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Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 42385

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Dr. Sylvia Ley

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Guest Editor

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
Interests: lactation; breastfeeding; maternal and child health; chronic disease; life-course

Dr. Cuilin Zhang

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Guest Editor

Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20814, USA
Interests: pregnancy complications; gestational diabetes; obesity; long-term health consequences
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Dear Colleagues,

Human milk offers health benefits to children, including lower risk of cardiometabolic disease and immune system development. These benefits have been attributed to composition of human milk, which provides not only the optimal nutrients but also an array of bioactive substances. Milk composition is known to be influenced by maternal health status and behaviors. Early feeding exposures can be important in infant development, including the function and the modulation of the infant gastrointestinal system and infant metabolism, therefore offering future potential for intervening the developmental trajectories. However, limited longitudinal data are available on how child development is influenced by early feeding exposures, including breastfeeding exclusivity and introduction to solids in addition to milk composition. Further, breastfeeding has short-term and long-term health consequences on lactating mothers. Based on limited data, women who breastfeed recover postpartum body weight and metabolism more rapidly. Growing evidence indicates that women with longer lifetime lactation duration have a lower risk for developing several chronic diseases later in life. However, the pathophysiologic explanations behind these observed associations remain unclear.

Dr. Sylvia Ley
Dr. Cuilin Zhang
Guest Editors

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Keywords

human milk
breastfeeding
lactation
exclusive breastfeeding
maternal and child health
child development
women’s health
life-course

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Published Papers (9 papers)

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Research

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10 pages, 413 KiB

Open AccessArticle

Associations of Metabolic and Obstetric Risk Parameters with Timing of Lactogenesis II

by Amber J. Mullen, Deborah L. O’Connor, Anthony J. Hanley, Giovanni Piedimonte, Maeve Wallace and Sylvia H. Ley

Nutrients 2022, 14(4), 876; https://doi.org/10.3390/nu14040876 - 19 Feb 2022

Cited by 12 | Viewed by 2682

Abstract

Lactogenesis II is the onset of copious milk production following parturition. Delayed onset of lactogenesis II (DLII) often contributes to poorer lactation performance, which may adversely affect maternal and child health. The present study aims to identify the metabolic and obstetric risk factors for DLII in a secondary analysis of a prospective cohort study following pregnant women through postpartum. We defined the onset of lactogenesis II as delayed if it occurred ≥72 h postpartum. Multiple logistic regression analyses were conducted to evaluate the associations of metabolic and obstetric variables with DLII. Median onset of lactogenesis II was 72.4 h (IQR 60.4–91.6) postpartum, and 55.4% (98 of 177) of women experienced DLII. Time to first breast contact ≥ 2 h postpartum compared to ≤1 h postpartum was associated with DLII (OR 2.71 95% CI 1.12–6.53) with adjustment for age, race, pregravid BMI, primiparity, and mode of delivery, while metabolic variables were not significantly associated with DLII. In this comprehensive examination of potential metabolic and obstetric parameters, earlier timing of putting the infant to the breast remained significantly associated with earlier onset of milk coming in after consideration of the other potential risk factors. Obstetrical practices, including putting the baby to the breast later, may have an important impact on the timing of lactation, and interventions are needed to address this concern. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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12 pages, 272 KiB

Open AccessArticle

Cumulative Lactation and Clinical Metabolic Outcomes at Mid-Life among Women with a History of Gestational Diabetes

by Pandora L. Wander, Stefanie N. Hinkle, Daniel A. Enquobahrie, Jing Wu, Sylvia H. Ley, Louise G. Grunnet, Jorge E. Chavarro, Mengying Li, Anne A. Bjerregaard, Aiyi Liu, Peter Damm, Seth Sherman, Shristi Rawal, Yeyi Zhu, Liwei Chen, James L. Mills, Frank B. Hu, Allan Vaag, Sjurdur F. Olsen and Cuilin Zhang

Nutrients 2022, 14(3), 650; https://doi.org/10.3390/nu14030650 - 3 Feb 2022

Cited by 1 | Viewed by 2406

Abstract

Lactation is associated with a lower risk of subsequent cardiometabolic disease among parous women; however, the underlying mechanisms are unknown. Further, the potential protective effects of lactation on cardiometabolic risk markers at mid-life among high-risk women with past gestational diabetes (GDM) are not established. Using data from the Diabetes & Women’s Health Study (2012–2014; n = 577), a longitudinal cohort of women with past GDM from the Danish National Birth Cohort (1996–2002), we assessed associations of cumulative lactation duration (none, <6 months, 6–12 months, ≥12–24 months, and ≥24 months) with clinical metabolic outcomes (including type 2 diabetes [T2D], prediabetes, and obesity) and cardiometabolic biomarkers (including biomarkers of glucose/insulin metabolism, fasting lipids, inflammation, and anthropometrics) 9–16 years after enrollment when women were at mid-life. At follow-up, women were 43.9 years old (SD 4.6) with a BMI of 28.7 kg/m² (IQR 24.6, 33.0); 28.6% of participants had T2D, 39.7% had prediabetes, and 41.2% had obesity. Relative risks (95% CI) of T2D for 0–6, 6–12, 12–24, and ≥24 months of cumulative lactation duration compared to none were 0.94 (0.62,1.44), 0.88 (0.59,1.32), 0.73 (0.46,1.17), and 0.71 (0.40,1.27), respectively. Cumulative lactation duration was not significantly associated with any other clinical outcome or continuous biomarker. In this high-risk cohort of middle-aged women with past GDM, T2D, prediabetes, and obesity were common at follow-up, but not associated with history of cumulative lactation duration 9–16 years after the index pregnancy. Further studies in diverse populations among women at mid-age are needed to understand associations of breastfeeding with T2D. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

14 pages, 1473 KiB

Open AccessArticle

Longitudinal Associations of Plasma Phospholipid Fatty Acids in Pregnancy with Neonatal Anthropometry: Results from the NICHD Fetal Growth Studies—Singleton Cohort

by Emily Wang, Yeyi Zhu, Rana F. Chehab, Jing Wu, Stefanie N. Hinkle, Natalie L. Weir, Andrew A. Bremer, Jiaxi Yang, Zhen Chen, Michael Y. Tsai and Cuilin Zhang

Nutrients 2022, 14(3), 592; https://doi.org/10.3390/nu14030592 - 29 Jan 2022

Cited by 1 | Viewed by 2313

Abstract

Despite increasing interest in the health effects of polyunsaturated FAs (PUFAs), their roles in fetal and neonatal growth remain understudied. Within the NICHD Fetal Growth Studies—Singleton Cohort, we prospectively investigated the associations of individual and subclasses of plasma phospholipid PUFAs at gestational weeks (GW) 10–14, 15–26, 23–31, and 33–39 with neonatal anthropometric measures as surrogates for fetal growth among 107 women with gestational diabetes mellitus (GDM) and 214 non-GDM controls. Multivariable weighted linear regression models estimated the associations between plasma phospholipid PUFAs and neonatal anthropometric measures. Adjusted beta coefficients for phospholipid docosahexaenoic acid (DHA) per standard deviation (SD) increase at GW 23–31 in association with birthweight z-score, neonatal length, and neonatal fat mass were 0.25 (95% CI: 0.08–0.41), 0.57 (0.11–1.03) cm, and 54.99 (23.57–86.42) g, respectively; all false discovery rates (FDRs) < 0.05. Estimated Δ5-desaturase activity per SD increase at GW 33–39 but not at other time points was positively associated with birthweight z-score: 0.29 (95% CI: 0.08–0.33); neonatal length: 0.61 (0.29–0.94) cm; and neonatal fat mass: 32.59 (8.21–56.96) g; all FDRs < 0.05. Longitudinal analysis showed consistent results. Our findings suggest that mid-to-late pregnancy presented as critical windows for primarily diet-derived DHA and Δ5-desaturase activity in relation to neonatal anthropometric measures. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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14 pages, 1221 KiB

Open AccessArticle

Macro- and Trace-Element Intake from Human Milk in Australian Infants: Inadequacy with Respect to National Recommendations

by Sabrina H. Bilston-John, Ardra Narayanan, Ching T. Lai, Alethea Rea, John Joseph and Donna T. Geddes

Nutrients 2021, 13(10), 3548; https://doi.org/10.3390/nu13103548 - 9 Oct 2021

Cited by 6 | Viewed by 2488

Abstract

Longitudinal variations of macro- and trace elements in human milk (HM) are not well characterised, and therefore, the recommendations for intake for Australian infants require more evidence to ensure accuracy. We aimed to investigate the longitudinal variation of HM macro- and trace-element concentrations (1–12 months) and infant intake (1–6 months) and to investigate the relationships between intake and infant growth parameters at 3 and 6 months, and determine if intake was sufficient when compared to national guidelines. HM samples were collected monthly for the first 6 months and then at 9 and 12 months postpartum from mother–infant dyads (n = 83). Test–weighing was used to determine the volume of HM consumed daily. Element concentrations (Na, Ca, K, Mg, P, I, Se, Zn, Cu, Mn, Mo, and Fe) were measured using ICP-MS, and intake was calculated using the measured concentrations and the volume of HM consumed. The average intake of HM was 776.3 ± 24.0 mL for the infants. Changes in concentration from months 1 to 12 postpartum were observed for all the measured micronutrients (all p < 0.05). The calculated intakes of all the macro- and trace elements showed that 0% to 82% of infants met the current adequate recommendations at varying periods of lactation. The calculated macro- and trace-element intakes were below the adequate intake recommendations, suggesting that they are not reflective of healthy infant requirements. These findings suggest the need for larger studies using sensitive analytical techniques and the revision of current recommendations for breastfed infants. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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17 pages, 681 KiB

Open AccessArticle

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

by Zoya Gridneva, Alethea Rea, Ching Tat Lai, Wan Jun Tie, Sambavi Kugananthan, Kevin Murray, Peter E. Hartmann and Donna T. Geddes

Nutrients 2021, 13(9), 3294; https://doi.org/10.3390/nu13093294 - 21 Sep 2021

Cited by 10 | Viewed by 3376

Abstract

This study aimed to investigate relationships between infant abdominal visceral and subcutaneous adiposity and human milk (HM) components and maternal body composition (BC) during first year of lactation. Subcutaneous-abdominal depth (SAD), subcutaneous-abdominal fat area (SFA), visceral depth (VD) and preperitoneal fat area of 20 breastfed infants were assessed at 2, 5, 9 and 12 months using ultrasound. Maternal BC was determined with bioimpedance spectroscopy. HM macronutrients and bioactive components concentrations and infant 24-h milk intake were measured and calculated daily intakes (CDI) determined. Maternal adiposity associated with infant SFA (negatively at 2, 5, 12, positively at 9 months, all overall p < 0.05). 24-h milk intake positively associated with infant SAD (p = 0.007) and VD (p = 0.013). CDI of total protein (p = 0.013), total carbohydrates (p = 0.004) and lactose (p = 0.013) positively associated with SFA. Lactoferrin concentration associated with infant VD (negatively at 2, 12, positively at 5, 9 months, overall p = 0.003). CDI of HM components and maternal adiposity have differential effects on development of infant visceral and subcutaneous abdominal adiposity. Maintaining healthy maternal BC and continuing breastfeeding to 12 months and beyond may facilitate favourable BC development reducing risk of obesity. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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14 pages, 1601 KiB

Open AccessArticle

Longitudinal Plasma Metabolomics Profile in Pregnancy—A Study in an Ethnically Diverse U.S. Pregnancy Cohort

by Susanna D. Mitro, Jing Wu, Mohammad L. Rahman, Yaqi Cao, Yeyi Zhu, Zhen Chen, Liwei Chen, Mengying Li, Stefanie N. Hinkle, Andrew A. Bremer, Natalie L. Weir, Michael Y. Tsai, Yiqing Song, Katherine L. Grantz, Bizu Gelaye and Cuilin Zhang

Nutrients 2021, 13(9), 3080; https://doi.org/10.3390/nu13093080 - 1 Sep 2021

Cited by 18 | Viewed by 3447

Abstract

Amino acids, fatty acids, and acylcarnitine metabolites play a pivotal role in maternal and fetal health, but profiles of these metabolites over pregnancy are not completely established. We described longitudinal trajectories of targeted amino acids, fatty acids, and acylcarnitines in pregnancy. We quantified 102 metabolites and combinations (37 fatty acids, 37 amino acids, and 28 acylcarnitines) in plasma samples from pregnant women in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies—Singletons cohort (n = 214 women at 10–14 and 15–26 weeks, 107 at 26–31 weeks, and 103 at 33–39 weeks). We used linear mixed models to estimate metabolite trajectories and examined variation by body mass index (BMI), race/ethnicity, and fetal sex. After excluding largely undetected metabolites, we analyzed 77 metabolites and combinations. Levels of 13 of 15 acylcarnitines, 7 of 25 amino acids, and 18 of 37 fatty acids significantly declined over gestation, while 8 of 25 amino acids and 10 of 37 fatty acids significantly increased. Several trajectories appeared to differ by BMI, race/ethnicity, and fetal sex although no tests for interactions remained significant after multiple testing correction. Future studies merit longitudinal measurements to capture metabolite changes in pregnancy, and larger samples to examine modifying effects of maternal and fetal characteristics. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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13 pages, 664 KiB

Open AccessArticle

Longitudinal Changes in the Concentration of Major Human Milk Proteins in the First Six Months of Lactation and Their Effects on Infant Growth

by Jian Zhang, Ai Zhao, Shiyun Lai, Qingbin Yuan, Xiaojiang Jia, Peiyu Wang and Yumei Zhang

Nutrients 2021, 13(5), 1476; https://doi.org/10.3390/nu13051476 - 27 Apr 2021

Cited by 24 | Viewed by 4189

Abstract

Our knowledge related to human milk proteins is still limited. The present study determined the changes in multiple human milk proteins during the first six months of lactation, investigated the influencing factors of milk proteins, and explored the impact of milk proteins on infant growth. A total of 105 lactating women and their full-term infants from China were prospectively surveyed in this research. Milk samples were collected at 1–5 days, 8–14 days, 1 month, and 6 months postpartum. Concentrations of total protein and α-lactalbumin were measured in all milk samples, and concentrations of lactoferrin, osteopontin, total casein, β-casein, α_s−1 casein, and κ-casein were measured in milk from 51 individuals using ultra performance liquid chromatography coupled with mass spectrometry. The concentration of measured proteins in the milk decreased during the first six months of postpartum (p-trend < 0.001). Maternal age, mode of delivery, maternal education, and income impacted the longitudinal changes in milk proteins (p-interaction < 0.05). Concentrations of α_s−1 casein in milk were inversely associated with the weight-for-age Z-scores of the infants (1 m: r −0.29, p 0.038; 6 m: r −0.33, p 0.020). In conclusion, the concentration of proteins in milk decreased over the first six months postpartum, potentially influenced by maternal demographic and delivery factors. Milk protein composition may influence infant weights. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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18 pages, 1606 KiB

Open AccessArticle

Lactoferrin and Immunoglobulin Concentrations in Milk of Gestational Diabetic Mothers

by Jolanta Lis-Kuberka, Marta Berghausen-Mazur and Magdalena Orczyk-Pawiłowicz

Nutrients 2021, 13(3), 818; https://doi.org/10.3390/nu13030818 - 2 Mar 2021

Cited by 9 | Viewed by 3172

Abstract

Gestational diabetes mellitus (GDM) is associated with an increased risk of having a high-care newborn and has an impact on maternal wellbeing. This study aimed to assess the effect of GDM on the lactoferrin (LF), secretory immunoglobulin A (SIgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) concentrations in early colostrum, colostrum, and transitional milk samples of hyperglycemic (n = 53) and normoglycemic (n = 49) mothers using enzyme-linked immunosorbent assay (ELISA). The concentrations of milk lactoferrin and SIgA, but not IgG and IgM, from hyperglycemic and normoglycemic mothers, showed a similar negative correlation with lactation from the first to the fifteenth day. Apart from early colostral IgG, there were no differences in concentrations of LF and immunoglobulins in milk from hyperglycemic and normoglycemic mothers. For hyperglycemia compensated by diet (GDM G1) or insulin treatment (GDM G2), slight differences were seen for LF and IgG, but not for SIgA and IgM, during an early stage of lactation only. Early colostral IgG and colostral LF of insulin-treated mothers were higher (10.01 ± 4.48 mg/L and 11.50 ± 0.58 g/L, respectively) than for diet-control diabetic mothers (7.65 ± 5.67 mg/L and 8.05 ± 1.38 g/L, respectively). GDM of mothers does not have a significant impact on immunological quality of early milk. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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Review

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46 pages, 5972 KiB

Open AccessReview

25 Years of Research in Human Lactation: From Discovery to Translation

by Donna Tracy Geddes, Zoya Gridneva, Sharon Lisa Perrella, Leon Robert Mitoulas, Jacqueline Coral Kent, Lisa Faye Stinson, Ching Tat Lai, Vanessa Sakalidis, Alecia-Jane Twigger and Peter Edwin Hartmann

Nutrients 2021, 13(9), 3071; https://doi.org/10.3390/nu13093071 - 31 Aug 2021

Cited by 43 | Viewed by 16775

Abstract

Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation. Full article

(This article belongs to the Special Issue Nutrition, Lifestyle, and Breastfeeding: Potential Benefits for Maternal and Offspring Health)

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