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).
The British journal of nutrition 2022
Olga L, Vervoort J, van Diepen JA, Gross G, Petry CJ, Prentice PM, Chichlowski M, van Tol EA, Hughes IA, Dunger DB, Ong KK
DOI : 10.1017/S0007114522003178
PubMed ID : 36259139
PMCID :
Abstract
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 H-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 (HO) 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 ) 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 ). 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.