to other populations, as well as explore the possibility of using pH of mother’s own milk in future research. METHODS: We reviewed the Electronic Medical Records (EMRs) of participants to gather clinical and demographic characteristics (infants n = 53; mothers n = 45). Maternal participants also completed the Dietary Screener Questionnaire (DSQ). Spearman’s rank correlation and raw unadjusted linear regression analyses were used to investigate relationships between maternal diet and characteristics, mother’s own milk pH, and infant urinary intestinal fatty acid binding protein (I-FABP). Kruskal Wallis analysis was used to analyze between group differences of maternal comorbidities. RESULTS: None of our maternal participants met the guidelines for dietary recommendations by the United States Department of Agriculture (USDA) for pregnant women. This follows the trend in national data for women who are pregnant. The greatest number of women met the recommendation for fiber intake (n = 12). Maternal intake of fiber and whole grains was negatively correlated with pH of mother’s own milk (p <0.5). We did not find any significant correlations between maternal characteristics and maternal diet or pH of mother’s own milk. However, meeting the guidelines for added sugars differed by race (p = 0.03). We found no statistically significant correlations between urinary I-FABP and pH of mother’s own milk or maternal dietary intake. Urinary I-FABP values differed by infant sex (p = 0.03) and infant feeding status (> 50% formula or donor milk vs. < 50% formula or donor milk, p = 0.03). Analysis by groups showed statistically significant differences (p = 0.04). Preeclamptic participants had a higher intake of whole grains (0.97 oz) than women without preeclampsia (0.69 oz). Mothers with gestational diabetes had a lower intake of sugar (14.4 tsp) compared to women without diabetes (17.9 tsp) (p = 0.01). We found no other statistically significant results between groups for maternal diet, milk pH, or urinary I-FABP. CONCLUSION: Our findings suggest that additional research on mother’s own milk pH may be warranted, and that continued education on the importance of a healthy diet and its benefits during pregnancy is needed. Areas of planned future research include fat intake calculations and inflammatory measures of the maternal dietary data.