Article

Human Milk Glucose, Leptin, and Insulin Predict Cessation of Full Breastfeeding and Initiation of Formula Use

Emily NagelDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USALeslie KummerThe Mayo Clinic, Division of Community Pediatric and Adolescent Medicine, Minneapolis, Minnesota, USADavid R. JacobsDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USALaurie FosterDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USAKaty DuncanDepartment of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USAKelsey E. JohnsonDepartment of Genetics, Cell Biology, and Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USALisa HarnackDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USAJacob L. HaapalaHealthPartners Institute, Bloomington, Minnesota, USAHarmeet KharoudDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USATiffany T. GallagherDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USAElyse O. KharbandaHealthPartners Institute, Bloomington, Minnesota, USAStephanie PierceMaternal-Fetal Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USADavid A. FieldsDepartment of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USAEllen W. DemerathDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA

2021en

ABI

Abstract

Objective: We aimed to investigate prospective associations between milk bioactives related to metabolic health (glucose, insulin, leptin, C reactive protein [CRP], and interleukin 6 [IL-6]) and incident formula initiation at 3 and 6 months postpartum. Design: This study included 363 mother–infant dyads who were fully breastfed at 1 month and participated in the prospective Mothers and Infants Linked for Healthy Growth study from pregnancy to 6 months postpartum. Associations between milk glucose, leptin, insulin, CRP, and IL-6 at 1 and 3 months and incident formula feeding (FF) at 3 and 6 months, respectively, were tested using multiple logistic regression, adjusting for numerous potential confounders such as maternal age and prepregnancy body mass index. Results: At 3 months postpartum, 1-month glucose (odds ratio [OR] 0.45 [95% confidence interval (CI): 0.27–0.75], p ≤ 0.01) and smaller decreases in glucose from 1 to 3 months (OR 0.51 [95% CI: 0.28–0.92], p = 0.03) were associated with lower odds of FF, whereas 1-month leptin (OR 2.30 [95% CI: 1.30–4.07], p < 0.01) and larger increase in insulin (OR 1.86 [95% CI: 1.23–2.81], p < 0.01) and leptin (OR 2.17 [95% CI: 1.29–3.68], p < 0.01) from 1 to 3 months were associated with increased odds of FF. At 6 months, insulin increases (OR 2.08 [95% CI: 1.03–4.17], p = 0.04) were associated with higher odds of FF. Conclusions: In a cohort of women with established lactation, 1-month milk glucose, insulin, and leptin predicted initiation of FF at 3 months. Early milk composition may provide a window into mammary gland function, allowing identification of women at risk of not meeting their breastfeeding goals.

Identifiers

DOI: 10.1089/bfm.2021.0131

Citations and references

Cited by 20 references

Metrics — AkademScholar