“…Further, studies of HM leptin and adiponectin showed that it was not concentrations, but higher 24 h intake of whole milk leptin that was related to increased infant adiposity [45], and higher adiponectin intake was associated with increased infant adiposity and anthropometrics [45,46] and reduced infant fat-free mass during the first year of life [45]. Only a few studies have investigated the link between the intake of HM components and infant growth outcomes and these show promise in elucidating the mechanisms by which HM components influence infant growth and development of body composition [42,47]. Therefore, the results of this study provide recommendations for sampling and intake estimation protocols that could be applied to investigate the relationships between HM components and infant outcomes in future studies.…”
Limited attention is given to the efficacy of protocols for the estimation of infant intake of milk components when investigating their impact on infant outcomes. We compared the actual measured intake of human milk components with estimations derived from 15 protocols to determine the most reliable approach for estimating intake of HM leptin, adiponectin, insulin, glucose, and total lipid. Twenty mothers who were 3–5 months postpartum completed a 24 h milk profile study with pre-/post-feed milk samples collection. The true infant intake (control group) based on 24 h milk intake (MI) was compared to estimated infant intakes using concentrations from five sampling protocols that were multiplied by one of true infant MI, considered mean MI (800 mL), or global mean MI (766 mL). The mean measured concentrations of six samples (three sets of pre- and post-feed samples, from morning (06:00–09:00), afternoon (13:00–16:00), and evening (19:00–22:00)) multiplied by the true infant MI, mean considered MI, and global mean MI produced the most accurate estimates of infant intake of these components. Therefore, in the absence of 24 h measurements and sampling, a sampling protocol comprising three sets of pre-/post-feed samples provides the most reliable infant intake estimates of HM leptin, adiponectin, insulin, glucose, and total lipid.
“…Further, studies of HM leptin and adiponectin showed that it was not concentrations, but higher 24 h intake of whole milk leptin that was related to increased infant adiposity [45], and higher adiponectin intake was associated with increased infant adiposity and anthropometrics [45,46] and reduced infant fat-free mass during the first year of life [45]. Only a few studies have investigated the link between the intake of HM components and infant growth outcomes and these show promise in elucidating the mechanisms by which HM components influence infant growth and development of body composition [42,47]. Therefore, the results of this study provide recommendations for sampling and intake estimation protocols that could be applied to investigate the relationships between HM components and infant outcomes in future studies.…”
Limited attention is given to the efficacy of protocols for the estimation of infant intake of milk components when investigating their impact on infant outcomes. We compared the actual measured intake of human milk components with estimations derived from 15 protocols to determine the most reliable approach for estimating intake of HM leptin, adiponectin, insulin, glucose, and total lipid. Twenty mothers who were 3–5 months postpartum completed a 24 h milk profile study with pre-/post-feed milk samples collection. The true infant intake (control group) based on 24 h milk intake (MI) was compared to estimated infant intakes using concentrations from five sampling protocols that were multiplied by one of true infant MI, considered mean MI (800 mL), or global mean MI (766 mL). The mean measured concentrations of six samples (three sets of pre- and post-feed samples, from morning (06:00–09:00), afternoon (13:00–16:00), and evening (19:00–22:00)) multiplied by the true infant MI, mean considered MI, and global mean MI produced the most accurate estimates of infant intake of these components. Therefore, in the absence of 24 h measurements and sampling, a sampling protocol comprising three sets of pre-/post-feed samples provides the most reliable infant intake estimates of HM leptin, adiponectin, insulin, glucose, and total lipid.
“…Assessment of the macronutrient literature revealed positive associations between HM protein and infant length, but not weight [ 2 ]. In general, HM carbohydrates were positively associated with infant weight.…”
Section: Key Study Findings: Human Milk and Child Growthmentioning
confidence: 99%
“…1 ) . Due to the large number of articles included, we grouped the HM components into three categories and reported each in a separate manuscript: micronutrients (data extracted from 28 articles) [ 1 ], macronutrients (57 articles) [ 2 ], and bioactives (75 articles) [ 3 ]. Fig.…”
Background
Despite global public health organizations endorsing breastfeeding or human milk (HM) as the optimal source of nutrition for infants, detailed knowledge of how HM composition influences infant growth is lacking. In this commentary we summarize and interpret the key findings of a large systematic review on HM components and child growth (N = 141 articles included). We highlight the most consistent associations, discuss study quality issues, explore socio-economic and time trends in this body of research, and identify gaps and future research directions.
Key Findings of Systematic Review
We grouped HM components into three categories: micronutrients (28 articles), macronutrients (57 articles), and bioactives (75 articles). Overall, we struggled to find consistent associations between HM components and infant growth. The majority of studies (85%) were of moderate or low-quality, with inconsistent HM collection and analysis strategies being identified as the most substantial quality concerns. Additional quality issues included failing to account for potential confounding by factors such as breastfeeding exclusivity and maternal body mass index.
Considerations for Future Human Milk Research
Many opportunities exist for the future of HM research. Using untargeted metabolomics will expand our understanding of HM components beyond previously defined and well-understood components. Machine learning will allow researchers to investigate HM as an integrated system, rather than a collection of individual components. Future research on HM composition should incorporate evidence-based HM sampling strategies to encompass circadian variation as well as infant consumption. Additionally, researchers need to focus on developing high quality growth data using consistent growth metrics and definitions. Building multidisciplinary research teams will help to ensure that outcomes are meaningful and clinically relevant.
Conclusion
Despite a large body of literature, there is limited quality evidence on the relationship between HM composition and infant growth. Future research should engage in more accurate collection of breastfeeding data, use standardized HM collection strategies and employ assays that are validated for HM. By systematically evaluating the existing literature and identifying gaps in existing research methods and practice, we hope to inspire standardized methods and reporting guidelines to support robust strategies for examining relationships between HM composition and child growth.
“…Además, de optar por una población objetiva de menores de 6 meses o hasta los 3 años. En cambio, la presente investigación consideró a niños menores de dos años, ya que, durante este periodo, ocurre una programación temprana crucial para alcanzar el mejor desarrollo y salud a lo largo de la vida (6). Asimismo, el uso de datos a nivel nacional, regional, estratificado según edad, nivel educativo y pobreza permite un panorama completo de los factores de riesgo, confusores y no relevantes.…”
Introducción: La duración de la lactancia materna es crucial para la salud infantil, sin embargo, la prevalencia ha disminuido en los últimos años, situando a los niños en una población de riesgo. Objetivo: Determinar los factores asociados a la duración de la lactancia materna en niños menores de 2 años en el Perú 2021-2022.
Metodología: Estudio analítico transversal, a través del análisis secundario de datos de la Encuesta Demográfica y de Salud Familiar (ENDES) del año 2021 y 2022. El tamaño muestral fue de 4951 niños/niñas con sus respectivas madres. Se evaluaron factores infantiles y maternos utilizando el Estadístico F corregida para el análisis bivariado con una significancia estadística p<0,05 y un intervalo de confianza al 95%. Finalmente, para medir la asociación se calculó la razón de prevalencia cruda (RPc) y la razón de prevalencia ajustada (RPa) mediante la Regresión de Poisson con varianza robusta. Resultados: El 85,3% tuvo una duración de 0-6 meses y solo el 14,7% tiene una duración hasta los 23 meses. El no contacto piel a piel precoz bebe-madre (p <0,01) (RPa 1,19) y el consumo de bebidas diferentes a la leche materna los primeros 3 días de nacido (p <0,01) (RPa 0,66) se asociaron con una duración hasta los 6 meses de lactancia materna. Las madres adolescentes tuvieron un 30,7% de duración de lactancia materna de 6 meses (p<0,01) (RPa 2,49), por el contrario, el lugar de residencia rural, el grado no superior y un menor ingreso económico permiten una lactancia materna por más de 6 meses. Discusión: Los resultados asocian no recibir contacto piel a piel precoz bebe-madre, edad materna igual o menor de 18 años, grado superior, lugar de residencia urbano y mayor ingreso económico con una menor duración de lactancia materna en niños menores de 2 años.
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