Human Milk Composition Differs by Maternal BMI in the First 9 Months Postpartum

Abstract Objectives Recent studies indicate that human milk composition is modulated by maternal weight status; however, results are conflicting. The objective of this study was to examine the relationship between maternal body composition and human milk macronutrients and bioactive components, as well as the association between infant daily intakes and infant body composition. Methods Human milk samples (N = 990) were obtained from a longitudinal study (NCT#0,113,1117) in normal weight (NW: 18.5–24.9 kg/m,2 N = 88) and overweight/obese (OW: 25–35 kg/m,2 N = 86) women between 0.5 and 9 months postpartum. Macronutrient content was estimated using mid-infrared spectroscopy (MIRIS AB). Leptin, insulin, C-reactive protein (CRP), IL-6, IL-8 and TNF-α were measured using electrochemiluminescence immunoassays (Meso Scale Diagnostics). Infant body composition was obtained using quantitative magnetic resonance (Echo-MRI-AH). Linear mixed models adjusted for postpartum age and infant sex. Results Human milk was higher in fat and protein, and lower in carbohydrate content at only a few time points in OW compared to NW mothers. Human milk leptin and insulin concentrations were higher in OW mothers throughout lactation and CRP content differed at most time points compared to NW mothers. Similar results were observed when concentrations were normalized to infant daily intake and body weight. The effect sizes of infant daily intakes associated with infant growth parameters were small for macronutrients (0.005 to 0.05 Z-score units and 0.02 to 0.45 fat mass index (FMI)/fat free mass index (FFMI) units per unit of change in composition). Larger effect sizes were seen with human milk insulin and leptin, with infants of OW mothers exposed to 1.5 to 2.5 times higher concentrations compared to infants of NW mothers. Conclusions This study allows for a more comprehensive understanding of maternal BMI effects on human milk composition and its association with infant growth. Of note, the concentrations of leptin and insulin in human milk from OW mothers were higher than those in milk from NW mothers, resulting in higher daily intakes by their infants and modulation of FMI from 0.5 to 9 months postpartum. This study demonstrates the value of considering both human milk composition and infant daily intake when assessing infant growth. Funding Sources USDA/ARS Project # 6026–51,000-012–06S, NIH R01 DK107516.

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Human milk composition differs by maternal BMI in the first 9 months postpartum

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa098 ◽

2020 ◽

Vol 112 (3) ◽

pp. 548-557 ◽

Cited By ~ 1

Author(s):

Clark R Sims ◽

Melissa E Lipsmeyer ◽

Donald E Turner ◽

Aline Andres

Keyword(s):

Body Composition ◽

Human Milk ◽

Weight Status ◽

Daily Intake ◽

Milk Composition ◽

Quantitative Mri ◽

Fat Free Mass ◽

Effect Sizes ◽

Z Score ◽

Daily Intakes

ABSTRACT Background Studies indicate that maternal weight status modulates human milk composition; however, results are conflicting. Objectives Our objective was to examine the relation between maternal body composition and human milk macronutrients and bioactive components and also their association with infant daily intakes and body composition. Methods Human milk samples were obtained from a longitudinal study (NCT 01131117) in normal weight (NW: 18.5–24.9 kg/m2, n = 88) and overweight/obese (OW: 25–35 kg/m2, n = 86) women between 0.5 and 9 mo postpartum. Macronutrient content was estimated using mid-infrared spectroscopy. Leptin, insulin, and C-reactive protein (CRP) were measured using electrochemiluminescence immunoassays. Infant body composition was obtained using quantitative MRI. Linear mixed models were adjusted for postpartum age and infant sex. Results Human milk in OW mothers was higher in fat and protein and lower in carbohydrate content at some time points compared with that in NW mothers. Human milk leptin, insulin, and CRP concentrations were higher in OW mothers compared with NW mothers, with infants of OW mothers exposed to 1.5–2.5 times higher concentrations of leptin and insulin compared with infants of NW mothers. Similar results were observed when concentrations were normalized to infant daily intake and body weight. The effect sizes of infant daily intakes associated with infant growth parameters were small for macronutrients [0.005–0.05 z-score units and 0.02–0.45 fat mass index (FMI) or fat-free mass index units per unit of change in composition, P < 0.05]. Larger effect sizes were seen with human milk insulin and leptin (0.24 z-score units and 0.37–1.15 FMI units per unit of change in composition, P < 0.05). Conclusions These findings demonstrate that infants of OW mothers are exposed to higher concentrations of insulin, leptin, and, to a lesser extent, CRP. The bioavailability of these 3 human milk bioactives and their mechanisms of action in the infant are unclear. This trial was registered at clinicaltrials.gov as NCT01131117.

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Maternal Nutrition and Body Composition During Breastfeeding: Association with Human Milk Composition

Nutrients ◽

10.3390/nu10101379 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1379 ◽

Cited By ~ 25

Author(s):

Agnieszka Bzikowska-Jura ◽

Aneta Czerwonogrodzka-Senczyna ◽

Gabriela Olędzka ◽

Dorota Szostak-Węgierek ◽

Halina Weker ◽

...

Keyword(s):

Body Composition ◽

Human Milk ◽

Milk Fat ◽

Maternal Nutrition ◽

Milk Composition ◽

The Body ◽

Fat Free Mass ◽

Total Protein Content ◽

Time Points ◽

Dietary Record

The composition of human milk is dynamic and can vary according to many maternal factors, such as diet and nutritional status. This study investigated the association of maternal nutrition and body composition with human milk composition. All measurements and analyses were done at three time points: during the first (n = 40), third (n = 22), and sixth (n = 15) month of lactation. Human milk was analyzed using the Miris human milk analyzer (HMA), body composition was measured with bioelectrical bioimpedance (BIA) using a Maltron BioScan 920-II, and the assessment of women’s nutrition was based on a three-day dietary record. The correlation coefficient (Pearson’s r) did not show a significant statistical relationship between human milk composition and nutrients in women’s diet at three time points. For women in the third month postpartum, we observed moderate to strong significant correlations (r ranged from 0.47 to 0.64) between total protein content in milk and the majority of body composition measures as follows: positive correlations: % fat mass (r = 0.60; p = 0.003), fat-free mass expressed in kg (r = 0.63; p = 0.001), and muscle mass (r = 0.47; p = 0.027); and negative correlation: % total body water (r = −0.60; p = 0.003). The variance in milk fat content was related to the body mass index (BMI), with a significant positive correlation in the first month postpartum (r = 0.33; p = 0.048). These findings suggest that it is not diet, but rather the maternal body composition that may be associated with the nutritional value of human milk.

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Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy334 ◽

2019 ◽

Vol 110 (1) ◽

pp. 111-120 ◽

Cited By ~ 22

Author(s):

Elvira Isganaitis ◽

Sarah Venditti ◽

Tucker J Matthews ◽

Carles Lerin ◽

Ellen W Demerath ◽

...

Keyword(s):

Body Composition ◽

Weight Gain ◽

Childhood Obesity ◽

Human Milk ◽

False Discovery Rate ◽

Maternal Obesity ◽

Milk Composition ◽

False Discovery ◽

Postnatal Weight Gain ◽

Maternal Bmi

ABSTRACTBackgroundMaternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear.ObjectivesWe aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain.MethodsThis was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother–infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography–gas chromatography–mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum.ResultsAt 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI.ConclusionsMaternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother–child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.

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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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Carbohydrates in Human Milk and Body Composition of Term Infants during the First 12 Months of Lactation

Nutrients ◽

10.3390/nu11071472 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1472 ◽

Cited By ~ 11

Author(s):

Zoya Gridneva ◽

Alethea Rea ◽

Wan Jun Tie ◽

Ching Tat Lai ◽

Sambavi Kugananthan ◽

...

Keyword(s):

Body Composition ◽

Human Milk ◽

Bioelectrical Impedance ◽

Term Infant ◽

Fat Free Mass ◽

Mixed Effects Models ◽

First Year ◽

Term Infants ◽

Total Carbohydrates ◽

Daily Intakes

Human milk (HM) carbohydrates may affect infant appetite regulation, breastfeeding patterns, and body composition (BC). We investigated relationships between concentrations/calculated daily intakes (CDI) of HM carbohydrates in first year postpartum and maternal/term infant BC, as well as breastfeeding parameters. BC of dyads (n = 20) was determined at 2, 5, 9, and/or 12 months postpartum using ultrasound skinfolds (infants) and bioelectrical impedance spectroscopy (infants/mothers). Breastfeeding frequency, 24-h milk intake and total carbohydrates (TCH) and lactose were measured to calculate HM oligosaccharides (HMO) concentration and CDI of carbohydrates. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Higher TCH concentrations were associated with greater infant length, weight, fat-free mass (FFM), and FFM index (FFMI), and decreased fat mass (FM), FM index (FMI), %FM and FM/FFM ratio. Higher HMO concentrations were associated with greater infant FFM and FFMI, and decreased FMI, %FM, and FM/FFM ratio. Higher TCH CDI were associated with greater FM, FMI, %FM, and FM/FFM ratio, and decreased infant FFMI. Higher lactose CDI were associated with greater FM, FMI, %FM, and FM/FFM, ratio and decreased FFMI. Concentrations and intakes of HM carbohydrates differentially influence development of infant BC in the first 12 months postpartum, and may potentially influence risk of later obesity via modulation of BC.

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25 Years of Research in Human Lactation: From Discovery to Translation

Nutrients ◽

10.3390/nu13093071 ◽

2021 ◽

Vol 13 (9) ◽

pp. 3071

Author(s):

Donna Tracy Geddes ◽

Zoya Gridneva ◽

Sharon Lisa Perrella ◽

Leon Robert Mitoulas ◽

Jacqueline Coral Kent ◽

...

Keyword(s):

Body Composition ◽

Systems Approach ◽

Energy Content ◽

Research Programme ◽

Milk Composition ◽

Infant Growth ◽

Evidence Based ◽

Milk Secretion ◽

Human Lactation ◽

Growth Development

Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.

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Human Milk Casein and Whey Protein and Infant Body Composition over the First 12 Months of Lactation

Nutrients ◽

10.3390/nu10091332 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1332 ◽

Cited By ~ 8

Author(s):

Zoya Gridneva ◽

Wan J. Tie ◽

Alethea Rea ◽

Ching Tat Lai ◽

Leigh C. Ward ◽

...

Keyword(s):

Body Composition ◽

Human Milk ◽

Whey Protein ◽

Fat Mass ◽

Total Protein ◽

Fat Free Mass ◽

Maternal Weight ◽

Fat Mass Index ◽

Milk Casein ◽

Daily Intakes

Human milk (HM) influences infant feeding patterns and body composition (BC). This small proof-of concept longitudinal study investigated relationships between infant/maternal BC and HM casein, whey and total protein during the first 12 months of lactation. BC of breastfeeding dyads (n = 20) was measured at 2 (n = 15), 5 (n = 20), 9 (n = 19), and/or 12 (n = 18) months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). Proteins concentrations and 24-h milk intake were measured and calculated daily intakes (CDI) determined. Higher maternal weight, body mass index, fat-free mass, fat-free mass index, and fat mass index were associated with higher concentration of whey protein (p ≤ 0.034, n = 20). There were no associations between infant BC and concentrations of all proteins, and CDI of whey and total protein. Higher CDI of casein were associated with lower infant fat-free mass (p = 0.003, n = 18) and higher fat mass (p < 0.001), fat mass index (p = 0.001, n = 18), and % fat mass (p < 0.001, n = 18) measured with ultrasound skinfolds. These results show a differential effect of HM casein on development of infant BC during the first year of life, suggesting that there is a potential to improve outcome for the infant through interventions, such as continuation of breastfeeding during the first 12 months of life and beyond, which may facilitate favourable developmental programming that could reduce risk of non-communicable diseases later in life.

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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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Human Milk Adiponectin and Leptin and Infant Body Composition over the First 12 Months of Lactation

Nutrients ◽

10.3390/nu10081125 ◽

2018 ◽

Vol 10 (8) ◽

pp. 1125 ◽

Cited By ~ 11

Author(s):

Zoya Gridneva ◽

Sambavi Kugananthan ◽

Alethea Rea ◽

Ching Lai ◽

Leigh Ward ◽

...

Keyword(s):

Body Composition ◽

Human Milk ◽

Term Infant ◽

Fat Free Mass ◽

First Year ◽

Feeding Frequency ◽

Critical Window ◽

Whole Milk ◽

Daily Intakes ◽

First Year Of Life

Human milk (HM) adipokines may influence infant feeding patterns, appetite regulation, and body composition (BC). The associations between concentrations/calculated daily intakes (CDI) of HM adipokines in the first 12 months postpartum and maternal/term infant BC, and infant breastfeeding parameters were investigated. BC of breastfeeding dyads (n = 20) was measured at 2, 5, 9, and/or 12 months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). 24-h milk intake and feeding frequency were measured along with whole milk adiponectin and skim and whole milk leptin (SML and WML) and CDI were calculated. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Adipokine concentrations did not associate with infant BC. Higher CDI of adiponectin were associated with lower infant fat-free mass (FFM; p = 0.005) and FFM index (FFMI; p = 0.009) and higher fat mass (FM; p < 0.001), FM index (FMI; p < 0.001), and %FM (p < 0.001). Higher CDI of SML were associated with higher infant FM (p < 0.001), FMI (p < 0.001), and %FM (p = 0.002). At 12 months, higher CDI of WML were associated with larger increases in infant adiposity (2–12 month: FM, p = 0.0006; %FM, p = 0.0004); higher CDI of SML were associated with a larger decrease in FFMI (5–12 months: p = 0.0004). Intakes of HM adipokines differentially influence development of infant BC in the first year of life, which is a critical window of infant programming and may potentially influence risk of later disease via modulation of BC.

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