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Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake.

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.

SUBMITTER: George AD

PROVIDER: S-EPMC7675139 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake.

George Alexandra D AD Gay Melvin C L MCL Murray Kevin K Muhlhausler Beverly S BS Wlodek Mary E ME Geddes Donna T DT

The Journal of nutrition 20201101 11

<h4>Background</h4>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.<h4>Objectives</h4>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.<h4>Methods</h4>Monthly milk samples (n = 1026) from months 1 to 6 of la ...[more]

PMID: 32886106

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Project description:BackgroundBreastfed infants have lower disease risk compared to formula-fed infants, however, the mechanisms behind this protection are unknown. Human milk has a complex lipidome which may have many critical roles in health and disease risk. However, human milk lipidomics is challenging, and research is still required to fully understand the lipidome and to interpret and translate findings. This study aimed to address key human milk lipidome knowledge gaps and discuss possible implications for early life health.MethodsHuman milk samples from two birth cohorts, the Barwon Infant Study (n = 312) and University of Western Australia birth cohort (n = 342), were analysed using four liquid chromatography-mass spectrometry (LC-MS) methods (lipidome, triacylglycerol, total fatty acid, alkylglycerol). Bovine, goat, and soy-based infant formula, and bovine and goat milk were analysed for comparison. Composition was explored as concentrations, relative abundance, and infant lipid intake. Statistical analyses included principal component analysis, mixed effects modelling, and correlation, with false discovery rate correction, to explore human milk lipidome longitudinal trends and inter and intra-individual variation, differences between sample types, lipid intakes, and correlations between infant plasma and human milk lipids.ResultsLipidomics analysis identified 979 lipids. The human milk lipidome was distinct from that of infant formula and animal milk. Ether lipids were of particular interest, as they were significantly higher, in concentration and relative abundance, in human milk than in formula and animal milk, if present in the latter samples at all. Many ether lipids were highest in colostrum, and some changed significantly through lactation. Significant correlations were identified between human milk and infant circulating lipids (40% of which were ether lipids), and specific ether lipid intake by exclusively breastfed infants was 200-fold higher than that of an exclusively formula-fed infant.ConclusionThere are marked differences between the lipidomes of human milk, infant formula, and animal milk, with notable distinctions between ether lipids that are reflected in the infant plasma lipidome. These findings have potential implications for early life health, and may reveal why breast and formula-fed infants are not afforded the same protections. Comprehensive lipidomics studies with outcomes are required to understand the impacts on infant health and tailor translation.

Dataset Information

Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake.

Publications

Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake.

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