Abstract
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.
Highlights
Nutrition [1] and development of infant body composition (BC) in the early months postpartum [2]are known to play a significant role in the programming of obesity
Considering that lactose, the principal carbohydrate, is important for maintenance of constant osmotic pressure in human milk (HM) [10], it is unlikely that maternal adiposity would have a significant impact on lactose concentration, which is estimated to be approximately 60–78 g/L throughout the lactation, lactose concentration is still variable between women [11]
The missing data in this analysis included carbohydrates concentrations (from 80 expected measurements: total carbohydrates (TCH) (n = 12); lactose (n = 14); human milk oligosaccharides (HMO) (n = 15)) and calculated daily intakes (CDI) (from 60 expected measurements: lactose (n = 27); TCH and HMO (n = 28)); missing data were distributed across the time points (Table 1)
Summary
Nutrition [1] and development of infant body composition (BC) in the early months postpartum [2]are known to play a significant role in the programming of obesity. Breastfeeding and its duration are associated with reduced risk of developing obesity later in life [3]. These observations suggest a dose-dependent effect of breastfeeding on the development of infant BC, but the mechanisms of this effect are not fully elucidated. HM provides a constant supply of carbohydrates to the infant during early life, ensuring appropriate nutrition, maturation and development of their comparatively immature physiological systems. Considering that lactose, the principal carbohydrate, is important for maintenance of constant osmotic pressure in HM [10], it is unlikely that maternal adiposity would have a significant impact on lactose concentration, which is estimated to be approximately 60–78 g/L throughout the lactation, lactose concentration is still variable between women [11]. As lactose synthesis results in water being drawn into the milk, the rate of lactose synthesis is a major controlling factor of milk production [12], and during the established lactation higher lactose concentration is associated with higher 24-h volumes [13] and higher breastfeeding frequency [14], which is related to higher 24-h volumes [15]
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