Breast Milk Composition Research Articles

Breast milk oligosaccharides are the most essential ingredient in breast milk, affecting the health of infants: A review

Breastfeeding remains the “gold standard” of nutrition for children in the first years of life. However, factors such as hypogalactia, maternal stress, health problems and simply an unwillingness to breastfeed deprive the baby of breast milk (BM) and challenge pediatricians to choose an alternative food for the baby. The BM composition is complex, dynamic, and of scientific interest, and the attention of most scientists is directed to BM oligosaccharides (BMOs). Many benefits of BMOs have been proven in relation to the child's health, including the formation of the intestinal microbiota, maturation of the immune response, contribution to the barrier function of the intestine, and protection against pathogens. In the absence of breastfeeding, modern formulas containing BMOs can be used. The addition of a combination of 5 BMOs is a promising and effective approach to maintaining the overall health of formula-fed infants.

Effect of hepatitis B virus infection on the nutrient composition of human breast milk: A prospective cohort study

Effect of hepatitis B virus infection on the nutrient composition of human breast milk: A prospective cohort study

Changes in preterm breast milk composition according to lactation time and maternal characteristics

Changes in preterm breast milk composition according to lactation time and maternal characteristics

Dietary intake and growth of HIV exposed and unexposed 6-12 months old infants in South Africa.

Factors affecting the growth of HIV-exposed-uninfected (HEU) children are multi-factorial, with limited information available on the dietary intake from 6 months. This study compared the dietary intake, micronutrient composition of breastmilk, and growth of HEU and HIV-unexposed-uninfected (HUU) infants aged 6 and 12 months in an urban setting. A repeated cross-sectional study used structured questionnaires to collect socio-demographic, dietary intake, food group data, and anthropometric measurements in the Siyakhula study. The HEU (48%) and HUU (52%) infants were included (total n = 181). At 6 months, HEU infants had lower weight-for-age z-scores (WAZ) (-0.6 ± 1.1 vs. 0.1 ± 1.2; p < 0.001), length-for-age z-scores (-0.8 ± 1.4 vs. -0.1 ± 1.2; p < 0.001), and mid-upper-arm circumference-for-age z-scores (MUACAZ) (0.5 ± 1.1 vs. 1.0 ± 0.9; p < 0.001) than HUU infants. At 12 months, HEU infants had lower WAZ, MUACAZ, and weight-for-length z-scores compared to HUU infants (p < 0.05). Stunting was found at 6 (15%) and 12 (12%) months in HEU infants. The micronutrient composition of breastmilk fed to both groups was similar. Breastfeeding rates were lower in HEU than in HUU infants at 6 (49% vs. 64%; p = 0.005) and 12 (24% vs. 46%; p = 0.002) months. Less than 3% of HEU and HUU infants achieved minimal dietary diversity scores at 12 months. Dietary intake of fat was similar in all breastfed infants, but iron and vitamin B12 were higher in non-breastfed HEU infants at 12 months. HEU infants had lower breastfeeding rates than HUU infants. A lack of dietary diversity was found in all infants. Nutrition education and counselling in the complementary feeding phase are essential for optimal growth.

Breastfeeding in the prevention of long-term consequences of neuropsychiatric pathology in offspring with gestational diabetes mellitus

This literature review summarizes modern concepts of gestational diabetes mellitus as an independent risk factor for the development of long-term neuropsychiatric diseases in offspring and the mechanisms of their programming in this complication of pregnancy in the absence of the protective role of maternal melatonin as a consequence of chronodestruction. The article presents literature data on the composition of breast milk and the participation of its endogenous melatonin, microRNAs, long non-coding RNAs, stem cells, and microbiome in reprogramming epigenetic disorders as a result of adverse effects in the antenatal period, which helps to reduce the likelihood of developing neuropsychiatric pathology later in life. It is emphasized that breastfeeding during the first six months of life and later, along with complementary foods under the age of two years and older, is exclusively a physiological and unsurpassed method of preventing long-term consequences of impaired brain development in offspring with gestational diabetes mellitus.

Postnatal supplementation with alarmins S100a8/a9 ameliorates malnutrition-induced neonate enteropathy in mice.

Malnutrition is linked to 45% of global childhood mortality, however, the impact of maternal malnutrition on the child's health remains elusive. Previous studies suggested that maternal malnutrition does not affect breast milk composition. Yet, malnourished children often develop a so-called environmental enteropathy, assumed to be triggered by frequent pathogen uptake and unfavorable gut colonization. Here, we show in a murine model that maternal malnutrition induces a persistent inflammatory gut dysfunction in the offspring that establishes during nursing and does not recover after weaning onto standard diet. Early intestinal influx of neutrophils, impaired postnatal development of gut-regulatory functions, and expansion of Enterobacteriaceae were hallmarks of this enteropathy. This gut phenotype resembled those developing under deficient S100a8/a9-supply via breast milk, which is a known key factor for the postnatal development of gut homeostasis. We could confirm that S100a8/a9 is lacking in the breast milk of malnourished mothers and the offspring's intestine. Nutritional supply of S100a8 to neonates of malnourished mothers abrogated the aberrant development of gut mucosal immunity and microbiota colonization and protected them lifelong against severe enteric infections and non-infectious bowel diseases. S100a8 supplementation after birth might be a promising measure to counteract deleterious imprinting of gut immunity by maternal malnutrition.

Associations between Histo-Blood Group Antigen Status in Mother-Infant Dyads and Infant Oral Rotavirus Vaccine Immunogenicity in rural Zimbabwe.

Histo-blood group antigen (HBGA) phenotypes may contribute to poor oral rotavirus vaccine (RVV) immunogenicity, since rotavirus binds intestinal epithelial HBGA glycans, while maternal HBGA status shapes breastmilk composition, which influences the composition of the infant microbiome. We investigated associations between maternal/infant HBGA phenotypes and RVV immunogenicity in rural Zimbabwe. We undertook salivary FUT2/FUT3 phenotyping in mother-infant pairs. Serum anti-rotavirus IgA was measured by ELISA. We explored adjusted associations between FUT2/FUT3 status and RVV seroconversion (primary outcome, N=322), and seropositivity and geometric mean titre (secondary outcomes, N=776). Infants of FUT2-positive or FUT3-positive women were less likely to seroconvert post-RVV than infants of FUT2-negative or FUT3-negative women (FUT2-positive 20.1% versus FUT2-negative 27.5%, adjusted relative risk (aRR) 0.47, 95%CI 0.26, 0.82; P=0.008; FUT3-positive 18.1% versus FUT3-negative 30.0%, aRR 0.45, 95%CI 0.25, 0.78; P=0.005). Compared to FUT2-positive infants with FUT2-positive mothers, FUT2-positive infants with FUT2-negative mothers were twice as likely to seroconvert (36.8% versus 21.9%, aRR 2.12, 95%CI 1.23, 3.63; P=0.006). Compared to FUT3-positive infants with FUT3-positive mothers, FUT3-positive infants with FUT3-negative mothers were three times as likely to seroconvert (48.3% versus 18.2%, aRR 2.99, 95%CI 1.82, 4.90; P<0.001). Maternal and infant FUT2 and FUT3 status influences infant RVV immunogenicity.

Does the Composition of Breast Milk in the First Week Postpartum Differ Due to Maternal Factors or Neonatal Birth Weight and Percent Fat Body Mass?

Background: The composition of breast milk is dependent on numerous factors. However, the precise impact of maternal health conditions on breast milk composition remains to be fully elucidated. Similarly, there is a paucity of evidence regarding the correlation between neonatal body composition and human milk. The objective of the study was to evaluate the macronutrient composition of breast milk collected during the first week postpartum from mothers with gestational diabetes and healthy mothers in terms of selected maternal and neonatal factors. Methods: n = 70 breast milk samples were analyzed for fat, protein, carbohydrate, dry matter, true protein, and energy. The results were evaluated in terms of selected maternal factors, as well as neonatal birth weight (BW) and percent fat body mass (%FBM), which was assessed with a bioimpedance method. Results: Energy of breast milk in the study group was as follows: median 55.5 kcal/dL in GDM G1, median 55.5 kcal/dL in GDM G2, and median 65.0 kcal/dL in non-GDM, which differed significantly in Kruskal–Wallis ANOVA. Neonatal %FBM, but not BW, was found to be significantly related to concentrations of protein, true protein and dry matter. Maternal gestational weight gain, history of hypothyroidism, and classification by study group were identified as factors affecting both breast milk and neonatal body composition. Conclusions: The composition of breast milk in the initial week following childbirth is predominantly determined by maternal factors. The relationship between selected macronutrients and neonatal percent fat body mass was found to be weak, yet the significance of this finding is unclear. Further research is required to ascertain the influence of maternal milk composition on early infantile nutritional programming.

Amino acid requirements of the infant: the amino acid composition of human breast milk.

The recommended amino acid requirements of the infant are based on the amino acid composition of mature human breast milk. The amino acid composition of breast milk is usually determined following either acid or alkaline (for tryptophan) hydrolysis. For accuracy, however, the known effect of hydrolysis time on amino acid composition should be accounted for. Also, ideally the amino acid composition of breast milk should be given in units of digested (assumed to be absorbed) amino acids. A review of the literature is presented which gives mean total amino acid concentrations in mature human milk (n = 26 studies), mean hydrolysis correction factors (n = 3 studies) and mean true ileal amino acid digestibility coefficients (n = 3 studies, suckling piglet). There were differences between the estimates of amino acid concentration corrected for hydrolysis time and digestibility, and current FAO (2013) recommendations that were not corrected for these factors. The values based on the published literature up until 2023 (mg/g true protein) corrected for hydrolysis time and digestibility gave higher values (more than 16% higher) for leucine, lysine and threonine, and considerably higher values (greater than 30%) for histidine and tryptophan. Current recommendations may need revision.

The Association Between Maternal Psychological Health and Human Milk Oligosaccharide Composition.

Background and Objective: Human milk oligosaccharides (HMOs) are carbohydrates abundant in human breast milk. Their composition varies widely among women, and prior research has identified numerous factors contributing to this variation. However, the relationship between maternal psychological health and HMO levels is currently unknown. Thus, our objective was to identify whether maternal stress, anxiety, or depressive symptoms are associated with HMOs. Methods: Data originated from 926 lactating individuals from the UC San Diego Human Milk Biorepository. Nineteen prevalent HMOs were assayed using high-performance liquid chromatography. Participants self-reported measures of the Edinburgh Postnatal Depression Scale (n = 495), State-Trait Anxiety Inventory S-Scale (n = 486), and/or Perceived Stress Scale (n = 493) within 60 days of their milk collection; their results were categorized using standard screening cutoffs. HMOs were assessed individually and grouped by principal component analysis (PCA), and associations with maternal psychological symptoms were analyzed using multivariable linear regression adjusted for covariates. Results: After Bonferroni correction (p < 0.002), the following HMOs significantly varied with maternal psychological distress in multivariate analysis: lacto-N-fucopentaose III (LNFP III) and lacto-N-hexaose (LNH) among Secretors with depressive symptoms and difucosyllactose (DFLac), LNFP III, and disialyl-LNH (DSLNH) among Secretors with stress. In PCA, depressive symptoms and stress were associated with one principal component among Secretors. No HMOs varied with anxiety symptoms. Conclusions: Several HMOs varied with maternal depressive symptoms and stress, suggesting a relationship between maternal psychological health and breast milk composition. Additional studies are needed to determine the impact of this variation on infant health.

Determination of sodium, chlorine, and bromine concentrations in breast milk using neutron activation: Correlation, regression, and machine learning predictions

Breast milk plays a vital role in infant health, providing essential nutrients that directly impact nutrition and development. Understanding its elemental composition, as well as the relationships among these elements, is crucial for assessing its nutritional adequacy. This study focused on determining the concentrations of sodium (Na), chlorine (Cl), and bromine (Br) in the breast milk of lactating mothers in Tehran, Iran, during early lactation. The primary objectives were to analyze the concentrations of these elements, investigate their interrelationships, and employ machine-learning techniques to predict their concentrations in breast milk. Neutron activation analysis (NAA) was used to precisely measure the levels of Na, Cl, and Br, while statistical methods, including correlation and regression analyses, were applied to further explore these relationships. Machine-learning models, specifically Random Forest and Linear Regression, were utilized to predict the concentrations of these elements based on their interdependencies. The study revealed mean concentrations of 5.12 mg/g for Na, 8.14 mg/g for Cl, and 11.84 mg/kg for Br in the breast milk samples. A strong positive correlation was observed between Na and Cl (r = 0.976, p < 0.001), while moderate positive correlations were found between Na and Br (r = 0.558, p < 0.001) and Cl and Br (r = 0.606, p < 0.001). Multiple regression models showed that 94.7 % of the variance in Na concentration could be explained by Cl and Br levels (R-squared = 0.947), with a strong positive association between Cl and Na, and a slight inverse relationship between Br and Na. A similar model for Cl concentrations showed strong predictive power, with Na being a significant predictor. However, the model for Br concentrations explained a smaller proportion of variance (R-squared = 0.318), suggesting that additional factors influencing Br levels were not captured in this study. Furthermore, multicollinearity was observed between Na and Cl (VIF = 20.675), indicating potential interactions between these elements. This study highlights the significant correlations between Na, Cl, and Br in breast milk, with particularly strong predictive models for Na and Cl concentrations. The findings also suggest the need for further investigation into the factors affecting Br concentrations. Overall, this research provides valuable insights into the elemental composition of breast milk and its implications for infant nutrition and health.

Nutritional composition evaluation with emphasis on the lipid quality of infant formulas

Infant formulas play a crucial role in the nutrition of non-breastfed infants, providing essential nutrients for their healthy development. This study aimed to investigate the nutritional composition and lipid profile of commercial infant formulas intended for infants up to six months of age, assessing whether their composition aligns with dietary recommendations for this age group. To achieve this, we determined the macronutrient composition and lipid profile through proximate analysis, gas chromatography, and mass spectrometry, to confirm whether these formulas meet the established requirements. Although there were distinctions in quality and composition offered, through the proximate composition it was revealed that 66.66 % of the formulas met the recommendations for protein and lipid content. Additionally, the lipid composition of these formulas comprises a variety of fatty acids, primarily composed of triacylglycerols, supplemented through vegetable oils, fish oil, and coconut oil, in an effort to resemble the lipid quality of human milk. Gas chromatography demonstrated a predominance of monounsaturated fatty acids in the formulas evaluated, suggesting that the lipid composition of predominant breast milk was successfully reproduced. To ensure adequate nutritional balance for newborns, nutritional guidelines establish standards for infant feeding through specific recommendations. These results are of utmost importance for the infant food industry, providing insights for the continuous improvement of the nutritional quality of infant formulas, aiming to ensure the healthy and proper development of children from the early months of life, contributing to their long-term well-being.

An observational cohort study to investigate the impact of dolutegravir in pregnancy and its obesogenic effects on the metabolic health of women living with HIV and their children: Study protocol.

Dolutegravir (DTG)-based antiretroviral therapy is the World Health Organization's preferred first-line regimen for all persons with HIV, including pregnant women. While DTG has been implicated as an obesogen associated with greater weight gain compared to other antiretrovirals, there is a paucity of data in pregnant women and their children. The Obesogenic oRigins of maternal and Child metabolic health Involving Dolutegravir (ORCHID) study is investigating associations between DTG, weight gain, and metabolic outcomes in the context of HIV. ORCHID is a prospective observational study taking place in Cape Town, South Africa (NCT04991402). A total of 1920 pregnant women with and without HIV infection are being followed from ≤18 weeks gestational age to 24 months postpartum with their children. Participants attend eleven study visits: 3 antenatal, delivery, and 7 postnatal visits. Several embedded sub-studies address specific scientific aims. Primary outcome measurements in mothers include anthropometry, blood pressure, body composition, dysglycemia, insulin resistance (IR), and dyslipidemia. Other maternal measures include demographics, resting energy expenditure, viral load, physical activity, dietary intake, hepatic steatosis, and repository specimens. Sub-study measurements include markers of adipose inflammation, gut integrity, and satiety/hunger, subcutaneous adipose tissue morphology and mitochondrial function, and metabolomics. Primary outcome measurements in children include anthropometry, adipose tissue mass, dysglycemia, IR, and dyslipidemia. Other variables include fetal growth, birth outcomes, medical/breastfeeding history, caloric intake, neurodevelopment, and repository specimens. Sub-study measurements include metabolites/lipid subspecies in umbilical cord blood, as well as breast milk composition and DTG exposure. ORCHID will play a pivotal role in defining obesogenic mechanisms and clinical consequences of DTG use in pregnancy in women with HIV and their children. It will provide insights into metabolic disease risk reduction in the context of HIV/DTG, identify intervention targets, and inform public health approaches to diminish chronic metabolic co-morbidities for women and children.

Relationship between maternal biological features, environmental factors, and newborn neuromotor development associated with visual fixation abilities

Newborn visual fixation abilities predict future cognitive, perceptive, and motor skills. However, little is known about the factors associated with the newborn visual fixation, which is an indicator of neurocognitive abilities. We analyzed maternal biological and environmental characteristics associated with fine motor skills (visual tracking) in 1 month old infants. Fifty-one infants were tested on visual tracking tasks (Infant Visuomotor Behavior Assessment Scale/ Guide for the Assessment of Visual Ability in Infants) and classified according to visual conducts scores. Differences between groups were compared considering motor development (Alberta Infant Motor Scale) maternal mental health (Edinburgh Postnatal Depression Scale and Hamilton Anxiety Scale); home environment (Affordances in the Home Environment for Development Scale); maternal care (Coding Interactive Behavior); breastmilk composition (total fatty acids, proteins, and cortisol); and maternal metabolic profile (serum hormones and interleukins). Mothers of infants with lower visual fixation scores had higher levels of protein in breastmilk at 3 months. Mothers of infants with better visual conduct scores had higher serum levels of T4 (at 1 month) and prolactin (at 3 months). There were no associations between visual ability and motor development, home environment, or maternal care. Early newborn neuromotor development, especially visual and fine motor skills, is associated with maternal biological characteristics (metabolic factors and breastmilk composition), highlighting the importance of early detection of maternal metabolic changes for the healthy neurodevelopment of newborns.

Investigating the Dietary Impact on Trans-Vaccenic Acid (Trans-C18:1 n-7) and Other Beneficial Fatty Acids in Breast Milk and Infant Formulas.

Maternal diet plays a significant role in the fatty acid composition of breast milk. Dietary products such as milk and meat are the primary sources of natural TFAs for humans. These peculiar fatty acids hold nutritional significance as they not only lack the detrimental effects of industrially produced trans fats on the endothelium characteristic, but they also exhibit anti-inflammatory properties. The relationship between the presence of eight fatty acids in breast milk (including natural TFAs trans-vaccenic and conjugated linoleic acid) and the maternal diet has been explored, and their abundance has been compared to that of infant formulas. Two cohorts of lactating women, originating from a Spanish region, participated in this study; they adhered to the Southern European Atlantic diet or the Atlantic diet. While the consumption of conventional meat or dairy products does not seem to increase the abundance of TFAs in breast milk, trans-vaccenic and oleic acid are among the most distinctive features of breast milk fat in mothers consuming naturally improved dairy products with an improved fatty acid profile. The most significant differences between natural breastfeeding and formula feeding lie in natural TFAs, since formulas are notably deficient in natural TFAs while being overfortified in alpha-linolenic acid in comparison to breast milk. We suggest an improvement in the formulation of these products through using cow's milk with an optimal fatty acid profile that better mimics the fatty acid composition found in human milk.

The Role of Breastfeeding in Acute Respiratory Infections in Infancy.

Acute respiratory infections (ARIs) affect the respiratory tract, are often caused by viruses such as respiratory syncytial virus and rhinovirus, and present symptoms such as coughing, fever, respiratory distress, and breathing difficulty. The global adherence to exclusive breastfeeding (BF) for the first 6 months of life has reached 44%, supported by the World Health Organization and United Nations International Children's Emergency Fund efforts. BF provides vital nutrients and contributes to infant immune system development, protecting against infections. The role of BF in preventing and reducing complications of ARIs in infants is gaining attention, prompting a review of current data and future research needs. This review aims to summarize the evidence on the role of BF in reducing the risk and severity of ARIs in infants, elucidate the adaptations in breast milk composition during infections, and identify relevant research needs. Human milk (HM) is rich in immunoglobulins, antimicrobial peptides, and immunomodulatory factors that protect against various pathogens, including respiratory viruses. Several studies have demonstrated that BF is associated with a significant reduction in hospitalization, oxygen requirements, and mortality in infants with ARIs. The effectiveness of BF varies according to the specific respiratory virus, and a longer duration of exclusive BF appears to enhance its protective effect. It is documented that the composition of HM adjusts dynamically in response to infections, fortifying the infant's immune defenses. Specific immunological components of HM, including leukocytes and immunoglobulins, increase in response to infection in the infant, contributing to the enhancement of the immune defense in infants. Immune-boosting microRNAs enhance immune transfer to the infants and promote early gut maturation, and the HM microbiome along with other factors modifies the infant's gut microbiome and immune system. BF defends infants from respiratory infections, and the investigation of the microRNAs in HM offers new insights into its antiviral properties. The promotion of BF, especially in vulnerable communities, is of paramount importance in alleviating the global burden of ARIs in infancy.

Improved breast milk proteome coverage by DIA based LC-MS/MS method.

The breast milk composition includes a multitude of bioactive factors such as viable cells, lipids and proteins. Measuring the levels of specific proteins in breast milk plasma can be challenging because of the large dynamic range of protein concentrations and the presence of interfering substances. Therefore, most proteomic studies of breast milk have been able to identify under 1000 proteins. Optimised procedures and the latest separation technologies used in milk proteome research could lead to more precise knowledge of breast milk proteome. This study (n=53) utilizes three different protein quantification methods, including direct DIA, library-based DIA method and a hybrid method combining direct DIA and library-based DIA. On average we identified 2400 proteins by hybrid method. By applying these methods, we quantified body mass index (BMI) associated variation in breast milk proteomes. There were 210 significantly different proteins when comparing the breast milk proteome of obese and overweight mothers. In addition, we analysed a small cohort (n=5, randomly selected from 53 samples) by high field asymmetric waveform ion mobility spectrometry (FAIMS). FAIMS coupled with the Orbitrap Fusion Lumos mass spectrometer, which led to 41.7% higher number of protein identifications compared to Q Exactive HF mass spectrometer.

A systematic review article on anaesthesia and analgesia drug effects on Breast milk composition and lactation

A systematic review article on anaesthesia and analgesia drug effects on Breast milk composition and lactation

The relationship between mothers' body composition and anthropometric characteristics of baby and breast milk nutrient content: A cross-sectional study.

The composition and amount of breast milk is affected by factors such as the duration and frequency of breastfeeding, the time between two breastfeeding sessions, the effectiveness of breastfeeding, breastfeeding technique, genetic characteristics of the mother and diet. Breast milk macronutrients are provided by milk synthesized in lactocytes, mother's diet and maternal stores. This study was conducted to investigate the relationship between the body composition of mothers and the anthropometric characteristics of the baby and the nutritional content of breast milk. The descriptive study was conducted between March and November 2023 in a hospital in a low socioeconomic neighbourhood in Turkey. The study sample consisted of 96 mothers and ibabies. Anthropometric measurements of mothers and babies and the nutrient content of breast milk were evaluated on the first postpartum day, Days 5 and 15. Breast milk macronutrient content was analyzed by Miris milk analyzer and body composition of mothers was analyzed by TANITA BC 730. From the weight and body composition of the mothers in the study group; a positive correlation was found between body fat, muscle and water ratio, and breast milk carnonhydrate and protein (p < 0.05). There was no correlation between the gestational age of the baby and the content of breast milk (p > 0.05). A positive correlation was found between the weight and height of the babies and the macronutrients of breast milk (p < 0.05). As the weight of mothers increases, breast milk protein and carbohydrate levels increase. As breast milk macronutrients increase, babies' weight and height increase.

Breastfeeding Measurement - Teleological Considerations: Human Milk Collection for Research.

We discuss the evolution and composition of breast milk and briefly describe how mammalian evolution resulted in lactation, which played a crucial role in infant growth and development. We focus on three teleological factors that significantly contribute to breast milk composition: (1) biological sex at birth, (2) gestational age, and (3) circadian rhythms. We also explain how these factors lead to variability in human milk composition. We emphasize the importance of standardizing the definitions of "preterm" and "term" to accurately study the effects of gestational age on milk composition. Finally, we discuss the role of the circadian clock in regulating lactation and the impact of breast milk on fetal and infant sleep. Investigators may integrate these critical factors when designing a research study that involves the collection of breast milk samples. Teleological factors greatly influence milk composition, and these factors may be considered when designing a study that requires breast milk. We provide both the rationale and application of solutions to address these factors.