Does Circadian Variation of Mothers Affect Macronutrients of Breast Milk?

Çetinkaya, Aslıhan Köse; Dizdar, Evrim Alyamaç; Yarcı, Erbu; Sarı, Fatma Nur; Oğuz, Şerife Suna; Uraş, Nurdan; Canpolat, Fuat Emre

doi:10.1055/s-0036-1597327

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…Carbohydrates serve as an important energy source for neonatal metabolism, especially for the brain [ 22 ]. As shown in three independent studies of sufficient quality [ 23 , 24 , 25 ], total carbohydrate concentration in human milk does not show any circadian variation. For glucose, more research is necessary since the only two studies [ 26 , 27 ] on this component are contradictive.…”

Section: Resultsmentioning

confidence: 93%

“…Furthermore, they are an important source of energy [ 31 ]. The total protein content of human milk does not exhibit circadian variation in nine out of eleven studies [ 23 , 24 , 25 , 28 , 29 , 32 , 33 , 34 , 35 ]. In the two studies [ 27 , 36 ] that do indicate a circadian rhythm in total protein concentration, the acrophase (peak) is discordant and, therefore, it potentially indicates false-positive findings.…”

Section: Resultsmentioning

confidence: 99%

“…The fat content of human milk accounts for ±50% of its total energy supply and is the supplier of essential fatty acids required for the central nervous system and retina development [ 22 ]. Out of the 19 included studies on total fat content variation in human milk [ 23 , 27 , 44 , 45 ], 15 report circadian variation in total fat concentration [ 24 , 25 , 29 , 32 , 38 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. In the majority of studies, the acrophase was found in the evening [ 25 , 32 , 47 , 48 , 50 , 51 , 52 , 53 , 55 ] (See Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Circadian Variation in Human Milk Composition, a Systematic Review

et al. 2020

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Background: Breastfeeding is considered the most optimal mode of feeding for neonates and mothers. Human milk changes over the course of lactation in order to perfectly suit the infant’s nutritional and immunological needs. Its composition also varies throughout the day. Circadian fluctuations in some bioactive components are suggested to transfer chronobiological information from mother to child to assist the development of the biological clock. This review aims to give a complete overview of studies examining human milk components found to exhibit circadian variation in their concentration. Methods: We included studies assessing the concentration of a specific human milk component more than once in 24 h. Study characteristics, including gestational age, lactational stage, sampling strategy, analytical method, and outcome were extracted. Methodological quality was graded using a modified Newcastle-Ottawa Scale (NOS). Results: A total of 83 reports assessing the circadian variation in the concentration of 71 human milk components were included. Heterogeneity among studies was high. The methodological quality varied widely. Significant circadian variation is found in tryptophan, fats, triacylglycerol, cholesterol, iron, melatonin, cortisol, and cortisone. This may play a role in the child’s growth and development in terms of the biological clock.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Circadian Variation in Human Milk Composition, a Systematic Review

et al. 2020

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“…There is yet no clear explanation but only suggestions and speculations of why these diurnal fluctuations of human milk composition exist and what impact they have on a newborn's health and development. Hormonal changes in lactating women, breastfeeding patterns, the influence of the degree of breast fullness, circadian dietary habits, ethnic differences, and different techniques for the measurement of milk macronutrients are among the factors that can influence circadian changes in milk composition [9,27,29,30]. However, the particular role of each factor and why and how these factors affect dynamic changes in specific macronutrients are unknown.…”

Section: Discussionmentioning

confidence: 99%

Circadian changes in the composition of human milk macronutrients depending on pregnancy duration: a cross-sectional study

et al. 2020

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Background The purpose of this study was to evaluate the circadian variation of human milk macronutrients and energy content depending upon pregnancy duration. Methods One hundred eighty fresh human milk samples from 45 mothers (27 of preterm and 18 of full-term newborns) were collected on a single day chosen between the 14th to 16th day after delivery. The samples were taken four times per day at 12 PM, 6 PM, 12 AM and 6 AM. Only lactating women, who could not breastfeed their hospitalized newborns and expressed milk by breast pump, were enrolled in the study. Human milk macronutrient composition and energy count were evaluated by mid-infrared spectrophotometry. Results Significant differences in macronutrient content were observed between 6 AM and 12 PM for mean protein content (t = − 4.62, df = 44, p < 0.001), for mean fat content (t = − 2.10, df = 44, p = 0.04) and for mean energy content (t = − 2.24, df = 44, p = 0.03); between 6 AM and 6 PM for mean protein content (t = − 2.41, df = 43, p = 0.02), for mean fat content (t = − 3.76, df = 43, p = 0.001) and for mean energy content (t = − 3.85, df = 43, p < 0.001); between 12 PM and 12 AM for mean protein content (Wilcoxon test V = 75.5, p = 0.001), for mean fat content (t = 2.50, df = 44, p = 0.02) and for mean energy content (t = 2.74, df = 44, p = 0.01); between 6 PM and 12 AM for mean protein content (V = 229, p = 0.02), for mean fat content (t = 4.39, df = 43, p < 0.001) and for mean energy content (t = − 4.57, df = 43, p < 0.001). The average content of carbohydrates did not change significantly during the 24 h. The samples of preterm newborns’ mothers had more apparent diurnal fluctuations in macronutrient content. Conclusions Our study revealed significant diurnal variations in protein and fat in human milk, and these circadian fluctuations were more apparent in the milk of mothers of preterm infants.

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“…Despite progress in analytical technologies enabling the growth of data over the past decade, HM composition remains only partially elucidated [1,2,3,4]. Recent studies revealed countless inter- and intra-individual factors influencing HM composition, such as maternal, circadian, pregnancy, delivery, infantile, chronological and environmental variables [5,6,7,8,9]. Among these factors, temporal changes of HM composition before and after term equivalent time are of particular interest considering the critical challenges of preterm (PT) infants’ nutrition and the critical importance of HM for this vulnerable population [10,11].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study

et al. 2019

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Background: Mother’s own milk is the optimal source of nutrients and provides numerous health advantages for mothers and infants. As they have supplementary nutritional needs, very preterm infants may require fortification of human milk (HM). Addressing HM composition and variations is essential to optimize HM fortification strategies for these vulnerable infants. Aims: To analyze and compare macronutrient composition in HM of mothers lactating very preterm (PT) (28 0/7 to 32 6/7 weeks of gestational age, GA) and term (T) infants (37 0/7 to 41 6/7 weeks of GA) over time, both at similar postnatal and postmenstrual ages, and to investigate other potential factors of variations. Methods: Milk samples from 27 mothers of the PT infants and 34 mothers of the T infants were collected longitudinally at 12 points in time during four months for the PT HM and eight points in time during two months for the T HM. Macronutrient composition (proteins, fat, and lactose) and energy were measured using a mid-infrared milk analyzer, corrected by bicinchoninic acid (BCA) assay for total protein content. Results: Analysis of 500 HM samples revealed large inter- and intra-subject variations in both groups. Proteins decreased from birth to four months in the PT and the T HM without significant differences at any postnatal time point, while it was lower around term equivalent age in PT HM. Lactose content remained stable and comparable over time. The PT HM contained significantly more fat and tended to be more caloric in the first two weeks of lactation, while the T HM revealed higher fat and higher energy content later during lactation (three to eight weeks). In both groups, male gender was associated with more fat and energy content. The gender association was stronger in the PT group, and it remained significant after adjustments. Conclusion: Longitudinal measurements of macronutrients compositions of the PT and the T HM showed only small differences at similar postnatal stages in our population. However, numerous differences exist at similar postmenstrual ages. Male gender seems to be associated with a higher content in fat, especially in the PT HM. This study provides original information on macronutrient composition and variations of HM, which is important to consider for the optimization of nutrition and growth of PT infants.

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Does Circadian Variation of Mothers Affect Macronutrients of Breast Milk?

Cited by 4 publications

References 10 publications

Circadian Variation in Human Milk Composition, a Systematic Review

Circadian Variation in Human Milk Composition, a Systematic Review

Circadian changes in the composition of human milk macronutrients depending on pregnancy duration: a cross-sectional study

Longitudinal Analysis of Macronutrient Composition in Preterm and Term Human Milk: A Prospective Cohort Study

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