Maternal dietary intake, nutritional status and macronutrient composition of human breast milk: systematic review

Abstract

Introduction: Human breast milk is the best source of nutrition in early life, particularly during the first six months. Nevertheless, human breast milk composition is variable and more insight in the exact factors contributing to this variability is warranted. In this review, we explored the impact of maternal dietary intake and nutritional status (e.g., anthropometric measures, body mass index, bioimpedance) on human milk macronutrient composition. Method: PubMed, Scopus and Cochrane were systematically searched till November 2019. Results: In total, 4946 publications underwent title-abstract screening; 101 publications underwent full-text screening. Eventually, 50 publications were included in this review, investigating either associations between maternal dietary intake (n=29) and/or maternal nutritional status (n=29), and macronutrient composition of human breast milk. Reported energy composition ranged from 51-72 kcal/dl, and 67% and 54% of the studies reported associations between with maternal nutritional intake and status, respectively. Protein content ranged from 0.8-3.3g/dl and four studies suggested a negative association with nutritional status. Fat content ranged from 2.1- 9.8g/dl, and 68% of the studies reported positive associations with nutritional status. Carbohydrate content ranged from 5.8-7.5g/dl, and 67% of the included studies did not report an association between intake or status. Conclusion: Literature investigating associations of maternal dietary intake and nutrition status with breast milk composition of macronutrients and energy content is diversified, both in terms of used methodology as well as results. Further studies using well defined and standard parameters are essential to aid the formulation of scientific recommendations.

Century Wide Changes in Macronutrient Levels in Indian Mothers’ Milk: A Systematic Review

“…Apart from methodological factors, human milk is known to be influenced by maternal nutritional status, dietary intake, socioeconomic status, and regional variations [ 23 , 35 , 39 , 40 , 41 , 50 , 96 ]. In this review, four studies objectively compared different maternal BMI categories and its potential impact on milk composition [ 58 , 83 , 88 , 89 ].…”

“…Therefore, basis this review, we observe there may be a mild association of maternal BMI on milk protein (specially in colostrum), but needs to be further confirmed as data on maternal BMI and milk protein composition was limited. A recent review reported mixed results for maternal BMI and milk protein with almost 58% of the studies citing no association [ 41 ]. Similarly, another review reported protein concentration in breast milk was comparable between overweight and normal weight women in different stages of lactation [ 40 ].…”

“…Thus, inadequate data on Indian mother’s milk exploring an association between maternal BMI with fat and lactose limits the ability for reporting conclusive associations. A recent review reported that BMI was associated with higher lactose levels at different stages of lactation [ 40 ], whereas another review stated that there was no association between lactose and maternal nutritional status in two-thirds of the studies included in the review [ 41 ].…”

“…Physiological factors, including feeding pattern, duration of feeding, and lactational stage are understood well [ 13 , 33 , 36 , 37 ]. Conclusive research on the effect of maternal dietary intake, anthropometry, and nutritional status on breast milk composition [ 17 , 35 , 38 , 39 , 40 , 41 , 42 ] is ongoing. Infant and maternal genes also contribute significantly to human milk composition [ 13 , 36 ].…”

Dietary Fats, Human Nutrition and the Environment: Balance and Sustainability

“…Countries with high food deficits coincide with parts of the world with large fat gaps: Eastern, Northern, Middle and Western Africa; East, Southeast and South Asia, and the Caribbean ( 5 ). Understanding fats in diets of undernourished people is important, and may also impact infants through quality of breast milk related to fat intake by mothers ( 30 ). Regional studies in South America note, however, that feeding energy-rich micronutrient-poor foods to undernourished people can promote obesity ( 31 ).…”