Abstract
The objective of the study was to investigate the potential association of human milk leptin concentrations with child body mass index (BMI) and BMI trajectory patterns up to two years of age among children in the Ulm SPATZ Health Study. Leptin concentration was measured in skimmed human milk by ELISA (R&D System). Child BMI was determined at two to three days, three to four weeks, four to five months, one year, and two years of age. In SPATZ, leptin concentration at six weeks was inversely associated with child BMI at four to five weeks [beta –0.13, 95%CI –0.21;–0.05)] and at three to four months –0.12 –0.21;–0.03)]. Among infants of average BMI shortly after delivery, six week leptin was positively associated with greater increase in BMI from four to five weeks up to two years of age [0.16 (0.04;0.27)]. No associations were observed for six month leptin. Direction of association was the same in the Ulm Birth Cohort Study (UBCS), but statistically insignificant as the point estimate included the null effect value. Our results from SPATZ suggest human milk leptin may play a role in early infant growth. However, it is plausible that the lack of associations in UBCS suggest that these differences of human milk leptin composition between populations could have an impact in infant growth and development in a given population.
Highlights
Infant weight and length is a known precursor of weight gain or obesity in childhood [1] and may have long-lasting implications on cardiometabolic health
In both Ulm Birth Cohort Study (UBCS) and SPATZ, mothers who provided human milk samples at six weeks were higher educated, less likely to have had a history of smoking and less likely to have been overweight or obese compared to their respective full cohort populations [28]
Our findings further suggest that leptin concentration in human milk during early lactation is a potential influencer of early infant body mass index, which may be associated with body composition related growth patterns up to two years of age
Summary
Infant weight and length (which represent fetal growth) is a known precursor of weight gain or obesity in childhood (which potentially represent catch-up growth) [1] and may have long-lasting implications on cardiometabolic health. Breastfeeding is often the exclusive, or primary, source of nutrition in early infancy and has been suggested as a potential influencer of infant and child growth. Infants whose early diet does not consist predominantly of human milk are more likely to be larger during infancy and overweight later in childhood [2,3,4,5,6]. Longer duration of breastfeeding has been widely associated with lower risk of being overweight or obese in child and adulthood [7,8]. These effects have been mainly attributed to multiple synergetic mechanisms associated with the composition of human milk [9]. Leptin, a component in human milk, is highly correlated with maternal adiposity [10,11]
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