OBJECTIVE To determine the impact of maternal obesity on breastmilk composition. STUDY DESIGN Breastmilk and food records from 21 lean and 21 obese women who delivered full-term infants were analyzed at 2 months post-partum. Infant growth and adiposity were measured at birth and 2 months of age. RESULT Breastmilk from obese mothers had higher omega-6 to omega-3 fatty acid ratio and lower concentrations of docosahexaenoic acid, eicosapentaenoic acid, docasapentaenoic acid and lutein compared with lean mothers (P < 0.05), which were strongly associated with maternal body mass index. Breastmilk saturated fatty acid and monounsaturated fatty acid concentrations were positively associated with maternal dietary inflammation, as measured by dietary inflammatory index. There were no differences in infant growth measurements. CONCLUSION Breastmilk from obese mothers has a pro-inflammatory fatty acid profile and decreased concentrations of fatty acids and carotenoids that have been shown to have a critical role in early visual and neurodevelopment. Studies are needed to determine the link between these early-life influences and subsequent cardiometabolic and neurodevelopmental outcomes.

Maternal obesity is associated with adverse offspring outcomes. Inflammation and deficiency of anti-inflammatory nutrients like omega(n)-3 polyunsaturated fatty acids (PUFA) may contribute to these associations. Fetal supply of n-3 PUFA is dependent on maternal levels and studies have suggested that improved offspring outcomes are associated with higher maternal intake. However, little is known about how maternal obesity affects the response to n-3 supplementation during pregnancy. We sought to determine (1) the associations of obesity with PUFA concentrations and (2) if the systemic response to n-3 supplementation differs by body mass index (BMI). This was a secondary analysis of 556 participants (46% lean, 28% obese) in the Maternal-Fetal Medicine Units Network trial of n-3 (Docosahexaenoic acid (DHA) + Eicosapentaenoic acid (EPA)) supplementation, in which participants had 2g/day of n-3 (n = 278) or placebo (n = 278) from 19 to 22 weeks until delivery. At baseline, obese women had higher plasma n-6 arachidonic acid concentrations (β: 0.96% total fatty acids; 95% Confidence Interval (CI): 0.13, 1.79) and n-6/n-3 ratio (β: 0.26 unit; 95% CI: 0.05, 0.48) compared to lean women. In the adjusted analysis, women in all BMI groups had higher n-3 concentrations following supplementation, although obese women had attenuated changes (β = −2.04%, CI: −3.19, −0.90, interaction p = 0.000) compared to lean women, resulting in a 50% difference in the effect size. Similarly, obese women also had an attenuated reduction (β = 0.94 units, CI: 0.40, 1.47, interaction p = 0.046) in the n-6/n-3 ratio (marker of inflammatory status), which was 65% lower compared to lean women. Obesity is associated with higher inflammation and with an attenuated response to n-3 supplementation in pregnancy.

Higher maternal inflammation during pregnancy, as measured by using the n6:n3 FA ratio, may be a marker of adverse perinatal and neonatal outcomes, particularly among OWOB women.

Objective To examine the association between maternal body mass index (BMI) and SERUM 25-hydroxy vitamin D (25(OH)D) concentration and bone density in mother-infant pairs. Study design The study was a secondary analysis of 234 exclusively breastfeeding dyads who were recruited in the first post-partum month for a randomized controlled trial of maternal versus infant vitamin D supplementation. Mean 25(OH)D concentrations and bone mineral density were compared by BMI group. The adjusted association between maternal BMI and 25(OH)D and bone density was examined at one, four and seven months postpartum. Results Obese breastfeeding women had lower 25(OH)D concentrations and higher bone mineral density than lean women at all three time points (p<0.01). Higher maternal BMI was associated with lower maternal serum levels of 25(OH)D at one, four and seven months postpartum (adjusted βadjustedstp per kg/m2, 95% CI −.76, −0.14, at one month) and higher bone mineral density (BMD) at the same time points (ointsya BMD Z-score; 95% CI 0.003, 0.01 at one month). Seventy-six percent of infants were vitamin D deficient at one month of age. Infants born to overweight and obese mothers had lower 25(OH)D concentrations than infants of lean mothers (p<0.01). For infants in the maternal supplementation group, higher maternal BMI was associated with lower 25(OH)D concentrations at four months (onthstra 95% CI −1.17, −0.20) and lower bone density at seven months (onthsyrat 95% CI −0.002, −0.0001). Conclusions In exclusively breastfeeding dyads, maternal obesity is associated with lower maternal and infant serum 25(OH)D concentrations, which may impact infant bone density.

BackgroundPreviously, we have shown that breastmilk (BM) of obese (Ob) mothers has a pro‐inflammatory fatty acid (FA) profile. Nutrition provided in infancy has a profound impact on obesity risk in offspring. Maternal diet, through changes in BM composition, could also impact offspring growth. Here we use a literature‐derived population‐based Dietary Inflammatory Index (DII), a predictor of dietary inflammatory potential, to determine whether BM composition is influenced by modifiable maternal dietary factors.ObjectiveTo examine the relationship between maternal DII, BM composition and infant growth.MethodsBM was collected 4‐10 weeks post‐partum from 21 lean (BMI 18‐25kg/m2) and 21 Ob (BMI>30kg/m2) women. These samples were analyzed for micronutrient and macronutrient composition. Food diaries were collected and specific food parameter estimates were used to calculate a DII for each subject. A higher DII score indicates a pro‐inflammatory diet. Infant growth was obtained at the same time point.ResultsOb women had a higher DII (p=0.059). BM from Ob mothers had a higher omega (n)‐6:n‐3 FA ratio (p<0.01) compared to lean mothers. The DII was strongly positively correlated with BM saturated FA (R=0.46, p<0.01), and strongly negatively correlated with BM n‐3 FA (R= ‐0.46, p<0.01). BM n6:n3 was positively correlated with infant z‐score (R=0.43, p<0.05). These relationships remained significant after adjustment for maternal BMI. image imageConclusionsOur study suggests that maternal diet is a major modifiable factor that affects the inflammatory composition of BM.