Abstract
Human milk oligosaccharides (HMOs) are complex unconjugated glycans associated with positive infant health outcomes. This study has examined current knowledge of the effect of maternal diet and nutritional status on the composition of HMOs in breast milk. Using the PRISMA-ScR guidelines, a comprehensive, systematic literature search was conducted using Scopus, Web of Science, Global Health (CABI), and MEDLINE. Titles and abstracts were screened independently by two reviewers against predefined inclusion and exclusion criteria. Fourteen studies met the inclusion criteria and reported on maternal dietary intake (n = 3), maternal body composition indices (n = 9), and dietary supplementation interventions (n = 2). In total, data from 1388 lactating mothers (4011 milk samples) were included. Design methodologies varied substantially across studies, particularly for milk sample collection, HMO analysis, dietary and body composition assessment. Overall, this review has identified potential associations between maternal dietary intake and nutritional status and the HMO composition of human milk, though an abundance and sufficiency of evidence is lacking. Standardised procedures for human milk sample collection and HMO analysis, along with robust and validated nutrition assessment techniques, should be employed to further investigate the impact of maternal nutritional factors on HMO composition.
Highlights
Breast milk is a unique and ideal source of nutrition for most infants [1]
Papers reported on maternal dietary intake (n = 3), dietary supplementation interventions (n = 2), and maternal body composition (n = 9), in relation to human milk oligosaccharides (HMOs) composition of milk samples
Research into the influence of maternal dietary intake on HMO composition and profiles in colostrum and mature milk is in its infancy and has been explored in only three studies included in this review [12,21,27]
Summary
Breast milk is a unique and ideal source of nutrition for most infants [1] It is comprised of essential nutrients in the right proportions and contains beneficial bioactive factors such as antibodies, hormones and over 200 defined human milk oligosaccharides (HMOs) [1]. HMOs are structurally diverse and complex unconjugated glycans and represent the third largest solid component of human milk after lactose and lipids [2,3]. Their presence in human milk is associated with many positive infant health outcomes, and they play an important role in influencing the development of the infant immune system and gut microbiome [2,4]. As a potential dietary source of sialic acid, some of the sialylated HMOs may be important for infant learning and memory development, though this observation is based primarily on animal studies [6,7]
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