Factors affecting lactoferrin concentration in human milk: how much do we know?

Abstract

Lactoferrin (LF) is a breast milk glycoprotein with antimicrobial and anti-inflammatory effects. Its beneficial properties in infants, especially in those born preterm, are currently being studied in clinical trials. However, the maternal and nursing infant factors that may affect the concentration of LF in breast milk are still not clear. We conducted a systematic review to investigate the factors that may affect LF concentration. We used a 2-step approach to identify the eligible studies according to inclusion/exclusion criteria and to determine which studies would be considered. We included 70 qualified articles from 29 countries with publication dates ranging from 1976 to 2015. We described the correlation between LF concentration in breast milk and lactation stage; 10 maternal factors, such as race, parity, among others; and 2 infant factors, infections and prematurity. Colostrum has the highest LF levels, but they decrease with days postpartum. No other factor has been consistently associated with LF concentration. A major limitation of the majority of the published studies is the small sample size and the different methods used to measure LF concentration. Therefore, there is a need for large, multicenter studies with standardized study design, sample collection, and LF measurement methods to identify clinically significant factors associated with LF expression in breast milk, which will help promote exclusive breastfeeding in preterm infants.

New Achievements in High-Pressure Processing to Preserve Human Milk Bioactivity

“…In the case of lactoferrin the mean concentration detected in raw milk samples was 1.63 ± 0.47 mg/ml (range 1.17–2.11 mg/ml) which is similar to those reported in the literature ( 39 ) (Table 1 ) The reduction of lactoferrin level by HoP in current experiments is 60% of the level detected in raw milk samples. The difference was statistically significant.…”

Concentration of Lactoferrin in Human Milk and Its Variation during Lactation in Different Chinese Populations

“…Several maternal factors significantly corrected with the Lf concentration in human milk. A previous review of factors that affect the concentration of Lf in breast milk revealed conflicting reports of the relationship of maternal factors to breast milk Lf [ 30 ]. The present study showed that maternal age, maternal BMI, mode of delivery, parity, maternal serum albumin level, and protein intake were not significantly correlated with milk Lf concentration, whereas the amount of milk expressed from one breast and maternal serum ferritin were negatively correlated with milk Lf concentration.…”

Influence of Maternal Milk on the Neonatal Intestinal Microbiome

“…It is a member of the transferrin family of proteins and strongly binds iron [88]. The amount of lactoferrin in the milk varies depending on the stage of lactation as colostrum contains a high concentration of lactoferrin and it slowly decreases through the first month of lactation [89,90]. The reduced digestive capacity of the infant intestine protects milk-derived lactoferrin from degradation and maintains its functional properties, thus restricting the growth of bacteria in early life [91].…”