Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

Abstract

Objective The aim of this study was to test associations of prepregnancy BMI, gestational weight gain, oral glucose challenge test results, and postpartum weight loss as predictors of breast milk leptin, insulin, and adiponectin concentrations and whether these relationships vary over time. Methods Milk was collected at 1 and 3 months from 135 exclusively breastfeeding women from the longitudinal Mothers and Infants Linked for Healthy Growth (MILk) study. Hormones were assayed in skimmed samples using ELISA. Mixed‐effects linear regression models were employed to assess main effects and effect‐by‐time interactions on hormone concentrations. Results In adjusted models, BMI was positively associated with milk leptin (P < 0.001) and insulin (P = 0.03) and negatively associated with milk adiponectin (P = 0.02); however, the association was stronger with insulin and weaker with adiponectin at 3 months than at 1 month (time interaction P = 0.017 for insulin and P = 0.045 for adiponectin). Gestational weight gain was positively associated and postpartum weight loss was negatively associated with milk leptin (both P < 0.001), independent of BMI. Oral glucose challenge test results were not associated with these milk hormone concentrations. Conclusions Maternal weight status before, during, and after pregnancy contributes to interindividual variation in human milk composition. Continuing work will assess the role of these and other milk bioactive factors in altering infant metabolic outcomes.

Human milk oligosaccharide 2’-fucosyllactose links feedings at 1 month to cognitive development at 24 months in infants of normal and overweight mothers

“…As we postulated in a previous publication in the same cohort [19], maternal obesity may persist after pregnancy, and alter breast milk characteristics [8,9,19,34]: this includes neuroactive components for infant cognitive development [9,34]. However, we found that maternal obesity before pregnancy was a separate influence, unrelated to breast milk factors.…”

“…First, maternal characteristics contribute to breast milk characteristics: mothers who are obese may have more difficulty with breast milk expression to meet the demands of the infant [8]. Moreover, maternal obesity alters breast milk composition: this includes neuroactive components, e.g., leptin and adiponectin [9]. Exposure to these compounds has been shown to influence infant cognitive performance [10,11].…”

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

“…Therefore, we aim to determine the microbiota composition of mothers and children (faecal, oral, vaginal, breast milk) and determine the role of weight loss herein. In addition, breast milk composition/metabolome will be investigated,76 77 and placenta tissue will be collected for RNA-sequencing analysis, histology and epigenetics.…”

Centering human milk composition as normal human biological variation

“…Presently, the majority of human milk studies do use BMI as a measure of maternal adiposity, often without discussion of its limitations (Andreas et al, 2014; Chan et al, 2018; Dietz & Bellizzi, 1999; Kugananthan et al, 2017; Martin et al, 2006; Prentice et al, 1994; Sadr Dadres et al, 2019). The fact that human milk leptin shows a consistent, positive association with maternal BMI (Table 3) at the time of milk collection illustrates the strength of the relationship between maternal adiposity and breast milk leptin, as such relationship is present even with such a poor measure of maternal adiposity (Fields et al, 2017; Houseknecht et al, 1997).…”