Maternal Nutrition Supplementation during Preconception and Pregnancy and Human Milk Composition
Background: Human milk (HM) provides essential nutrients and energy for infant growth and development. HM composition can be influenced by a range of maternal, infant, and environmental factors, and is suggested to be tailored for each infant. Understanding the factors that influence HM nutrient composition, such as maternal supplement use and lactation stage, is essential to ensure optimal outcomes for breastfeeding infants. Aim: Through an international, double-blind, randomised controlled trial, the effects of a maternal supplementation from preconception throughout pregnancy until birth on HM nutrient composition were investigated in association with a range of maternal and infant factors. Moreover, longitudinal changes in HM nutrients were characterised over 12 months of lactation. Methods: HM samples were collected at 1 week, 3 weeks, 6 weeks, and/or 3 months of lactation from 158 mothers in Singapore and 180 mothers in New Zealand. In New Zealand, HM samples were also collected at 6, 9, and 12 months of lactation. HM samples were quantified for macronutrients, minerals including zinc, vitamins D3, B1, B2, B3, B6, and B9, and HM oligosaccharides (HMOs). Effects of the supplementation on HM nutrients were examined on all samples collected over the first 3 months of lactation. Temporal changes in HM components from 1 week to 12 months of lactation were examined for the New Zealand site only. Findings: Over the first 3 months of lactation, increases in HM fat and energy content in mothers with overweight/obesity or gestational diabetes mellitus were attenuated with maternal supplementation. Furthermore, the intervention supplement led to higher HM concentrations of zinc and vitamin D3. However, there were no effects on HM concentrations of other minerals and B-vitamins. HMO composition was altered among mothers with a specific genetic background, implying an effect of the supplement on the activities of certain enzymes. Finally, HM composition changed dynamically throughout 12 months of lactation. Conclusion: Maternal nutritional supplementation during preconception and pregnancy resulted in alterations of certain HM components. Further research is required to understand the underlying mechanisms of these alterations and ascertain whether the alterations in HM composition are associated with both short- and long-term offspring outcomes.
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