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Stinson LF, Ma J, Lai CT, Rea A, Perrella SL, Geddes DT. Milk microbiome transplantation: recolonizing donor milk with mother's own milk microbiota. Appl Microbiol Biotechnol 2024; 108:74. [PMID: 38194146 PMCID: PMC10776751 DOI: 10.1007/s00253-023-12965-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/29/2023] [Accepted: 12/10/2023] [Indexed: 01/10/2024]
Abstract
Donor human milk (DHM) provides myriad nutritional and immunological benefits for preterm and low birthweight infants. However, pasteurization leaves DHM devoid of potentially beneficial milk microbiota. In the present study, we performed milk microbiome transplantation from freshly collected mother's own milk (MOM) into pasteurized DHM. Small volumes of MOM (5%, 10%, or 30% v/v) were inoculated into pasteurized DHM and incubated at 37 °C for up to 8 h. Further, we compared microbiome recolonization in UV-C-treated and Holder-pasteurized DHM, as UV-C treatment has been shown to conserve important biochemical components of DHM that are lost during Holder pasteurization. Bacterial culture and viability-coupled metataxonomic sequencing were employed to assess the effectiveness of milk microbiome transplantation. Growth of transplanted MOM bacteria occurred rapidly in recolonized DHM samples; however, a greater level of growth was observed in Holder-pasteurized DHM compared to UV-C-treated DHM, potentially due to the conserved antimicrobial properties in UV-C-treated DHM. Viability-coupled metataxonomic analysis demonstrated similarity between recolonized DHM samples and fresh MOM samples, suggesting that the milk microbiome can be successfully transplanted into pasteurized DHM. These results highlight the potential of MOM microbiota transplantation to restore the microbial composition of UV-C-treated and Holder-pasteurized DHM and enhance the nutritional and immunological benefits of DHM for preterm and vulnerable infants. KEY POINTS: • Mother's own milk microbiome can be successfully transplanted into donor human milk. • Recolonization is equally successful in UV-C-treated and Holder-pasteurized milk. • Recolonization time should be restricted due to rapid bacterial growth.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Australia.
| | - Jie Ma
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, Australia
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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Sindi AS, Stinson LF, Gridneva Z, Leghi GE, Netting MJ, Wlodek ME, Muhlhausler BS, Rea A, Trevenen ML, Geddes DT, Payne MS. Maternal dietary intervention during lactation impacts the maternal faecal and human milk microbiota. J Appl Microbiol 2024:lxae024. [PMID: 38323424 DOI: 10.1093/jambio/lxae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
AIMS To determine the effect of a two-week reduced fat and sugar and increased fibre maternal dietary intervention on the maternal faecal and human milk (HM) microbiomes. METHODS AND RESULTS Faecal swabs and HM samples were collected from mothers (n = 11) immediately pre-intervention, immediately post-intervention, and 4- and 8-weeks post-intervention, and were analysed using full-length 16S rRNA gene sequencing. Maternal macronutrient intake was assessed at baseline and during the intervention. Maternal fat and sugar intake during the intervention were significantly lower than pre-intervention (P=<0.001, 0.005, respectively). Significant changes in the bacterial composition of maternal faeces were detected after the dietary intervention, with decreases in the relative abundance of Bacteroides caccae (P=<0.001) and increases in the relative abundance of Faecalibacillus intestinalis (P = 0.006). In HM, the diet resulted in a significant increase in Cutibacterium acnes (P = 0.001) and a decrease in Haemophilus parainfluenzae (P=<0.001). The effect of the diet continued after the intervention, with faecal swabs and HM samples taken 4- and 8-weeks after the diet showing significant differences compared to baseline. CONCLUSION This pilot study demonstrates that short-term changes in maternal diet during lactation can alter the bacterial composition of the maternal faeces and HM. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12619000606189). Website: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377188&isReview=true.
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Affiliation(s)
- Azhar S Sindi
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Subiaco, WA 6008, Australia
- College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Gabriela E Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Urrbrae, South Australia 5064, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, South Australia 5000, Australia
- Discipline of Paediatrics, The University of Adelaide, North Adelaide, South Australia 5006, Australia
- Women's and Children's Hospital, North Adelaide, South Australia 5006, Australia
| | - Mary E Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Beverly S Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Urrbrae, South Australia 5064, Australia
- CSIRO, Adelaide, South Australia 5000, Australia
| | - Alethea Rea
- Centre for Applied Statistics, The University of Western Australia, Crawley, WA 6009, Australia
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia
| | - Michelle L Trevenen
- Centre for Applied Statistics, The University of Western Australia, Crawley, WA 6009, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Subiaco, WA 6008, Australia
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Stinson LF, George A, Gridneva Z, Jin X, Lai CT, Geddes DT. Effects of Different Thawing and Warming Processes on Human Milk Composition. J Nutr 2024; 154:314-324. [PMID: 38042352 DOI: 10.1016/j.tjnut.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023] Open
Abstract
The composition of human milk is influenced by storage and processing practices. The effects of thawing and warming practices on human milk composition remain poorly studied despite their prevalence in home, research, and donor milk bank settings. This review comprehensively examines the impact of different thawing and warming methods on nutritional and bioactive human milk components. While some components such as carbohydrates and minerals remain stable under most typical thawing and warming conditions, others, such as fat, immune proteins, bacterial and human cells, and peptide amine hormones, are sensitive to warming. This review has identified that the data on the effects of milk thawing and warming is limited and often contradictory. Given that numerous important components of milk are diminished during cold storage, it is important that thawing and warming practices do not lead to further loss of or alterations to beneficial milk components. Further work in this field will facilitate greater standardization of thawing methods among researchers and underpin recommendations for thawing and warming of expressed milk for parents.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Australia.
| | - Alexandra George
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Xuehua Jin
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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Suwaydi MA, Lai CT, Gridneva Z, Perrella SL, Wlodek ME, Geddes DT. Sampling Procedures for Estimating the Infant Intake of Human Milk Leptin, Adiponectin, Insulin, Glucose, and Total Lipid. Nutrients 2024; 16:331. [PMID: 38337616 PMCID: PMC10857176 DOI: 10.3390/nu16030331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Limited attention is given to the efficacy of protocols for the estimation of infant intake of milk components when investigating their impact on infant outcomes. We compared the actual measured intake of human milk components with estimations derived from 15 protocols to determine the most reliable approach for estimating intake of HM leptin, adiponectin, insulin, glucose, and total lipid. Twenty mothers who were 3-5 months postpartum completed a 24 h milk profile study with pre-/post-feed milk samples collection. The true infant intake (control group) based on 24 h milk intake (MI) was compared to estimated infant intakes using concentrations from five sampling protocols that were multiplied by one of true infant MI, considered mean MI (800 mL), or global mean MI (766 mL). The mean measured concentrations of six samples (three sets of pre- and post-feed samples, from morning (06:00-09:00), afternoon (13:00-16:00), and evening (19:00-22:00)) multiplied by the true infant MI, mean considered MI, and global mean MI produced the most accurate estimates of infant intake of these components. Therefore, in the absence of 24 h measurements and sampling, a sampling protocol comprising three sets of pre-/post-feed samples provides the most reliable infant intake estimates of HM leptin, adiponectin, insulin, glucose, and total lipid.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- School of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or (M.A.S.); (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- ABREAST Network, Perth, WA 6000, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
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Reyes SM, Brockway MM, McDermid JM, Chan D, Granger M, Refvik R, Sidhu KK, Musse S, Monnin C, Lotoski L, Geddes DT, Jehan F, Kolsteren P, Allen LH, Hampel D, Eriksen KG, Rodriguez N, Azad MB. Human Milk Micronutrients and Child Growth and Body Composition in the First 2 years: A Systematic Review. Adv Nutr 2024; 15:100082. [PMID: 37315898 PMCID: PMC10831887 DOI: 10.1016/j.advnut.2023.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023] Open
Abstract
Human milk (HM) provides a plethora of nutritional and non-nutritional compounds that support infant development. For many compounds, concentrations vary substantially among mothers and across lactation, and their impact on infant growth is poorly understood. We systematically searched MEDLINE, Embase, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born infants. Outcomes included weight-for-length, length-for-age, weight-for-age, body mass index (in kg/m2)-for-age, and growth velocity. From 9992 abstracts screened, 144 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Micronutrients (vitamins and minerals) are reported here, based on 28 articles involving 2526 mother-infant dyads. Studies varied markedly in their designs, sampling times, geographic and socioeconomic settings, reporting practices, and the HM analytes and infant anthropometrics measured. Meta-analysis was not possible because data were sparse for most micronutrients. The most-studied minerals were zinc (15 articles, 1423 dyads) and calcium (7 articles, 714 dyads). HM iodine, manganese, calcium, and zinc concentrations were positively associated with several outcomes (each in ≥2 studies), whereas magnesium (in a single study) was negatively associated with linear growth during early lactation. However, few studies measured HM intake, adjusted for confounders, provided adequate information about complementary and formula feeding, or adequately described HM collection protocols. Only 4 studies (17%) had high overall quality scores. The biological functions of individual HM micronutrients are likely influenced by other HM components; yet, only 1 study analyzed data from multiple micronutrients simultaneously, and few addressed other HM components. Thus, available evidence on this topic is largely inconclusive and fails to address the complex composition of HM. High-quality research employing chronobiology and systems biology approaches is required to understand how HM components work independently and together to influence infant growth and to identify new avenues for future maternal, newborn, or infant nutritional interventions.
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Affiliation(s)
- Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Deborah Chan
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Larisa Lotoski
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Donna T Geddes
- School of Molecular Sciences, the University of Western Australia, Perth, Western Australia, Australia
| | - Fyezah Jehan
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Lindsay H Allen
- Department of Nutrition, University of California, Davis, Davis, CA, USA; United States Department of Agriculture, Western Human Nutrition Research Center, Agriculture Research Service, Davis, CA, USA
| | - Daniela Hampel
- Department of Nutrition, University of California, Davis, Davis, CA, USA; United States Department of Agriculture, Western Human Nutrition Research Center, Agriculture Research Service, Davis, CA, USA
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Brockway MM, Daniel AI, Reyes SM, Gauglitz JM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes DT, Jehan F, Kolsteren P, Bode L, Eriksen KG, Allen LH, Hampel D, Rodriguez N, Azad MB. Human Milk Bioactive Components and Child Growth and Body Composition in the First 2 Years: A Systematic Review. Adv Nutr 2024; 15:100127. [PMID: 37802214 PMCID: PMC10831900 DOI: 10.1016/j.advnut.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
Human milk (HM) contains macronutrients, micronutrients, and a multitude of other bioactive factors, which can have a long-term impact on infant growth and development. We systematically searched MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born infants. From 9992 abstracts screened, 141 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Bioactives including hormones, HM oligosaccharides (HMOs), and immunomodulatory components are reported here, based on 75 articles from 69 unique studies reporting observations from 9980 dyads. Research designs, milk collection strategies, sampling times, geographic and socioeconomic settings, reporting practices, and outcomes varied considerably. Meta-analyses were not possible because data collection times and reporting were inconsistent among the studies included. Few measured infant HM intake, adjusted for confounders, precisely captured breastfeeding exclusivity, or adequately described HM collection protocols. Only 5 studies (6%) had high overall quality scores. Hormones were the most extensively examined bioactive with 46 articles (n = 6773 dyads), compared with 13 (n = 2640 dyads) for HMOs and 12 (n = 1422 dyads) for immunomodulatory components. Two studies conducted untargeted metabolomics. Leptin and adiponectin demonstrated inverse associations with infant growth, although several studies found no associations. No consistent associations were found between individual HMOs and infant growth outcomes. Among immunomodulatory components in HM, IL-6 demonstrated inverse relationships with infant growth. Current research on HM bioactives is largely inconclusive and is insufficient to address the complex composition of HM. Future research should ideally capture HM intake, use biologically relevant anthropometrics, and integrate components across categories, embracing a systems biology approach to better understand how HM components work independently and synergistically to influence infant growth.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Allison I Daniel
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | | | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Deborah Chan
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, Unites States
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Larisa Lotoski
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Fyezah Jehan
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Lars Bode
- Department of Pediatrics, Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego (UC San Diego), San Diego, CA, United States
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Lindsay H Allen
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Daniela Hampel
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Jin X, Perrella SL, Lai CT, Taylor NL, Geddes DT. Causes of Low Milk Supply: The Roles of Estrogens, Progesterone, and Related External Factors. Adv Nutr 2024; 15:100129. [PMID: 37832920 PMCID: PMC10831895 DOI: 10.1016/j.advnut.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
Low milk supply (LMS) poses a significant challenge to exclusive and continued breastfeeding, affecting ∼10% to 15% of mothers. Milk production is intricately regulated by both endocrine and autocrine control mechanisms, with estrogens and progesterone playing pivotal roles in this process. In addition to endogenously produced hormones, external substances capable of interfering with normal hormonal actions, including phytoestrogens, mycoestrogens, synthetic estrogens, and hormonal contraceptives, can influence milk production. The effects of these extrinsic hormones on milk production may vary based on maternal body mass index. This comprehensive review examines the multifaceted causes of LMS, focusing on the involvement of estrogens, progesterone, and related external factors in milk production. Furthermore, it investigates the interplay between hormonal factors and obesity, aiming to elucidate the endocrine mechanisms underlying obesity-associated LMS. Insights from this review provide valuable perspectives for developing interventions to improve milk production and address the challenges associated with LMS.
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Affiliation(s)
- Xuehua Jin
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Nicolas L Taylor
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia; ARC Training Centre in Biomedical Analysis, The University of Western Australia, Crawley, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia; ARC Training Centre in Biomedical Analysis, The University of Western Australia, Crawley, Western Australia, Australia. donna@
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Arishi RA, Lai CT, Geddes DT, Stinson LF. Impact of breastfeeding and other early-life factors on the development of the oral microbiome. Front Microbiol 2023; 14:1236601. [PMID: 37744908 PMCID: PMC10513450 DOI: 10.3389/fmicb.2023.1236601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
The oral cavity is home to the second most diverse microbiome in the human body. This community contributes to both oral and systemic health. Acquisition and development of the oral microbiome is a dynamic process that occurs over early life; however, data regarding longitudinal assembly of the infant oral microbiome is scarce. While numerous factors have been associated with the composition of the infant oral microbiome, early feeding practices (breastfeeding and the introduction of solids) appear to be the strongest determinants of the infant oral microbiome. In the present review, we draw together data on the maternal, infant, and environmental factors linked to the composition of the infant oral microbiome, with a focus on early nutrition. Given evidence that breastfeeding powerfully shapes the infant oral microbiome, the review explores potential mechanisms through which human milk components, including microbes, metabolites, oligosaccharides, and antimicrobial proteins, may interact with and shape the infant oral microbiome. Infancy is a unique period for the oral microbiome. By enhancing our understanding of oral microbiome assembly in early life, we may better support both oral and systemic health throughout the lifespan.
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Affiliation(s)
- Roaa A. Arishi
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Ching T. Lai
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
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Suwaydi MA, Lai CT, Rea A, Gridneva Z, Perrella SL, Wlodek ME, Geddes DT. Circadian Variation in Human Milk Hormones and Macronutrients. Nutrients 2023; 15:3729. [PMID: 37686759 PMCID: PMC10490050 DOI: 10.3390/nu15173729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
There is an inadequate understanding of the daily variations in hormones and macronutrients in human milk (HM), and sample collection protocols vary considerably from study to study. To investigate changes in these milk components across 24 h, 22 lactating women collected small milk samples before and after each breastfeed or expression from each breast. Test weighing was used to determine the volume of HM consumed in each feed. The concentrations of leptin, adiponectin, insulin, fat, and glucose were measured, and the intakes were calculated. A linear mixed model was fitted to assess within-feed and circadian variation in HM feed volume and concentration, and intakes of several components. The average infant intake of HM was 879 g/24 h. Significantly higher pre-feed concentrations were found for adiponectin and glucose and lower post-feed concentrations were found for insulin and fat. Significant circadian rhythms were displayed for leptin, adiponectin, insulin, glucose (both concentration and intake), fat concentration, and milk volume. These findings demonstrate the necessity for setting up standardised and rigorous sampling procedures that consider both within-feed and circadian variations in HM components to gain a more precise understanding of the impacts of these components on infant health, growth and development.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- School of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Alethea Rea
- Mathematics and Statistics, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia;
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
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10
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Binte Abu Bakar SY, Salim M, Clulow AJ, Seibt S, Landersdorfer CB, Geddes DT, Nicholas KR, Boyd BJ. Construction of a Synthetic Colostrum Substitute and Its Protection of Intestinal Cells against Inflammation in an In Vitro Model of Necrotizing Enterocolitis. ACS Appl Mater Interfaces 2023. [PMID: 37480336 DOI: 10.1021/acsami.3c05012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Colostrum provides bioactive components that are essential for the colonization of microbiota in the infant gut, while preventing infectious diseases such as necrotizing enterocolitis. As colostrum is not always available from the mother, particularly for premature infants, effective and safe substitutes are keenly sought after by neonatologists. The benefits of bioactive factors in colostrum are recognized; however, there have been no accounts of human colostrum being studied during digestion of the lipid components or their self-assembly in gastrointestinal environments. Due to the weaker bile pool in infants than adults, evaluating the lipid composition of human colostrum and linking it to structural self-assembly behavior is important in these settings and thus enabling the formulation of substitutes for colostrum. This study is aimed at the rational design of an appropriate lipid component for a colostrum substitute and determining the ability of this formulation to reduce inflammation in intestinal cells. Gas chromatography was utilized to map lipid composition. The self-assembly of lipid components occurring during digestion of colostrum was monitored using small-angle X-ray scattering for comparison with substitute mixtures containing pure triglyceride lipids based on their abundance in colostrum. The digestion profiles of human colostrum and the substitute mixtures were similar. Subtle differences in lipid self-assembly were evident, with the substitute mixtures exhibiting additional non-lamellar phases, which were not seen for human colostrum. The difference is attributable to the distribution of free fatty acids released during digestion. The biological markers of necrotizing enterocolitis were modulated in cells that were treated with bifidobacteria cultured on colostrum substitute mixtures, compared to those treated with infant formula. These findings provide an insight into a colostrum substitute mixture that resembles human colostrum in terms of composition and structural behavior during digestion and potentially reduces some of the characteristics associated with necrotizing enterocolitis.
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Affiliation(s)
- Syaza Y Binte Abu Bakar
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Malinda Salim
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Andrew J Clulow
- Australian Synchrotron, ANSTO, 800 Blackburn Road, Clayton, Victoria 3168, Australia
| | - Susanne Seibt
- Australian Synchrotron, ANSTO, 800 Blackburn Road, Clayton, Victoria 3168, Australia
| | - Cornelia B Landersdorfer
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Donna T Geddes
- School of Molecular Science, The University of Western Australia, M310, 25 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Kevin R Nicholas
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Ben J Boyd
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
- Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 København Ø, Denmark
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11
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Abstract
Human milk is the optimal nutrition source for infants and contains a complex mix of bioactive compounds and microorganisms. When unavailable, pasteurised donor milk may be provided, particularly to preterm infants. Holder pasteurisation (HP) is typically implemented in human milk banks to prevent pathogen transmission. Given the impact of heat on milk bioactives, ultraviolet-C irradiation (UV-C) is an alternative being explored and has demonstrated effective bactericidal activity. In addition to bacteria, milk contains viruses including primarily bacteriophages (phages) and which likely influence the developing bacterial microbiome of infants. However, the effect of pasteurisation on human milk phages is unknown. This study assessed the effect of HP and UV-C on titres of exogenous bacteriophages inoculated into human milk. Ten donor human milk samples were tested in parallel with water controls. Milk samples or water controls were inoculated to a final concentration of 1 × 104 PFU/mL (±1 log) each of a thermotolerant Escherichia coli phage (T4) and a thermosensitive Staphylococcus aureus phage (BYJ20) and subjected to HP and UV-C treatments. UV-C inactivated both phages within milk and water controls, however, HP was ineffective against the thermotolerant T4 phages. Initial data suggests that UV-C treatment may eliminate phage with potential to affect preterm infant gut colonization. Further studies should extend this to other phages.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Lucy L Furfaro
- Division of Obstetrics and Gynaecology, Medical School, The University of Western Australia, Perth, Australia
- Women and Infants Research Foundation, Subiaco, Australia
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12
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Norrish I, Sindi A, Sakalidis VS, Lai CT, McEachran JL, Tint MT, Perrella SL, Nicol MP, Gridneva Z, Geddes DT. Relationships between the Intakes of Human Milk Components and Body Composition of Breastfed Infants: A Systematic Review. Nutrients 2023; 15:nu15102370. [PMID: 37242254 DOI: 10.3390/nu15102370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Human milk provides all of the elements necessary for infant growth and development. Previous studies have reported associations between breastfeeding and a reduced risk of developing obesity and late-onset metabolic disorders; however, the underlying mechanisms are poorly understood. Recently, intakes of human milk components have been associated with infant body composition, which is likely partially implicated in the reduced risk of developing childhood obesity among breastfed infants. In this systematic review, we searched electronic bibliographic databases for studies that explored relationships between the 24 h intakes of human milk macronutrients and bioactive components and infant body composition and/or growth parameters. Of 13 eligible studies, 10 assessed relationships of infant body composition and growth outcomes with human milk macronutrients, while 8 studies assessed relationships with human milk bioactive components. Significant time-dependent relationships with infant anthropometrics and body composition were found for intakes and no relationships for concentrations of several human milk components, such as lactose, total protein, and human milk oligosaccharides, suggesting that measuring concentrations of human milk components without quantifying the intake by the infant may provide a limited understanding. Future studies investigating the effect of human milk components on infant growth and body composition outcomes should consider measuring the actual intake of components and employ standardised methods for measuring milk intake.
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Affiliation(s)
- Isabella Norrish
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Azhar Sindi
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, WA 6009, Australia
- College of Applied Medical Sciences, Umm Al-Qura University, Makkah 24381-8156, Saudi Arabia
| | - Vanessa S Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Jacki L McEachran
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A * STAR), Singapore 117609, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Mark P Nicol
- School of Biomedical Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
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13
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Sindi AS, Cheema AS, Trevenen ML, Geddes DT, Payne MS, Stinson LF. Characterisation of human milk bacterial DNA profiles in a small cohort of Australian women in relation to infant and maternal factors. PLoS One 2023; 18:e0280960. [PMID: 36696407 PMCID: PMC9876237 DOI: 10.1371/journal.pone.0280960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Human milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.
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Affiliation(s)
- Azhar S Sindi
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ali S Cheema
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Michelle L Trevenen
- Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Women and Infants Research Foundation, Perth, Western Australia, Australia
| | - Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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14
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Stinson LF, Ma J, Sindi AS, Geddes DT. Methodological approaches for studying the human milk microbiome. Nutr Rev 2022; 81:705-715. [PMID: 36130405 DOI: 10.1093/nutrit/nuac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human milk contains a low-biomass, low-diversity microbiome, consisting largely of bacteria. This community is of great research interest in the context of infant health and maternal and mammary health. However, this sample type presents many unique methodological challenges. In particular, there are numerous technical considerations relating to sample collection and storage, DNA extraction and sequencing, viability, and contamination. Failure to properly address these challenges may lead to distortion of bacterial DNA profiles generated from human milk samples, ultimately leading to spurious conclusions. Here, these technical challenges are discussed, and various methodological approaches used to address them are analyzed. Data were collected from studies in which a breadth of methodological approaches were used, and recommendations for robust and reproducible analysis of the human milk microbiome are proposed. Such methods will ensure high-quality data are produced in this field, ultimately supporting better research outcomes for mothers and infants.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Jie Ma
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Azhar S Sindi
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Perth, Australia.,is with the College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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15
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Suwaydi MA, Zhou X, Perrella SL, Wlodek ME, Lai CT, Gridneva Z, Geddes DT. The Impact of Gestational Diabetes Mellitus on Human Milk Metabolic Hormones: A Systematic Review. Nutrients 2022; 14:nu14173620. [PMID: 36079876 PMCID: PMC9460195 DOI: 10.3390/nu14173620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term health consequences for the infant and mother. Breastfeeding is the recommended mode of feeding as it offers an opportunity to reduce the risk of GDM consequences, likely partially mediated through changes in human milk (HM) composition. This review systematically reviewed 12 identified studies that investigated the impact of GDM on concentrations of HM metabolic hormones. Meta-analysis was not possible due to significant heterogeneity in study designs and hormone measurement techniques. The risk of bias was assessed using the National Institute for Clinical Excellence (NICE) tool. The methodological qualities were medium in half of the studies, while 25% (3/12) of studies carried a high risk of bias. Significant relationships were reported between GDM and concentrations of HM ghrelin (3/3 studies), insulin (2/4), and adiponectin (2/6), which may play an integral role in infant growth and development. In conclusion, preliminary evidence suggests that GDM may alter HM metabolic hormone concentrations; however, these relationships may be limited to the early lactation stage.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan 54142, Saudi Arabia
| | - Xiaojie Zhou
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Population Health, Murdoch Children’s Research Institute (MCRI), Parkville, VI 3052, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
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16
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Sindi AS, Stinson LF, Lean SS, Chooi YH, Leghi GE, Netting MJ, Wlodek ME, Muhlhausler BS, Geddes DT, Payne MS. Effect of a reduced fat and sugar maternal dietary intervention during lactation on the infant gut microbiome. Front Microbiol 2022; 13:900702. [PMID: 36060782 PMCID: PMC9428759 DOI: 10.3389/fmicb.2022.900702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveA growing body of literature has shown that maternal diet during pregnancy is associated with infant gut bacterial composition. However, whether maternal diet during lactation affects the exclusively breastfed infant gut microbiome remains understudied. This study sets out to determine whether a two-week of a reduced fat and sugar maternal dietary intervention during lactation is associated with changes in the infant gut microbiome composition and function.DesignStool samples were collected from four female and six male (n = 10) infants immediately before and after the intervention. Maternal baseline diet from healthy mothers aged 22–37 was assessed using 24-h dietary recall. During the 2-week dietary intervention, mothers were provided with meals and their dietary intake was calculated using FoodWorks 10 Software. Shotgun metagenomic sequencing was used to characterize the infant gut microbiome composition and function.ResultsIn all but one participant, maternal fat and sugar intake during the intervention were significantly lower than at baseline. The functional capacity of the infant gut microbiome was significantly altered by the intervention, with increased levels of genes associated with 28 bacterial metabolic pathways involved in biosynthesis of vitamins (p = 0.003), amino acids (p = 0.005), carbohydrates (p = 0.01), and fatty acids and lipids (p = 0.01). Although the dietary intervention did not affect the bacterial composition of the infant gut microbiome, relative difference in maternal fiber intake was positively associated with increased abundance of genes involved in biosynthesis of storage compounds (p = 0.016), such as cyanophycin. Relative difference in maternal protein intake was negatively associated with Veillonella parvula (p = 0.006), while positively associated with Klebsiella michiganensis (p = 0.047). Relative difference in maternal sugar intake was positively associated with Lactobacillus paracasei (p = 0.022). Relative difference in maternal fat intake was positively associated with genes involved in the biosynthesis of storage compounds (p = 0.015), fatty acid and lipid (p = 0.039), and metabolic regulator (p = 0.038) metabolic pathways.ConclusionThis pilot study demonstrates that a short-term maternal dietary intervention during lactation can significantly alter the functional potential, but not bacterial taxonomy, of the breastfed infant gut microbiome. While the overall diet itself was not able to change the composition of the infant gut microbiome, changes in intakes of maternal protein and sugar during lactation were correlated with changes in the relative abundances of certain bacterial species.Clinical trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12619000606189).
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Affiliation(s)
- Azhar S. Sindi
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, WA, Australia
- College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Soo Sum Lean
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Yit-Heng Chooi
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Gabriela E. Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - Merryn J. Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Discipline of Pediatrics, The University of Adelaide, Adelaide, SA, Australia
- Women’s and Children’s Hospital, Adelaide, SA, Australia
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
- Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, VIC, Australia
| | - Beverly S. Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
- CSIRO, Adelaide, SA, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Matthew S. Payne
- Division of Obstetrics and Gynecology, The University of Western Australia, Perth, WA, Australia
- Women and Infants Research Foundation, Perth, WA, Australia
- *Correspondence: Matthew S. Payne,
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17
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Gridneva Z, George AD, Suwaydi MA, Sindi AS, Jie M, Stinson LF, Geddes DT. Environmental determinants of human milk composition in relation to health outcomes. Acta Paediatr 2022; 111:1121-1126. [PMID: 35067980 DOI: 10.1111/apa.16263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/29/2021] [Accepted: 01/20/2022] [Indexed: 12/11/2022]
Abstract
Humans are exposed to environmental factors at every stage of life including infancy. The aim of this mini-review was to present a narrative of environmental factors influencing human milk composition. Current literature shows lactation is a dynamic process and is responsive to multiple environmental challenges including geographical location, lifestyle, persistent pollutants and maternal factors (ethnicity, diet, stress, allergy and adiposity) that may influence human milk composition in a synergistic manner and should be considered in order to improve infant and maternal outcomes on a populations scale. Further interventional studies on larger international cohorts are needed to elucidate these complex relationships. Lactating women should aim for a healthy lifestyle and maintain a healthy body composition prior to and throughout the reproductive period, including during lactation.
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Affiliation(s)
- Zoya Gridneva
- School of Molecular Sciences The University of Western Australia Crawley Western Australia Australia
- International Society for Research in Human Milk and Lactation Minneapolis MN USA
| | - Alexandra D. George
- International Society for Research in Human Milk and Lactation Minneapolis MN USA
- Metabolomics Laboratory Baker Heart and Diabetes Institute Melbourne Victoria Australia
| | - Majed A. Suwaydi
- School of Molecular Sciences The University of Western Australia Crawley Western Australia Australia
- Department of Medical Laboratory Technology College of Applied Medical Sciences Jazan University Jazan Saudi Arabia
| | - Azhar S. Sindi
- Division of Obstetrics and Gynaecology School of Medicine The University of Western Australia Crawley Western Australia Australia
- College of Applied Medical Sciences Umm Al‐Qura University Makkah Saudi Arabia
| | - Ma Jie
- School of Molecular Sciences The University of Western Australia Crawley Western Australia Australia
| | - Lisa F. Stinson
- School of Molecular Sciences The University of Western Australia Crawley Western Australia Australia
- International Society for Research in Human Milk and Lactation Minneapolis MN USA
| | - Donna T. Geddes
- School of Molecular Sciences The University of Western Australia Crawley Western Australia Australia
- International Society for Research in Human Milk and Lactation Minneapolis MN USA
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18
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Sakalidis VS, Perrella SL, Prosser SA, Geddes DT. Breastfeeding in a COVID-19 world. Curr Opin Clin Nutr Metab Care 2022; 25:188-194. [PMID: 35142722 DOI: 10.1097/mco.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The coronavirus disease 2019 (COVID-19) pandemic has changed the birthing and postnatal experience of women. This review highlights how policy changes have affected pregnant and breastfeeding women, the evidence for continued breastfeeding and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, and how the pandemic's unexpected consequences have affected these women's wellbeing. Additionally, we postulate the future of lactation and perinatal support as the pandemic continues. RECENT FINDINGS Women who have given birth during the pandemic have had restricted access to postnatal care. Although pregnant and breastfeeding women who contract SARS-CoV-2 are more vulnerable to poor health outcomes than their nonpregnant counterparts, they are also at higher risk of mental health difficulties, with limited access to support. Continued breastfeeding may be protective to the infant, offering passive immunity against SARS-CoV-2, and vaccination against COVID-19 is safe and effective for pregnant and lactating women. Innovative and adaptable lactation care, including holistic perinatal, mental health, and social support services, both digital and in-person, will help mothers continue breastfeeding during future outbreaks. SUMMARY Continued breastfeeding and vaccination may confer protection to the infant against SARS-CoV-2 infection. New mothers should not be isolated in future pandemics. Prioritizing lactation and perinatal care, including in-person services, remains paramount to optimizing breastfeeding during COVID-19.
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Affiliation(s)
- Vanessa S Sakalidis
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
| | - Sharon L Perrella
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
- One For Women, Mt Lawley, WA, Australia
| | - Stuart A Prosser
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
- One For Women, Mt Lawley, WA, Australia
| | - Donna T Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
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19
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Stinson LF, Trevenen ML, Geddes DT. Effect of Cold Storage on the Viable and Total Bacterial Populations in Human Milk. Nutrients 2022; 14:1875. [PMID: 35565846 PMCID: PMC9099816 DOI: 10.3390/nu14091875] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 01/27/2023] Open
Abstract
Expression and cold storage of human milk is a common practice. Current guidelines for cold storage of expressed milk do not take into account the impact on the milk microbiome. Here, we investigated the impact of cold storage on viable bacterial populations in human milk. Freshly expressed milk samples (n = 10) were collected and analysed immediately, stored at 4 °C for four days, −20 °C for 2.25 months and 6 months, and −80 °C for 6 months. Samples were analysed using propidium monoazide (PMA; a cell viability dye) coupled with full-length 16S rRNA gene. An aliquot of each sample was additionally analysed without PMA to assess the impact of cold storage on the total DNA profile of human milk. Cold storage significantly altered the composition of both the viable microbiome and total bacterial DNA profile, with differences in the relative abundance of several OTUs observed across each storage condition. However, cold storage did not affect the richness nor diversity of the samples (PERMANOVA all p > 0.2). Storage of human milk under typical and recommended conditions results in alterations to the profile of viable bacteria, with potential implications for infant gut colonisation and infant health.
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Affiliation(s)
- Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6000, Australia;
| | - Michelle L. Trevenen
- Centre for Applied Statistics, The University of Western Australia, Perth, WA 6000, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6000, Australia;
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Suwaydi MA, Wlodek ME, Lai CT, Prosser SA, Geddes DT, Perrella SL. Delayed secretory activation and low milk production in women with gestational diabetes: a case series. BMC Pregnancy Childbirth 2022; 22:350. [PMID: 35459144 PMCID: PMC9034612 DOI: 10.1186/s12884-022-04685-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/17/2022] [Indexed: 01/20/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is major pregnancy complication that is associated with short- and long-term consequences for both mother and infant, including increased risk of diabetes later in life. A longer breastfeeding duration has been associated with a reduced risk of diabetes, however, women with GDM are less likely to exclusively breastfeed and have shorter breastfeeding duration. While the timing of breastfeeding initiation and milk removal frequency affects subsequent breastfeeding outcomes, little is known about early infant feeding practices and milk production in women with GDM. This case series offers detailed prospective breastfeeding initiation data, as well as the first report of objective measures of milk production in women with GDM. Case presentation In this case series, we present the early infant feeding practices of eight women with GDM that gave birth at term gestation. Women recorded the timing of initiation of breastfeeding and secretory activation, as well as their breastfeeding, expression and formula feeding frequencies on postpartum days 1, 7 and 21. Measurement of 24 h milk production volume was performed at 3 weeks postpartum using the test weight method. We observed a delayed first breastfeed (> 1 h) in 6 (75%) cases, formula use in hospital in 5 (63%) cases and delayed secretory activation in 3 (38%) cases. At 3 weeks postpartum, 2 cases had measured milk productions that were insufficient to sustain adequate infant weight gain. Conclusions Our data suggest that despite early and frequent milk removal, women with GDM are at greater risk of delayed secretory activation and low milk supply. Cohort studies that consider co-morbidities such as obesity are needed to determine the lactation outcomes of women with GDM.
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Affiliation(s)
- Majed A Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia.,Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Mary E Wlodek
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Stuart A Prosser
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia.,One For Women, Mt Lawley, WA, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia. .,One For Women, Mt Lawley, WA, Australia.
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21
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Gridneva Z, Rea A, Lai CT, Tie WJ, Kugananthan S, Warden AH, Perrella SL, Murray K, Geddes DT. Human Milk Macronutrients and Bioactive Molecules and Development of Regional Fat Depots in Western Australian Infants during the First 12 Months of Lactation. Life (Basel) 2022; 12:life12040493. [PMID: 35454985 PMCID: PMC9029383 DOI: 10.3390/life12040493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/22/2022] [Accepted: 03/26/2022] [Indexed: 12/19/2022] Open
Abstract
We investigated associations between intakes of human milk (HM) components (macronutrients and biologically active molecules) and regional fat depots development in healthy term infants (n = 20) across the first year of lactation. Infant limb (mid-arm and mid-thigh) lean and fat areas were assessed by ultrasound imaging at 2, 5, 9 and 12 months of age. Concentrations of HM total protein, whey protein, casein, adiponectin, leptin, lysozyme, lactoferrin, secretory IGA, total carbohydrates, lactose, HM oligosaccharides (total HMO, calculated) and infant 24-h milk intake were measured, and infant calculated daily intakes (CDI) of HM components were determined. This pilot study shows higher 24-h milk intake was associated with a larger mid-arm fat area (p = 0.024), higher breastfeeding frequency was associated with larger mid-arm (p = 0.008) and mid-thigh (p < 0.001) fat areas. Lysozyme (p = 0.001) and HMO CDI (p = 0.004) were time-dependently associated with the mid-arm fat area. Intakes of HM components and breastfeeding parameters may modulate infant limb fat depots development during the first year of age and potentially promote favorable developmental programming of infant body composition; however, further studies are needed to confirm these findings.
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Affiliation(s)
- Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia;
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Wan Jun Tie
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Sambavi Kugananthan
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Ashleigh H. Warden
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
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22
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Britten FL, Lai CT, Geddes DT, Callaway LK, Duncan EL. Is Secretory Activation Delayed in Women with Type Two Diabetes? A Pilot Study. Nutrients 2022; 14:nu14071323. [PMID: 35405936 PMCID: PMC9002373 DOI: 10.3390/nu14071323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Background: Breastfeeding duration may be reduced in women with type 2 diabetes. Delayed secretory activation (SA) is associated with poorer breastfeeding outcomes; however, no prior studies have examined SA in women with type 2 diabetes. This pilot study aimed to assess SA in women with type 2 diabetes by assessing breastmilk constituents. Secondary aims were to assess breastfeeding rates postpartum, and contributory factors. (2) Methods: A prospective cohort of pregnant women with type 2 diabetes (n = 18) and two control groups with age- and parity-matched nondiabetic pregnant women (body mass index (BMI)) matched (n = 18) or normal-range BMI (n = 18)) were recruited. Breastmilk constituents (citrate, lactose, protein, and fat) were measured twice daily for 5 days postpartum and compared between groups. Associations between peripartum variables, breastmilk constituents, and breastfeeding at 4 months postpartum were explored. (3) Results: Women with type 2 diabetes had a slower increase in breastmilk citrate concentration postpartum, indicative of delayed SA, compared to both control groups. Higher predelivery insulin doses in women with type 2 diabetes were associated with increasing time to SA. Both women with type 2 diabetes and BMI-matched controls were less likely to fully breastfeed at 4 months, compared with normal-BMI controls. (4) Conclusion: SA is delayed in women with type 2 diabetes when compared to BMI-matched and normal-BMI women. Women with type 2 diabetes are less likely to fully breastfeed, at hospital discharge and by 4 months postpartum, compared to women with normal-BMI.
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Affiliation(s)
- Fiona L. Britten
- Department of Obstetric Medicine, Women’s and Newborn Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia;
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4006, Australia
- Correspondence: ; Tel.: +(61)736-468-111
| | - Ching T. Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (D.T.G.)
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (D.T.G.)
| | - Leonie K. Callaway
- Department of Obstetric Medicine, Women’s and Newborn Services, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia;
- Faculty of Medicine, University of Queensland, Brisbane, QLD 4006, Australia
| | - Emma L. Duncan
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London SE1 7EH, UK;
- Department of Endocrinology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
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23
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Stinson LF, Geddes DT. Microbial metabolites: the next frontier in human milk. Trends Microbiol 2022; 30:408-410. [DOI: 10.1016/j.tim.2022.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 12/26/2022]
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24
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Stinson LF, Trevenen ML, Geddes DT. The Viable Microbiome of Human Milk Differs from the Metataxonomic Profile. Nutrients 2021; 13:nu13124445. [PMID: 34959998 PMCID: PMC8708405 DOI: 10.3390/nu13124445] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 12/12/2022] Open
Abstract
Bacteria in human milk contribute to the establishment of the infant gut microbiome. As such, numerous studies have characterized the human milk microbiome using DNA sequencing technologies, particularly 16S rRNA gene sequencing. However, such methods are not able to differentiate between DNA from viable and non-viable bacteria. The extent to which bacterial DNA detected in human milk represents living, biologically active cells is therefore unclear. Here, we characterized both the viable bacterial content and the total bacterial DNA content (derived from viable and non-viable cells) of fresh human milk (n = 10). In order to differentiate the living from the dead, a combination of propidium monoazide (PMA) and full-length 16S rRNA gene sequencing was used. Our results demonstrate that the majority of OTUs recovered from fresh human milk samples (67.3%) reflected DNA from non-viable organisms. PMA-treated samples differed significantly in their bacterial composition compared to untreated samples (PERMANOVA p < 0.0001). Additionally, an OTU mapping to Cutibacterium acnes had a significantly higher relative abundance in PMA-treated (viable) samples. These results demonstrate that the total bacterial DNA content of human milk is not representative of the viable human milk microbiome. Our findings raise questions about the validity of conclusions drawn from previous studies in which viability testing was not used, and have broad implications for the design of future work in this field.
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Affiliation(s)
- Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley 6009, Australia;
- Correspondence:
| | - Michelle L. Trevenen
- Centre for Applied Statistics, The University of Western Australia, Crawley 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley 6009, Australia;
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25
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Cheema AS, Stinson LF, Rea A, Lai CT, Payne MS, Murray K, Geddes DT, Gridneva Z. Human Milk Lactose, Insulin, and Glucose Relative to Infant Body Composition during Exclusive Breastfeeding. Nutrients 2021; 13:nu13113724. [PMID: 34835980 PMCID: PMC8625960 DOI: 10.3390/nu13113724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/27/2022] Open
Abstract
Human milk (HM) components may influence infant growth and development. This study aimed to investigate relationships between infant body composition (BC) and HM lactose, insulin, and glucose (concentrations and calculated daily intakes (CDI)) as well as 24-h milk intake and maternal BC at 3 months postpartum. HM samples were collected at 2 months postpartum. Infant and maternal BC was assessed with bioimpedance spectroscopy. Statistical analysis used linear regression accounting for infant birth weight. 24-h milk intake and CDI of lactose were positively associated with infant anthropometry, lean body mass and adiposity. Higher maternal BC measures were associated with lower infant anthropometry, z-scores, lean body mass, and adiposity. Maternal characteristics including BC and age were associated with concentrations and CDI of HM components, and 24-h milk intake. In conclusion, 24-h intake of HM and lactose as well as maternal adiposity are related to development of infant BC.
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Affiliation(s)
- Ali S. Cheema
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Lisa F. Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia;
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Matthew S. Payne
- Division of Obstetrics and Gynaecology, UWA Medical School, The University of Western Australia, Crawley, WA 6009, Australia;
- Women and Infants Research Foundation, Subiaco, WA 6008, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.S.C.); (L.F.S.); (C.T.L.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
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26
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Bilston-John SH, Narayanan A, Lai CT, Rea A, Joseph J, Geddes DT. Macro- and Trace-Element Intake from Human Milk in Australian Infants: Inadequacy with Respect to National Recommendations. Nutrients 2021; 13:nu13103548. [PMID: 34684549 PMCID: PMC8537127 DOI: 10.3390/nu13103548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
Longitudinal variations of macro- and trace elements in human milk (HM) are not well characterised, and therefore, the recommendations for intake for Australian infants require more evidence to ensure accuracy. We aimed to investigate the longitudinal variation of HM macro- and trace-element concentrations (1-12 months) and infant intake (1-6 months) and to investigate the relationships between intake and infant growth parameters at 3 and 6 months, and determine if intake was sufficient when compared to national guidelines. HM samples were collected monthly for the first 6 months and then at 9 and 12 months postpartum from mother-infant dyads (n = 83). Test-weighing was used to determine the volume of HM consumed daily. Element concentrations (Na, Ca, K, Mg, P, I, Se, Zn, Cu, Mn, Mo, and Fe) were measured using ICP-MS, and intake was calculated using the measured concentrations and the volume of HM consumed. The average intake of HM was 776.3 ± 24.0 mL for the infants. Changes in concentration from months 1 to 12 postpartum were observed for all the measured micronutrients (all p < 0.05). The calculated intakes of all the macro- and trace elements showed that 0% to 82% of infants met the current adequate recommendations at varying periods of lactation. The calculated macro- and trace-element intakes were below the adequate intake recommendations, suggesting that they are not reflective of healthy infant requirements. These findings suggest the need for larger studies using sensitive analytical techniques and the revision of current recommendations for breastfed infants.
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Affiliation(s)
- Sabrina H. Bilston-John
- School of Molecular Sciences, The University of Western Australia, 35 Stirling Highway, M310 Crawley, Perth 6009, Australia; (S.H.B.-J.); (A.N.); (C.T.L.)
| | - Ardra Narayanan
- School of Molecular Sciences, The University of Western Australia, 35 Stirling Highway, M310 Crawley, Perth 6009, Australia; (S.H.B.-J.); (A.N.); (C.T.L.)
| | - Ching T. Lai
- School of Molecular Sciences, The University of Western Australia, 35 Stirling Highway, M310 Crawley, Perth 6009, Australia; (S.H.B.-J.); (A.N.); (C.T.L.)
| | - Alethea Rea
- School of Mathematics and Statistics, Murdoch University, Perth 6150, Australia;
| | - John Joseph
- Clinical Biochemistry and Pharmacology & Toxicology, PathWest, QEII Network, Perth 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, 35 Stirling Highway, M310 Crawley, Perth 6009, Australia; (S.H.B.-J.); (A.N.); (C.T.L.)
- Correspondence: ; Tel.: +61-8-6488-7006
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Pang WW, Geddes DT, Lai CT, Chan SY, Chan YH, Cheong CY, Fok D, Chua MC, Lim SB, Huang J, Pundir S, Tan KH, Yap F, Godfrey KM, Gluckman PD, Shek LP, Vickers MH, Eriksson JG, Chong YS, Wlodek ME. The association of maternal gestational hyperglycemia with breastfeeding duration and markers of milk production. Am J Clin Nutr 2021; 114:1219-1228. [PMID: 33963740 PMCID: PMC7611668 DOI: 10.1093/ajcn/nqab142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/05/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Previous studies focusing on the association between gestational diabetes and breastfeeding duration have been inconclusive. OBJECTIVES We aimed to determine whether maternal gestational hyperglycemia is associated with the duration of breastfeeding and the concentrations of markers linked to breastmilk production. METHODS Data from the prospective, multiethnic Growing Up in Singapore Towards Healthy Outcomes study were used to assess the association of fasting plasma glucose (FPG) and 2-h postglucose challenge (2hPG) measured at 26-28 wk of gestation with duration of breastfeeding and concentrations of protein, lactose, citrate, sodium, potassium, and zinc in breastmilk 3 wk postpartum. RESULTS Of the 1035 participants, 5.2% and 9.5% had elevated FPG and 2hPG, respectively, consistent with a diagnosis of gestational diabetes mellitus based on International Association of Diabetes and Pregnancy Study Groups criteria. FPG ≥5.1 mmol/L was associated with a crude reduction in median breastfeeding duration of 2.3 mo. In a model adjusted for maternal prepregnancy BMI and intention to breastfeed, FPG ≥5.1 mmol/L predicted earlier termination of any breastfeeding (adjusted HR: 1.47; 95% CI: 1.04, 2.08) but not full breastfeeding (adjusted HR: 1.08; 0.76, 1.55). 2hPG ≥8.5 mmol/L was not significantly associated with the durations of any (adjusted HR: 0.86; 95% CI: 0.62, 1.19) or full (adjusted HR: 0.85; 95% CI: 0.62, 1.18) breastfeeding. Maternal FPG was significantly and positively associated with breastmilk sodium (adjusted coefficient: 1.28; 95% CI: 1.08, 1.51) and sodium-to-potassium ratio (adjusted coefficient: 1.29; 95% CI: 1.08, 1.54) but not with other measured breastmilk components. CONCLUSIONS Women with FPG ≥5.1 mmol/L during pregnancy breastfeed for a shorter duration. Future work involving measurement of milk production is needed to determine whether low milk production predicts breastfeeding duration among women with elevated FPG. This trial was registered at www.clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Western Australia, Australia
| | - Ching-Tat Lai
- School of Molecular Sciences, The University of Western Australia, Western Australia, Australia
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Yiong Huak Chan
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Clara Y. Cheong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Doris Fok
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mei Chien Chua
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore
| | - Sok Bee Lim
- Department of Child Development, KK Women’s & Children’s Hospital, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shikha Pundir
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore,Duke-NUS Medical School, Singapore
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, UK,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore
| | - Mark H. Vickers
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Johan G. Eriksson
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland,Folkhälsan Research Center, Helsinki, Finland
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mary E. Wlodek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Department of Physiology, School of Biomedical Science, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
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28
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George AD, Gay MCL, Selvalatchmanan J, Torta F, Bendt AK, Wenk MR, Murray K, Wlodek ME, Geddes DT. Healthy Breastfeeding Infants Consume Different Quantities of Milk Fat Globule Membrane Lipids. Nutrients 2021; 13:nu13092951. [PMID: 34578827 PMCID: PMC8471100 DOI: 10.3390/nu13092951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 01/13/2023] Open
Abstract
The human milk fat globule membrane (MFGM) contains important lipids for growing infants. Anthropometric measurements, milk samples, and infant milk intake were collected in a cohort of eleven healthy mother–infant dyads during exclusive breastfeeding from birth to six months. One hundred and sixty-six MFGM lipids were analysed using liquid chromatography-mass spectrometry, and the infant intake was calculated. The concentrations and intake were compared and associations between infant intake and growth characteristics explored. The lipid concentrations and infant intake varied widely between mother–infant dyads and between months one and three. The infant intake for many species displayed positive correlations with infant growth, particularly phospholipid species. The high variation in lipid intake is likely an important factor in infant growth, with strong correlations identified between the intake of many MFGM lipids and infant head circumference and weight. This study highlights the need for intake measurements and inclusion in cohort studies to elucidate the role of the human milk lipidome in infant growth and development.
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Affiliation(s)
- Alexandra D. George
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.C.L.G.); (M.E.W.); (D.T.G.)
- Metabolomics Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Correspondence:
| | - Melvin C. L. Gay
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.C.L.G.); (M.E.W.); (D.T.G.)
| | - Jayashree Selvalatchmanan
- Precision Medicine Translational Research Programme and Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (J.S.); (F.T.); (M.R.W.)
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore;
| | - Federico Torta
- Precision Medicine Translational Research Programme and Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (J.S.); (F.T.); (M.R.W.)
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore;
| | - Anne K. Bendt
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore;
| | - Markus R. Wenk
- Precision Medicine Translational Research Programme and Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (J.S.); (F.T.); (M.R.W.)
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore 119077, Singapore;
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Nedlands, WA 6009, Australia;
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.C.L.G.); (M.E.W.); (D.T.G.)
- Department of Physiology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.C.L.G.); (M.E.W.); (D.T.G.)
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Suwaydi MA, Gridneva Z, Perrella SL, Wlodek ME, Lai CT, Geddes DT. Human Milk Metabolic Hormones: Analytical Methods and Current Understanding. Int J Mol Sci 2021; 22:ijms22168708. [PMID: 34445437 PMCID: PMC8395916 DOI: 10.3390/ijms22168708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
Human milk (HM) contains a wide array of peptide hormones including leptin and adiponectin, which are involved in the regulation of infant growth and development. These essential hormones might play an important role in the regulation of metabolic reprogramming of the new-born infant. However, HM hormone studies are sparse and heterogeneous in regard to the study design, sample collection, preparation and analysis methods. This review discussed the limitations of HM hormone analysis highlighting the gaps in pre-analytical and analytical stages. The methods used to quantify HM metabolic hormones (leptin, adiponectin, ghrelin, insulin, obestatin, resistin and apelin) can be classified as immunoassay, immunosensor and chromatography. Immunoassay methods (ELISA and RIA) have been predominantly used in the measurement of these HM hormones. The relative validity parameters of HM hormones analysis are often overlooked in publications, despite the complexity and differences of HM matrix when compared to that of plasma and urine. Therefore, appropriate reports of validation parameters of methodology and instrumentation are crucial for accurate measurements and therefore better understanding of the HM metabolic hormones and their influences on infant outcomes.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan 54142, Saudi Arabia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Population Health, Murdoch Children’s Research Institute (MCRI), Parkville, VIC 3052, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
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30
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Leghi G, Netting MJ, Middleton PF, Wlodek ME, Geddes DT, Muhlhausler BS. The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab046_070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity, including body mass index (BMI) and other measures of adiposity, on the concentrations of macronutrients (fat, protein and lactose) in human milk (HM).
Methods
EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction and quality assessment independently. Meta-analyses of eligible studies were conducted using Review Manager software version 5.3.
Results
A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and 9 studies (872 lactating women) in the quantitative synthesis. The meta-analysis indicated that maternal overweight and obesity were associated with higher concentrations of fat in mature HM (p = 0.01) and lactose in colostrum (p = 0.002). While the qualitative analyses broadly supported the findings of the meta-analysis, the qualitative assessment identified considerable variability in the results between studies and low quality of many of the included studies, making it difficult to draw robust conclusions.
Conclusions
Overall, maternal BMI and adiposity measurements were associated with differences in the concentrations of fat and lactose in HM, however the direction of change was dependent on the stage of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.
Funding Sources
GEL was supported by a FOODplus Early Life Nutrition Scholarship, The University of Adelaide. BSM received a Career Development Award from the National Health and Medical Research Council of Australia (NHMRC).
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Affiliation(s)
- Gabriela Leghi
- School of Agriculture, Food and Wine, The University of Adelaide
| | | | | | - Mary E Wlodek
- Department of Physiology, The University of Melbourne
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia
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31
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Bilston-John SH, Narayanan A, Tat Lai C, Rea A, Joseph J, Geddes DT. Daily and within-feed variation of macro- and trace-element concentrations in human milk and implications for sampling. Food Chem 2021; 363:130179. [PMID: 34166949 DOI: 10.1016/j.foodchem.2021.130179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/20/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Daily variations of macro- and trace-elements in human milk (HM) are not well characterised and sampling protocols are highly variable between studies. OBJECTIVES To investigate diurnal and within-feed variation of HM macro- and trace-elements using pre- and post- feed concentrations and to compare infant intake estimates using limited samples with measured 24-hour intake. METHODS HM Samples were collected pre- and post- every feed in a 24-hour period from 11 mother-infant dyads. Test-weighing was used to determine the volume of HM consumed in each feed. For macro- and trace-elements within-feed and daily variation was measured. Intake estimated from a morning pre-feed sample was compared to the measured milk intake calculated from every feed over 24-hours. Macro- and trace-elements concentrations were measured using ICP-MS. Linear mixed modelling was used for statistical analysis. RESULTS Average intake of HM was 737 ± 63 mL for infants aged 1-6 months and 508 ± 50 for infants aged 6-12 months. Pre- and post-feed HM variation was found for phosphorus, calcium, manganese, iron, copper, zinc, selenium, molybdenum, and iodine (p < 0.05). Variation across 24 h was found for magnesium, phosphorus, potassium, manganese, iron, and selenium (p < 0.05). Estimated intake using morning, pre-feed samples resulted in significantly lower intake when compared to measured milk intake for iron, phosphorus, selenium, and manganese (p < 0.05). CONCLUSION Standardised sampling protocols using large sample volumes and multiple collections over 24-hours provide a calculated intake that is more reflective of actual infant HM macro- and trace-elements intake.
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Affiliation(s)
| | - Ardra Narayanan
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, Australia
| | - John Joseph
- Clinical Biochemistry and Pharmacology & Toxicology, PathWest, QEII Network, Perth, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia.
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Sakalidis VS, Rea A, Perrella SL, McEachran J, Collis G, Miraudo J, Prosser SA, Gibson LY, Silva D, Geddes DT. Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study. Nutrients 2021; 13:1831. [PMID: 34072039 PMCID: PMC8230305 DOI: 10.3390/nu13061831] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/17/2023] Open
Abstract
During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.
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Affiliation(s)
- Vanessa S. Sakalidis
- Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland;
- University of Basel, 4001 Basel, Switzerland
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, WA 6150, Australia;
| | - Sharon L. Perrella
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Jacki McEachran
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
| | - Grace Collis
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | | | - Stuart A. Prosser
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Lisa Y. Gibson
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- The University of Western Australia, Perth, WA 6009, Australia
- School of Health and Medical Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Desiree Silva
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- Health and Medical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Joondalup Health Campus, Perth, WA 6027, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
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Stinson LF, Sindi ASM, Cheema AS, Lai CT, Mühlhäusler BS, Wlodek ME, Payne MS, Geddes DT. The human milk microbiome: who, what, when, where, why, and how? Nutr Rev 2021; 79:529-543. [PMID: 32443154 DOI: 10.1093/nutrit/nuaa029] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human milk (HM) contains an incredible array of microorganisms. These likely contribute to the seeding of the infant gastrointestinal microbiome, thereby influencing infant immune and metabolic development and later-life health. Given the importance of the HM microbiota in this context, there has been an increase in research efforts to characterize this in different populations and in relation to different maternal and infant characteristics. However, despite a decade of intensive research, there remain several unanswered questions in this field. In this review, the "5 W+H" approach (who, what, when, where, why, and how) is used to comprehensively describe the composition, function, and origin of the HM microbiome. Here, existing evidence will be drawn together and critically appraised to highlight avenues for further research, both basic and applied. Perhaps the most interesting of these is the potential to modulate the HM microbiome using pre/probiotics or dietary interventions. Another exciting possibility is the personalization of donor milk for women with insufficient supply. By gaining a deeper understanding of the HM microbiome, opportunities to intervene to optimize infant and lifelong health may be identified.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Azhar S M Sindi
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - Ali S Cheema
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Beverly S Mühlhäusler
- CSIRO, Adelaide, South Australia, Australia, and School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mary E Wlodek
- Department of Physiology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Leghi GE, Lai CT, Narayanan A, Netting MJ, Dymock M, Rea A, Wlodek ME, Geddes DT, Muhlhausler BS. Daily variation of macronutrient concentrations in mature human milk over 3 weeks. Sci Rep 2021; 11:10224. [PMID: 33986316 PMCID: PMC8119942 DOI: 10.1038/s41598-021-89460-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/24/2021] [Indexed: 11/28/2022] Open
Abstract
Human milk (HM) composition is known to be highly variable, both between individuals and across the duration of lactation. It is less clear, however, to what extent fat, lactose and protein concentrations in HM change daily over shorter time periods in mature HM, and no studies have evaluated this to date. The aim of this study was to systematically assess and compare HM macronutrient concentrations in samples collected at different times of day, from left and right breasts and daily across a 3-week period in the same woman. Fifteen lactating women (1.6–4.9 months postpartum) collected daily pre-feed HM samples from both breasts each morning for 21 consecutive days and completed intensive sampling once a week (morning, afternoon and evening samples) during this period. Concentrations of fat, protein and lactose in HM did not differ according to time of day, day of week or breast used for collection. The results of this study suggest that pre-feed samples collected at any point across a 3-week period and from either the left or right breast provide comparable measures of fat, protein and lactose concentrations in mature HM, in pragmatic studies where women are collecting their own HM samples. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12619000606189).
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Affiliation(s)
- Gabriela E Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia
| | - Ching T Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Ardra Narayanan
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Michael Dymock
- Centre for Applied Statistics, University of Western Australia, Perth, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, Australia
| | - Mary E Wlodek
- Department of Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Beverly S Muhlhausler
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, Australia.
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35
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Stinson LF, Ma J, Rea A, Dymock M, Geddes DT. Author Correction: Centrifugation does not remove bacteria from the fat fraction of human milk. Sci Rep 2021; 11:9957. [PMID: 33953231 PMCID: PMC8100291 DOI: 10.1038/s41598-021-88094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Australia.
| | - Jie Ma
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, Australia
| | - Michael Dymock
- Centre for Applied Statistics, The University of Western Australia, Perth, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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Abstract
Background: Nipple pain is a common cause of early cessation of breastfeeding. A nipple shield (shield) is often used to improve breastfeeding comfort. There are concerns that shield use may limit milk transfer. The aims of this study were to determine whether shield use reduces milk transfer and maternal nipple pain. Methods: A within-subject study of two groups of breastfeeding dyads (infants <6 months) was conducted; Control Group (CG): no breastfeeding difficulties; Pain Group (PG) shield used for nipple pain. There were two monitored sessions where shield use was randomized. Test weights and pain questionnaires were completed, and percentage of available milk removed (PAMR) was calculated. Results: Twenty-five PG (6 ± 4 postnatal weeks) and 34 CG (9 ± 6 postnatal weeks) had similar 24-hour milk production (PG: 676 ± 239 mL, CG: 775 ± 162 mL, p = 0.083). PG mean milk transfer volume and PAMR did not differ with shield use (no shield: 46 mL, 59%; shield: 40 mL, 53%, volume p = 0.38, PAMR p = 0.64). CG mean volume and PAMR were reduced with shield use (no shield: 65 mL, 64%; shield: 31 mL, 33%, volume p < 0.001, PAMR p < 0.001). PG pain scores were similar with and without shield use (Visual Analog Scale p = 0.44, McGill p = 0.97). Conclusions: Shield use did not impact either milk production or milk transfer in breastfeeding women experiencing nipple pain.
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Affiliation(s)
- Viviane S Coentro
- Faculty of Science, School of Molecular Sciences, The University of Western Australia, Crawley, Australia
| | - Sharon L Perrella
- Faculty of Science, School of Molecular Sciences, The University of Western Australia, Crawley, Australia
| | - Ching Tat Lai
- Faculty of Science, School of Molecular Sciences, The University of Western Australia, Crawley, Australia
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, Australia
| | - Kevin Murray
- Faculty of Health and Medical Sciences, Population and Global Health, School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Donna T Geddes
- Faculty of Science, School of Molecular Sciences, The University of Western Australia, Crawley, Australia
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37
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Sindi AS, Geddes DT, Wlodek ME, Muhlhausler BS, Payne MS, Stinson LF. Can we modulate the breastfed infant gut microbiota through maternal diet? FEMS Microbiol Rev 2021; 45:6133472. [PMID: 33571360 DOI: 10.1093/femsre/fuab011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/09/2021] [Indexed: 12/11/2022] Open
Abstract
Initial colonisation of the infant gut is robustly influenced by regular ingestion of human milk, a substance that contains microbes, microbial metabolites, immune proteins, and oligosaccharides. Numerous factors have been identified as potential determinants of the human milk and infant gut microbiota, including maternal diet; however, there is limited data on the influence of maternal diet during lactation on either of these. Here, we review the processes thought to contribute to human milk and infant gut bacterial colonisation and provide a basis for considering the role of maternal dietary patterns during lactation in shaping infant gut microbial composition and function. Although only one observational study has directly investigated the influence of maternal diet during lactation on the infant gut microbiome, data from animal studies suggests that modulation of the maternal gut microbiota, via diet or probiotics, may influence the mammary or milk microbiota. Additionally, evidence from human studies suggests that the maternal diet during pregnancy may affect the gut microbiota of the breastfed infant. Together, there is a plausible hypothesis that maternal diet during lactation may influence the infant gut microbiota. If substantiated in further studies, this may present a potential window of opportunity for modulating the infant gut microbiome in early life.
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Affiliation(s)
- Azhar S Sindi
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia.,College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Mary E Wlodek
- Department of Physiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Beverly S Muhlhausler
- CSIRO, Adelaide, South Australia, Australia.,School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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Spatz DL, Davanzo R, Müller JA, Powell R, Rigourd V, Yates A, Geddes DT, van Goudoever JB, Bode L. Promoting and Protecting Human Milk and Breastfeeding in a COVID-19 World. Front Pediatr 2021; 8:633700. [PMID: 33614547 PMCID: PMC7888272 DOI: 10.3389/fped.2020.633700] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/31/2020] [Indexed: 12/18/2022] Open
Abstract
The global COVID-19 pandemic has put enormous stress on healthcare systems and hospital staffing. However, through all this, families will continue to become pregnant, give birth, and breastfeed. Unfortunately, care of the childbearing family has been de-prioritized during the pandemic. Additionally, many healthcare practices during the pandemic have not been positive for the childbearing family or breastfeeding. Despite recommendations from the World Health Organization to promote early, direct breastfeeding and skin to skin contact, these and other recommendations are not being followed in the clinical setting. For example, some mothers have been forced to go through labor and birth alone in some institutions whilst some hospitals have limited or no parental visitation to infants in the NICU. Furthermore, hospitals are discharging mothers and their newborns early, limiting the amount of time that families receive expert lactation care, education, and technical assistance. In addition, some hospitals have furloughed staff or transferred them to COVID-19 wards, further negatively impacting direct care for families and their newborns. We are concerned that these massive changes in the care of childbearing families will be permanently adopted. Instead, we must use the pandemic to underscore the importance of human milk and breastfeeding as lifesaving medical interventions. We challenge healthcare professionals to change the current prenatal and post-birth practice paradigms to protect lactation physiology and to ensure that all families in need receive equal access to evidence-based lactation education, care and technical assistance.
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Affiliation(s)
- Diane L. Spatz
- University of Pennsylvania School of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Riccardo Davanzo
- Institute for Maternal and Child Health Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofolo, Trieste, Italy
| | - Janis A. Müller
- Department of Virology, Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Rebecca Powell
- Division of Infectious Diseases, Department of Medicine, Mount Sinai Hospital, New York, NY, United States
| | - Virginie Rigourd
- Regional Human Milk Bank (Ile de France), Hôpital Necker Enfants Malade, Paris, France
| | - Ann Yates
- International Confederation of Midwives, The Hague, Netherlands
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Johannes B. van Goudoever
- Emma Children's Hospital, Amsterdam University Medical Centers (Amsterdam UMC), Amsterdam, Netherlands
| | - Lars Bode
- Department of Pediatrics and Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego, La Jolla, CA, United States
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Wang A, Koleva P, du Toit E, Geddes DT, Munblit D, Prescott SL, Eggesbø M, Johnson CC, Wegienka G, Shimojo N, Campbell D, Kozyrskyj AL, Slupsky CM. The Milk Metabolome of Non-secretor and Lewis Negative Mothers. Front Nutr 2021; 7:576966. [PMID: 33634158 PMCID: PMC7901958 DOI: 10.3389/fnut.2020.576966] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/30/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: The functional role of milk for the developing neonate is an area of great interest, and a significant amount of research has been done. However, a lot of work remains to fully understand the complexities of milk, and the variations imposed through genetics. It has previously been shown that both secretor (Se) and Lewis blood type (Le) status impacts the human milk oligosaccharide (HMO) content of human milk. While some studies have compared the non-HMO milk metabolome of Se+ and Se− women, none have reported on the non-HMO milk metabolome of Se− and Le– mothers. Method and Results: To determine the differences in the non-HMO milk metabolome between Se–Le– mothers and other HMO phenotypes (Se+Le+, Se+Le–, and Se–Le+), 10 milk samples from 10 lactating mothers were analyzed using nuclear magnetic resonance (NMR) spectroscopy. Se or Le HMO phenotypes were assigned based on the presence and absence of 6 HMOs generated by the Se and Le genes. After classification, 58 milk metabolites were compared among the HMO phenotypes. Principal component analysis (PCA) identified clear separation between Se–Le– milk and the other milks. Fold change analysis demonstrated that the Se–Le– milk had major differences in free fatty acids, free amino acids, and metabolites related to energy metabolism. Conclusion: The results of this brief research report suggest that the milk metabolome of mothers with the Se–Le– phenotype differs in its non-HMO metabolite composition from mothers with other HMO phenotypes.
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Affiliation(s)
- Aidong Wang
- Department of Food Science and Technology, University of California, Davis, Davis, CA, United States.,InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States
| | - Petya Koleva
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Elloise du Toit
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Donna T Geddes
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,School of Molecular Sciences, University of Western Australia, Perth, WA, Australia
| | - Daniel Munblit
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Susan L Prescott
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,The ORIGINS Project, Telethon Kids Institute, Perth Childrens Hospital, University of Western Australia, Crawley, WA, Australia
| | - Merete Eggesbø
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine C Johnson
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, United States
| | - Ganesa Wegienka
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, United States
| | - Naoki Shimojo
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Dianne Campbell
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Allergy and Immunology, Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Anita L Kozyrskyj
- InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Carolyn M Slupsky
- Department of Food Science and Technology, University of California, Davis, Davis, CA, United States.,InVivo Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Nutrition, University of California, Davis, Davis, CA, United States
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40
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Cheema AS, Lai CT, Dymock M, Rae A, Geddes DT, Payne MS, Stinson LF. Impact of expression mode and timing of sample collection, relative to milk ejection, on human milk bacterial DNA profiles. J Appl Microbiol 2021; 131:988-995. [PMID: 33421237 DOI: 10.1111/jam.14998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/21/2020] [Accepted: 01/02/2021] [Indexed: 01/16/2023]
Abstract
AIM To investigate the impact of expression mode: electric breast pump or hand expression, and timing of sample collection: pre- and post-milk ejection on human milk (HM) bacterial DNA profiles. METHODS AND RESULTS Three HM samples from the same breast were collected from 30 breastfeeding mothers: a pre-milk ejection pump-expressed sample (pre-pump), a post-milk ejection pump-expressed sample (post-pump) and a post-milk ejection hand-expressed sample (post-hand). Full-length 16S rRNA gene sequencing was used to assess milk bacterial DNA profiles. Bacterial profiles did not differ significantly based on mode of expression nor timing of sample collection. No significant differences were detected in the relative abundance of any OTUs based on expression condition (pre-pump/ post-pump and post-pump/post-hand) with univariate linear mixed-effects regression analyses (all P-values > 0·01; α = 0·01). Similarly, no difference in richness was observed between sample types (number of observed OTUs: post-pump/post-hand P = 0·13; pre-pump/post-pump P = 0. 45). CONCLUSION Bacterial DNA profiles of HM did not differ according to either expression method or timing of sample collection. SIGNIFICANCE AND IMPACT OF THE STUDY Hand or pump expression can be utilized to collect samples for microbiome studies. This has implications for the design of future HM microbiome studies.
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Affiliation(s)
- A S Cheema
- School of Molecular Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
| | - C T Lai
- School of Molecular Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
| | - M Dymock
- Centre for Applied Statistics, Department of Mathematics and Statistics, Faculty of Engineering and Mathematical Sciences, The University of Western Australia, Perth, WA, Australia
| | - A Rae
- Mathematics and Statistics, School of Engineering and Information Technology, Murdoch University, Perth, WA, Australia
| | - D T Geddes
- School of Molecular Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
| | - M S Payne
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - L F Stinson
- School of Molecular Sciences, Faculty of Science, The University of Western Australia, Perth, WA, Australia
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Abstract
Human milk lipids are among the many nutrients delivered to the infant, providing >50% of the infant's calorie intake. These lipids are highly complex and variable, and bioactive, contributing to infant growth, development, and health. The lipid concentration of milk samples is often measured in human cohorts; however, few studies measure infant intake of milk. Intake is important because it considers the variability of both lipid concentration and infants' consumed volume of milk. Measurement of infants' lipid intake in exclusively breastfeeding infants requires 3 main considerations: human milk sampling protocol (ie, the collection of representative samples); measurement of the infant milk intake, because volume varies widely between infants; and appropriate analytical laboratory methods. The purpose of this review was to provide an overview of existing methodology and demonstrate the importance of measuring infants' lipid intake to understand the impact that human milk lipids have on infant outcomes.
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Affiliation(s)
- Alexandra D George
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Melvin C L Gay
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Mary E Wlodek
- Department of Physiology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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42
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Pundir S, Gridneva Z, Pillai A, Thorstensen EB, Wall CR, Geddes DT, Cameron-Smith D. Human Milk Glucocorticoid Levels Are Associated With Infant Adiposity and Head Circumference Over the First Year of Life. Front Nutr 2020; 7:166. [PMID: 33015131 PMCID: PMC7516011 DOI: 10.3389/fnut.2020.00166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Human milk (HM) is a complex and dynamic biological fluid, which contains appreciable concentrations of the glucocorticoids, cortisol and cortisone. Experimental studies in non-human primates suggest the HM glucocorticoids' impact on infant growth and body composition. In this current study, analysis is made of the relationships between HM glucocorticoid concentrations and the infant growth and development over the first year of life. HM was collected by lactating healthy women (n = 18), using a standardized protocol, at 2, 5, 9, and 12 months after childbirth. Cortisol and cortisone concentrations in the HM were measured using liquid chromatography mass spectrometry. Infant weight, length and head circumference were measured by standard protocols and percentage fat mass (% FM) determined by whole body bioimpedance. Cortisol and cortisone concentrations were unaltered over the analyzed lactation period (2–12 months), and were altered by infant sex. Although, HM cortisol was positively associated with infant percentage fat mass (% FM) (p = 0.008) and cortisone positively associated with infant head circumference (p = 0.01). For the first 12 months of life, the concentration of HM glucocorticoids levels was positively associated with infant adiposity (%FM) and head circumference. This preliminary evidence provides insight to a possible relationship between ingested HM glucocorticoids and infant body composition. Further studies are required to determine the mechanisms regulating HM glucocorticoids.
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Affiliation(s)
- Shikha Pundir
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Avinesh Pillai
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Eric B Thorstensen
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Clare R Wall
- Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
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43
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George AD, Gay MCL, Murray K, Muhlhausler BS, Wlodek ME, Geddes DT. Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake. J Nutr 2020; 150:2924-2930. [PMID: 32886106 PMCID: PMC7675139 DOI: 10.1093/jn/nxaa246] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/01/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Human milk (HM) lipid content is highly variable, and infants consume different volumes of milk. This makes precise sampling and calculation of the infant lipid intake problematic. OBJECTIVES In order to describe inaccuracies of estimates of lipid content introduced by various sampling protocols, we compared the true infant lipid intake with estimated intakes using different milk sampling protocols. METHODS Monthly milk samples (n = 1026) from months 1 to 6 of lactation were collected from 20 healthy, exclusively breastfeeding women. Infant lipid intake was measured by 24-hour test-weighing at month 3. Total lipid content was measured by creamatocrit. Concentrations and infant lipid intakes were calculated using 11 sampling protocols, using either the true milk intake or an average of 800 mL/d. These estimates were compared with the true infant lipid intake using repeated-measures ANOVA and linear mixed modeling with multiple comparisons. RESULTS The mean maternal age was 32.0 years (SD ± 3.10), and infants were born term (40.1 ± 1.1 weeks) with a mean birth weight of 3.87 kg (SD ± 0.39). The mean true infant lipid intake was 28.6 g/d (SD ± 9.8). The mean estimated lipid intake using 1 morning pre-feed sample underestimated intake by >8.0 g/d. Estimates of infant lipid intake using other sampling protocols and an assumed intake volume of 800 mL/d also resulted in a wide range of differences (0.8-18.1 g/d) from the true intake. Use of 6 daily pre- and post-feed milk samples had a mean difference of only 0.1 g/d (95% CI, -2.9 to 2.7) from the true intake. CONCLUSIONS A sampling protocol with 6 pre- and post-feed samples provides the most accurate estimate of lipid intake if it is not possible to perform 24-hour test weights. The potential inaccuracies of sampling protocols should be taken into consideration in the interpretation and translation of infant lipid intake results.
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Affiliation(s)
| | - Melvin C L Gay
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Beverly S Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia
- Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia
| | - Mary E Wlodek
- Department of Physiology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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Abstract
BACKGROUND The health and developmental advantages of human milk and breastfeeding are particularly important for infants with Down syndrome. However, they typically have shorter breastfeeding duration due to sucking issues that are not well understood. This case report describes serial measures of milk transfer volumes, sucking dynamics and tongue movement in a breastfeeding infant with Down syndrome. Management of maternal milk production enabled feeding of only breast milk until maturation of breastfeeding skills and the achievement of full breastfeeding by 6 months. CASE PRESENTATION The mother of a term infant with Down syndrome and no associated health complications presented with concerns regarding adequacy of milk removal at the breast and low milk supply. We monitored sucking dynamics during breastfeeding by measuring intraoral vacuum strength, nutritive and non-nutritive suck rates and burst durations, and tongue movement using submental ultrasound. Breastfeeds were monitored at 4, 10, 14, 19 and 24 weeks, and maternal 24 h milk production was measured at 4, 10 and 24 weeks postpartum. We observed a weaker suck strength and shorter nutritive suck duration, and atypical tongue movement up to 19 weeks, with low milk transfer volumes. Regular breast expression was effective in increasing maternal milk production, providing expressed milk for all complementary feeds. Full breastfeeding was achieved by 6 months when reference sucking values were observed. CONCLUSIONS This case report illustrates that infants with Down syndrome may have low intraoral vacuum and limited nutritive sucking that persists for several months, likely due to delayed oro-motor development. In the absence of effective sucking human milk feeding can continue when milk production is stimulated with frequent and adequate breast expression. It is possible for infants with Down syndrome and no associated health complications to eventually establish full breastfeeding. Mothers that wish to breastfeed their infant with Down syndrome require anticipatory guidance and continuing lactation and family support.
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Affiliation(s)
- Viviane Silva Coentro
- School of Molecular Sciences, The University of Western Australia, M310, 35 Stirling Highway, Crawley, 6008, Western Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, M310, 35 Stirling Highway, Crawley, 6008, Western Australia
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, M310, 35 Stirling Highway, Crawley, 6008, Western Australia.
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45
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Cheema AS, Stinson LF, Lai CT, Geddes DT, Payne MS. DNA extraction method influences human milk bacterial profiles. J Appl Microbiol 2020; 130:142-156. [PMID: 32654260 DOI: 10.1111/jam.14780] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/19/2022]
Abstract
AIMS To evaluate four DNA extraction methods to elucidate the most effective method for bacterial DNA recovery from human milk (HM). METHODS AND RESULTS Human milk DNA was extracted using the following methods: (i) Qiagen MagAttract Microbial DNA Isolation Kit (kit QM), (ii) Norgen Milk Bacterial DNA Isolation Kit (kit NM), (iii) Qiagen MagAttract Microbiome DNA/RNA Isolation Kit (kit MM) and (iv) TRIzol LS Reagent (method LS). The full-length 16S rRNA gene was sequenced. Kits MM and method LS were unable to extract detectable levels of DNA in 9/11 samples. Detectable levels of DNA were recovered from all samples using kits NM (mean = 0·68 ng μl-1 ) and QM (mean = 0·55 ng μl-1 ). For kits NM and QM, the greatest number of reads were associated with Staphylococcus epidermidis, Streptococcus vestibularis, Propionibacterium acnes, Veillonella dispar and Rothia mucilaginosa. Contamination profiles varied substantially between kits, with one bacterial species detected in negative extraction controls generated with kit QM and six with kit NM. CONCLUSIONS Kit QM is the most suitable of the kits tested for the extraction of bacterial DNA from human milk. SIGNIFICANCE AND IMPACT OF THE STUDY Choice of extraction method impacts the efficiency of bacterial DNA extraction from human milk and the resultant bacterial community profiles generated from these samples.
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Affiliation(s)
- A S Cheema
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - L F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - C T Lai
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - D T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - M S Payne
- Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, WA, Australia
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46
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Stinson LF, Gay MCL, Koleva PT, Eggesbø M, Johnson CC, Wegienka G, du Toit E, Shimojo N, Munblit D, Campbell DE, Prescott SL, Geddes DT, Kozyrskyj AL. Human Milk From Atopic Mothers Has Lower Levels of Short Chain Fatty Acids. Front Immunol 2020; 11:1427. [PMID: 32903327 PMCID: PMC7396598 DOI: 10.3389/fimmu.2020.01427] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022] Open
Abstract
Short chain fatty acids (SFCAs) are microbial metabolites produced in the gut upon fermentation of dietary fiber. These metabolites interact with the host immune system and can elicit epigenetic effects. There is evidence to suggest that SCFAs may play a role in the developmental programming of immune disorders and obesity, though evidence in humans remains sparse. Here we have quantified human milk (HM) SCFA levels in an international cohort of atopic and non-atopic mothers (n = 109). Our results demonstrate that human milk contains detectable levels of the SCFAs acetate, butyrate, and formate. Samples from atopic mothers had significantly lower concentrations of acetate and butyrate than those of non-atopic mothers. HM SCFA levels in atopic and non-atopic women also varied based on maternal country of residence (Australia, Japan, Norway, South Africa, USA). Reduced exposure to HM SCFA in early life may program atopy or overweight risk in breastfed infants.
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Affiliation(s)
- Lisa F Stinson
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia.,inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States
| | - Melvin C L Gay
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia.,inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States
| | - Petya T Koleva
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Merete Eggesbø
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine C Johnson
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States
| | - Ganesa Wegienka
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States
| | - Elloise du Toit
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Naoki Shimojo
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pediatrics, Chiba University, Chiba, Japan
| | - Daniel Munblit
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Inflammation, Repair and Development Section, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Dianne E Campbell
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Allergy and Immunology, Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Susan L Prescott
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,The ORIGINS Project, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Donna T Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA, Australia.,inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States
| | - Anita L Kozyrskyj
- inVIVO Planetary Health of the Worldwide Universities Network (WUN), West New York, NJ, United States.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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47
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Leghi GE, Middleton PF, Netting MJ, Wlodek ME, Geddes DT, Muhlhausler BS. A Systematic Review of Collection and Analysis of Human Milk for Macronutrient Composition. J Nutr 2020; 150:1652-1670. [PMID: 32240307 DOI: 10.1093/jn/nxaa059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/02/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND As human milk (HM) composition varies by time and across even a single feed, methods of sample collection can significantly affect the results of compositional analyses and complicate comparisons between studies. OBJECTIVE The aim was to compare the results obtained for HM macronutrient composition between studies utilizing different sampling methodologies. The results will be used as a basis to identify the most reliable HM sampling approach. METHODS EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Observational and interventional studies were included, and at least 2 authors screened studies and undertook data extraction. Quality assessment was conducted using the Newcastle-Ottawa scale and previously published pragmatic score. RESULTS A total of 5301 publications were identified from our search, of which 101 studies were included (n = 5049 breastfeeding women). Methods used for HM collection were divided into 3 categories: collection of milk from all feeds over 24 h (32 studies, n = 1309 participants), collection at one time point (62 studies, n = 3432 participants), and "other methods" (7 studies, n = 308 participants). Fat and protein concentrations varied between collection methods within lactation stage, but there were no obvious differences in lactose concentrations. There was substantial variability between studies in other factors potentially impacting HM composition, including stage of lactation, gestational age, and analytical method, which complicated direct comparison of methods. CONCLUSIONS This review describes the first systematic evaluation of sampling methodologies used in studies reporting HM composition and highlights the wide range of collection methods applied in the field. This information provides an important basis for developing recommendations for best practices for HM collection for compositional analysis, which will ultimately allow combination of information from different studies and thus strengthen the body of evidence relating to contemporary HM composition. This trial was registered at PROSPERO as CRD42017072563, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017072563.
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Affiliation(s)
- Gabriela E Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia.,Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Philippa F Middleton
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,Discipline of Pediatrics, The University of Adelaide, Adelaide, Australia
| | - Mary E Wlodek
- Department of Physiology, The University of Melbourne, Melbourne, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Beverly S Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia.,Commonwealth Scientific and Industrial Research Organization (CSIRO), Adelaide, Australia
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48
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Mills N, Lydon A, Davies‐Payne D, Keesing M, Geddes DT, Mirjalili SA. Imaging the breastfeeding swallow: Pilot study utilizing real-time MRI. Laryngoscope Investig Otolaryngol 2020; 5:572-579. [PMID: 32596502 PMCID: PMC7314469 DOI: 10.1002/lio2.397] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/20/2020] [Accepted: 04/29/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Knowledge of the breastfeeding swallow is limited by practical challenges. Radiation exposure to both mother and infant and the radiolucent properties of breastmilk make videofluoroscopy an unsuitable imaging modality. Furthermore, ultrasound is not ideal for capturing the complex 3-dimensional functional anatomy of swallowing. In this study we explore the feasibility of using real-time MRI to capture the breastfeeding swallow. METHODS Prospective observational study: Review of imaging from 12 normal infants (<5 months of age) and their mothers while breastfeeding using real-time MRI. RESULTS Static images were successfully captured in 11 infants and dynamic images in nine infants. This imaging modality confirms the dorsal surface of the infant's tongue elevates the maternal nipple to the hard palate, closing the space around the nipple with no air visible in the oral cavity during sucking and swallowing. We obtained dynamic imaging of mandibular movement with sucking, palatal elevation and pharyngeal constriction with swallowing, diaphragm movement with breathing and milk entering the stomach. Breastmilk was easily visualized, being high intensity on T2 sequences. Technical challenges were encountered secondary to infant movement and difficulties acquiring and maintaining midsagittal orientation. The similarity in tissue densities of the lips, tongue, nipple and hard palate limited definition between these structures. CONCLUSION Real-time MRI imaging was successful in capturing dynamic images of the breastfeeding swallow. However, technical and practical challenges make real-time MRI unlikely at present to be suitable for swallow assessment in clinical practice. Advances in technology and expertise in dynamic image capture may improve the feasibility of using MRI to understand and assess the breastfeeding swallow in the near future. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Nikki Mills
- Paediatric Otolaryngology DepartmentStarship Children's HospitalAucklandNew Zealand
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Anna‐Maria Lydon
- Centre for Advanced MRI, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - David Davies‐Payne
- Paediatric Radiology DepartmentStarship Children's HospitalAucklandNew Zealand
| | - Melissa Keesing
- Paediatric Speech‐language Therapy DepartmentStarship Children's HospitalAucklandNew Zealand
| | - Donna T Geddes
- School of Molecular Sciences, Faculty of ScienceUniversity of Western AustraliaCrawleyWAAustralia
| | - Seyed Ali Mirjalili
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
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Rivera OC, Geddes DT, Barber-Zucker S, Zarivach R, Gagnon A, Soybel DI, Kelleher SL. A common genetic variant in zinc transporter ZnT2 (Thr288Ser) is present in women with low milk volume and alters lysosome function and cell energetics. Am J Physiol Cell Physiol 2020; 318:C1166-C1177. [PMID: 32320289 DOI: 10.1152/ajpcell.00383.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Suboptimal lactation is a common, yet underappreciated cause for early cessation of breastfeeding. Molecular regulation of mammary gland function is critical to the process lactation; however, physiological factors underlying insufficient milk production are poorly understood. The zinc (Zn) transporter ZnT2 is critical for regulation of mammary gland development and maturation during puberty, lactation, and postlactation gland remodeling. Numerous genetic variants in the gene encoding ZnT2 (SLC30A2) are associated with low milk Zn concentration and result in severe Zn deficiency in exclusively breastfed infants. However, the functional impacts of genetic variation in ZnT2 on key mammary epithelial cell functions have not yet been systematically explored at the cellular level. Here we determined a common mutation in SLC30A2/ZnT2 substituting serine for threonine at amino acid 288 (Thr288Ser) was found in 20% of women producing low milk volume (n = 2/10) but was not identified in women producing normal volume. Exploration of cellular consequences in vitro using phosphomimetics showed the serine substitution promoted preferential phosphorylation of ZnT2, driving localization to the lysosome and increasing lysosome biogenesis and acidification. While the substitution did not initiate lysosome-mediated cell death, cellular ATP levels were significantly reduced. Our findings demonstrate the Thr288Ser mutation in SLC30A2/ZnT2 impairs critical functions of mammary epithelial cells and suggest a role for genetic variation in the regulation of milk production and lactation performance.
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Affiliation(s)
- Olivia C Rivera
- Department of Cellular and Molecular Physiology, Penn State Hershey College of Medicine, Hershey, Pennsylvania.,Surgery, Penn State Hershey College of Medicine, Hershey, Pennsylvania
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Shiran Barber-Zucker
- Department of Life Sciences, The National Institute for Biotechnology in the Negev and Ilse Katz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Raz Zarivach
- Department of Life Sciences, The National Institute for Biotechnology in the Negev and Ilse Katz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Annie Gagnon
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
| | - David I Soybel
- Surgery, Penn State Hershey College of Medicine, Hershey, Pennsylvania
| | - Shannon L Kelleher
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts
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Leghi GE, Netting MJ, Middleton PF, Wlodek ME, Geddes DT, Muhlhausler BS. The impact of maternal obesity on human milk macronutrient composition: A systematic review and meta-analysis. Nutrients 2020; 12:nu12040934. [PMID: 32230952 PMCID: PMC7231188 DOI: 10.3390/nu12040934] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022] Open
Abstract
Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.
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Affiliation(s)
- Gabriela E. Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA 5064, Australia;
| | - Merryn J. Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (M.J.N.); (P.F.M.)
- Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Philippa F. Middleton
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (M.J.N.); (P.F.M.)
| | - Mary E. Wlodek
- Department of Physiology, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6009, Australia;
| | - Beverly S. Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA 5064, Australia;
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, SA 5000, Australia
- Correspondence: ; Tel.: +61-8-8305-0697
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