@article{8613750,
  abstract     = {{Background: The breast-milk composition in the first 6 wk postpartum of women who have undergone bariatric surgery (BS) is unknown. 
Objective: The aim of this study was to examine 1) the breast-milk macronutrient and vitamin A composition in women who had and who had not undergone BS and 2) the impact of maternal diet on the breast-milk composition. We hypothesized that the milk of women who had undergone BS would be less energy dense and have a lower vitamin A concentration than that of other women. 
Methods: A multicenter prospective substudy was conducted at 2 university hospitals. Breast-milk samples were collected from 24 normal-weight [NW; mean +/- SD body mass index (BMI; kg/m(2)): 21.5 +/- 1.7; mean +/- SD age: 29 +/- 6 y], 39 overweight (OW; BMI: 26.9 +/- 1.5; aged 29 +/- 5 y), and 12 obese women (BMI: 35.0 +/- 5.7; aged 29 +/- 5 y) as well as from 11 women who had undergone BS (BMI: 28.0 +/- 4.4; aged 30 +/- 4 y) from day 3 until week 6 of lactation. Milk energy and macronutrients (Human Milk Analyzer; Miris) and vitamin A concentrations (iCheck Fluoro; BioAnalyt) were determined at the end of each week. Maternal diet (food-frequency questionnaire) and physical activity (Kaiser Physical Activity Survey) were measured during the third trimester of pregnancy and on day 3 or 4 and during week 6 of lactation. Statistical analyses include 1-factor ANOVA, Spearman and Pearson correlations, and multiple linear regression. 
Results: In all women, a weekly increase in milk energy, total fat, and total carbohydrates was seen, whereas a weekly decrease in proteins and vitamin A was found during the first 2 wk of lactation, followed by a stable concentration of all nutrients. At week 4, milk protein concentrations were higher in women who had undergone BS (14 g/L) compared with NW (8 g/L; P = 0.005) and OW (9 g/L; P = 0.019) women. At week 5, milk carbohydrate concentrations were higher in women who had undergone BS (74 g/L) compared with NW women (68 g/L; P = 0.042). 
Conclusions: Breast milk of women who have undergone BS appears to be adequate in energy, macronutrients, and vitamin A during the first 6 wk of lactation. This supports the conclusion that breast feeding should not be discouraged in this group of women.}},
  author       = {{Jans, Goele and Devlieger, Roland and De Preter, Vicky and Ameye, Lieveke and Roelens, Kristien and Lannoo, Matthias and Van der Schueren, Bart and Verhaeghe, Johan and Matthys, Christophe}},
  issn         = {{0022-3166}},
  journal      = {{JOURNAL OF NUTRITION}},
  keywords     = {{MATERNAL GASTRIC BYPASS,PHYSICAL-ACTIVITY SURVEY,PREGNANT-WOMEN,MACRONUTRIENT COMPOSITION,VITAMIN-A,PROSPECTIVE COHORT,LIFE-STYLE,DEFICIENCY,VALIDATION,IMPACT,breast milk,macronutrients,vitamin A,maternal diet,bariatric surgery}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1096--1102}},
  title        = {{Bariatric surgery does not appear to affect women's breast-milk composition}},
  url          = {{http://dx.doi.org/10.1093/jn/nxy085}},
  volume       = {{148}},
  year         = {{2018}},
}

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