The American journal of clinical nutrition · 2026
Trajectory and predictors of human milk intake from 1 to 8.5 months of lactation: findings from the multicenter Mothers, Infants, and Lactation Quality (MILQ) cohort study.
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Silva Gabriela Torres, Campos Adriana Divina de Souza, Paula Daniela Polessa, Figueiredo Amanda Caroline Cunha, Michaelsen Kim F, Islam M Munirul, Peerson Janet M, Allen Lindsay H, Moore Sophie E, Kac Gilberto
Аннотация
BACKGROUND: Understanding patterns and determinants of human milk (HM) intake in early infancy is important for supporting optimal practices; however, data are limited across diverse populations.
OBJECTIVES: This study aimed to describe the trajectory of HM intake (g/d) from 1 to 8.5 mo postpartum and to identify sociodemographic, maternal, infant, and breastfeeding-related predictors of HM intake.
METHODS: This multicenter cohort analysis from the Mothers, Infants, and Lactation Quality study included 665 healthy mother-infant dyads assessed at 1 to 3.49 mo (M1), 3.5 to 5.99 mo (M2), and 6 to 8.5 mo (M3) postpartum. HM intake was assessed at M1 to M3 using the dose-to-mother technique in Bangladesh, Brazil, and The Gambia, and 24-h test weighing in Denmark. Longitudinal mixed-effects models with linear and quadratic terms for postpartum time were used to examine HM intake trajectories and identify predictors. Interaction models were adjusted for maternal BMI (kg/m2), infant sex, exclusive breastfeeding (EBF) for 6 mo, and infant weight-for-age (WAZ) z-score. An additional model included breastfeeding frequency for 3 sites.
RESULTS: HM intake showed a significant nonlinear association over time (βquadratic = -0.62; 95% CI: -0.71, -0.52). Higher maternal BMI (β = -5.27; 95% CI: -8.54, -2.00), female infant sex (β = -38.19; 95% CI: -58.98, -17.39), and not being EBF for 6 mo (β = -50.81; 95% CI: -75.08, -26.54) were associated with lower HM intake, whereas higher infant WAZ was associated with higher intake (β = 78.36; 95% CI: 66.45, 90.28). Higher breastfeeding frequency was associated with greater HM intake (β = 6.32; 95% CI: 3.70, 8.93). EBF for 6 mo, infant WAZ, and breastfeeding frequency modified HM intake trajectories. EBF-related differences increased over time, whereas WAZ interaction attenuated and breastfeeding frequency interaction increased.
CONCLUSIONS: Maternal BMI, infant sex, EBF for 6 mo, WAZ, and breastfeeding frequency predict HM intake between 1 and 8.5 months of lactation, whereas EBF, WAZ, and breastfeeding frequency shape the HM intake trajectory. This trial was registered at clinicaltrials.gov as NCT03254329 (https://clinicaltrials.gov/study/NCT03254329).
OBJECTIVES: This study aimed to describe the trajectory of HM intake (g/d) from 1 to 8.5 mo postpartum and to identify sociodemographic, maternal, infant, and breastfeeding-related predictors of HM intake.
METHODS: This multicenter cohort analysis from the Mothers, Infants, and Lactation Quality study included 665 healthy mother-infant dyads assessed at 1 to 3.49 mo (M1), 3.5 to 5.99 mo (M2), and 6 to 8.5 mo (M3) postpartum. HM intake was assessed at M1 to M3 using the dose-to-mother technique in Bangladesh, Brazil, and The Gambia, and 24-h test weighing in Denmark. Longitudinal mixed-effects models with linear and quadratic terms for postpartum time were used to examine HM intake trajectories and identify predictors. Interaction models were adjusted for maternal BMI (kg/m2), infant sex, exclusive breastfeeding (EBF) for 6 mo, and infant weight-for-age (WAZ) z-score. An additional model included breastfeeding frequency for 3 sites.
RESULTS: HM intake showed a significant nonlinear association over time (βquadratic = -0.62; 95% CI: -0.71, -0.52). Higher maternal BMI (β = -5.27; 95% CI: -8.54, -2.00), female infant sex (β = -38.19; 95% CI: -58.98, -17.39), and not being EBF for 6 mo (β = -50.81; 95% CI: -75.08, -26.54) were associated with lower HM intake, whereas higher infant WAZ was associated with higher intake (β = 78.36; 95% CI: 66.45, 90.28). Higher breastfeeding frequency was associated with greater HM intake (β = 6.32; 95% CI: 3.70, 8.93). EBF for 6 mo, infant WAZ, and breastfeeding frequency modified HM intake trajectories. EBF-related differences increased over time, whereas WAZ interaction attenuated and breastfeeding frequency interaction increased.
CONCLUSIONS: Maternal BMI, infant sex, EBF for 6 mo, WAZ, and breastfeeding frequency predict HM intake between 1 and 8.5 months of lactation, whereas EBF, WAZ, and breastfeeding frequency shape the HM intake trajectory. This trial was registered at clinicaltrials.gov as NCT03254329 (https://clinicaltrials.gov/study/NCT03254329).