Published online March 1, 2006
PEDIATRICS Vol. 117 No. 3 March 2006, pp. 989-990 (doi:10.1542/peds.2005-3063)
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Fat Content in Human Milk According to Duration of Lactation: In Reply

Dror Mandel, MD, MHA
Shaul Dollberg, MD, FACN
Francis B. Mimouni, MD, FAAP, FACN
Department of Neonatology
Lis Maternity Hospital
Sackler School of Medicine
Tel Aviv University
Tel Aviv 64239, Israel

Ronit Lubetzky, MD
Department of Neonatology
Lis Maternity Hospital
Department of Pediatrics
Dana Children's Hospital
Tel Aviv Sourasky Medical Center
Sackler School of Medicine
Tel Aviv University
Tel Aviv 64239, Israel

Shimon Barak, MD
Department of Neonatology
Lis Maternity Hospital
Tel Aviv University
Tel Aviv 64239, Israel

In Reply.—

We are thankful to Larnkjaer et al for their interest in our article1 and for their thoughtful comments. When we ran our Medline search while writing our article, using the key words "lactation" or "breast milk" and "duration," we were not able to retrieve their important communication.2

We are very pleased to see that Michaelsen et al2 found similar results to ours1 in that fat content increased massively during prolonged lactation, as shown in their illustrative graph. We are quite surprised, however, that they found a positive association between maternal BMI and fat content in breast milk. Their findings led them to speculate that the size of fat stores built on pregnancy can affect fat concentration in breast milk. It was clear in our article that the multiple-regression analysis of the data did not support this concept. Furthermore, women with shorter lactation duration (closer to the delivery than women with longer lactation duration) in fact had a lower creamatocrit. We believe that, because of the strong inverse correlation between lactation duration and BMI, it is impossible, in fact, to introduce in the same multiple regression both variables as independent ones (to examine their effect on creamatocrit or fat content), because it would create a problem of colinearity,3 rendering the prediction equation unstable. We cannot comment on the relationship between weight gain during pregnancy and fat content in the milk, because weight gain in pregnancy was not prospectively obtained in our cross-sectional study.

REFERENCES

  1. Mandel D, Lubetzky R, Dollberg S, Barak S, Mimouni FB. Fat and energy contents of expressed human breast milk in prolonged lactation. Pediatrics. 2005;116(3) . Available at: www.pediatrics.org/cgi/content/full/116/3/e432
  2. Michaelsen KF, Skafte L, Badsberg JH, Jorgensen M. Variation in macronutrients in human bank milk: influencing factors and implications for human milk banking. J Pediatr Gastroenterol Nutr. 1990;11 :229 –239[ISI][Medline]
  3. Samsa G, Hu G, Root M. Combining information from multiple data sources to create multivariable risk models: illustration and preliminary assessment of a new method. J Biomed Biotechnol. 2005;2005 :113 –123[Medline]
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

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Fat Content in Human Milk According to Duration of Lactation
Anni Larnkjaer, Lene Schack-Nielsen, and Kim Fleischer Michaelsen
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