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

Abstract

Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.

Impact of Infant and Maternal Factors on Energy and Macronutrient Composition of Human Milk

“…What is more, our findings showed an association between current BMI, maternal body composition during breastfeeding and infant sex and the macronutrient concentration in mature HM, collected 1–2 months postpartum. Similar to other studies [ 16 ], our data show that fat concentration in HM was positively correlated with maternal nutritional status. However, our study provides better insight by assessing nutritional status not only with BMI value, but mainly with body composition analysis and analyzing milk samples from a 24-h period.…”

“…Chang et al [ 35 ] observed that women’s current BMI was positively correlated with fat concentration in HM at early (1–2 weeks) and late (7–8 months) lactation stages. However, Leghi et al [ 16 ] reported in their meta-analysis that the fat concentration in transitional milk showed an inverse correlation. Simultaneously, no impact of maternal overweight or obesity on fat concentration in colostrum was observed.…”

“…The impact of physiological factors, e.g., sequential stages of lactation [ 8 , 9 ], pre-/post-feed [ 10 ] and daytime [ 11 ] is the best investigated. Changes in maternal diet [ 12 , 13 , 14 ] and nutritional status [ 15 , 16 ] also significantly influence HM composition, mainly within the lipid fraction. Likewise, the concentrations of non-nutritive milk components (e.g., hormones, steroids, growth and satiety factors) are affected by maternal factors [ 17 ].…”

The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review

“…In particular, it is known that the gut microbiome composition differs in healthy and obese people; therefore, an aberrant microbiome can be vertically transmitted from an obese mother to her infant. Mother-to-newborn transmission of microbiota might be a causal factor underlying obesity’s transmission [ 91 , 92 ].…”

Editorial: Impact of Early Life Nutrition on Immune System Development and Related Health Outcomes in Later Life

“…Maternal obesity and maternal atopy are highly prevalent states that may have an effect on HM composition and infants' health outcomes (9)(10)(11)(12)(13)(14). Few studies, however, have attempted to evaluate associations between HM metabolome composition and measures of infants' health and development.…”