The American journal of clinical nutrition · 2025
Human milk composition is associated with maternal overweight/obesity and low milk supply, with implications for infant weight outcomes: a cross-sectional study.
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Jin Xuehua, Warden Ashleigh H, Lai Ching Tat, Perrella Sharon L, McEachran Jacki L, Taylor Nicolas L, Gridneva Zoya, Geddes Donna T
Аннотация
BACKGROUND: Low milk supply (LMS) is a major barrier to exclusive and continued lactation. Maternal factors such as overweight/obesity (OW) and gestational diabetes mellitus may contribute to LMS and alter human milk (HM) composition, affecting infant growth.
OBJECTIVES: This cross-sectional study examined associations of HM components with LMS and maternal factors, and relationships between infant milk intake and weight outcomes.
METHODS: Twenty-four-hour milk production was measured at 1-6 mo postpartum using the test-weigh method. HM samples, demographic, obstetric, and infant data were collected from 225 participants. Macronutrients (fat, protein, lactose, and glucose) and hormones (estrone, estradiol, progesterone, leptin, adiponectin, and insulin) were analyzed.
RESULTS: Maternal OW was associated with higher concentrations of HM fat [β = 5.2; 95% confidence interval (CI): 6.5 × 10-3, 10.4], leptin (β = 197.4; 95% CI: 125.8, 269.1), insulin (β = 5.9; 95% CI: 2.5, 9.2), and higher infant intake of leptin (β = 135.9; 95% CI: 86.3, 185.4) and insulin (β = 3.2; 95% CI: 1.3, 5.0). In the LMS group, despite higher concentrations of HM protein, lactose, insulin, estrone, and progesterone, infant total intakes of fat (β = -9.5; 95% CI: -1.4, -5.4), carbohydrates (β = -6.0; 95% CI: -10.2, -1.8), estrone (β = -9.9; 95% CI: -14.5, -5.4), estradiol (β = -3.5; 95% CI: -5.1, -1.9), leptin (β = -55.9; 95% CI: -109.0, -2.7), and adiponectin (β = -3.9; 95% CI: -6.0, -1.7) were lower. Additionally, infant carbohydrates (β = 11.5 × 10-3; 95% CI: 4.6 × 10-3, 18.4 × 10-3), energy (β = 1.0 × 10-3; 95% CI: 0.3 × 10-3, 1.6 × 10-3), and 24-h total intakes (β = 1.7 × 10-3; 95% CI: 1.1 × 10-3, 2.4 × 10-3) were positively associated with infant weight-for-age z-score.
CONCLUSIONS: Maternal OW influences HM composition and infant milk intake. LMS impacts infant weight gain by limiting milk volume, underscoring the importance of timely LMS detection to ensure adequate infant nutrition.
OBJECTIVES: This cross-sectional study examined associations of HM components with LMS and maternal factors, and relationships between infant milk intake and weight outcomes.
METHODS: Twenty-four-hour milk production was measured at 1-6 mo postpartum using the test-weigh method. HM samples, demographic, obstetric, and infant data were collected from 225 participants. Macronutrients (fat, protein, lactose, and glucose) and hormones (estrone, estradiol, progesterone, leptin, adiponectin, and insulin) were analyzed.
RESULTS: Maternal OW was associated with higher concentrations of HM fat [β = 5.2; 95% confidence interval (CI): 6.5 × 10-3, 10.4], leptin (β = 197.4; 95% CI: 125.8, 269.1), insulin (β = 5.9; 95% CI: 2.5, 9.2), and higher infant intake of leptin (β = 135.9; 95% CI: 86.3, 185.4) and insulin (β = 3.2; 95% CI: 1.3, 5.0). In the LMS group, despite higher concentrations of HM protein, lactose, insulin, estrone, and progesterone, infant total intakes of fat (β = -9.5; 95% CI: -1.4, -5.4), carbohydrates (β = -6.0; 95% CI: -10.2, -1.8), estrone (β = -9.9; 95% CI: -14.5, -5.4), estradiol (β = -3.5; 95% CI: -5.1, -1.9), leptin (β = -55.9; 95% CI: -109.0, -2.7), and adiponectin (β = -3.9; 95% CI: -6.0, -1.7) were lower. Additionally, infant carbohydrates (β = 11.5 × 10-3; 95% CI: 4.6 × 10-3, 18.4 × 10-3), energy (β = 1.0 × 10-3; 95% CI: 0.3 × 10-3, 1.6 × 10-3), and 24-h total intakes (β = 1.7 × 10-3; 95% CI: 1.1 × 10-3, 2.4 × 10-3) were positively associated with infant weight-for-age z-score.
CONCLUSIONS: Maternal OW influences HM composition and infant milk intake. LMS impacts infant weight gain by limiting milk volume, underscoring the importance of timely LMS detection to ensure adequate infant nutrition.