Association of maternal body composition and diet on breast milk hormones and neonatal growth during the first month of lactation

Abstract

IntroductionPreterm birth is associated with altered growth patterns and an increased risk of cardiometabolic diseases, with breast milk (BM) being a counteracting factor. Preterm infants also show alterations in adipokines and gut hormones influencing appetite and metabolism. Since these hormones are present in BM, it is possible that their levels may equilibrate deficiencies improving infant growth. We aimed to assess 1) the BM levels of ghrelin, resistin, leptin, insulin, peptide YY, and the gastrointestinal peptide in women with preterm and term labor; 2) the relationship between BM hormones and neonatal growth; and 3) the influence of maternal body composition and diet on these BM hormones.MethodsBM from 48 women (30 term and 18 preterm labor) was collected at days 7, 14, and 28 of lactation. Maternal body composition was evaluated by bioimpedance, and neonate anthropometric parameters were collected from medical records. The maternal dietary pattern was assessed by a 72-h dietary recall at days 7 and 28 of lactation. BM hormones were analyzed by the U-Plex Ultra-sensitive method. Data were analyzed using linear regression models. BM from women with preterm labor had lower ghrelin levels, with the other hormones being significantly higher compared to women with term delivery.ResultsIn premature infants, growth was positively associated with BM ghrelin, while, in term infants, it was positively associated with insulin and negatively with peptide YY. In the first week of lactation, women with preterm labor had higher body fat compared to women with term labor. In this group, ghrelin levels were positively associated with maternal body fat and with fiber and protein intake. In women with term labor, no associations between anthropometric parameters and BM hormones were found, and fiber intake was negatively associated with peptide YY.DiscussionPreterm labor is a factor influencing the levels of BM adipokines and gut hormones, with BM ghrelin being a relevant hormone for premature infant growth. Since ghrelin is lower in BM from women with preterm labor and the levels are associated with maternal fat storage and some dietary components, our data support the importance to monitor diet and body composition in women who gave birth prematurely to improve the BM hormonal status.

The Effect of Maternal Overweight/Obesity on Serum and Breastmilk Leptin, and Its Associations with Body Composition, Cardiometabolic Health Indices, and Maternal Diet: The BLOOM Study

“…On the contrary, it has been previously suggested that leaner mothers could have a greater sensitivity to adiposity [41]. Nevertheless, our results are consistent with the majority of previous studies that found moderate or no correlations between the current maternal or pre-pregnancy BMI and breastmilk leptin [9,10,22,[41][42][43], and that FM% (if assessed) was a stronger predictor of breastmilk leptin compared to BMI [41,44,45]. We observed intriguing results regarding the association between adipose tissue distribution and serum or breastmilk leptin.…”

“…With that said, leptin could beneficially influence the development of the intestinal microbiota [21]. But the effect of leptin on infant growth and body composition has been more widely discussed with ambiguous results [2,18,43]. A recent systematic review revealed that leptin showed consistent negative associations with infant anthropometrics (weight, weight gain, length, BMI z-score, FM%).…”

Neonatal Leptin Levels Predict the Early Childhood Developmental Assessment Scores of Preterm Infants

“…We did not assess body composition or outpatient leptin levels, but other studies have suggested that leptin levels in early childhood could potentially predict later cardiometabolic risk [43]. In a recent investigation, leptin levels were higher in the breast milk of mothers of preterm than term infants, again suggesting an evolutionary role for leptin in infant development, but the differential leptin levels present in breast milk did not negatively impact the neonatal growth of the preterm or term infants [44]. Interestingly, Project Viva investigators obtained longitudinal leptin levels throughout childhood and showed that children with gradually increasing leptin levels had greater adiposity, as would be expected given the production of leptin by adipose tissue, but they also had lower SBP than those that lacked increasing childhood leptin [45].…”

Hormonal Determinants of Growth and Weight Gain in the Human Fetus and Preterm Infant

“…Another study found no correlation between milk adiponectin and growth outcomes [ 347 ]. Milk IGF-1 concentrations are associated with fat-free mass at 4 months’ corrected age, while milk ghrelin concentrations are associated with neonatal weight gain and linear growth [ 347 , 349 ].…”