Literature review for - Flourish Paediatrics

SELENIUM AND BREASTFEEDING OUTCOMES
What nutritional factors are important in optimizing breastfeeding outcomes?
Evidence statement
Grade
Component Rating Notes
Evidence Base
Breast-feeding is associated with higher infant selenium
status compared to formula-feeding.
C
Satisfactory 1 Systematic review (O) with >190 references covering all
aspects of selenium (Se) nutrition in relation to breastmilk
and maternal factors impacting on this.
Consistency Good Internationally, there is a wide range of breast-milk Se
concentrations, dependent on Se consumed in natural foods
which is impacted by the Se content of the soils where
foods are grown. Despite wide variation in median Se
breastmilk concentration worldwide and that infants
commonly do not achieve recommendations, Se status is
greater in breast-fed than in formula-fed infants.
Clinical impact
Satisfactory The Australian studies (1983-1997) reporting breastmilk Se
concentrations, indicate they are comparable to the median
concentrations reported internationally. Maternal Se status
and most dietary intakes appear not sufficient to optimise
breastfed infant’s Se status, but are still associated with
higher Se status compared to formula-fed infants.
Generalisability Excellent Breastmilk Se concentrations are generalisable to Australian
women and the review includes Australian data.
Applicability Excellent Directly applicable to Australia. Australian soil Se
concentrations will vary by region and therefore Se intake
and breastmilk concentration.
The study included in the body of evidence statement is shown in Table 26.2.
This is a major review that discusses selenium (Se) nutrition during breast-feeding, including
environmental and maternal constitutional factors that affect breast-milk-Se metabolism and
secretion. Papers in this review were located via a literature search of Medline and Web of Science
on Se and breastmilk. The following headings are covered; Selenium species in breast milk;
Maternal constitutional factors; Environmental factors; Selenium prophylaxis and breast-feeding;
Selenium interactions and breast-feeding; Excess selenium in breast milk; Breast-feeding and the
infant’s selenium status.
The median Se concentration from studies worldwide are 26, 18, 15 and 17 ug/L in colostrum (0-5
days), transitional milk (6-21 days), mature milk (1-3 months) and late lactation (>5 months)
respectively. Se recommendations are not achieved by approx. 30% of the reported breastmilk Se
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