Impact of maternal overweight and obesity on milk composition and infant growth

Abstract

Overweight and obesity (OW/OB) impact half of the pregnancies in the United States and can have negative consequences for offspring health. Studies are limited on human milk alterations in the context of maternal obesity. Alterations in milk are hypothesized to impact offspring development during the critical period of lactation. We aimed to evaluate the relationships between mothers with OW/OB (body mass index [BMI] ≥25 kg/m2), infant growth, and selected milk nutrients. We recruited mother–infant dyads with pre‐pregnancy OW/OB and normal weight status. The primary study included 52 dyads with infant growth measures through 6 months. Thirty‐two dyads provided milk at 2 weeks, which was analysed for macronutrients, long‐chain fatty acids, and insulin. We used multivariable linear regression to examine the association of maternal weight status with infant growth, maternal weight status with milk components, and milk components with infant growth. Mothers with OW/OB had infants with higher weight‐for‐length (WFL) and BMI Z‐scores at birth. Mothers with OW/OB had higher milk insulin and dihomo‐gamma‐linolenic, adrenic, and palmitic acids and reduced conjugated linoleic and oleic acids. N6 long‐chain polyunsaturated fatty acid (LC‐PUFA)‐driven factor 1 was associated with higher WFL, lower length‐for‐age (LFA), and lower head circumference‐for‐age Z‐scores change from 2 weeks to 2 months in human milk‐fed infants, whereas N6 LC‐PUFA‐driven factor 5 was associated with lower LFA Z‐score change. Human milk composition is associated with maternal pre‐pregnancy weight status and composition may be a contributing factor to early infant growth trajectory.

The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

“…There are increasing suggestions that, in addition to increasing the risk of pregnancy and neonatal complications, maternal overweight and obesity may be associated with changes in the macronutrient composition of human milk (HM) [8][9][10]. This is of clinical relevance, given the increasing number of studies that have reported associations between the levels of specific HM components, including fat, protein, and lactose in HM, as well as growth and fat deposition in the infant in the first 12 months of age [11,12]. Thus, changes in HM composition have the potential to promote weight gain and fat deposition in the infant [11], and thereby increase their risk of obesity and metabolic disease later in life.…”

The Human Breast Milk Metabolome in Overweight and Obese Mothers

“…( 24 ): Average age of lean mothers: 32.0 ± 4.1 years; Average age of obese mothers: 30.5 ± 5.7 years. ( 25 ): Average age of overweight-obese mothers: 29.9 ± 3.8 years (no statistically significant differences with lean group). ( 26 ): Maternal age in relation to BMI is not reported.…”

“…Infant growth up to 6 months of life was correlated with higher levels of dihomo-gamma-linolenic (20:3 n6-DGLA), adrenic (22:4 n-6), palmitic acids, conjugated linoleic isomers and reduced level of oleic acids in BM of overweight-obese mothers (25).…”

“…This group correlates with a greater increase in the weight for age (WFA) z-score, a smaller increase in the lengh for age z-score and of the CC between 2 weeks and 2 months of age. The effects on long distance obesity are clearly to be determined (25).…”

“…As result, we found and discussed a single article on untargeted metabolomics (15), a total of four articles on targeted metabolomics (16)(17)(18)(19), and 10 articles on lipidomics (20)(21)(22)(23)(24)(25)(26)(27)(28)(29) published since 2013-2020. Review articles were excluded.…”