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Am J Clin Nutr. 2019 Apr 4. pii: nqy334. doi: 10.1093/ajcn/nqy334. [Epub ahead of print]

Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain.

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Research Division, Joslin Diabetes Center, Boston, MA.
Department of Pediatrics, Harvard Medical School, Boston, MA.
Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.



Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear.


We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain.


This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother-infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography-gas chromatography-mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum.


At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI.


Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother-child transmission of obesity. This trial was registered at as NCT02535637.


body composition; breast milk; human milk; human milk oligosaccharides; infant; maternal obesity; metabolomics


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