Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain

Elvira Isganaitis, Sarah Venditti, Tucker J. Matthews, Carles Lerin, Ellen W. Demerath, David A. Fields

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


BACKGROUND: Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear.

OBJECTIVES: We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain.

METHODS: This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother-infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography-gas chromatography-mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum.

RESULTS: At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI.

CONCLUSIONS: Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother-child transmission of obesity. This trial was registered at as NCT02535637.

Original languageEnglish (US)
Article numbernqy334
Pages (from-to)111-120
Number of pages10
JournalAmerican Journal of Clinical Nutrition
Issue number1
StatePublished - Jul 1 2019

Bibliographical note

Publisher Copyright:
© American Society for Nutrition 2019.


  • Body composition
  • Breast milk
  • Human milk
  • Human milk oligosaccharides
  • Infant
  • Maternal obesity
  • Metabolomics


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