A Study of Breast Milk Intake by Infants Forms Basis of Doctoral Study

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“A Longitudinal Study of Breast Milk Intake Volumes in African Infants in a Typical Urban Disadvantaged South African Community” was the title of a study which resulted in Dr Helen Mulol graduating with a PhD through UKZN’s Department of Paediatrics and Child Health.

Mulol followed 100 mother-infant pairs for a year following birth during which five study ages were used – six weeks, three months, six months, nine months and one year.

She used a stable isotope method which measures how much breast milk an infant receives and also measures water intake from sources other than breast milk.

‘This makes it possible to determine if an infant was exclusively breastfeeding. The volume of breast milk and the exclusivity of breastfeeding is then correlated with maternal and infant factors such as maternal HIV status, infant gender and nutritional status.’

Mulol said the stable isotope method could also be used to determine infant and maternal body composition in terms of whole body fat mass and fat-free mass.

‘It is the first time this method has been used in South Africa and the first study worldwide with a large amount of HIV positive mothers,’ said Mulol.

The study showed that breast milk output was not significantly different according to the maternal HIV status and that maternal body composition was not compromised during lactation.

‘The method also showed that infants who were exclusively breastfed for six months had significantly less fat mass at 12 months of age, compared to infants who were not exclusively breastfed for  six months,’ said Mulol.

Study Supervisor, Professor Anna Coutsoudis, described Mulol as a dedicated student. ‘She entered the field of medical science as a Chemistry graduate and set about immersing herself in important primary health care issues which were outside her original skill set,’ Coutsoudis said.

As part of her PhD, Mulol set up for the first time in South Africa the deuterium dilution technique to be able to accurately determine the breast milk intake of infants.

‘Helen successfully undertook valuable explorations in a cohort of 100 mother-infant pairs in a disadvantaged community in Durban,’ said Coutsoudis. ‘Her study revealed that HIV-infected mothers can exclusively breastfeed their infants for six months without compromising their own health and the breast milk output of these mothers was comparable to that of HIV uninfected mothers.’

Mulol, who is currently writing journal articles from her PhD work, is also involved in a follow-on research project from her PhD, is assisting in data management for another research project, and is doing contract lecturing at DUT.

‘My husband encouraged me to start my PhD at the age of 47 and he has been a great support,’ she said.

 Nombuso Dlamini