Century Wide Changes in Macronutrient Levels in Indian Mothers’ Milk: A Systematic Review

Abstract

The purpose of this systematic review was to understand Indian mothers’ milk composition and report changes in it over the past 100 years. A review was conducted in accordance with PRISMA and registered with PROSPERO (CRD42022299224). All records published between 1921 and 2021 were identified by searching databases Google Scholar, ResearchGate, PubMed, and the Cochrane Database of Systematic Reviews. All observational, interventional, or supplementation studies reporting macronutrients (protein, fat, lactose) in milk of Indian mothers, delivering term infants, were included. Publications on micronutrients, preterm, and methods were excluded. Milk was categorized into colostrum, transitional, and mature. In all, 111 records were identified, of which 34 were included in the final review. Fat ranged from 1·83 to 4·49 g/100 mL, 2·6 to 5·59 g/100 mL, and 2·77 to 4·78 g/100 mL in colostrum, transitional, and mature milk, respectively. The protein was higher in colostrum (1·54 to 8·36 g/100mL) as compared to transitional (1·08 to 2·38 g/100 mL) and mature milk (0·87 to 2·33 g/ 100 mL). Lactose was lower in colostrum (4·5–6·47 g/100 mL) as compared to transitional (4·8–7·37 g/100 mL) and mature milk ranges (6·78–7·7 g/100 mL). The older studies (1950–1980) reported higher fat and protein in colostrum as compared to subsequent time points. There were variations in maternal nutritional status, diet, socioeconomic status , and regions along with study design specific differences of time or methods of milk sampling and analysis. Additionally, advancements in methods over time make it challenging to interpret time trends. The need for conducting well-designed, multicentric studies on nutrient composition of Indian mother’s milk using standardized methods of sampling and estimation for understanding the role of various associated factors cannot be undermined.

Oropharyngeal administration of colostrum targeting gut microbiota and metabolites in very preterm infants: protocol for a multicenter randomized controlled trial

“…Lactational stages are categorized as colostrum (≤ 5 days postpartum), transitional milk (6–15 days postpartum), and mature milk (≥ 16 days postpartum) [ 3 , 60 , 61 ]. In addition, the peak of IgA in human milk has been reported to range between the fourth and fifth days after delivery [ 62 ].…”

Understanding the Immunological Quality of Breast Milk in Maternal Overweight and Obesity

“…The lactose content in breast milk shows variations depending on the stage of lactation. It ranges from 45 to 64.7 g/L in colostrum, 48 to 73.7 g/L in transitional milk, and 67.8 to 77 g/L in mature milk [53].…”

Correlation Between Maternal Age and Cytokine (IL-6 and TGF-Beta) Levels in Colostrum

“…It has always been of interest whether colostrum characteristics are affected by maternal nutritional and health status. Relationship between maternal circulating vitamin status and colostrum vitamin composition [ 4 ], lactoferrin levels with maternal nutritional status [ 5 ], and micronutrient levels [ 6 ], etc. have been explored in various previous studies, indicating that maternal health state is reflected in colostrum.…”