Longitudinal human milk macronutrients, body composition and infant appetite during early life

Abstract

Background & aims: Breastfeeding is the gold standard infant feeding. Data on macronutrients in relation to longitudinal body composition and appetite are very scarce. The aim of this study was to investigate longitudinal human milk macronutrients at 1 and 3 months in association with body composition and appetite during early life in healthy, term-born infants. We hypothesized that infants receiving higher caloric human milk would have more body fat mass and satiate earlier. Methods: In 133 exclusively breastfed infants (Sophia Pluto Cohort), human milk samples at 1 and 3 months were analyzed for macronutrients (fat, protein, carbohydrate) by MIRIS Human Milk Analyzer, with appetite assessment by Baby Eating Behavior Questionnaires. Fat mass (FM) and fat-free mass (FFM) were measured by PEA POD and DXA, and abdominal FM by ultrasound. Results: Milk samples showed large differences in macronutrients, particularly in fat content. Protein and energy content decreased significantly from 1 to 3 months. Fat and carbohydrate content tended to decrease (p ¼ 0.066 and 0.081). Fat (g/100 ml) and energy (kcal/100 ml) content at 3 months were associated with FM% at 6 months (b 0.387 and 0.040, resp.) and gain in FM% from 1 to 6 months (b 0.088 and 0.009, resp.), but not with FM% at 2 years. Carbohydrate content at 3 months tended to associate with visceral FM at 2 years (b 0.290, p ¼ 0.06). Infants receiving higher caloric milk were earlier satiated and finished feeding faster. Conclusions: Our longitudinal data show decreasing milk protein and energy content from age 1 to 3 months, while fat and carbohydrate tended to decrease. Macronutrient composition, particularly fat content, differed considerably between mothers. Milk fat and energy content at 3 months associated with gain in FM% from age 1 to 6 months, indicating that higher fat and energy content associate with higher gain in FM% during the critical window for adiposity programming. As infants receiving higher caloric breastfeeding were earlier satiated, this self-regulatory mechanism might prevent intake of excessive macronutrients.

Development of Visceral and Subcutaneous-Abdominal Adipose Tissue in Breastfed Infants during First Year of Lactation

“…The third study showed no difference in both subcutaneous-abdominal and preperitoneal fat thicknesses between breastfed and formula-fed infants [ 13 ]. The most recent study investigated the effect of HM macronutrient composition reporting positive relationships between HM fat concentration (measured in post-feed sample which is the most varied between women and feeds) and infant subcutaneous-abdominal fat thickness, and negative between protein concentration and VF thickness [ 15 ]. These results suggest independent regulation of the visceral and subcutaneous-abdominal fat depots in this population.…”

“…Furthermore, the duration of exclusive breastfeeding was found to relate positively to percentage fat mass (%FM) and subcutaneous, but not VF [ 14 ], with maternal factors having no effect on development of these fat depots; however, infants were followed up to 6 months only, with 38% exclusively breastfed at 3 months of age (19% at 6 months). The only study that investigated effect of HM macronutrient composition on infant abdominal adiposity showed positive relationships between HM fat concentration and infant abdominal subcutaneous fat thickness, but negative between protein concentration and VF thickness [ 15 ].…”

Cohort profile: Japanese human milk study, a prospective birth cohort: baseline data for lactating women, infants and human milk macronutrients

“…The composition of human milk was comparable to that reported in previous studies. [20][21][22] We used mid-infrared spectrophotometer that was specifically developed for the evaluation of human milk and calibrated to human milk values for analysing the milk macronutrients and energy content. 23 In this study, fat was the most variable macronutrient in human milk, which is consistent with the literature on mature milk.…”

Appetite-regulating hormone trajectories and relationships with fat mass development in term-born infants during the first 6 months of life

“…Breastfeeding mothers were instructed to collect hind milk samples, thus after their infants were breastfed, at infant’s age of 3 months as described before [ 26 ]. For 61 exclusively breastfed infants, human milk samples were analyzed for macronutrient composition (fat, energy, carbohydrate and protein).…”

“…Human milk macronutrient composition could potentially influence appetite-regulating hormone levels in BF infants as we previously found that exclusively BF infants-receiving human milk with higher fat and energy were satiated earlier. This could be a self-regulatory mechanism to prevent intake of excessive macronutrients [ 26 ]. Associations between ARH and human milk macronutrients and infant appetite until age 6 months, a critical window for adiposity programming as mentioned above, are lacking.…”