Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

Abstract

Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

Worldwide Variation in Human Milk Metabolome: Indicators of Breast Physiology and Maternal Lifestyle?

“…In our comparison, all human milk samples were obtained within one month of birth, removing timing of collection as an explanation for differences in milk lactose or other metabolite concentrations. In two to five months old infants, Gridneva et al documented higher lactose milk levels in Australian women who breastfed more frequently [ 16 ]. Their results are congruent with a metabolomics study of sow milk, whereby Tan et al reported higher milk lactose levels with higher rather than lower lactation performance [ 25 ].…”

“…With representation across ethnicity, maternal atopy status, and infant sex, 109 milk samples collected one month after birth were selected from six existing international cohorts: Perth, Australia ( n = 29 from 2 cohorts which include 21 atopic mothers, i.e., Perth #1, [ 15 ] and 8 non-atopic mothers, i.e., Perth #2) [ 16 ]; Chiba, Japan ( n = 12); Detroit, USA ( n = 18) [ 17 ]; Oslo, Norway ( n = 40) [ 18 ]; and Cape Town, South Africa ( n = 10) [ 4 ]. The one-month postpartum time period was selected because human milk composition has stabilized by then [ 2 ].…”

Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk

“…This suggests that the association between HM adiponectin and infant growth may in fact be parabolic, further highlighting the pleiotropic effects of adiponectin during development and the adaptive mechanisms that humans display in the marginal environments [66]. Our recent study of gastric emptying and breastfeeding patterns in fully breastfed term infants has established that higher concentrations and doses of HM adiponectin are associated with longer times between breastfeeds (gastric emptying time) [69], which may partially explain the growth-regulating effect of adiponectin in some populations. As such, investigations into other factors that may affect adiponectin concentrations in HM and its effect on infant growth and BC development are warranted.…”

Casein hydrolysate supplementation in low‐crude protein diets increases feed intake and nitrogen retention without affecting nitrogen utilization of growing pigs

“…The increase in feed intake after the casein hydrolysate supplementation in the low‐CP diet may be associated with appetite enhancement. It has been reported that dietary peptides were able to accelerate gastric emptying, while the increased gastric emptying was usually accompanied by appetite enhancement . These findings point to the important role of dietary peptides in appetite regulation.…”