Infant sex differences in human milk intake and composition from 1- to 3-month post-delivery in a healthy United States cohort

Eckart, Erin; Peck, Jennifer D.; Kharbanda, Elyse O.; Nagel, Emily; Fields, David A.; Demerath, Ellen W.

doi:10.1080/03014460.2021.1998620

Cited by 10 publications

(4 citation statements)

References 53 publications

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“…It is worth noting that the two previous studies did not directly observe the actual intake of milk but instead estimated it using isotope-labeled water. Another study that measured infant feed consumption found no difference in volume intake between boys and girls at one month and three months of age [ 9 ]. However, when considering volume intake per kilogram of body weight and daily consumption, girls consumed 126 mL/kg/d while boys consumed 114 mL/kg/d.…”

Section: Discussionmentioning

confidence: 99%

Sex-Specific Differences in Nutrient Intake in Late Preterm Infants

Alur,

Ramarao,

Hitt

et al. 2024

Children

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Challenging the assumption of uniform nutritional needs in preterm feeding, this study identifies crucial sex-specific disparities in formula milk intake and growth among late preterm infants. Premature infants have difficulty regulating their oral intake during feeds, which is why clinicians prescribe feeding volume, calories, and protein via the nasogastric route. However, premature male and female infants have different body compositions at birth, and, subsequently, there is no evidence to suggest that male and female preterm infants differ in their nutritional consumption once they begin feeding ad libitum. This study investigates whether there are any differences in the volume and nutrient intake between the sexes when fed formula ad libitum. Methods: The study involved a retrospective analysis of preterm infants admitted to the NICU and evaluated between 34 0/7 and 36 6/7 weeks of corrected gestation. Late preterm infants appropriate for gestational age who were spontaneously fed formula milk ad-lib and free of any respiratory support for at least two days were included. The study excluded infants with short gut syndrome, severe chromosomal anomalies, or congenital heart conditions. We included 85 male and 85 female infants in this study. The data collected included sex, gestational age, birth weight, anthropometric data at birth, maternal data, nutritional intake, and neonatal morbidity. Results: This study found that female infants consumed more volume, protein, and calories than male infants. The mean formula intake in female and male infants was 145.5 ± 20.8 mL/kg/d and 135.3 ± 19.3 mL/kg/d, respectively, with p = 0.002. However, ad-lib feeding duration was not different between the sexes. Growth velocity was also higher in female infants. Conclusions: This study is the first to demonstrate differences in formula milk intake among late preterm infants fed ad libitum. Additional research is needed to confirm our findings and understand sex-specific differences in neonatal nutrition in extremely early preterm infants.

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Section: Discussionmentioning

confidence: 99%

Sex-Specific Differences in Nutrient Intake in Late Preterm Infants

Alur,

Ramarao,

Hitt

et al. 2024

Children

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“…There are previous studies investigating BM macronutrient intakes, but they usually estimated BM intake volume via 24-h test weighing (i.e. weighing infants before and after every feed for a 24-h period) ( 44 , 45 ) during EBF period or using the values reported from the literature ( 46 ) . In this study, 2 H-labelled water was perceived to provide more precise BM intake volume estimates compared with the other methods.…”

Section: Discussionmentioning

confidence: 99%

Associations between breast milk intake volume, macronutrient intake and infant growth in a longitudinal birth cohort: the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF)

et al. 2022

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Growth patterns of breastfed infants, while widely considered to be optimal, show substantial inter-individual differences, partly influenced by breast milk (BM) nutritional composition. However, BM nutritional composition does not accurately indicate BM nutrient intakes. This study aimed to examine the associations between both BM intake volumes and macronutrient intakes with infant growth and adiposity. Mother-infant dyads (N=94) were recruited into the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF) from a single maternity hospital at birth; all infants were vaginally delivered and received exclusive breastfeeding (EBF) for at least 6 weeks. Infant weight, length, and skinfolds thicknesses (reflecting adiposity) were repeatedly measured from birth to 12 months. Post-feed BM samples were collected at 6 weeks to measure triglycerides (fat), lactose (carbohydrate) (both by 1H-NMR) and protein concentrations (DUMAS method). BM intake volume was estimated from 70 infants between 4-6 weeks using dose-to-the-mother deuterium-oxide (2H2O) turnover. In the full cohort and among 60 infants who received EBF for 3+ months, higher BM intake at 6 weeks was associated with initial faster growth between 0-6 weeks (B±SE 3.58±0.47 for weight and 4.53±0.6 for adiposity gains, both p<0.0001) but subsequent slower growth between 3-12 months (B±SE -2.27±0.7 for weight and -2.65±0.69 for adiposity gains, both p<0.005). BM carbohydrate and protein intakes at 4-6 weeks were positively associated with early (0-6 weeks) but tended to be negatively related with later (3-12 months) adiposity gains, while BM fat intake showed no association, suggesting that carbohydrate and protein intakes may have more functional relevance to later infant growth and adiposity.

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“…Evolutionary approaches examining how parental investment may interact and influence human milk composition (e.g., Fujita et al, 2019;Powe et al, 2010) have typically centered on whether there are associations between a mother's milk composition and the sex of her infant (e.g., do male infants receive milk that has higher energy density than female infants?). A subset of these papers has directly or indirectly examined the Trivers-Willard hypothesis or the interaction effects between maternal condition and infant sex on milk composition (Eckart et al, 2021;Fujita et al, 2012Fujita et al, , 2019Powe et al, 2010;Quinn, 2013). Trivers-Willard posits that mothers attain greater reproductive success through investing in offspring that are most likely to obtain greater fitness (Trivers & Willard, 1973).…”

Section: Evolutionary Approaches To Human Parental Investment and Hum...mentioning

confidence: 99%

Human milk immune factors, maternal nutritional status, and infant sex: The INSPIRE study

Caffé

Blackwell

Fehrenkamp

et al. 2023

American J Hum Biol

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ObjectivesBreastfeeding is an energetically costly and intense form of human parental investment, providing sole‐source nutrition in early infancy and bioactive components, including immune factors. Given the energetic cost of lactation, milk factors may be subject to tradeoffs, and variation in concentrations have been explored utilizing the Trivers‐Willard hypothesis. As human milk immune factors are critical to developing immune system and protect infants against pathogens, we tested whether concentrations of milk immune factors (IgA, IgM, IgG, EGF, TGFβ2, and IL‐10) vary in response to infant sex and maternal condition (proxied by maternal diet diversity [DD] and body mass index [BMI]) as posited in the Trivers‐Willard hypothesis and consider the application of the hypothesis to milk composition.MethodsWe analyzed concentrations of immune factors in 358 milk samples collected from women residing in 10 international sites using linear mixed‐effects models to test for an interaction between maternal condition, including population as a random effect and infant age and maternal age as fixed effects.ResultsIgG concentrations were significantly lower in milk produced by women consuming diets with low diversity with male infants than those with female infants. No other significant associations were identified.ConclusionsIgG concentrations were related to infant sex and maternal diet diversity, providing minimal support for the hypothesis. Given the lack of associations across other select immune factors, results suggest that the Trivers‐Willard hypothesis may not be broadly applied to human milk immune factors as a measure of maternal investment, which are likely buffered against perturbations in maternal condition.

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Infant sex differences in human milk intake and composition from 1- to 3-month post-delivery in a healthy United States cohort

Cited by 10 publications

References 53 publications

Sex-Specific Differences in Nutrient Intake in Late Preterm Infants

Sex-Specific Differences in Nutrient Intake in Late Preterm Infants

Associations between breast milk intake volume, macronutrient intake and infant growth in a longitudinal birth cohort: the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF)

Human milk immune factors, maternal nutritional status, and infant sex: The INSPIRE study

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