Anne Sütünün Osteopontin Düzeyleri ile Maternal Beslenme ve Bebek Sağlığı Arasındaki İlişkinin Değerlendirilmesi

Abstract

Osteopontin (OPN) is a glycosylated phosphoprotein. Eighty-five subjects who have their routine check-up visits at Hacettepe University Faculty of Medicine Ihsan Dogramaci Children's Hospital Social Pediatrics Unit participated in this study which aimed to examine OPN levels of mature breast milk and maternal factors that possibly affect OPN level and possible relations between breast milk OPN levels and newborn's health. A questionnaire was applied to evaluate general characteristics of subjects and their health status, food frequencies with amounts and general characteristics of infants and height and weight of mothers and height, weight and head circumference infants were recorded. Subjects were asked to breastfeed their babies (10 minutes average), then milk samples (5 ml) were taken in glass bottles (pyrex teflon covered glass bottle). Osteopontin analysis of milk samples were analysed by ELISA method. Osteopontin level of breast milk were determined as 137.1±56.8 mg/L. Breast milk osteopontin levels were higher in mothers who had vitamin D supplementation (p<0.05) than who did not have and lower in mothers who used antibiotics (p<0.05) than who did not use during lactation period. Breast milk osteopontin levels of mothers who smoke were also lower than who did not smoke (p<0.05). Subjects who had excessive weight gain during pregnancy had lower breast milk osteopontin levels than who had adequate or normal weight gain (p<0.05). According to BMI classification during lactation period, breast milk osteopontin levels of obese subjects were found lower than lean and normal subjects (p<0,05). A negative correlation determined between breast milk osteopontin levels and weight gain during pregnancy (β=-3.048, p=0.012) and maternal BMI (β=-6.267, p=0.000) in regression modelling. In fixed regression modelling according to maternal BMI and pregnancy weight gain, there was a negative correlation between maternal energy intake and breast milk osteopontin levels (β=-0.038, p=0.001). In regression modelling which was calculated to assess relations breast milk levels which were fixed according to maternal BMI and energy intake and other maternal diet components, there were not significant relation between diet components except energy and breast milk osteopontin levels (p>0.05). When breast milk osteopontin levels classified by quartiles, 1st and 3rd month weights of infants whose mother had lower breast milk osteopontin levels were significantly lower than infants whose mother had normal and high breast milk osteopontin levels (p<0.05). Similarly, heights of infants whose mother had lower breast milk osteopontin levels were significantly lower than infants whose mother had normal and high breast milk osteopontin levels (p<0.05). There were not any significant relation between breast milk osteopontin levels and head circumference of infants. It was observed that mothers with higher breast milk OPN had better growth patterns and the frequency of fever complaints and hospital admission was lower (p<0.05). According to the results of this study, breast milk OPN levels vary depending on maternal factors and these differences can affect the immune system development and growth of infants. For this reason, mothers should be supported and educated in establishing an adequate and balanced maternal feeding pattern. In addition, more research, implementation and state policies should be implented in the addition of osteopontin to standard fomulae for babies who cannot get breast milk.