Search

Background: Moderate-to-late preterm infants (32-34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking., Methods: Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2-10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks., Result: Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001)., Conclusion: Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value., Impact Statement: Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants., (© 2024. The Author(s).)

Early-life exposure to natural and synthetic chemicals can impact acute and chronic health conditions. Here, a suspect screening workflow anchored on high-resolution mass spectrometry was applied to elucidate xenobiotics in breast milk and matching stool samples collected from Nigerian mother-infant pairs (n = 11) at three time points. Potential correlations between xenobiotic exposure and the developing gut microbiome, as determined by 16S rRNA gene amplicon sequencing, were subsequently explored. Overall, 12,192 and 16,461 features were acquired in the breast milk and stool samples, respectively. Following quality control and suspect screening, 562 and 864 features remained, respectively, with 149 of these features present in both matrices. Taking advantage of 242 authentic reference standards measured for confirmatory purposes of food bio-actives and toxicants, 34 features in breast milk and 68 features in stool were identified and semi-quantified. Moreover, 51 and 78 features were annotated with spectral library matching, as well as 416 and 652 by in silico fragmentation tools in breast milk and stool, respectively. The analytical workflow proved its versatility to simultaneously determine a diverse panel of chemical classes including mycotoxins, endocrine-disrupting chemicals (EDCs), antibiotics, plasticizers, perfluorinated alkylated substances (PFAS), and pesticides, although it was originally optimized for polyphenols. Spearman rank correlation of the identified features revealed significant correlations between chemicals of the same classification such as polyphenols. One-way ANOVA and differential abundance analysis of the data obtained from stool samples revealed that molecules of plant-based origin elevated as complementary foods were introduced to the infants' diets. Annotated compounds in the stool, such as tricetin, positively correlated with the genus Blautia. Moreover, vulgaxanthin negatively correlated with Escherichia-Shigella. Despite the limited sample size, this exploratory study provides high-quality exposure data of matched biospecimens obtained from mother-infant pairs in sub-Saharan Africa and shows potential correlations between the chemical exposome and the gut microbiome., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Aim: We aimed to gain insights into current nutritional management practices of late preterm infants (34-36 weeks gestational age) in Nigeria., Methods: Purposive sampling was employed to recruit 19 healthcare professionals (neonatologists, paediatricians, general practitioners and nurses) involved in the care and nutritional management of late preterm infants in Lagos and Ogun states, Nigeria. Data were collected using interviews, either individually or in small focus groups, between 15 August and 6 September 2022. Thematic analysis of interview transcripts was carried out to interpret the data., Results: Ten distinct themes emerged across the research questions and objectives. For growth monitoring, 11, 6, 1 and 1 of our participants preferred to use the 2006 WHO growth standards, Fenton preterm growth chart, Ballard score and Intergrowth-21, respectively. Regarding the growth velocity of late preterm infants, most healthcare professionals aimed for 15 g/kg BW/day or more during hospitalisation. Breastmilk was unanimously the primary feeding option for late preterm infants. Most healthcare professionals preferred to use international guidelines over local guidelines., Conclusion: Our study shows that there is a wide divergence in the nutritional guidelines used in managing late preterm infants in Nigeria. Regarding growth monitoring, healthcare professionals tended to aim for a growth velocity higher than necessary for late preterm infants, which may be disadvantageous for their long-term health., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Introduction: there is growing interest in the link between maternal and infant vitamin D (VD) levels. Breast milk transmission and the fact that the mother and her child may share risk factors for VD, such as exposure to sunlight, diet, and sociocultural influences may impact VD status, the magnitude of which is largely unknown in our topical low-middle income setting. We assessed the connection between maternal and infant VD status including their correlates., Methods: this cross-sectional study investigated 95 maternal-infant pairs in Jos. Mothers were interviewed using a questionnaire. Blood sampling and analysis of serum total 25 hydroxy VD were performed using the chemiluminescent immunoassay method. Maternal and infant VD levels were classified as VD deficient (VDD), VD insufficient (VDI), and VD sufficient (VDS). The mean maternal and infant VD were compared, and the Spearman correlation between them was assessed, a stepwise linear regression was also performed with infant vitamin D as a dependent variable. For all statistical analysis, p<0.05 was considered significant., Results: the median maternal and infant VD was 29.68 ng/ml and 29.41 ng/ml, respectively. The mean infant VD (32.19 ± 10.61 ng/ml) was comparable to maternal VD (31.12 ± 12.94 ng/ml) (p=0.483), with a Spearman correlation coefficient of 0.3 (p=0.037). Maternal vitamin D (beta=0.539, duration of exclusive breastfeeding (beta=-3.490), and infant age (beta=1.655) were found to be significant independent predictors of infant vitamin., Conclusion: beyond neonatal age, a significant positive relationship between maternal and infants´ VD levels exists and suggests that family-focused vitamin D intervention might be an effective public health approach in the tropical city of Jos., Competing Interests: The authors declare no competing interests., (Copyright: Ishaya Ibrahim Abok et al.)

Introduction: Breastfeeding is a public health practice that is critical for the survival of infants and young children. This study aimed at determining the knowledge, attitude, and future intention to breastfeed among female undergraduates in tertiary institutions in Ekiti State, Southwest Nigeria. Methodology: A prospective cross-sectional study was conducted among 1312 female students of the tertiary institutions in Ekiti State. By convenience sampling, female students were invited to participate in the study after giving verbal consent and those studying medical, nursing, and other courses allied to medicine were excluded. Internal consistency of the data obtained from this research instrument was determined using Cronbach's coefficient Alpha with a reliability value of 0.82. Data analysis was conducted using SPSS version 25. Descriptive as well as inferential statistics were computed. Results were summarized as frequencies and percentages. The differences in knowledge, attitude, and intention to practice breastfeeding as well as other responses among the participants were compared among age groups, faculties and the sources of information using Chi-square test., Result: Although 93% of the respondents agreed that breast milk is important for the development of the infant's brain thereby demonstrating good knowledge; 51.6% of the respondents demonstrated poor perception to breastfeeding believing breastfeeding makes the breast to sag while only 34% of the respondents indicated their intention to breastfeed their future babies., Conclusion: The intention to breastfeed among our study participants was poor. This study revealed the need to increase awareness about breastfeeding and its benefits among this huge population of future mothers.

Background: Breast milk transfer of first-line ART from mother to infant is not fully understood., Objectives: To determine the concentrations of lamivudine, emtricitabine and tenofovir in maternal blood, breast milk and infant blood from breastfeeding mother-infant pairs., Methods: Intensive pharmacokinetic sampling of maternal dried blood spots (DBS), dried breast milk spots (DBMS) and infant DBS from 30 Ugandan and 29 Nigerian mothers receiving first-line ART and their infants was conducted. DBS and DBMS were collected pre-dose and at 5-6 timepoints up to 12 h following observed dosing. Infant DBS were sampled twice during this period. Lamivudine, emtricitabine and tenofovir were quantified using LC-MS/MS, with non-compartmental analysis to calculate key pharmacokinetic parameters., Results: Peak concentrations in breast milk from women taking lamivudine and emtricitabine occurred later than in plasma (4-8 h compared with 2 h for lamivudine and 2-4 h for emtricitabine). Consequently, the milk-to-plasma (M:P) ratio of lamivudine taken once daily was 0.95 (0.82-1.15) for AUC0-12, whereas for AUC12-20 this was 3.04 (2.87-4.16). Lamivudine was detectable in 36% (14/39) of infants [median 17.7 (16.3-22.7) ng/mL]. For 200 mg of emtricitabine once daily, the median M:P ratio was 3.01 (2.06-3.38). Three infants (19%) had measurable emtricitabine [median 18.5 (17.6-20.8) ng/mL]. For 300 mg of tenofovir once daily, the median M:P ratio was 0.015 (0-0.03) and no infant had measurable tenofovir concentrations., Conclusions: Emtricitabine and lamivudine accumulate in breast milk and were detected in breastfeeding infants. In contrast, tenofovir penetrates the breast milk to a small degree, but is undetectable in breastfeeding infants.

Background: Breast milk is the main source of neonatal nutrition. It is not known whether diabetes increases the excretion of toxic heavy metals in the breast milk of postpartum mothers. We compared the concentration of toxic heavy metals in breast milk between diabetic and non-diabetic postpartum mothers in Yenagoa., Material and Methods: A cross-sectional design was utilized on a purposive sample of 144 consenting postpartum mothers (72 diabetic and 72 non-diabetic mothers) from three public hospitals. Breast milk samples were collected at 5-6 weeks postpartum between 1st November 2020 and 30th April 2021. Atomic-Absorption-Spectrophotometer and Direct-Mercury-Analyzer were used to analyze the breast milk samples. A data collection form (proforma) was used and data were analyzed at a 5% significance level with IBM-SPSS 25 software., Result: High levels of Arsenic (63.9% vs. 62.5%), Lead (95.8% vs. 95.8%), Mercury (68.1% vs. 72.2%), and Cadmium (84.7% vs. 86.1%) were detected in the breast milk of the diabetic and non-diabetic groups respectively. The mean concentrations for Arsenic (0.6 vs. 0.6 ng/mL), Lead (13.2 vs. 12.2 ng/mL), Mercury (2.9 vs. 3.0 ng/mL), and Cadmium (3.3 vs. 3.2 ng/mL) were above the WHO permissible limits, thus showing evidence of risk to the health of the mother and neonate. There was no significant difference in the concentration of toxic heavy metals in breast milk between the groups (p = > 0.585)., Conclusions: Diabetes did not seem to increase the concentration of toxic heavy metals expressed in breast milk. More rigorous studies are needed to confirm these findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Philip-Slaboh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This case report seeks to create awareness of the aetiology of rickets of prematurity among very low birth weight infants in Nigeria, Methods and Result: This is a case report of an 800 gramme premature male neonate delivered by caesarean section at 28 weeks gestation following severe maternal pre-eclampsia. The infant was hospitalised for sixty days and fed exclusively on his mother's breast milk for seven months. He had two episodes of sepsis and was transfused twice while on admission. He was on Abidec drops, which contained 400 IU/0.6 ml of vitamin D from the age of two weeks. He defaulted from the follow up clinic at postnatal age of 16 weeks only to reappear at 30 weeks postnatal age with overt clinical, biochemical and radiologic signs of rickets. He responded well to calcium and phosphate supplementation., Conclusion: This case highlights the role of mineral deficiency in the aetiology of rickets of prematurity in very low birth weight infants fed with their mothers' breast milk.

A multi-specimen, multi-mycotoxin approach involving ultra-sensitive LC-MS/MS analysis of breast milk, complementary food and urine was applied to examine mycotoxin co-exposure in 65 infants, aged 1-18 months, in Ogun state, Nigeria. Aflatoxin M 1 was detected in breast milk (4/22 (18%)), while six other classes of mycotoxins were quantified; including dihydrocitrinone (6/22 (27%); range: 14.0-59.7 ng/L) and sterigmatocystin (1/22 (5%); 1.2 ng/L) detected for the first time. Seven distinct classes of mycotoxins including aflatoxins (9/42 (21%); range: 1.0-16.2 µg/kg) and fumonisins (12/42 (29%); range: 7.9-194 µg/kg) contaminated complementary food. Mycotoxins covering seven distinct classes with diverse structures and modes of action were detected in 64/65 (99%) of the urine samples, demonstrating ubiquitous exposure. Two aflatoxin metabolites (AFM 1 and AFQ 1 ) and FB 1 were detected in 6/65 (9%), 44/65 (68%) and 17/65 (26%) of urine samples, respectively. Mixtures of mycotoxin classes were common, including 22/22 (100%), 14/42 (33%) and 56/65 (86%) samples having 2-6, 2-4, or 2-6 mycotoxins present, for breast milk, complementary food and urine, respectively. Aflatoxin and/or fumonisin was detected in 4/22 (18%), 12/42 (29%) and 46/65 (71%) for breast milk, complimentary foods and urine, respectively. Furthermore, the detection frequency, median concentrations and occurrence of mixtures were typically greater in urine of non-exclusively breastfed compared to exclusively breastfed infants. The study provides novel insights into mycotoxin co-exposures in early-life. Albeit a small sample set, it highlights transition to higher levels of infant mycotoxin exposure as complementary foods are introduced, providing impetus to mitigate during this critical early-life period and encourage breastfeeding., (Copyright © 2021. Published by Elsevier Ltd.)

Background: Trans fatty acids (TFAs) and conjugated linoleic acids (CLAs) are present in dairy products and human milk and can have detrimental and beneficial effects in humans. The content of TFAs and CLAs in milk is determined largely by the diet of the mother., Methods: We compared the proportions of TFAs and CLAs in the milk of rural Fulani in northern Nigeria who consume dairy products to that of women living in an urban center who consume little in the way of dairy products. Lactating Fulani women (n=41) and women residing in the city of Jos, Nigeria (n=41) were recruited into the study. We predicted that the milk of the Fulani pastoralists would contain higher amounts of TFAs and CLAs compared to their urban counterparts., Results: The mean total TFA proportions for the Fulani and urban women were 0.22% and 0.34%, respectively, and were not significantly different. The percentages of CLAs in milk fat were not different between rural and urban women (0.16% vs 0.14%). These TFA and CLA values were 4- to 10-fold lower than for milk of women elsewhere in the world., Conclusions: The percentages of TFAs and CLAs in milk were not different between rural and urban dwellers in northern Nigeria whose diets differ greatly in the amounts of dairy products they contain. However, the fact that the percentages of TFAs and CLAs in the milk of Nigerian women were much lower than the percentages reported from other parts of the world may have implications for the long-term growth and development of infants in the northern Nigeria and elsewhere in the Western Sahel.

Intermediate chain-length fatty acids (C10-C14) in human milk triglycerides provide an easily absorbable fuel that provide a significant amount of the energy needed for growth during the first few months of life. The C10-C14 fatty acid and trace mineral content of human milk is variable. In this report we examined the relationship between the content of calcium, copper, magnesium, manganese, phosphorus, and zinc, and the weight percentage of C10-C14 fatty acids in milk from 33 Fulani women in northern Nigeria between 2 and 24 weeks post-gestation. The milk from these women contained proportions of C10-C14 fatty acids that were comparable to those reported for other populations around the world, as were the concentrations of Ca, Cu, Mg, Mn, Zn and P. Significant correlations were observed between the milk content of Cu and the wt% of C10 (P=0. 005, r=0.475), C12 (P=0.001, r=0.539), C14 (P=0.44, r=0.352) and the total intermediate chain-length fatty acids (P=0.008, r=0.450). No correlations were observed between these fatty acids and any of the other five minerals. We speculate that the relationship between Cu and fatty acids could be related to a requirement for Cu by an enzyme required for C10-C14 fatty acid biosynthesis (e.g. decanoyl deacylase) in mammary tissue, or to some unique Cu binding properties of the intermediate chain length fatty acids., (Copyright 2000 Harcourt Publishers Ltd.)

This paper reports the results of our analysis of the impact high levels of de novo fatty acids have on the proportions of essential and non-essential fatty acids in human milk lipids. The data for seven fatty acids (linoleic, alpha-linolenic, arachidonic (AA), docosahexaenoic (DHA), palmitic, stearic and oleic) were derived from several studies conducted in Nigeria. The proportion by weight of each of these fatty acids was plotted versus the proportion of C10-14 fatty acids. As the proportion of C10-14 fatty acids increased from 15 to 65%, there was not a proportional decrease in the percentages of all seven fatty acids, but, instead, preferential incorporation of the essential fatty acids, AA and DHA into the triacylglycerol component of the milk. At the same time, the proportions of stearic and oleic acid declined by 69% and 86%, respectively. However, the proportions of linoleic acid, palmitic acid, DHA, AA and alpha-linolenic acid, in milk lipids decreased by only 44%, 40%, 39%, 28% and 2.3%, respectively. These observations indicate that as the contribution of C10-14 fatty acids increases, essential fatty acids are preferentially incorporated into milk triacylglycerols at the expense of oleic acid and stearic acid.

Human milk is an invaluable food resource for infants and young children in Sub-Saharan Africa. Statistics on production of human milk at local and national levels are lacking. In this article, estimates of the quantity of human milk production in Mali, Senegal, Nigeria, and Zimbabwe were calculated. Annual production in the urban and rural areas in Mali was 13 and 17 kg per capita, respectively. National annual median production ranged from 93,000 (Zimbabwe) to 1.3 million metric tons (Nigeria), and from 9 (Zimbabwe) to 15 kg per capita (Mali). Given a value of (US)$1 per liter, inclusion of human milk in calculations of the gross national product (GNP) for these countries would increase this value by more than 5% for Mali, and nearly 2% for Senegal. Human milk is a significant food source to children in this region and should be included in national food statistics due to its nutritional and economic importance.

Introduction: Lassa virus (LASV), the causative agent of Lassa fever (LF), an endemic acute viral haemorrhagic illness in Nigeria, is transmitted by direct contact with the rodent, contaminated food or household items. Person-to-person transmission also occurs and sexual transmission has been reported. Thus, this study investigated the presence of LASV in body fluids of suspected and confirmed cases., Methods: this was a cross-sectional study between March 2018 and April 2019 involving 112 consenting suspected and post ribavirin confirmed cases attending the Lassa fever treatment center in Ondo State. Whole blood was collected from 57 suspected and 29 confirmed cases. Other samples from confirmed cases were 5 each of High Vaginal Swab (HVS) and seminal fluid; 12 breast milk and 4 urine. All samples were analyzed using reverse transcription-PCR (RT-PCR) targeting the S-gene of LASV., Results: analysis of whole blood by RT-PCR showed that 1/57 (1.8%) suspected and 1/29 (3.4%) confirmed post ribavirin treated cases were positive. While LASV was detected in 2/5 (40%) post ribavirin treated seminal fluids and 1/11 (8.3%) breast milk. However, LASV was not detected in any of the HVS and urine samples., Conclusion: the detection of LASV in seminal fluid and breast milk of discharged post ribavirin treated cases suggests its persistence in these fluids of recovering Nigerians. The role of postnatal and sexual transmissions in the perennial outbreak of LF needs to be further evaluated., Competing Interests: The authors declare no competing interests., (Copyright: Olumuyiwa Babalola Salu et al.)

Background: Despite the existence of evidence-based HIV-exposed infant feeding guidelines, infants in Africa still acquire HIV through inappropriate feeding practices., Objective: To identify predictors of HIV-exposed infant feeding knowledge and counseling practice among health care workers (HCW) in Nigeria., Methods: Structured, pretested questionnaires were administered to HCW (n=262) in a tertiary health facility in Kano, Nigeria. Multivariate logistic regression was used to determine predictors of HIV-exposed infant feeding knowledge and counseling practice., Results: Of 262 respondents, (58.0%, n=152) had good knowledge of recommended feeding options. Respondents listed exclusive breastfeeding (57.6%, n=151), human milk substitutes (45.4%, n=119), HIV-negative wet-nursing (37.0%, n=97), heated expressed human milk (20.6%, n=54) and mixed feeding (13.4%, n=35) as appropriate feeding choices. Over half (57.3%, n=150) of the respondents have ever counseled a HIV-positive mother on infant feeding. Knowledge was predicted by female sex (Adjusted Odds Ratio (AOR)=2.47, 95% Confidence Interval (CI):1.35-4.52), profession (physician vs. laboratory scientist, AOR=4.00, 95%CI:1.25-12.87; nurse/midwife vs. laboratory scientist, AOR=2.75, 95%CI:1.17-9.28), infant feeding counseling training (AOR=3.27, 95%CI:1.87-5.71), and number of children (2-4 vs. 0, AOR=1.75, 95%CI:1.23-3.92). Infant feeding counseling was predicted by female sex (AOR=2.85, 95%CI:1.39-5.85), age (>40 vs. <30 years, AOR=3.87, 95%CI:1.27-15.65), knowledge of infant feeding options (good vs. fair/poor, AOR=3.96, 95%CI:2.07-7.59), training (AOR=2.60, 95%CI:1.42-5.32), and profession (physician vs. laboratory scientist, AOR=10.7, 95%CI:2.85-40.54; nurse/midwife vs. laboratory scientist, AOR=4.8, 95%CI:1.26-18.02)., Conclusion: The practice of infant feeding counseling among HCW in Nigeria is associated with sex, knowledge, and profession. Our findings may inform the development of targeted training programs for HCW in similar settings., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

We are constantly exposed to a variety of environmental contaminants and hormones, including those mimicking endogenous estrogens. These highly heterogeneous molecules are collectively referred to as xenoestrogens and hold the potential to affect and alter the delicate hormonal balance of the human body. To monitor exposure and investigate potential health implications, comprehensive analytical methods covering all major xenoestrogen classes are needed but not available to date. Herein, we describe a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous determination of multiple classes of endogenous as well as exogenous estrogens in human urine, serum, and breast milk to enable proper exposure and risk assessment. In total, 75 analytes were included, whereof a majority was successfully in-house validated in the three matrices. Extraction recoveries of validated analytes ranged from 71% to 110% and limits of quantification from 0.015 to 5 μg/L, 0.03 to 14 μg/L, and 0.03 to 4.6 μg/L in urine, serum, and breast milk, respectively. The applicability of the novel method was demonstrated in proof-of-principle experiments by analyzing urine from Austrian individuals and breast milk from Austrian and Nigerian individuals. Thereby, we proved the methods' feasibility to identify and quantify different classes of xenoestrogens simultaneously. The results illustrate the general importance of multiclass exposure assessment in the context of the exposome paradigm. Specifically, they highlight the need for estimating total estrogenic burden rather than single analyte or chemical class measurements and its potential impact in endocrine disruption and hormone related diseases including cancers.

Riboflavin content of breast milk was determined in 100 lactating Nigerian women attending the clinic 6 weeks post partum. The women, from different ethnic groups, were fully breastfeeding at the time of the study and consisted of primi and multigravidae. Urine and milk samples were obtained at the clinic and analyzed for riboflavin. Parity had no effect of breast milk riboflavin (P0.05), the mean riboflavin content was 0.34 + or - 0.07 mg/1 (range 0.22-0.47 mg/1) with 27% of the mothers secreting above 0.4 mg riboflavin/1. There was no association between urinary riboflavin excretion and milk riboflavin. A greater number of infants, if exclusively breast fed without vitamin supplementation, may not meet their daily need for riboflavin. Storage of breast milk samples in the refrigerator for as long as 2 weeks had no effect on the component riboflavin. This may be an advantage where breast milk banks are operated.

380 milk samples (96 colostrum and 284 mature milk samples) collected from 240 lactating Nigerian women within the first 9 months of lactation were analyzed for zinc, copper, iron, calcium, and magnesium concentrations by atomic absorption spectrophotometry. Mean levels of zinc, copper, iron, calcium, and magnesium in colostrum were 5.83, 0.52, 0.55, 400, and 33 mcg/ml, respectively; the levels for the same minerals in mature milk collected in the 8th and 12th week of lactation were 3.08, 0.29, 0.38, 300, and 31 mcg/ml, respectively. While milk levels of all minerals decreased with increase in lactation age, zinc levels showed the fastest rate of decrease. Milk zinc levels at the 9th month were only 13% of that in colostrum. Similar percentages for copper, iron, calcium, and magnesium were 49, 60, 34, and 74%, respectively. Estimates of intake by solely breastfed infants during the first 6 months showed gross inadequacies when compared with Recommended Daily Allowances. Results suggest the need for early supplementation, especially as zinc deficiencies as well as a high incicdence of iron deficiency anemia has been reported in Nigerian infants.

A cross-sectional study of breast-feeding practice amongst rural Nigerian mothers and their babies is reported. At 1, 14, 30, 60 and 90 d after birth 56, 17, 45, 31 and 26 mothers/baby pairs were studied. Ninety-five per cent of the babies had sips of water immediately after birth--only 3 were offered the breast at this time. Breast-feeding was begun in the others between 2 to 25 h after birth. At 14, 30, 60 and 90 d respectively, mean breast milk intakes were 252.9 +/- 88 g, 393 +/- 199, 341 +/- 156 and 350 +/- 181 g. Intake was related to the number of breastfeeds given by the mother. Reports of breastmilk intake of babies should also record child rearing practices as these could affect breastmilk consumption.

Microbiological and biochemical analyses of 59 breast nipple swab samples and 15 manually expressed breast milk samples of lactating mothers aged 15 to 40 years, was carried out using standard procedures. The incidence of bacterial species in swab samples was Staphylococus aureus (63.8%), Streptococcus sp (25.5%), Escherichia coli (6.4%) and Klebsiella sp (4.26%), indicating the poor sanitary status of the lactating mothers. S. aureus was recovered from only 1 (6.7%) of the milk samples, indicating that breast milk is relatively sterile. The nutritional values for the breast milk were 22.5 mg/ml (protein), 0.3 mg/ml (calcium), 3.5 mg/ml (sugar) and 300 microg/ml (vitamin A) in age group 15-20 years, and 16.4 mg/ml (protein), 0.16 mg/ml (calcium), 1.8 mg/ml (sugar) and 100 microg/ml (vitamin A) in the age group 36-40 years. In conclusion, the nutritive and antimicrobial properties of breast milk decrease with increasing age of lactating mothers. The need for public health enlightenment of lactating mothers regarding hygiene, and the provision of oral vitamin A supplement to infants, is discussed.

Aflatoxin M1 (AF M1), a hydroxylated metabolite of AF B1, is an important toxin that can contaminate the milk of lactating mothers. A correlation study was conducted to determine the relationship between AF M1 content of breast milk, dietary exposure to AF B1 and socioeconomic status of lactating mothers in the three Senatorial districts of Ogun State, Nigeria. Equal amounts of breast milk (20 ml) and food rations (40 kg) obtained from 50 volunteer lactating mothers and eighty-two frequently consumed food commodities in the preceding month were used for the study. The level of contamination of the foods by AF B1 was low (0.16-0.33 μg/kg) and differed significantly (p<0.05) across the state but did not exceed the EU limit of 2 μg/kg. The occurrence level of AF B1 was however high (93.75-94.45%) and was more pronounced in Ogun East Senatorial district (94.45%). Eighty-two percent of the breast milk was contaminated with AF M1 (3.49-35 ng/l) and 16% exceeded the EU limit of 25 ng/l while a 100% occurrence risk was recorded in Ogun Central Senatorial district. The socioeconomic status of the mothers also significantly influenced their dietary exposure and exposure risk of the sucklings to AF M1., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Deficiencies in micronutrients are common in our environment, leading to indiscriminate replacement strategies. Selenium is an antioxidant micronutrient that may undergo depletion during pregnancy and lactation. Regrettably, information in this matter is scanty in Nigeria., Objectives: To determine maternal selenium concentration during pregnancy and lactation., Methods: This was a cross-sectional research involving 120 pregnant women, 40 in each trimester. They were attending antenatal clinic of one tertiary and two secondary health care facilities in Enugu, Southeastern Nigeria. Control subjects constitute age, parity and socioeconomic matched 35 apparently healthy, non pregnant women. Serum selenium concentration was measured during pregnancy and postpartum. Breast milk selenium concentration was also determined by Atomic Absorption Spectrophotometer (AAS)., Results: The mean serum selenium levels were significantly decreased (P < 0.0001) in pregnancy when compared with non-pregnant control subjects; also as pregnancy progressed. However, there was a non significant increase immediately after birth. In the breast milk, selenium concentration significantly decreased (P < 0.0001) as lactation progressed., Conclusion: The observed significant decreases in the levels of selenium during pregnancy and breast milk may leave the mothers and their neonates at risk and, therefore, may necessitate maternal supplementation. Dietary intervention such as food diversification and bio-fortification is recommended to improve dietary selenium intakes in pregnant and lactating mothers, and infants in this region.

The influence of prolonged breastfeeding on breast-milk alpha tocopherol was assessed in 112 lactating mothers practicing exclusive breast-feeding on term infants. The cross sectional study was carried out between May 1st and 30th, 2005 at the University of Benin/University of Benin Teaching Hospital, Benin City among lactating mothers. Employing the Quaife's method, mean alpha-tocopherol values were determined in spot samples of breast milk. Though not significant mean Breast-milk (BM) alpha-tocopherol tended to decline with maternal age (p > 0.05) parity (p > 0.05) and duration of breastfeeding. Similarly, family socio-economic status did not significantly influence mean BM alpha-tocopherol levels. Exclusive and or prolonged breast feeding do not predispose the infant to low vitamin E supplies through the breast milk. Further studies are advocated to evaluate the effects of other biosocial variables on the levels of BM anti-oxidant vitamins including alpha-tocopherol.

It has been shown that infant feeding pattern affects mother-to-child transmission of HIV. This study reports the infant feeding practices of HIV-positive mothers in southwestern Nigeria.

A survey was undertaken to determine the aflatoxin M(1) contamination of milk and some locally produced dairy products in Abeokuta and Odeda local governments of Ogun State, Nigeria. Samples of human and cow milk, yoghurt, "wara", ice cream and "nono" were collected randomly within the local governments and analysed for aflatoxin M(1) using the two-dimensional TLC. Aflatoxin M(1) contamination in the range of 2.04-4.00 microg l(-1) was noticed only in milk and ice cream. In particular, samples of human milk, cow milk and ice cream recorded high scores of 4.0 microg l(-1), 2.04 microg l(-1) and 2.23 microg l(-1), respectively in Abeokuta local governments and a score of 4.0 microg l(-1) for cow milk in Odeda local government. This indicates a high level contamination in the local governments since the weighted mean concentration of aflatoxin M1 in milk for African diet is 0.002 microg l(-1). Therefore the concentration of AFB1 in feeds which is transformed to AFM1 in milk should be reduced by good manufacturing and good storage practices. Furthermore, there is need for stringent quality control during processing and distribution of these products.

Background: Exclusive Breastfeeding has been recommended the world over as the optimal feeding mode for young infants. A cross sectional study to determine the current level of knowledge and practice of nursing mothers on exclusive breastfeeding in Jos was carried out., Methods: The target population of interest was nursing mothers who have infants aged 6-12 months in Jos, a cosmopolitan city in the north central zone of Nigeria. A pre-tested, structured close ended interviewer questionnaire was used. Four hundred and seventy nursing mothers who consented were recruited for the study through a house-to-house visit. Three assistants (two females and a male) were recruited and trained on the questionnaire administration. Data analysis was by SPSS software and chi-square test of proportion for statistical significance of association was done., Results: Out of the 470 nursing mothers studied 387 (82.3%) were able to define correctly exclusive breastfeeding while 315 (67.0%) practiced or were practicing exclusive breastfeeding at the time of this study. The knowledge and practice of exclusive breastfeeding was found to increase with increasing age and better educational status of the women. Ninety six (20.4%) nursing mothers said they never breastfed their babies while in public place., Conclusion: Although knowledge and practice of exclusive breastfeeding among the women were considerably high, the younger age brackets were less knowledgeable arid adherent to the practice. Targeting adolescents for exclusive breastfeeding education and sensitization is necessary in preparing them for motherhood.

Health experts worldwide recognize breastmilk as the superior infant food. Recommendations from the American Academy of Pediatrics and the World Health Organization (WHO) identify exclusive breastfeeding for the first half-year of life and continuation of breastfeeding into toddlerhood as offering maximum protection from illness, providing a substrate for immunological protection. Data from developed countries identify increasing morbidity and mortality rates for infants who have never received breastmilk in life and demonstrate that infants benefit from exclusive breastfeeding, especially, in areas of severe poverty. Preterm infants, most at risk for morbidity and mortality in developing countries, are identified as needing their own mother's milk for survival. Exclusive feeding of own mothers' milk (OMM) is associated with improved infant survival; however, inadequate maternal milk volume (MMV) often necessitates adding artificial feedings or exogenous substances to OMM. The objective of this study was to compare mean daily MMV for mothers of premature or sick infants in special care nurseries (SCN) using one of three methods of OMM expression: electric breast pump, non-electric pedal breast pump, and hand (manual) expression. We studied 65 mothers whose infants were cared for in two SCN in Africa (Kenya and Nigeria) and were unable to feed directly at the breast. In this randomized trial, mothers were randomly assigned to one of three milk expression groups at birth. MMV, the dependent variable, was measured for an average of 8.7 days. MMV for the electric and pedal pump and hand milk expression was 578 +/- 228 ml (n = 22), 463 +/- 302 ml (n = 24) and 323 +/- 199 ml (n = 19), respectively. Data were evaluated using a one-way ANOVA (p = 0.014). The Tukey revealed significant differences (p < 0.01) between electric breast pump expression and hand expression but not between the electric and pedal pump or the pedal pump and hand expression. Findings revealed greater MMV with electric breast pumps than hand-expression for mothers of infants in African nurseries. This data has important implications for international policy if exclusive OMM feeding is to be achieved for the vulnerable infant. Funded by West Virginia University Department of Research and Graduate Studies HSC Grant # 2U023U; Non-monetary donations of breast pumps and breast pump kits were made by Medela (Medela, Inc., McHenry, IL, USA).

Aim: Despite similarly low calcium intakes and normal vitamin D status, only some Nigerian children develop nutritional rickets. We hypothesized that mothers with children who had developed rickets might have lower breast-milk calcium concentration than mothers with normal children and compared the breast-milk calcium concentration of mothers who had had children with rickets with those who had not (controls)., Methods: We collected breast milk from 35 Nigerian mothers who had previously had children with nutritional rickets. For each case mother, we collected breast milk from three matched control mothers at the same stage of lactation (+/-4 weeks) who had had no children with rickets. Data were collected about parity, stage of lactation, and the infant's intake. The mother's bone density was measured., Results: The mean breast milk calcium concentration of mothers of children with rickets (4.30+/-1.24 mmol/L) was less than that of control mothers (4.65+/-1.03 mmol/L; P=0.034 in multivariate regression controlling for duration of lactation and resumption of menses). Forearm bone mineral content was significantly related to breast milk calcium concentration (r=0.20) after adjusting for height, weight, and bone area (P=0.028)., Conclusion: Reduced breast-milk calcium concentration may contribute to a reduced calcium intake in infancy and predispose children to nutritional rickets.

Maternal and cord blood collected from 33 Nigerian mother-child pairs were tested for measles-sepcific IgG. All 33 had protective measles antibodies at the time of delivery with a positive correlation of r = 0.87. Determination of the rate of waning of these antibodies revealed that 58 per cent of these children had lost the protective maternal antibody by the age of 4 months and only 3 per cent of the children had enough antibody to protect them between the ages of 6-9 months. Fifty-five colostrum samples from the same mothers and 347 breastmilk samples collected at various periods of breastfeeding also showed that anti-measles IgA had dropped below the protective cut-off within the first 2 weeks of birth. It is evident that the Nigerian child is born with solid anti-measles antibody but the rate of waning has left a large number unprotected before the first dose of the vaccine. There is an urgent need to review the measles vaccination programme in Nigeria to protect these susceptible infants.

A feasibility study was used to determine (1) if hindmilk feedings of own mother's milk, as reported in the United States, could be instituted in a Nigerian neonatal intensive care unit and result in adequate infant weight gain without exogenous additives; and (2) if the use of a hospital-grade electric breast pump to separate foremilk from hindmilk was feasible in this setting. Mean weight gain for 16 preterm infants during the hindmilk intervention (18.8 g/d) exceeded intrauterine standards without the use of exogenous substances. At the time of hospital discharge, mean maternal daily milk volume was 342 mL/kg/d, indicating that the infants, on average, had 90% more milk available to them than they required. Mean infant weight gains were 14.2 and 16.6 g/d from 1 to 7 and 8 to 23 (x = 14.8) days postdischarge, respectively. Therefore, hindmilk feedings are effective and feasible for hospitalized, low birth weight infants in developing countries, and lactation specialists may use our protocol for further research.

Objective: Because prelacteal feeds can adversely affect breastfeeding, UNICEF/WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds., Design: Survey., Setting: Primary, secondary and tertiary health facilities in Kaduna township Nigeria., Subjects: Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not., Methods: Use of a pretested validated questionnaire., Results: Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P=0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst., Conclusions: Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

Human milk provides newborns with several physiologically important proteins not found in cow's milk, including bile salt-stimulated lipase (BSSL) that compensates for the reduced lipolytic capability of the newborn intestine. We analyzed the milk of two ethnically distinct groups of women in northern Nigeria and Nepal. The milk of the Nepalese women (n = 36) contained slightly more BSSL activity (mean, 38.8 units/mL) than that of Fulani (n = 48; mean, 30.3 units/mL) and Kanuri (n = 90; mean 27.6 units/mL) women in Nigeria. There was also a weak positive correlation between the BSSL content of the milk and the body mass index (BMI) of the lactating women. The BSSL activity declined with the length of lactation for both well-nourished and undernourished women. The presence of a heat-stable inhibitor of BSSL in cow's milk was also demonstrated. This finding, along with the decrease in BSSL activity postgestation, could be of significance to populations such as the Fulani of the western Sahel who supplement the diets of their infants with unpasteurized cow's milk.

Levels of lead were determined in the milk of 34 Fulani women in Plateau State in northern Nigeria. The Fulani are nomadic, semi-pastoralists who inhabit the western Sahel, including the countries of Mali, Burkino Faso, the Republic of Niger, Nigeria and Chad. The mean age of the women in this study was 26.0 +/- 7.5 years and their mean body mass index (BMI, kg/m2) was 19.4 (range, 14.5-24.0). Their average parity was 4 (range, 1-10). Milk was collected 2-24 weeks postgestation (mean, 11 weeks). Fifteen of the 34 milk specimens contained measurable lead (limit of detection, 4.6 microg/dL); the milk of the other 19 women (56%) did not contain a detectable level of lead. The data were not normally distributed. The median lead concentration of all 34 milk specimens, determined by end on plasma-axial view spectrometry, was 6.7 microg/dL (range, < 4.6-130 microg/dL). Given the mean weight of the 34 infants in the study (4.6 kg) and assuming that each infant consumed 0.7 L/day of milk, the average lead intake of these exclusively breastfed infants was 9.9 microg/kg/day, a value which is twice the daily permissible intake (DPI) of 5.0 microg/g/day set by the World Health Organization in 1972. These data indicate that some exclusively breastfed Fulani infants in the Jos Plateau are at risk of injury from lead derived from their mothers' milk, and raise questions about the actual blood levels in these nursing infants and the source(s) of the maternal lead.

This study was undertaken to determine the levels of calcium, aluminium and chromium in the serum of apparently healthy exclusively breastfed infants at the sixth month of lactation. Forty-five infants (with a male:female ratio 2:1) were studied. They were of an average age six months and one week, weighed 6.8-10.0 kg. The mean calcium levels of 83.92 ug/ml (2.1 mmol/L) obtained is within the reference range (2.1-2.5 mmol/L) in this area. The mean level of chromium was 0.11 u/ml while that of aluminium is significantly (P < 0.001) higher than the toxic level reported by some workers, yet none of the subject was manifesting any obvious signs of toxicity. We can then infer from our data that the exclusively breastfed infants are able to extract enough calcium, aluminium and chromium from the maternal breastmilk.

We previously reported that, relative to milk of women elsewhere in the world, the lipid fraction of milk of Fulani women in northern Nigeria contained relatively low proportions of alpha-linolenic acid and docosahexaenoic acid (DHA). This led us to question the essential fatty acid status of Fulani infants and the relation between the proportion of critical n-3 and n-6 fatty acids in the serum phospholipids of the mothers, their milk, and the serum phospholipids of their exclusively breast-fed infants. We were also interested in the effect de novo intermediate chain length-fatty acids (C10-C14) had on the proportions of critical and non-essential fatty acids in milk. Capillary gas-liquid chromatography was used to analyze the fatty acid content of the total milk lipids of 34 Fulani women, as well as the fatty acid content of serum phospholipids of the women and their breast-fed infants during the first 6 months of life. The proportions of critical n-3 and n-6 fatty acids in the milk of the Fulani women were adequate, but the proportions of these same fatty acids were low in their exclusively breast-fed infants. The serum phospholipids of the infants contained 18.8% linoleic acid, 0.13% alpha-linolenic acid, 12.8% arachidonic acid, and 3.40% DHA, whereas, the mean percentages of linoleic, alpha-linolenic, arachidonic and DHA in the serum phospholipids of the Fulani mothers' were 21.4, 0.20, 9.79, and 1.97, respectively. There was a strong positive correlation between fatty acid content of serum phospholipids of Fulani women and the fatty acid content of their milk lipids. As the proportion of C10-C14 fatty acids in the milk lipids increased, the proportions of critical n-3 and n-6 fatty acids in milk remained relatively constant; however, proportions of three non-essential fatty acids decreased dramatically. C10-C14 fatty acids do not appear to displace critical n-3 and n-6 fatty acids in milk.

The milk of 89 women in northern Nigeria was analyzed for the fatty acid composition of the total milk lipids, and assessed for the effect nutritional status has on the conservation of essential and non-essential fatty acids when the proportions of C(10)-C(14)fatty acids are increased. The women were stratified on the basis of their body mass index, and calculations were made to estimate the effects of a 3.3-fold increase in the proportion of C(10)-C(14)fatty acids on the proportion of alpha-linolenic acid, docosahexaenoic acid, linoleic acid and arachidonic in total milk lipids. In the well-nourished group (group III, body mass index >23 kg/m(2)), the critical n-3 and n-6 fatty acids were not conserved, while in poorly nourished women (group I, body mass index <19 kg/m(2)), marked conservation of alpha-linolenic acid, docosahexaenoic acid, arachidonic acid, and palmitic acid was seen. Poor nutritional status of the mother appears to promote selective retention of critical essential and non-essential fatty acids in the milk lipid fraction., (Copyright 2000 Harcourt Publishers Ltd.)

The authors previously reported that the milk of Yoruba women in southwestern Nigeria was deficient in alpha-linolenic acid and contained a high percentage (42%) of medium chain-length fatty acids (MCFA, C10-C14). In the present study, the authors used capillary gas-liquid chromatography to analyze the milk of Hausa women in the northern region of Nigeria. The milk of the Hausa women contained 27% MCFA, 10.6% linoleic acid, 0.41% alpha-linolenic acid, 0.52% arachidonic acid, and 0.32% docosahexaenoic acid. The proportion of alpha-linolenic acid in the serum phospholipids of a subset of exclusively breastfed infants (n = 15; mean age, 6.2 +/- 0.3 months) was below the limit of detection (< 0.03%). While the milk of women in northern Nigeria is adequate with regard to n-3 and n-6 fatty acids, to satisfy the requirements for alpha-linolenic acid, it may be necessary to supplement the infants of these women after the first 6 months of life.

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

Little is known about the nutrition of the infants of the Fulani, migratory nomads of the western Sahel of Africa. Milk was collected from 18 Fulani women 10 to 30 days postpartum and the fatty acid compositions of the triacylglycerol and phospholipid fractions were determined by capillary gas-liquid chromatography. De novo fatty acids (10:0-14:0) comprised 36.3 +/- 12.7% of fatty acids of the triacylglycerols. Compared to the milk of various populations worldwide, the milk of the Fulani women contained adequate proportions of alpha-linolenic acid (0.50 +/- 0.16%) and arachidonic acid (0.42 +/- 0.22%), but relatively low amounts of linoleic acid (9.95 +/- 2.13%) and docosahexaenoic acid (DHA) (0.15 +/- 0.08%). In addition, the milk of the Fulani women contained adequate concentrations of beta-carotene (1.58 +/- 0.69 micrograms/dl) and vitamin A (42.7 +/- 40.3 micrograms/dl), but very low levels of vitamin E (0.11 +/- 0.10 mg/dl). These data indicate that exclusively breasted infants of Fulani women were receiving relatively low amounts of critical fatty acids and vitamin E.

The aim of the study was to evaluate the in vitro activity of term human milk on the organisms of Ophthalmia neonatorum and was a prospective study of consecutive neonates with the organism. The study was undertaken in a special care baby unit/lying-in ward in Benin City, Nigeria, and consisted of 22 neonates with ophthalmia neonatorum. Bacterial organisms grown on blood agar, were obtained from eye swabs of neonates with ophthalmia neonatorum. Inoculated isolates were incubated with known antibiotic discs, term colostrum, and mature milk. Bacteria were isolated in 77 per cent (17/22) of the neonatal eye swabs, 59 per cent of which were Staphylococcus aureus and 41 per cent coliform organisms. Sensitivity of Staphylococcus aureus to gentamicin was 100 per cent and for coliform organisms 42 per cent. The sensitivity of Staphylococcus aureus to term colostrum was 50 per cent and to mature milk 0. Coliform organisms had a sensitivity of 57 per cent to colostrum and 28 per cent to mature milk. The zone of inhibition of colostrum against Staphylococcus aureus and coliform organisms was between 3 and 5 mm, while for mature milk, there was partial or no inhibition, respectively, to coliform organisms and Staphylococcus aureus. The mean duration of inhibition was 6 hours for colostrum and 3 hours for mature milk. Colostrum has about half the in vitro inhibitory activity of gentamicin (recommended as a first line topical agent, based on the bacteriological sensitivity of this study) against Staphylococcus aureus and coliform organisms. The inhibitory activity of colostrum is > or = 50 per cent against Staphylococcus aureus and coliform organisms for a mean duration of 6 hours. Mature milk had no inhibitory activity against Staphylococcus aureus and only 28 per cent inhibition, for a mean duration of 3 hours to coliform organisms.

A total of 216 breast milk samples collected from nursing mothers and corresponding numbers of finger prick sera from their suckling babies were tested for measles antibodies. Fifty (22.1%) of the nursing mothers had antibody while 38 (16.8%) of the sera were positive for measles haemagglutinating (HI) antibodies. Forty-one (18.9%) breast milk samples were found to contain measles complement fixing (CF) antibody while none of the serum samples from the suckling babies had CF antibody. Only 12 of the positive sera were from HI positive mothers. Our result suggests that very little level of measles antibody is passed through the breast milk.

Instrumental neutron activation analysis (INAA) and proton-induced X-ray emission (PIXE) analysis have been employed to determine the concentration of 13 elements in human breast milk, various infant formulas, and locally produced cereals from Nigeria, as well as from various infant formulas and natural cow and goat milk available in the UK. The study shows that if the locally produced cereal is to be used on a regular basis for babies in Nigeria, then their diet must be supplemented with essential trace elements. Furthermore, parents should be discouraged from giving their infants cow and goat milk because of the high concentration of major elements compared to human breast milk.

Trace element concentrations in serum and breast milk were studied longitudinally in 197 Nigerian women from 6 months of gestation to 6 months postpartum; 99 of them received a daily iron supplement of 100 mg from 6 months of gestation to delivery. During the last 3 months of pregnancy, serum selenium declined, whereas serum zinc remained unchanged and serum copper increased. After delivery, copper concentration in maternal serum decreased, whereas serum zinc increased from delivery to 3 months postpartum and then reached a plateau. Serum selenium increased from delivery to 6 months postpartum. In breast milk, selenium and zinc decreased from 5 days to 6 months postpartum. Copper in breast milk also declined during the course of lactation but reached a plateau by 3 months postpartum. Iron concentration in breast milk remained unchanged during the study. Iron supplementation had no significant effect upon the concentrations of copper, selenium and zinc in mother serum and breast milk. In umbilical serum, iron status, copper and zinc levels were similar in the two groups, whereas, unexpectedly, selenium concentration was significantly decreased (p < 0.03) in the iron-supplemented group. Taken together, our results suggest that the beneficial effect of iron supplementation on iron deficiency was not associated with an adverse effect on copper and zinc status. On the other hand, our results suggest that Nigerian women had a marginal zinc status but an adequate selenium status.

Ivermectin levels were measured in breastmilk and plasma of 4 healthy mothers after an oral 150 micrograms/kg dose. Mean +/- S.D. plasma and milk values were 37.9 +/- 0.54 and 14.13 +/- 0.43 (ng/ml) respectively. Steady-state ivermectin levels in milk were low. Our results suggest that exclusion of lactating mothers from mass chemotherapy with ivermectin may be unnecessary.

The lactose levels of the transition milk of term mothers were significantly higher compared with preterm mothers (5.87 versus 5.32 g/100 ml). The same trends were found in colostrum and mature milk. These differences were not significant. The protein contents of the colostrum in term mothers were significantly lower than in their preterm counterparts (1.80 versus 2.20 g/100 ml). Again the same trend (not significant) was showed in transition and mature milk. A significantly lower level of fat in milk of term mothers than of preterm mothers was found in all 3 types of milk (1.84 versus 2.26; 2.16 versus 2.95; 2.72 versus 3.32 in colostrum, transition milk and mature milk respectively). This study showed differences in the macronutrients measured in the different types of milk, hence term babies in Baby care units should be fed term milk and preterm babies with preterm milk.

The fatty acid composition of mature human milk from 10 rural Nigerian women was analyzed by high-resolution capillary gas-liquid chromatography and compared to previously determined results on mature human milk from 15 German mothers. Human milk of the Nigerian group contains significantly higher proportions of saturated fatty acids (median 54.07 vs. 42.76% wt/wt). The difference is primarily caused by high values for lauric (C12:0, 8.34%) and myristic acids (C14:0, 9.57%), but not of medium chain fatty acids (C8:0, C10:0), presumably due to increased de novo fatty acid synthesis in the African women consuming a high carbohydrate and low-fat diet. Markedly lower values of oleic and total cis-monounsaturated (22.82 vs. 37.98%) as well as trans-isomeric fatty acids (1.20 vs. 4.40%) in Nigerian milk appear to result from low dietary intakes of animal and partially hydrogenated fats, respectively. Although percentage contribution of linoleic acid (18:2n-6) is similar, arachidonic acid (C20:4n-6) and total n-6 long-chain polyunsaturates with 20 and 22 carbons (n-6 LCP) are higher in the African samples. N-6 LCP secretion with human milk lipids is not correlated to the precursor linoleic acid and seems not to depend on maternal dietary intake of preformed dietary LCP with animal fats. N-3 LCP are very high in milk of the Nigerian women who obtain a large portion of dietary lipids from sea fish, but even then docosaehexanoic (C22:6n-3) and not eicosapentaenoic (C20: 5n-3) is the predominant n-3 LCP in milk.(ABSTRACT TRUNCATED AT 250 WORDS)

The fatty acid composition of samples of breast milk obtained from well-nourished Nigerian and Japanese women was determined by gas chromatography. The cultural differences in dietary intake was reflected in the fatty acid composition of breast milk samples. The milk of Nigerian women contained a significantly higher percentage of saturated fatty acids (48.75%) than that of Japanese women (46.65%). Nigerian milks were also richer in arachidonic (20:4 n-6), eicosatrienoic (20:3 n-6), and docosatetraenoic (22:4 n-6) acids. Conversely, the milk of Japanese woman contained significantly higher percentages of monoun-saturates as palmitoleic, heptadecenoic, oleic, and polyunsaturates of n-3 series as alpha-linolenic, eicosapentaenoic, and docosahexaenoic acid.