Abstract
Zinc concentration in breast milk varies within and between mothers. Neither environmental (zinc intake — either in natural food or supplemented, nutrient interaction, cigarette smoking, and oral contraceptives) nor constitutional (premature delivery, number of children, teen age pregnancy, undernutrition, infection, and diabetes) variables consistently affected zinc concentration or its rate of decrease in breast milk. Stage of lactation is the only variable associated with important changes in milk zinc concentrations. In the first days of postpartum, the zinc concentrations in breast-milk fall steeply, and after the first weeks gradually decreases throughout the following 6 weeks, reaching relatively stable levels by the 3rd month. In spite of increasing volumes of milk consumed by nursing infants the total zinc intake falls as a function of the rate of decrease in the milk metal concentration. For postpartum days 1, 7, 15, 30, 60, 90, 120, 150, and 180 the reported median zinc concentrations (mg/L) are respectively 8.12, 4.56, 3.36, 2.65, 1.66, 1.35, 1.2, 0.98 and 0.93. So far, neither maternal controlling mechanisms have been studied, nor any infant benefit is found in association with such unique pattern. Although human milk is adequate in meeting infant's nutrition requirements for growth, zinc deficiency in full term and preterm breast-fed infants was reported mainly as dermatitis with symptoms appearing circa the 3rd month. This condition has been reported more frequently in preterm than in term babies. However breast-milk zinc concentrations were below the median of expected values, and in some cases milk zinc was abnormaly low for lactation age. Susceptibility of breast-fed infants to develop zinc responsive dermatitis seems associated with metabolism of their own body zinc reserves. Experiments with maternal zinc supplementation aimed at enriching breast milk have not been effective. However, maternal zinc therapy seems to correct abnormalities of zinc metabolism during gestation and lactation.
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