Dietary supplementation of lactating Gambian women. I. Effect on breast-milk volume and quality.

In order to test whether lactational capacity can be improved by dietary interventions, a nutritionally balanced supplement was provided under carefully controlled conditions to 130 nursing mothers in Keneba, The Gambia over 12 months. Maternal mean energy intake (+/- s.e.) increased from 1568 +/- 15 kcal/d (6.56 +/- 0.06 MJ/d) to 2291 +/- 14 kcal/d (9.59 +/- 0.06 MJ/d). Protein intake was in excess of the WHO/FAO recommended intake after supplementation and serious deficits of riboflavin, vitamin A, vitamin C and calcium were rectified. The supplement had no effect on breast-milk volume, compared with retrospective controls, at any stage of lactation or in any season of the year. There was no selective effect on women with poor milk outputs. The average milk protein concentration was slightly improved over the entire period of lactation (+ 6.6 per cent, P less than 0.01), but the total energy content was unchanged since an increase in breast-milk fat concentration (+ 7.9 per cent, n.s.) was offset by a decrease in the milk lactose concentration (- 7.6 per cent, P less than 0.01). Breast milk vitamin content was improved for those vitamins for which the supplement provided a significant proportion of the recommended dietary intake.