Adiponectin, leptin and insulin in breast milk: associations with maternal characteristics and infant body composition in the first year of life



Breastfeeding may protect against excessive weight gain during infancy. However, the breast milk components responsible for this effect are unknown. We examined the variation of three breast milk hormones (adiponectin, leptin and insulin) according to maternal characteristics and determined their association with infant body composition.


We studied a representative subset of 430 breastfed infants in the CHILD birth cohort. Breast milk was collected at 4 months postpartum and hormone concentrations were measured using the MesoScale Discovery System. Weight-for-length (WFL) and body mass index (BMI) z-scores were calculated according to the World Health Organization reference standard from infant anthropometrics measured at 4 months and 1 year. Maternal BMI and demographics were self-reported.


Breast milk hormone concentrations varied widely between mothers. The geometric mean (range) was 19.4 (3.7–74.4) ngml−1 for adiponectin; 361 (31–3968) pgml−1 for leptin; and 589 (53–5557) pgml−1 for insulin. Maternal BMI was positively correlated with breast milk insulin (r=+0.40, P<0.0001) and leptin (r=+0.71, P<0.0001), but not adiponectin (r=−0.02, P=0.68). Breast milk hormone concentrations were also associated with maternal ethnicity, parity and breastfeeding exclusivity at sample collection. Independent of these factors and maternal diabetes, smoking and breastfeeding duration, higher breast milk leptin was associated with lower infant WFL z-score at 4 months (β −0.67, 95% confidence interval (CI): −1.17, −0.17 for highest vs lowest quintile) and 1 year (β −0.58, 95% CI: −1.02, −0.14). Insulin showed a U-shaped association, with intermediate concentrations predicting the lowest infant WFL z-score at 4 months (β −0.51, 95% CI: −0.87, −0.15 for third vs lowest quintile) and 1 year (β −0.35, 95% CI: −0.66, −0.04). Similar results were seen with infant BMI. Breast milk adiponectin was not significantly associated with infant body composition.


Breast milk hormone concentrations were associated with several fixed and modifiable maternal characteristics. Higher concentrations of leptin and intermediate concentrations of insulin were associated with lower infant WFL in the first year of life.

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  1. 1

    James WPT . The challenge of childhood obesity. Int J Pediatr Obes 2006; 1: 7–10.

    CAS  Article  PubMed  Google Scholar 

  2. 2

    World Health Organization. Obesity: Preventing and Managing the Global Epidemic. WHO Technical Report Series 894. WHO: Geneva, 2000.

  3. 3

    World Health Organization. Report of the Commission on Ending Childhood Obesity. WHO: Geneva, 2016.

  4. 4

    World Health Organization.Obesity and Overweight. WHO: Geneva, 2014.

  5. 5

    Barker D . The fetal and infant origins of adult disease. Br Med J 1990; 301: 1111.

    CAS  Article  Google Scholar 

  6. 6

    Symonds ME, Sebert SP, Hyatt MA, Budge H . Nutritional programming of the metabolic syndrome. Nat Rev Endocrinol 2009; 5: 604–610.

    CAS  Article  PubMed  Google Scholar 

  7. 7

    Smego A, Woo JG, Klein J, Suh C, Bansal D, Bliss S et al. High body mass index in infancy may predict severe obesity in early childhood. J Pediatr 2017; 183: 87–93.

    Article  PubMed  Google Scholar 

  8. 8

    Horta BL, Victora CG . Long-Term Health Effects of Breastfeeding. World Health Organization: Geneva, 2013; pp 57–64.

  9. 9

    Owen C, Martin R, Whincup P, Davey-Smith G, Gillman M, Cook D . The effect of breastfeeding on mean body mass index throughout life: a quantative review of published and unpublished obsevational evidence. Am J Clin Nutr 2005; 82: 1298–1307.

    CAS  Article  PubMed  Google Scholar 

  10. 10

    Arenz S, Rückerl R, Koletzko B, von Kries R . Breast-feeding and childhood obesity—a systematic review. Int J Obes 2004; 28: 1247–1256.

    CAS  Article  Google Scholar 

  11. 11

    Bartok CJ, Ventura AK . Mechanisms underlying the association between breastfeeding and obesity. Int J Pediatr Obes 2009; 4: 196–204.

    Article  PubMed  Google Scholar 

  12. 12

    Young BE, Johnson SL, Krebs NF . Biological determinants linking infant weight gain and child obesity: current knowledge and future directions. Adv Nutr 2012; 3: 675–686.

    Article  PubMed  Google Scholar 

  13. 13

    Savino F, Benetti S, Liguori SA, Sorrenti M, Cordero Di Montezemolo L . Advances on human milk hormones and protection against obesity. Cell Mol Biol 2013; 59: 89–98.

    CAS  PubMed  Google Scholar 

  14. 14

    Fields DA, Schneider CR, Pavela G . A narrative review of the associations between six bioactive components in breast milk and infant adiposity. Obesity 2016; 24: 1213–1221.

    Article  PubMed  Google Scholar 

  15. 15

    Weyermann M, Brenner H, Rothenbacher D . Adipokines in human milk and risk of overweight in early childhood: a Prospective Cohort Study. Epidemiology 2007; 18: 722–729.

    Article  PubMed  Google Scholar 

  16. 16

    Savino F, Petrucci E, Nanni GE . Adiponectin: an intriguing hormone for paediatricians. Acta Paediatr 2008; 97: 701–705.

    CAS  Article  PubMed  Google Scholar 

  17. 17

    Catli G, Dundar N, Dundar B . Adipokines in breast milk: an update. J Clin Res Pediatr Endocrinol 2014; 6: 192–201.

    Article  PubMed  Google Scholar 

  18. 18

    Friedman JM . Leptin at 14 y of age: an ongoing story. Am J Clin Nutr 2009; 89 (suppl): 973–979.

    Article  Google Scholar 

  19. 19

    Yoneda K, Tomimoto A, Endo H, Iida H, Sugiyama M, Takahashi H et al. Expression of adiponectin receptors, AdipoR1 and AdipoR2, in normal colon epithelium and colon cancer tissue. Oncol Rep 2008; 20: 479–483.

    CAS  PubMed  Google Scholar 

  20. 20

    Barrenetxe J, Villaro AC, Guembe L, Pascual I, Muñoz-Navas M, Barber A et al. Distribution of the long leptin receptor isoform in brush border, basolateral membrane, and cytoplasm of enterocytes. Gut 2002; 50: 797–802.

    CAS  Article  PubMed  Google Scholar 

  21. 21

    Menard D, Corriveau B . Insulin modulates cellular proliferation in developing human jejunum and colon. Biol Neonate 1999; 75: 143–151.

    CAS  Article  PubMed  Google Scholar 

  22. 22

    Andreas NJ, Hyde MJ, Gale C, Parkinson JRC, Jeffries S, Holmes E et al. Effect of maternal body mass index on hormones in breast milk: a systematic review. PLoS ONE 2014; 9: 1–25.

    Article  Google Scholar 

  23. 23

    Subbarao P, Anand SS, Becker AB, Befus AD, Brauer M, Brook JR et al. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma. Thorax 2015; 70: 998–1000.

    Article  PubMed  Google Scholar 

  24. 24

    Woo JG, Lourdes Guerrero M, Guo F, Martin LJ, Davidson BS, Ortega H et al. Human milk adiponectin impacts infant weight trajectory during the second year of life. J Pediatr Gastroenterol Nutr 2012; 54: 532–539.

    CAS  Article  PubMed  Google Scholar 

  25. 25

    Fields DA, Demerath EW . Relationship of insulin, glucose, leptin, IL-6 and TNF-alpha in human breast milk with infant growth and body composition. Pediatr Obes 2012; 7: 304–312.

    CAS  Article  PubMed  Google Scholar 

  26. 26

    Moraes TJ, Lefebvre DL, Chooniedass R, Becker AB, Brook JR, Denburg J et al. The Canadian Healthy Infant Longitudinal Development Birth Cohort Study: biological samples and biobanking. Paediatr Perinat Epidemiol 2015; 29: 84–92.

    CAS  Article  PubMed  Google Scholar 

  27. 27

    Ewaschuk JB, Unger S, Connor DLO, Stone D, Harvey S, Clandinin MT et al. Effect of pasteurization on selected immune components of donated human breast milk. J Perinatol 2011; 31: 593–598.

    CAS  Article  PubMed  Google Scholar 

  28. 28

    WHO. Child growth standards based on length/height, weight, and age. Acta Paediatr Suppl 2006; 450: 76–85.

    Google Scholar 

  29. 29

    WHO Multicenter Growth Reference Study. WHO Child Growth Standards: Length/Height-For-Age, Weight-For-Age, Weight-For-Length, Weight-For-Height and Body Mass Index-For-Age: Methods and Development. World Health Organization: Geneva, Switzerland: 2006.

  30. 30

    Rolland-Cachera MF . Childhood obesity: current definitions and recommendations. Int J Pediatr Obes 2011; 33: 325–331.

    Article  Google Scholar 

  31. 31

    Rifas-Shiman SL, Gillman MW, Oken E, Kleinman K, Taveras EM . Similarity of the CDC and WHO weight-for- length growth charts in predicting risk of obesity at age 5 years. Obesity 2012; 20: 1261–1265.

    Article  PubMed  Google Scholar 

  32. 32

    Roy SM, Spivack JG, Faith MS, Chesi A, Mitchell JA, Struan G et al. Infant BMI or weight-for-length and obesity risk in early childhood. Pediatrics 2016; 137: 1–9.

    Article  Google Scholar 

  33. 33

    Azad M, Sharma A, de Souza R, Dolinsky VW, Becker AB, Mandhane PJ et al. Association between artificially sweetened beverage consumption during pregnancy and infant body mass index. JAMA Pediatr 2016; 170: 662–670.

    Article  PubMed  Google Scholar 

  34. 34

    American Congress of Obstetricians and Gynecologists. Weight gain during pregnancy. Committee Opinion No. 548. Obstet Gynecol 2013; 5: 210–212.

    Google Scholar 

  35. 35

    Schuster S, Hechler C, Gebauer C, Kiess W, Kratzsch J . Leptin in maternal serum and breast milk: association with infants’ body weight gain in a longitudinal study over 6 months of lactation. Pediatr Res 2011; 70: 633–637.

    CAS  Article  PubMed  Google Scholar 

  36. 36

    Doneray H, Orbak Z, Yildiz L . The relationship between breast milk leptin and neonatal weight gain. Acta Paediatr 2009; 98: 643–647.

    CAS  Article  PubMed  Google Scholar 

  37. 37

    Miralles O, Sanchez J, Palou A, Pico C . A physiological role of breast milk leptin in body weight control in developing infants. Obesity 2006; 14: 1371–1377.

    CAS  Article  PubMed  Google Scholar 

  38. 38

    Brunner S, Schmid D, Zang K, Much D, Knoeferl B, Kratzsch J et al. Breast milk leptin and adiponectin in relation to infant body composition up to 2 years. Pediatr Obes 2014; 10: 67–73.

    Article  PubMed  Google Scholar 

  39. 39

    Uçar B, Kirel B, Bör O, Kiliç F, Doğruel N, Aydoğdu S et al. Breast milk leptin concentrations in initial and terminal milk samples: relationships to maternal and infant plasma leptin concentrations, adiposity, serum glucose, insulin, lipid and lipoprotein levels. J Pediatr Endocrinol Metab 2000; 13: 149–159.

    Article  PubMed  Google Scholar 

  40. 40

    Uysal FK, Onal EE, Aral YZ, Adam B, Dilmen U, Ardiçolu Y . Breast milk leptin: its relationship to maternal and infant adiposity. Clin Nutr 2002; 21: 157–160.

    CAS  Article  PubMed  Google Scholar 

  41. 41

    Meyer DM, Brei C, Stecher L, Much D, Brunner S, Hauner H . The relationship between breast milk leptin and adiponectin with child body composition from 3 to 5 years: a follow-up study. Pediatr Obes 2016; 2–6.

  42. 42

    Woo JG, Guerrero ML, Altaye M, Ruiz-Palacios GM, Martin LJ, Dubert-Ferrandon A et al. Human milk adiponectin is associated with infant growth in two independent cohorts. Breastfeed Med 2009; 4: 101–109.

    Article  PubMed  Google Scholar 

  43. 43

    Fields DA, George B, Williams M, Whitaker K, Allison DB, Teague A et al. Associations between human breast milk hormones and adipocytokines and infant growth and body composition in the first 6 months of life. Pediatr Obes 2017; pp 1–8.

  44. 44

    Sánchez J, Priego T, Palou M, Tobaruela A, Palou A, Picó C . Oral supplementation with physiological doses of leptin during lactation in rats improves insulin sensitivity and affects food preferences later in life. Endocrinology 2008; 149: 733–740.

    Article  PubMed  Google Scholar 

  45. 45

    Buts J, De Keyser N, Sokal E, Marandi S . Oral insulin is biologically active on rat immature enterocytes. J Pediatr Gastroenterol Nutr 1997; 25: 230–232.

    CAS  Article  PubMed  Google Scholar 

  46. 46

    Kinouchi T, Koizumi K, Kuwata T, Yajima Y . Milk-borne insulin with trypsin inhibitor in milk induces pancreatic amylase development at the onset of weaning in rats. J Pediatr Gastroenterol Nutr 2000; 30: 515–521.

    CAS  Article  PubMed  Google Scholar 

  47. 47

    Shehadeh N, Wies R, Fishach O, Berant M, Etzioni A, Shamir R . Influence of oral insulin supplementation on carbohydrate, lipid and protein metabolism, in weaned Balb/c mice. J Pediatr Endocrinol Metab 2003; 16: 431–437.

    CAS  Article  PubMed  Google Scholar 

  48. 48

    Lemas DJ, Young BE, Ii PRB, Tomczik AC, Soderborg TK, Hernandez TL et al. Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome. Am J Clin Nutr 2016; 103: 1291–1300.

    CAS  Article  PubMed  Google Scholar 

  49. 49

    Azad M, Konya T, Persaud R, Guttman D, Chari R, Field C et al. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG An Int J Obstet Gynaecol 2016; 123: 983–993.

    CAS  Article  Google Scholar 

  50. 50

    Arrieta M-C, Stiemsma LT, Dimitriu PA, Thorson L, Russell S, Yurist-Doutsch S et al. Early infancy microbial and metabolic alterations affect risk of childhood asthma. Sci Transl Med 2015; 7: 1–14.

    Article  Google Scholar 

  51. 51

    Young BE, Patinkin Z, Palmer C, Houssaye De B, Barbour LA, Hernandez T et al. Human milk insulin is related to maternal plasma insulin and BMI: but other components of human milk do not differ by BMI. Eur J Clin Nutr 2017; 1–7.

  52. 52

    Ley SH, Hanley AJ, Sermer M, Zinman B, O’Connor DL . Associations of prenatal metabolic abnormalities with insulin and adiponectin concentrations in human milk. Am J Clin Nutr 2012; 95: 867–874.

    CAS  Article  PubMed  Google Scholar 

  53. 53

    Hatsu IE, Mcdougald DM, Anderson AK . Effect of infant feeding on maternal body composition. Int Breastfeed J 2008; 3: 1–8.

    Article  Google Scholar 

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We are grateful to all the families who took part in this study, and the whole CHILD team, which includes interviewers, nurses, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers and receptionists. We also thank Drs Atul Sharma and Arthur Owora for their statistical expertise. This research was funded by the Manitoba Medical Service Foundation and the Children’s Hospital Research Institute of Manitoba and supported by the Canadian Institutes of Health Research and the Allergy, Genes and Environment Networks of Centres of Excellence of Canada.

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Correspondence to M B Azad.

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Chan, D., Goruk, S., Becker, A. et al. Adiponectin, leptin and insulin in breast milk: associations with maternal characteristics and infant body composition in the first year of life. Int J Obes 42, 36–43 (2018).

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