In examining blood and breastmilk samples from participants enrolled in “The actual zinc and iron intakes among breastfed infants during the first 6 months of life” research project at Ramathibodi Hospital, Mahidol University, researchers at Ludwig-Maximilians-Universität München are exploring whether:
• the amount of nutrients consumed per kilogram of body weight per day by breastfed infants reflects the maternal metabolism and dietary composition, and
• whether the consumed amount of nutrients affects the infant metabolome, growth and health outcomes.

“The study also should be able to identify metabolites that can act as physiological biomarkers for micronutrients such as iron and zinc, thus overcoming the limitations in direct measurements.”
Engy Shokry, PhD, Department of Metabolism and Nutrition, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität, München

Under the direction of Principal Investigator Berthold Koletzko, MD PhD, Professor of Paediatrics, Ludwig-Maximilians-Universität München, and Head, Division of Metabolic & Nutritional Medicine at Dr. von Hauner Children’s Hospital, University of Munich, the research team assesses the samples by precise quantification, and measures consumed breastmilk volume using the deuterium dilution method and breastmilk composition using state-of-the-art biochemical, metabolomic and lipidomic methodologies. This will establish quantitative relationships between the amounts of macro- and micronutrients provided to the mother and their breastfed infants.

Their findings are expected to improve understanding of mechanistic causal pathways, advance knowledge of breastmilk and its metabolic effects, and lead to evidence-based recommendations on maternal dietary intake before and during lactation. FLRF donated EUR 87,000 to the study.

Further reading

Demmelmair H, Koletzko B. Detailed knowledge of maternal and infant factors and human milk composition could inform recommendations for optimal composition. Acta Paediatr [Internet]. 2021. DOI: 10.1111/apa.16174

Usheva N, Lateva M, Galcheva S, Koletzko BV, Cardon G, De Craemer M, et al. Breastfeeding and overweight in European preschoolers: The ToyBox study. Nutrients. 2021;13(8):2880. DOI: 10.3390/nu13082880

Schaefer E, Demmelmair H, Horak J, Holdt L, Grote V, Maar K, et al. Multiple micronutrients, lutein, and docosahexaenoic acid supplementation during lactation: A randomized controlled trial. Nutrients. 2020;12(12):3849. DOI: 10.3390/nu12123849

Bognar Z, De Luca D, Domellöf M, Hadjipanayis A, Haffner D, Johnson M, et al. Promoting breastfeeding and interaction of pediatric associations with providers of nutritional products. Front Pediatr. 2020;8:562870. DOI: 10.3389/fped.2020.562870

Dumrongwongsiri O, Winichagoon P, Chongviriyaphan N, Suthutvoravut U, Grote V, Koletzko B. Determining the actual zinc and iron intakes in breastfed infants: Protocol for a longitudinal observational study. JMIR Res Protoc. 2020;9(11):e19119. DOI: 10.2196/19119

Grunewald M, Hellmuth C, Kirchberg FF, Mearin ML, Auricchio R, Castillejo G, et al. Variation and interdependencies of human milk macronutrients, fatty acids, adiponectin, insulin, and IGF-II in the European PreventCD cohort. Nutrients. 2019;11(9):2034. DOI: 10.3390/nu11092034

Koletzko B, Godfrey KM, Poston L, Szajewska H, van Goudoever JB, de Waard M, et al. Nutrition during pregnancy, lactation and early childhood and its implications for maternal and long-term child health: The early nutrition project recommendations. Ann Nutr Metab. 2019;74(2):93–106. DOI: 10.1159/000496471

Kirchberg FF, Grote V, Gruszfeld D, Socha P, Closa-Monasterolo R, Escribano J, et al. Are all breast-fed infants equal? Clustering metabolomics data to identify predictive risk clusters for childhood obesity. J Pediatr Gastroenterol Nutr. 2019;68(3):408–15. DOI: 10.1097/MPG.0000000000002184

Bravi F, Wiens F, Decarli A, Dal Pont A, Agostoni C, Ferraroni M. Impact of maternal nutrition on breast-milk composition: a systematic review. Am J Clin Nutr. 2016; 104(3):646-662. DOI: 10.3945/ajcn.115.120881.

International Atomic Energy Agency. IAEA human health series No. 7. Stable isotope technique to assess intake of human milk in breastfed infants. Vienna: International Atomic Energy Agency; 2010. 67p.

Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006; 117(3):e387-395. DOI: 10.1542/peds.2005-1417.

Lönnerdal B. Trace element transport in the mammary gland. Annu Rev Nutr. 2007; 27:165-177. DOI:10.1146/annurev.nutr.27.061406.093809.

Nommsen LA, Lovelady CA, Heinig MJ, Lönnerdal B, Dewey KG. Determinants of energy, protein, lipid, and lactose concentrations in humanmilk during the first 12 mo of lactation: the DARLING Study. Am JClinNutr. 1991; 53(2):457-465. DOI: 10.1093/ajcn/53.2.457.

Prentice P, Ong KK, Schoemaker MH, van Tol EA, Vervoort J, Hughes IA et al. Breast milk nutrient content and infancy growth. Acta Paidiatr. 2016; 105(6):641-647. DOI: 10.1111/apa.13362.