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Nutrition during the early life cycle

The impact of maternal obesity and breast milk inflammation on developmental programming of infant growth



Little is known about how maternal obesity impacts breast milk (BM) composition and how BM composition may impact growth. We sought to determine the role of maternal body mass index (BMI) on BM inflammatory and oxidative stress markers and to delineate the role of these BM markers on infant growth.


This was a secondary analysis of 40 mother-infant dyads. We first assessed the association between maternal BMI and BM marker (omega-6:omega-3 polyunsaturated fatty acid ratio (n-6:n-3 PUFA), leptin, interleukin (IL)-8, IL-6, IL-1β and malondialdehyde (MDA)) concentration at one (V1) and four (V4) months postpartum. We then examined the association between BM markers on infant growth trajectory from birth to seven months.


Higher maternal BMI was associated with higher BM n-6:n-3 PUFA (V1 β = 0.12, 95% CI 0.01, 0.2; V4 β = 0.13, 95% CI 0.01, 0.3) and leptin (V1 β = 107, 95% CI 29, 184; V4 β = 254, 95% CI 105, 403) concentrations. Infants exposed to high BM n-6:n-3 PUFA had higher BMI z-scores over time (p = 0.01). Higher BM leptin was associated with lower infant percent fat mass at V4 (β = −9, 95% CI −17, −0.6). Infants exposed to high BM IL-8, IL-6, or IL-1β had higher weight z-scores over time (IL-8 p < 0.001; IL-6 p < 0.001; IL-1β p = 0.02). There was no association between BM MDA and maternal BMI or infant growth.


Higher maternal BMI is associated with higher BM n-6:n-3 PUFA and leptin concentrations. In addition, higher BM n-6:n-3 PUFA and inflammatory cytokines were associated with accelerated weight gain in infancy.

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Fig. 1: Association between breast milk n-6:n-3 PUFA and infant growth trajectory.


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We would like to thank Dr. Thu Huong Pham and Peter O. Isesele for their expertise in breast milk analyte analysis.


National Institutes of Health (NIH) 5R01HD043921, NIH RR01070, NIH P30 DK040561, NIH/National Center for Advancing Translational Sciences UL1 TR000062.

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All authors were involved in the conceptualization of the study and design. SE and SS carried out analysis of data. SC, RT, and RF carried out experiments. CRM, POG, and CLW provided feedback on the analysis and results. All authors were involved in writing the paper and had final approval of the submitted and published versions.

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Correspondence to Samantha Enstad.

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Enstad, S., Cheema, S., Thomas, R. et al. The impact of maternal obesity and breast milk inflammation on developmental programming of infant growth. Eur J Clin Nutr 75, 180–188 (2021).

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