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Brief Report

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

by 1,2,3,* and 1,4
1
Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
2
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
3
Department of Clinical Pharmacy, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands
4
Neonatal Intensive Care Unit, University Hospitals UZ Leuven, Herestraat 49, 3000 Leuven, Belgium
*
Author to whom correspondence should be addressed.
Received: 5 April 2020 / Revised: 28 May 2020 / Accepted: 5 June 2020 / Published: 10 June 2020
(This article belongs to the Section Global and Public Health)
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. View Full-Text
Keywords: lactation; physiology-based lactation models; drug exposure prediction; fasting; drug safety; newborn; infant; human milk lactation; physiology-based lactation models; drug exposure prediction; fasting; drug safety; newborn; infant; human milk
MDPI and ACS Style

Allegaert, K.; Smits, A. Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance. Children 2020, 7, 60. https://0-doi-org.brum.beds.ac.uk/10.3390/children7060060

AMA Style

Allegaert K, Smits A. Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance. Children. 2020; 7(6):60. https://0-doi-org.brum.beds.ac.uk/10.3390/children7060060

Chicago/Turabian Style

Allegaert, Karel, and Anne Smits. 2020. "Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance" Children 7, no. 6: 60. https://0-doi-org.brum.beds.ac.uk/10.3390/children7060060

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