Abstract
ABSTRACTBackgroundThe stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk water intake demonstrates that maternal self-report methods of infant feeding overestimate the true prevalence of exclusively breastfeeding practices.ObjectiveWe aimed to determine potential monosaccharide and oligosaccharide markers that distinguish between exclusively breastfed (EBF) versus nonexclusively breastfed (non-EBF) infants utilizing LC-MS-based methods.MethodsData for the analysis were collected as part of a larger, longitudinal study of 192 breastfed Indonesian infants aged 2 mo and followed up at 5 mo. Feces samples were collected from infants aged 2 mo (n = 188) and 5 mo (n = 184). EBF and non-EBF strata at each time point were determined via the DTM technique. Feces samples were analyzed to determine monosaccharide content using ultra-high-performance LC-triple quadrupole MS (UHPLC-QqQ MS). Relative abundances of fecal oligosaccharides were determined using nano-LC-Chip-quadrupole time-of-flight MS (nano-LC-Chip-Q-ToF MS).ResultsAt age 2 mo, monosaccharide analysis showed the abundance of fructose and mannose were significantly higher (+377% and +388%, respectively) in non-EBF compared with EBF infants (P <0.0001). Fructose and mannose also showed good discrimination with areas under the curve (AUC) of 0.86 and 0.82, respectively. Oligosaccharide analysis showed that a 6-hexose (Hex6) isomer had good discrimination (AUC = 0.80) between EBF and non-EBF groups at 5 mo.ConclusionCarbohydrate products, particularly fecal mono- and oligosaccharides, differed between EBF and non-EBF infants aged under 6 mo and can be used as potential biomarkers to distinguish EBF versus non-EBF feeding practices.
Highlights
Breastfeeding has been shown to significantly reduce the incidence of infant disease and mortality [1,2,3,4,5,6,7,8,9,10]
The present study examines monosaccharides and plant based-oligosaccharides as potential biomarkers in infant feces in order to distinguish between exclusively breastfed (EBF) and nonexclusively breastfed (non-EBF) status designated using a state-of-the-art DTM method [17, 18]
Relative abundances of fucose (P = 0.003), galactose (P = 0.045), glucose (P = 0.029), and GlcNAc (P = 0.014) were higher in feces of EBF infants than non-EBF infants at 2 mo (Table 1)
Summary
Breastfeeding has been shown to significantly reduce the incidence of infant disease and mortality [1,2,3,4,5,6,7,8,9,10]. The D2O method (dose-tomother; DTM) has been shown to be precise and accurate, and recent efforts to shorten the protocol have enhanced its usability in larger-scale surveys [17, 18]. It is not Copyright C The Author(s) on behalf of the American Society for Nutrition 2020. The stable isotope deuterium dose-to-mother (DTM) technique to estimate nonbreast milk water intake demonstrates that maternal self-report methods of infant feeding overestimate the true prevalence of exclusively breastfeeding practices. Results: At age 2 mo, monosaccharide analysis showed the abundance of fructose and mannose were significantly higher (+377% and +388%, respectively) in non-EBF compared with EBF infants (P
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