Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
Centre for Population Health Research, University of Turku, Turku, Finland.
Am J Clin Nutr. 2020 Apr 1;111(4):769-778. doi: 10.1093/ajcn/nqaa010.
Breastfeeding modulates infant growth and protects against the development of obesity. However, whether or not maternal variation in human milk components, such as human milk oligosaccharides (HMOs), is associated with programming of child growth remains unknown.
Our objective was to determine the association between maternal HMO composition and child growth during the first 5 y of life. In addition, the association between maternal prepregnancy BMI and HMO composition was assessed.
Human milk samples from 802 mothers were obtained from a prospective population-based birth cohort study, Steps to healthy development of Children (STEPS), conducted in Turku, Finland. HMO composition in these milk samples was analyzed by HPLC. Child growth data from 3 mo to 5 y were collected from municipal well-baby clinics and linked to maternal HMO composition data to test for associations.
Maternal HMO composition 3 mo after delivery was associated with height and weight during the first 5 y of life in children of secretor mothers. Specifically, HMO diversity and the concentration of lacto-N-neo-tetraose (LNnT) were inversely associated and that of 2'-fucosyllactose (2'FL) was directly associated with child height and weight z scores in a model adjusted for maternal prepregnancy BMI, mode of delivery, birthweight z score, sex, and time. Maternal prepregnancy BMI was associated with HMO composition.
The association between maternal HMO composition and childhood growth may imply a causal relation, which warrants additional testing in preclinical and clinical studies, especially since 2'FL and LNnT are among the HMOs now being added to infant formula. Furthermore, altered HMO composition may mediate the impact of maternal prepregnancy BMI on childhood obesity, which warrants further investigation to establish the cause-and-effect relation.
母乳喂养可调节婴儿的生长速度，并预防肥胖的发生。然而，人乳成分（如人乳寡糖，HMOs）是否与儿童生长的编程有关尚不清楚。
本研究旨在确定母亲 HMO 组成与儿童生命最初 5 年生长之间的关联。此外，还评估了母亲孕前 BMI 与 HMO 组成之间的关系。
从芬兰图尔库进行的一项前瞻性基于人群的出生队列研究“儿童健康发展的步骤”（STEPS）中获得了 802 位母亲的人乳样本。通过 HPLC 分析这些乳样中的 HMO 组成。从 3 个月到 5 岁收集儿童生长数据，并与母亲 HMO 组成数据相关联，以检验关联。
分娩后 3 个月母亲的 HMO 组成与分泌型母亲的儿童生命最初 5 年的身高和体重有关。具体而言，HMO 多样性和乳糖-N-新四糖（LNnT）的浓度与儿童身高和体重 z 分数呈负相关，而 2'-岩藻糖基乳糖（2'FL）与儿童身高和体重 z 分数呈正相关，该模型调整了母亲孕前 BMI、分娩方式、出生体重 z 分数、性别和时间。母亲孕前 BMI 与 HMO 组成有关。
母亲 HMO 组成与儿童生长之间的关联可能暗示存在因果关系，这需要在临床前和临床试验中进行进一步的测试，特别是因为 2'FL 和 LNnT 是目前正在添加到婴儿配方奶粉中的 HMO 之一。此外，改变的 HMO 组成可能介导了母亲孕前 BMI 对儿童肥胖的影响，这需要进一步研究以建立因果关系。
