A Review of the Relationship Between the Appetite-Regulating Hormone Leptin Present in Human Milk and Infant Growth

Background: Breastfeeding mothers commonly experience nipple pain accompanied by radiating, stabbing or constant breast pain between feeds, sometimes associated with pink shiny nipple epithelium and white flakes of skin. Current guidelines diagnose these signs and symptoms as mammary candidiasis and stipulate antifungal medications. Aim: This study reviews existing research into the relationship between Candida albicans and nipple and breast pain in breastfeeding women who have been diagnosed with mammary candidiasis; whether fluconazole is an effective treatment; and the presence of C. albicans in the human milk microbiome. Method: The author conducted three searches to investigate (a) breastfeeding-related pain and C. albicans; (b) the efficacy of fluconazole in breastfeeding-related pain; and (c) composition of the human milk mycobiome. These findings are critiqued and integrated in a narrative review. Results: There is little evidence to support the hypothesis that Candida spp, including C. albicans, in maternal milk or on the nipple-areolar complex causes the signs and symptoms popularly diagnosed as mammary candidiasis. There is no evidence that antifungal treatments are any more effective than the passage of time in women with these symptoms. Candida spp including C. albicans are commonly identified in healthy human milk and nipple-areolar complex mycobiomes. Discussion: Clinical breastfeeding support remains a research frontier. The human milk microbiome, which includes a mycobiome, interacts with the microbiomes of the infant mouth and nipple-areolar complex, including their mycobiomes, to form protective ecosystems. Topical or oral antifungals may disrupt immunoprotective microbial homeostasis. Unnecessary use contributes to the serious global problem of antifungal resistance. Conclusion: Antifungal treatment is rarely indicated and prolonged courses cannot be justified in breastfeeding women experiencing breast and nipple pain. Multiple strategies for stabilizing microbiome feedback loops when nipple and breast pain emerge are required, in order to avoid overtreatment of breastfeeding mothers and their infants with antifungal medications.

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Longitudinal Changes in the Concentration of Major Human Milk Proteins in the First Six Months of Lactation and Their Effects on Infant Growth

Nutrients ◽

10.3390/nu13051476 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1476

Author(s):

Jian Zhang ◽

Ai Zhao ◽

Shiyun Lai ◽

Qingbin Yuan ◽

Xiaojiang Jia ◽

...

Keyword(s):

Human Milk ◽

Maternal Education ◽

Mode Of Delivery ◽

Milk Proteins ◽

Protein Composition ◽

Infant Growth ◽

Term Infants ◽

Longitudinal Changes ◽

Milk Samples ◽

The Impact

Our knowledge related to human milk proteins is still limited. The present study determined the changes in multiple human milk proteins during the first six months of lactation, investigated the influencing factors of milk proteins, and explored the impact of milk proteins on infant growth. A total of 105 lactating women and their full-term infants from China were prospectively surveyed in this research. Milk samples were collected at 1–5 days, 8–14 days, 1 month, and 6 months postpartum. Concentrations of total protein and α-lactalbumin were measured in all milk samples, and concentrations of lactoferrin, osteopontin, total casein, β-casein, αs−1 casein, and κ-casein were measured in milk from 51 individuals using ultra performance liquid chromatography coupled with mass spectrometry. The concentration of measured proteins in the milk decreased during the first six months of postpartum (p-trend < 0.001). Maternal age, mode of delivery, maternal education, and income impacted the longitudinal changes in milk proteins (p-interaction < 0.05). Concentrations of αs−1 casein in milk were inversely associated with the weight-for-age Z-scores of the infants (1 m: r −0.29, p 0.038; 6 m: r −0.33, p 0.020). In conclusion, the concentration of proteins in milk decreased over the first six months postpartum, potentially influenced by maternal demographic and delivery factors. Milk protein composition may influence infant weights.

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Human milk oligosaccharides, infant growth, and adiposity over the first 4 months of lactation

Pediatric Research ◽

10.1038/s41390-020-01328-y ◽

2021 ◽

Author(s):

Aristea Binia ◽

Luca Lavalle ◽

Cheng Chen ◽

Sean Austin ◽

Massimo Agosti ◽

...

Keyword(s):

Human Milk ◽

Infant Growth ◽

Human Milk Oligosaccharides ◽

Milk Oligosaccharides

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THE RELATIONSHIP OF THE SODIUM, POTASSIUM, AND CHLORIDE CONCENTRATION OF THE FEEDING TO THE WEIGHT GAIN OF PREMATURE INFANTS

PEDIATRICS ◽

10.1542/peds.30.6.909 ◽

1962 ◽

Vol 30 (6) ◽

pp. 909-916

Author(s):

Herbert I. Goldman ◽

Samuel Karelitz ◽

Hedda Acs ◽

Eli Seifter

Keyword(s):

Weight Gain ◽

Sodium Chloride ◽

Human Milk ◽

Premature Infants ◽

Chloride Concentration ◽

The Other ◽

Milk Formula ◽

Sodium Potassium ◽

Relationship Of ◽

The Relationship

One hundred four healthy premature infants, of birth weight 1,000 to 1,800 gm, were fed one of five feedings: (1) human milk; (2) human milk plus 13 meq/l of sodium chloride; (3) human milk plus 13 meq/l of sodium chloride and 18 meq/l of potassium chloride; (4) a half-skimmed cows milk formula; and (5) a partially-skimmed vegetable oil, cows milk formula. The infants fed any of the three human milk formulas gained weight at a slower rate than the infants fed either of the two cows milk formulas. Infants whose diets were changed from unmodified human milk to the half-skimmed cows milk gained large amounts of weight, and at times were visibly edematous. Infants whose diets were changed from the human milks with added sodium chloride, to the half-skimmed cows milk, gained lesser amounts of weight and did not become edematous. The infants fed the two cows milk diets gained similar amounts of weight, although one diet provided 6.5 gm/kg/day, the other 3.1 gm/kg/day of protein.

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Human milk composition and infant growth

Current Opinion in Clinical Nutrition & Metabolic Care ◽

10.1097/mco.0000000000000466 ◽

2018 ◽

Vol 21 (3) ◽

pp. 200-206 ◽

Cited By ~ 30

Author(s):

Kamilla G. Eriksen ◽

Sophie H. Christensen ◽

Mads V. Lind ◽

Kim F. Michaelsen

Keyword(s):

Human Milk ◽

Milk Composition ◽

Infant Growth

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Measurement of N- and C-terminal-region fragments of parathyroid hormone-related peptide in milk from lactating women and investigation of the relationship of their concentrations to calcium in milk

Journal of Endocrinology ◽

10.1677/joe.0.1530445 ◽

1997 ◽

Vol 153 (3) ◽

pp. 445-451 ◽

Cited By ~ 26

Author(s):

H Uemura ◽

T Yasui ◽

N Yoneda ◽

M Irahara ◽

T Aono

Keyword(s):

Parathyroid Hormone ◽

Human Milk ◽

Physiological Role ◽

Terminal Region ◽

Related Peptide ◽

Milk Volume ◽

Parathyroid Hormone Related Peptide ◽

High Concentrations ◽

Relationship Of ◽

The Relationship

Abstract Parathyroid hormone-related peptide (PTHrP) is found in very high concentrations in the milk of various mammals. However, little is known about its physiological role in this fluid. To obtain detailed profiles of PTHrP in milk, we measured the concentrations of PTHrP in human milk by two different region-specific assays, PTHrP(1–87) (N-PTHrP) and PTHrP(109–141) (C-PTHrP). We also examined the correlations between PTHrP and Ca concentrations in milk as well as the correlations between PTHrP and secreted milk volume. The levels of N-PTHrP and C-PTHrP were relatively low after delivery and gradually increased to 13·87 ± 2·40 nmol/l (mean ± s.e.m.) and 56·39 ± 11·31 nmol/l respectively on the 10th day postpartum. N-PTHrP concentration remained steady until the 6th month postpartum when weaning starts, at which point it decreased slightly. C-PTHrP levels changed in a similar way to N-PTHrP levels but were 2- to 5-fold higher. Milk Ca concentration, and content, correlated with C-PTHrP concentration, and content (r=0·422 and r=0·769 respectively; P<0·0001) but not with N-PTHrP. N-PTHrP concentration in the milk samples on the 4th day postpartum correlated with the volume of milk secreted during the 24 h before the samples were taken (r=0·524, P<0·01), but C-PTHrP concentration did not. These results suggest that PTHrP in human milk may play some role in the maintenance of lactation through the N-terminal region and in promoting Ca transfer into milk via the C-terminal region. Journal of Endocrinology (1997) 153, 445–451

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Cerium in human milk samples and its transfer from blood to milk: Is there an elevated nutritional risk for breast-fed babies?

Pure and Applied Chemistry ◽

10.1351/pac-con-11-07-08 ◽

2011 ◽

Vol 84 (2) ◽

pp. 313-324 ◽

Cited By ~ 3

Author(s):

Bernhard Michalke ◽

Montserrat González-Estecha ◽

Elena M. Trasobares ◽

Miguel Angel Herraiz ◽

Augusto Giussani ◽

...

Keyword(s):

Breast Milk ◽

Human Milk ◽

Fission Products ◽

Nutritional Risk ◽

Endomyocardial Fibrosis ◽

Limit Of Quantification ◽

Milk Samples ◽

Paired Serum ◽

The Relationship ◽

Breast Fed

The general population is increasingly exposed to cerium (Ce), which is contained in industrial products or is present as nuclear Ce fission products. Some studies suggested a link between elevated Ce levels and endomyocardial fibrosis. Since breast milk is the optimal, and directly after birth, usually the sole nutrition for newborns, exposure of females to Ce and its transfer to infants by breast-feeding is of concern in neonate protection. Consequently, the transfer rate of Ce from blood to breast milk is of interest for elucidating the Ce exposure of infants. Biomonitoring of paired serum and breast milk samples provides such information about Ce transfer to human milk. Therefore, this study is aimed at clarification of the relationship between Ce in human milk and serum from respective mothers for elucidating Ce enrichment in human milk with possible nutritional risk for newborns. As a prerequisite a strictly quality-controlled Ce determination method applicable to very low Ce concentration was developed, and its figures of merit were determined and found to be sufficient for our purpose. It turned out that Ce concentration in milk from Munich (Germany) and Madrid (Spain) showed a median of 13 ng/L. Ce concentrations in serum were at limit of quantification (LOQ) 10 ng/L (Munich) or 21.6–70.3 ng/L (Madrid), suggesting a higher Ce intake in Madrid. No enrichment from blood to milk was seen, and no elevated nutritional risk for breast-fed babies from Ce was found. Ce in serum, but not in milk, could indicate environmental Ce.

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Free Amino Acids in Human Milk and Associations With Maternal Anthropometry and Infant Growth

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0000000000001195 ◽

2016 ◽

Vol 63 (3) ◽

pp. 374-378 ◽

Cited By ~ 14

Author(s):

Anni Larnkjær ◽

Signe Bruun ◽

Dorthe Pedersen ◽

Gitte Zachariassen ◽

Vibeke Barkholt ◽

...

Keyword(s):

Amino Acids ◽

Human Milk ◽

Free Amino Acids ◽

Free Amino ◽

Infant Growth

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Influence of the Type of Breastfeeding and Human Milk Polyamines on Infant Anthropometric Parameters

Frontiers in Nutrition ◽

10.3389/fnut.2021.815477 ◽

2022 ◽

Vol 8 ◽

Author(s):

Nelly C. Muñoz-Esparza ◽

Edgar M. Vásquez-Garibay ◽

Elizabeth Guzmán-Mercado ◽

Alfredo Larrosa-Haro ◽

Oriol Comas-Basté ◽

...

Keyword(s):

Body Composition ◽

Human Milk ◽

Infant Growth ◽

Polyamine Metabolism ◽

Inverse Association ◽

Anthropometric Parameters ◽

Anthropometric Indicators ◽

Breastfed Infants ◽

Cell Proliferation And Differentiation ◽

Polyamine Content

Feeding choices in the early months of life are key determinants of growth during infancy. Polyamines participate in cell proliferation and differentiation, and it has also been suggested that polyamine metabolism plays a role in adipogenesis. As the main exogenous source of polyamines in the infant is human milk, the aim of this work was to study if the type of breastfeeding received and the polyamine intake from human milk has an influence on infant anthropometric parameters. A cohort of 78 full-term healthy newborns was followed up until 4 months of age; 55 were fully and 23 partially breastfed. Anthropometric measurements were taken at 2 and 4 months, when human milk samples were also collected for analysis of polyamine content by UHPLC-FL. Fully breastfed infants had a better anthropometric profile than those partially breastfed (p < 0.05). Furthermore, polyamine intake in partially breastfed infants was significantly lower compared to those fully breastfed. However, only two of the 15 anthropometric indicators evaluated (triceps skinfold and mean upper arm circumference) showed a significant inverse association with polyamine content in human milk and intake (p < 0.05). Infant growth and body composition differ according to the type of breastfeeding received. Based on the weak associations between polyamines and anthropometric indicators, it is not possible to conclude the influence of polyamines in infant growth and body composition.

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