Carotenoids and Breastfeeding
by Anne Eglash MD, IBCLC, FABM
Few people would argue with the statement that vegetables and fruit are good for us. We are told that eating more produce reduces various health risks such as high blood pressure, heart disease, stroke, and various types of cancers. Carotenoids, which are antioxidants responsible for the yellow, orange, and red colors of various fruits and vegetables, appear to protect us from several diseases. Carotenoids are also found in egg yolk, trout, and salmon. There are approximately 50 different types of carotenoids in the human diet, but 95% of the carotenoids found in human blood include beta-carotene, alpha-carotene, lycopene, beta-cryptoxanthin, lutein and zeaxanthin.
A recent study found that increasing carotenoids in the maternal diet increases the amount of carotenoids in breastmilk. These same authors have outlined the role of carotenoids in pregnancy and infant health, which is our current topic.
Carotenoids have their highest concentration in colostrum, causing its deep yellow color. The carotenoid concentration in breastmilk decreases by the third week, during the mature milk stage when the milk turns white. After this time, the level is dependent on the maternal diet. Carotenoid levels are highest in breastmilk fat. Infant formulas are not required to contain carotenoids, although some do. Humans cannot manufacture carotenoids on their own, so they must come from the diet. People who consume a diet heavy in carotenoids may have a yellowish hue to their fat just under the skin, such as on their palms and soles. Infants who love carrots and sweet potatoes also display carotenemia, typically evidenced by their bright yellow noses. This is a benign condition.
Carotenoids are considered anti-oxidants, which play a role in reducing the effects of oxidative stress in the human body. Oxidative stress, such as decreased blood flow to the fetus or maternal tobacco use, causes bodily damage, contributing to the risk of infant illness such as necrotizing enterocolitis, respiratory distress syndrome, and bronchopulmonary dysplasia.
- Carotenoids have their lowest concentration in the brain.
- Lower maternal serum levels of carotenoids has been found in some research to be associated with preterm birth.
- High maternal plasma levels of carotenoids is associated with less risk of small-for-gestational-age status of the newborn.
- Carotenoids promote optimal retinal development and help to prevent retinal damage in infants.
- There is good evidence that carotenoids help prevent pre-eclampsia.
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Adequate nutrition is particularly important during pregnancy since it is needed not only for maintaining the health of the mother, but also determines the course of pregnancy and its outcome, fetus development as well as the child’s health after birth and during the later period of life. Data coming from epidemiological and interventions studies support the observation that carotenoids intake provide positive health effects in adults and the elderly population. These health effects are the result of their antioxidant and anti-inflammatory properties. Recent studies have also demonstrated the significant role of carotenoids during pregnancy and infancy. Some studies indicate a correlation between carotenoid status and lower risk of pregnancy pathologies induced by intensified oxidative stress, but results of these investigations are equivocal. Carotenoids have been well studied in relation to their beneficial role in the prevention of preeclampsia. It is currently hypothesized that carotenoids can play an important role in the prevention of preterm birth and intrauterine growth restriction. Carotenoid status in the newborn depends on the nutritional status of the mother, but little is known about the transfer of carotenoids from the mother to the fetus. Carotenoids are among the few nutrients found in breast milk, in which the levels are determined by the mother’s diet. Nutritional status of the newborn directly depends on its diet. Both mix feeding and artificial feeding may cause depletion of carotenoids since infant formulas contain only trace amounts of these compounds. Carotenoids, particularly lutein and zeaxanthin play a significant role in the development of vision and nervous system (among others, they are important for the development of retina as well as energy metabolism and brain electrical activity). Furthermore, more scientific evidence is emerging on the role of carotenoids in the prevention of disorders affecting preterm infants, who are susceptible to oxidative stress, particularly retinopathy of prematurity.
The research on carotenoids’ role in maternal child health is intriguing and much more work needs to be done. Carotenoids, particularly lutein, have their highest concentrations in the brain and retinal tissue, and there is some evidence that lutein protects the retina from damage due to blue light exposure. Blue light, which comes from sunlight and a variety of other light sources, can cause macular degeneration over time. This explains the old adage that carrots prevent blindness.
There is certainly no harm in encouraging mothers to have a diet plentiful of fruits and vegetables with the explanation that healthy carotenoid compounds in produce may reduce risks of maternal and fetal illnesses during pregnancy. Further, generous amounts of produce in the maternal diet during lactation increases infant intake of carotenoids, which are protective of oxidative stress to various infant tissues, especially the retina and brain.