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J Nutr. 2017 Aug 9. pii: jn252981. doi: 10.3945/jn.117.252981. [Epub ahead of print]

Lipid-Based Nutrient Supplements During Pregnancy and Lactation Did Not Affect Human Milk Oligosaccharides and Bioactive Proteins in a Randomized Trial.

Author information

1
Departments of Nutrition, jjorgensen@ucdavis.edu.
2
Departments of Nutrition.
3
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
4
Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
5
Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA.
6
Department of Community Health, University of Malawi College of Medicine, Blantyre, Malawi.
7
Centre for Quantitative Medicine, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; and.
8
Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore.
9
Chemistry, and.

Abstract

Background: Human milk oligosaccharides (HMOs) and bioactive proteins are beneficial to infant health. Recent evidence suggests that maternal nutrition may affect the amount of HMOs and proteins in breast milk; however, the effect of nutrient supplementation on HMOs and bioactive proteins has not yet been well studied.Objective: We aimed to determine whether lipid-based nutrient supplements (LNSs) affect milk bioactive protein and HMO concentrations at 6 mo postpartum in women in rural Malawi. These are secondary outcomes of a previously published randomized controlled trial.Methods: Women were randomly assigned to consume either an iron and folic acid capsule (IFA) daily from ≤20 wk gestation until delivery, followed by placebo daily from delivery to 6 mo postpartum, or a multiple micronutrient (MMN) capsule or LNS daily from ≤20 wk gestation to 6 mo postpartum. Breast milk concentrations of total HMOs, sialylated HMOs, fucosylated HMOs, lactoferrin, lactalbumin, lysozymes, antitrypsin, immunoglobulin A, and osteopontin were analyzed at 6 mo postpartum (n = 647). Between-group differences in concentrations and in proportions of women classified as having low concentrations were tested.Results: HMO and bioactive protein concentrations did not differ between groups (P > 0.10 for all comparisons). At 6 mo postpartum, the proportions of women with low HMOs or bioactive proteins were not different between groups except for osteopontin. A lower proportion of women in the IFA group had low osteopontin compared with the LNS group after adjusting for covariates (OR: 0.5; 95% CI: 0.3, 0.9; P = 0.016).Conclusion: The study findings do not support the hypothesis that supplementation with an LNS or MMN capsule during pregnancy and postpartum would increase HMO or bioactive milk proteins at 6 mo postpartum among Malawian women. This trial was registered at clinicaltrials.gov as NCT01239693.

KEYWORDS:

bioactive breast milk proteins; human milk oligosaccharides; lactation; lipid-based nutrient supplements; multiple micronutrient supplements; postpartum

Conflict of interest statement

Author disclosures: JMJ, CA, PA, UA, DC, YBC, JCCD, Y-MF, EG, EK, CK, CBL, KM, SMT, LDW, and KGD, no conflicts of interest.

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