Data regarding the association between breast milk composition and infant feeding patterns (frequency and amount of breast milk taken) would help in understanding the regulation of food intake in breastfed infants.
Objective:
This study examined the relationship between breast milk macronutrient concentration and patterns of milk intake in breastfeeding infants over a 24-hour breastfeeding period.
Methods:
Mothers of healthy term infants (n = 15) collected pre- and postfeed breast milk samples from each feed at each breast over a 24-hour period. Breast milk samples were analyzed for fat, lactose, total protein, casein, and whey protein content. The energy content for each feed was calculated.
Results:
Breastfeeding patterns and milk composition varied greatly between individuals. The fat content of milk significantly differed over 24 hours (P = .01), whereas the concentration of lactose and protein content remained the same. The mean 24-hour total protein, whey, and casein intake was inversely (P < .01), whereas lactose concentration was positively (P = .03) related to the number of breast feeds per day. No relationship was seen either between fat or energy content and feeding patterns. The mean (SD) concentration of fat, lactose, and total protein over the 24-hour period was 43 (12) g/L, 68 (7) g/L, and 13 (2) g/L, respectively.
Conclusion:
The association between milk protein intake and the breastfeeding frequency suggests that the protein intake may play a role in infant appetite control.
KentJCMitoulasLRCreganMDRamsayDTDohertyDAHartmannPE. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117:e387-e395.
2.
SieversEOldigsHDSanterRSchaubJ. Feeding patterns in breast-fed and formula-fed infants. Ann Nutr Metab. 2002;46:243-248.
3.
DeweyKGLonnerdalB. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2:497-506.
4.
DalySEOwensRAHartmannPE. The short-term synthesis and infant-regulated removal of milk in lactating women. Exp Physiol. 1993;78:209-220.
5.
DeweyKGLonnerdalB. Infant self-regulation of breast milk intake. Acta Paediatr Scand. 1986;75:893-898.
6.
MathenyRBirchLPiccianoM. Control of intake by human-milk-fed infants: relationships between feeding size and interval. Dev Psychobiol. 1990;23:511-518.
7.
NevilleMCKellerRSeacatJ. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. 1988;48(6):1375-1386.
8.
DoreaJGHornerMRBezerraV. Correlation between changeable human milk constituents and milk intake in breast-fed babies. J Pediatr. 1982;101:80-83.
9.
NysenbaumANSmartJL. Sucking behaviour and milk intake of neonates in relation to milk fat content. Early Hum Dev. 1982;6:205-213.
10.
HuntJN. A possible relation between the regulation of gastric emptying and food intake. Am J Physiol. 1980;239:G1-G4.
11.
KhoshooVBrownS. Gastric emptying of two whey-based formulas of different energy density and its clinical implication in children with volume intolerance. Eur J Clin Nutr. 2002;56:656-658.
12.
FleetIRLinzellJL. A rapid method of estimating fat in very small quantities of milk. J Physiol. 1964;175(suppl):15P-17P.
13.
CzankCSimmerKHartmannP. A method for standardizing the fat content of human milk for use in the neonatal intensive care unit. Int Breastfeed J. 2009;4:3.
14.
MitoulasLRKentJCCoxDBOwensRASherriffJLHartmannPE. Variation in fat, lactose and protein in human milk over 24h and throughout the first year of lactation. Br J Nutr. 2002;88:29-37.
15.
ArthurPGSmithMHartmannPE. Milk lactose, citrate, and glucose as markers of lactogenesis in normal and diabetic women. J Pediatr Gastroenterol Nutr. 1989;9:488-496.
16.
KhanSCasadioYSLaiCT. Investigation of short-term variations in casein and whey proteins in breastmilk of term mothers. J Pediatr Gastroenterol Nutr. 2012Feb6. [Epub ahead of print]
17.
KunzCLonnerdalB. Human milk proteins: separation of whey proteins and their analysis by polyacrylamide gel electrophoresis, fast protein liquid chromatography (FPLC) gel filtration, and anion-exchange chromatography. Am J Clin Nutr. 1989;49:464-470.
18.
KunzCLonnerdalB. Human-milk proteins: analysis of casein and casein subunits by anion-exchange chromatography, gel electrophoresis, and specific staining methods. Am J Clin Nutr. 1990;51:37-46.
19.
AtwoodCSHartmannPE. Collection of fore and hind milk from the sow and the changes in milk composition during suckling. J Dairy Res. 1992;59:287-298.
20.
NevilleMCRobertGJ. Volume and caloric density of human milk. In: JensenRG, ed. Handbook of Milk Composition. San Diego, CA: Academic Press; 1995:99-113.
21.
ArthurPGHartmannPESmithM. Measurement of the milk intake of breast-fed infants. J Pediatr Gastroenterol Nutr. 1987;6:758-763.
22.
DalySEDi RossoAOwensRAHartmannPE. Degree of breast emptying explains changes in the fat content, but not fatty acid composition, of human milk. Exp Physiol. 1993;78(6):741-755.
23.
R Development Core Team. R: A Language and Environment for Statistical Computing [computer program]. Vienna, Austria: R Foundation for Statistical Computing; 2009. http://www.r-project.org
24.
PinheiroJBatesDDebRoySSarkarD; The R Core Team. nlme: Linear and Nonlinear Mixed Effects Models. R Package, Version 3.1-96 [computer program]. Vienna, Austria: R Foundation for Statistical Computing; 2009.
25.
SaarelaTKokkonenJKoivistoM. Macronutrient and energy contents of human milk fractions during the first six months of lactation. Acta Paediatr. 2005;94:1176-1181.
26.
HallB. Uniformity of human milk. Am J Clin Nutr. 1979;32:304-312.
27.
JacksonDAImongSMSilprasertA. Circadian variation in fat concentration of breast-milk in a rural northern Thai population. Br J Nutr. 1988;59:349-363.
28.
CoxDBOwensRAHartmannPE. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996;81:1007-1020.
29.
LubetzkyRMimouniFBDollbergSSalomonMMandelD. Consistent circadian variations in creamatocrit over the first 7 weeks of lactation: a longitudinal study. Breastfeed Med. 2007;2:15-18.
30.
HyttenFE. Clinical and chemical studies in human lactation. Br Med J. 1954;1:175-182.
31.
KentJC. How breastfeeding works. J Midwifery Womens Health. 2007;52:564-570.
32.
AndersonGHMooreSE. Dietary proteins in the regulation of food intake and body weight in humans. J Nutr. 2004;134:974S-979S.
33.
YuYSouthTHuangXF. Inter-meal interval is increased in mice fed a high whey, as opposed to soy and gluten, protein diets. Appetite. 2009;52:372-379.
34.
WeigleDSBreenPAMatthysCC. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr. 2005;82:41-48.
35.
BoirieYDanginMGachonPVassonMPMauboisJLBeaufrereB. Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci U S A. 1997;94:14930-14935.
36.
HallWLMillwardDJLongSJMorganLM. Casein and whey exert different effects on plasma amino acid profiles, gastrointestinal hormone secretion and appetite. Br J Nutr. 2003;89:239-248.
37.
MaheSRoosNBenamouzigR. Gastrojejunal kinetics and the digestion of [15N]beta-lactoglobulin and casein in humans: the influence of the nature and quantity of the protein. Am J Clin Nutr. 1996;63:546-552.
38.
LuhovyyBLAkhavanTAndersonGH. Whey proteins in the regulation of food intake and satiety. J Am Coll Nutr. 2007;26:704S-712S.
39.
KoletzkoBvon KriesRClosaR. Can infant feeding choices modulate later obesity risk?Am J Clin Nutr. 2009;89:1502S-1508S.
40.
AxelssonIEIvarssonSARaihaNC. Protein intake in early infancy: effects on plasma amino acid concentrations, insulin metabolism, and growth. Pediatr Res. 1989;26:614-617.
41.
PalouAPicoC. Leptin intake during lactation prevents obesity and affects food intake and food preferences in later life. Appetite. 2009;52:249-252.
42.
AydinSOzkanYErmanF. Presence of obestatin in breast milk: relationship among obestatin, ghrelin, and leptin in lactating women. Nutrition. 2008;24:689-693.
43.
WoolridgeMWFisherC. Colic, “overfeeding,” and symptoms of lactose malabsorption in the breast-fed baby: a possible artifact of feed management?Lancet. 1988;2:382-384.
44.
NommsenLALoveladyCAHeinigMJLonnerdalBDeweyKG. Determinants of energy, protein, lipid, and lactose concentrations in human milk during the first 12 mo of lactation: the DARLING Study. Am J Clin Nutr. 1991;53:457-465.
45.
HartmannPEMorganSEGArthurPG. Milk let-down and the concentration of fat in breast milk. In: HamoshMGoldmanAS eds. Human Lactation 2:Maternal and Environmental Factors. New York: Plenum; 1986.
46.
LonnerdalB. Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr. 2003;77:1537S-1543S.
47.
KunzCLonnerdalB. Re-evaluation of the whey protein/casein ratio of human milk. Acta Paediatrica. 1992;81:107-112.
