Update Knowledge in Breastfeeding and Its Applicability in Thailand


  • Oraporn Dumrongwongsiri Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University
  • Pattanee Winichagoon Institute of Nutrition, Mahidol University, Nakhon Pathom


breastfeeding, benefit of breastfeeding, nutrition in lactation, breastfeeding promotion


Increasing evidence regarding the benefits of breastfeeding on both short- and long-term maternal and infant’s health. This review provides an update knowledge on breastfeeding that is potentially applicable in Thailand. Breastfeeding is beyond just a means to provide an appropriate food for infants.  Recent evidence showed the relationship between breastfeeding and gut microbiota, which is essential for the immunological system, among breastfed infants. Health and nutrition status of lactating women is crucial for quality of breast milk and success in breastfeeding. Several studies and recommendations support the need for improving dietary intakes and supplementation for lactating women, such as, polyunsaturated fatty acid (PUFA) and vitamin D. However, further studies may be needed to verify the necessity, compliance to and suitability to implement in the Thai context, before recommending as part of the promotion and protection of breastfeeding in Thailand.


Download data is not yet available.


Marseglia L, Manti S, D'Angelo G, Cuppari C, Salpietro V, Filippelli M, et al. Obesity and breastfeeding: The strength of association. Women Birth. 2015; 28(2):81-6.

Woo JG, Martin LJ. Does breastfeeding protect against childhood obesity? Moving beyond observational evidence. Curr Obes Rep. 2015; 4(2):207-16.

Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol. 2005; 162(5):397-403.

Horta BL, Victora CG. Long-term effects of breastfeeding. Geneva: World Health Organization. 2013.

Walker WA, Iyengar RS. Breast milk, microbiota, and intestinal immune homeostasis. Pediatr Res. 2015; 77(1-2):220-8.

Isolauri E. Development of healthy gut microbiota early in life. J Paediatr Child Health. 2012; 48 Suppl 3:1-6.

Torres-Fuentes C, Schellekens H, Dinan TG, Cryan JF. The microbiota-gut-brain axis in obesity. Lancet Gastroenterol Hepatol. 2017; 2(10):747-56.

Ventura AK. Does breastfeeding shape food preferences? Links to obesity. Ann Nutr Metab. 2017; 70 Suppl 3:8-15.

de Lauzon-Guillain B, Jones L, Oliveira A, Moschonis G, Betoko A, Lopes C, et al. The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts. Am J Clin Nutr. 2013; 98(3):804-12.

Horta BL, Loret de Mola C, Victora CG. Breastfeeding and intelligence: a systematic review and meta-analysis. Acta Paediatr. 2015; 104(467):14-9.

Horta BL, de Sousa BA, de Mola CL. Breastfeeding and neurodevelopmental outcomes. Curr Opin Clin Nutr Metab. 2018; 21(3):174-8.

Deoni SC, Dean DC, 3rd, Piryatinsky I, O'Muircheartaigh J, Waskiewicz N, Lehman K, et al. Breastfeeding and early white matter development: A cross-sectional study. NeuroImage. 2013; 82:77-86.

Victora CG, Bahl R, Barros AJ, Franca GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387(10017):475-90.

Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009; 113(5):974-82.

Feng L, Xu Q, Hu Z, Pan H. Lactation and progression to type 2 diabetes in patients with gestational diabetes mellitus: A systematic review and meta-analysis of cohort studies. J Diabetes Investig. 2018; 9(6):1360-9.

Ho NT, Li F, Lee-Sarwar KA, Tun HM, Brown BP, Pannaraj PS, et al. Meta-analysis of effects of exclusive breastfeeding on infant gut microbiota across populations. Nat Commun. 2018; 9(1):4169.

Le Doare K, Holder B, Bassett A, Pannaraj PS. Mother's milk: A purposeful contribution to the development of the infant microbiota and immunity. Front Immunol. 2018; 9:361.

Andreas NJ, Kampmann B, Mehring Le-Doare K. Human breast milk: A review on its composition and bioactivity. Early Hum Dev. 2015; 91(11):629-35.

Moossavi S, Sepehri S, Robertson B, Bode L, Goruk S, Field CJ, et al. Composition and variation of the human milk microbiota are influenced by maternal and early-life factors. Cell Host Microbe. 2019; 25(2):324-35.e4.

Gentile CL, Weir TL. The gut microbiota at the intersection of diet and human health. Science. 2018;

(6416): 779-80.

Dotterud CK, Avershina E, Sekelja M, Simpson MR, Rudi K, Storro O, et al. Does maternal perinatal probiotic supplementation alter the intestinal microbiota of mother and child? J Pediatr Gastroenterol Nutr. 2015; 61(2):200-7.

Allen LH. Maternal micronutrient malnutrition: effects on breast milk and infant nutrition, and priorities for intervention. SCN news. 1994; 11:21-4.

Lee S, Kelleher SL. Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology. Am J Physiol Endocrinol Metab. 2016; 311(2):E405-22.

við Streym S, Højskov CS, Møller UK, Heickendorff L, Vestergaard P, Mosekilde L, et al. Vitamin D content in human breast milk: a 9-mo follow-up study. Am J Clin Nutr. 2016; 103(1):107-14.

Taylor SN. ABM clinical protocol #29: Iron, zinc, and vitamin D supplementation during breastfeeding. Breastfeeding Med. 2018; 13(6):398-404.

Bae YJ, Kratzsch J. Vitamin D and calcium in human breast milk. Best Pract Res Clin Endocrinol Metab. 2018;


คณะกรรมการและคณะทำงานปรับปรุงข้อกำหนดสารอาหารที่ควรได้รับประจำวันสำหรับคนไทย สำนักโภชนาการ กรมอนามัย กระทรวงสาธารณสุข. ปริมาณสารอาหารอ้างอิงที่ควรได้รับประจำวันสำหรับคนไทย พ.ศ.2563. กรุงเทพมหานคร: เอ.วี.โปรเกรสซีฟ. 2563.

Delgado-Noguera MF, Calvache JA, Bonfill Cosp X, Kotanidou EP, Galli-Tsinopoulou A. Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database Syst Rev. 2015; 7:Cd007901.

Gould JF, Smithers LG, Makrides M. The effect of maternal omega-3 (n-3) LCPUFA supplementation during pregnancy on early childhood cognitive and visual development: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2013; 97(3):531-44.

Sosa-Castillo E, Rodriguez-Cruz M, Molto-Puigmarti C. Genomics of lactation: role of nutrigenomics and nutrigenetics in the fatty acid composition of human milk. Br J Nutr. 2017; 118(3):161-8.

Koletzko B, Cetin I, Brenna JT. Dietary fat intakes for pregnant and lactating women. Br J Nutr. 2007; 98(5):873-7.

EFSA Panel on Dietetic Products N, Allergies (NDA). Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA Journal. 2010; 8(3):1461.

Joint F. Fats and fatty acids in human nutrition. Report of an expert consultation, 10-14 November 2008, Geneva. 2010.

Jirapinyo P, Densupsoontorn N, Wiraboonchai D, Vissavavejam U, Tangtrakulvachira T, Chungsomprasong P, et al. Fatty acid composition in breast milk from 4 regions of Thailand. J Med Assoc Thai. 2008; 91(12): 1833-7.

Amatayakul K, Wongsawasdi L, Mangklabruks A, Tansuhaj A, Ruckphaopunt S, Chiowanich P, et al. Effects of parity on breastfeeding: a study in the rural setting in northern Thailand. J Hum Lact. 1999; 15(2):121-4.

IAEA., IAEA. Stable isotope technique to assess intake of human milk in breastfed infants: International Atomic Energy Agency; 2010.

Dror DK, Allen LH. Overview of nutrients in human milk. Adv Nutr. 2018; 9(suppl_1):278s-94s.

Bravi F, Wiens F, Decarli A, Dal Pont A, Agostoni C, Ferraroni M. Impact of maternal nutrition on breast-milk composition: a systematic review. Am J Clin Nutr. 2016; 104(3):646-62.

Dumrongwongsiri O, Suthutvoravut U, Chatvutinun S, Phoonlabdacha P, Sangcakul A, Siripinyanond A, et al. Maternal zinc status is associated with breast milk zinc concentration and zinc status in breastfed infants aged 4-6 months. Asia Pac J Clin Nutr. 2015; 24(2):273-80.

Holm C, Thomsen LL, Norgaard A, Markova V, Michaelsen KF, Langhoff-Roos J. Iron concentration in breast milk normalised within one week of a single high-dose infusion of iron isomaltoside in randomised controlled trial. Acta Paediatr. 2017; 106(2):256-60.

Mello-Neto J, Rondo PH, Oshiiwa M, Morgano MA, Zacari CZ, dos Santos ML. Iron supplementation in pregnancy and breastfeeding and iron, copper and zinc status of lactating women from a human milk bank. J Trop Pediatr. 2013; 59(2):140-4.

Jarjou LM, Prentice A, Sawo Y, Laskey MA, Bennett J, Goldberg GR, et al. Randomized, placebo-controlled, calcium supplementation study in pregnant Gambian women: Effects on breast-milk calcium concentrations and infant birth weight, growth, and bone mineral accretion in the first year of life. Am J Clin Nutr. 2006; 83(3):657-66.

Zhang ZQ, Chen YM, Wang RQ, Huang ZW. The effects of different levels of calcium supplementation on the bone mineral status of postpartum lactating Chinese women: a 12-month randomised, double-blinded, controlled trial. Br J Nutr. 2016; 115(1):24-31.

Valentine CJ, Wagner CL. Nutritional management of the breastfeeding dyad. Pediatri Clin North Am. 2013; 60(1):261-74.

Kominiarek MA, Rajan P. Nutrition recommendations in pregnancy and lactation. Med Clin North Am. 2016; 100(6):1199-215.

Lee S, Kelleher SL. Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology. Am J Physiol Endocrinol Metab. 2016; 311(2):E405-E22.

Marshall NE, Lau B, Purnell JQ, Thornburg KL. Impact of maternal obesity and breastfeeding intention on lactation intensity and duration. Matern Child Nutr. 2018; e12732.

Flores TR, Mielke GI, Wendt A, Nunes BP, Bertoldi AD. Prepregnancy weight excess and cessation of exclusive breastfeeding: a systematic review and meta-analysis. Eur J Clin Nutr. 2018; 72(4):480-8.




How to Cite

Dumrongwongsiri, O., & Winichagoon, P. (2020). Update Knowledge in Breastfeeding and Its Applicability in Thailand . Journal of Nutrition Association of Thailand, 55(2), 15–28. Retrieved from https://he01.tci-thaijo.org/index.php/JNAT/article/view/230534



Review article