Excessive weight gain during full breast-feeding
Maria Grunewald1, Christian Hellmuth, Hans Demmelmair
1Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
Insights
High protein content in breast milk may lead to excessive infant weight gain. This case study suggests variations in milk composition, specifically protein and adiponectin, could influence infant growth patterns, warranting further research.
Area of Science:
- Human lactation and infant nutrition.
- Pediatric endocrinology and growth studies.
Background:
- Breast-feeding is recognized for providing optimal infant nutrition and is linked to reduced obesity.
- However, this case highlights potential risks associated with specific human milk compositions.
Observation:
- An infant born macrosomic experienced rapid, excessive weight gain exceeding the 97th percentile while exclusively breast-fed.
- Weight gain slowed significantly after the introduction of complementary foods, reducing breast milk intake.
Findings:
- Human milk analysis revealed normal levels of lactose, fat, insulin, and carnitine species.
- Elevated adiponectin and significantly higher protein content (1.25 g/dl vs. reference 0.8 g/dl) were observed.
Implications:
- High protein intake in infancy can increase insulin, IGF-1, and promote weight gain, potentially leading to later obesity.
- Interindividual variations in human milk protein and adiponectin may modulate infant growth, contributing to excessive weight gain in some cases.
- Further cohort studies are needed to validate these findings.
Background:
Breast-feeding is considered to offer optimal nutrition for healthy infant growth and development. Observational studies have linked breast-feeding to reduced obesity. CASE OBSERVATION: We observed an infant who was born macrosomic (4.56 kg) and showed excessive weight gain markedly exceeding the 97th percentile of weight during full breast-feeding. At the age of 4 months, the weight was greater than 11 kg. Clinical evaluation did not reveal any underlying pathology. After the introduction of complementary feeding and hence reduction of the breast milk intake, the excessive weight gain was attenuated and the slope of the percentile curve paralleled upper percentiles. Since this pattern suggested full breast-feeding as the driver of excessive weight gain, we analyzed the human milk composition at the infant age of 1 year and compared the results with published data on composition at this stage of lactation.
Results:
The milk contents of lactose, fat, fatty acids, polar lipids, carnitine species, and insulin were similar to the reference data. The adiponectin content was increased. The most remarkable alteration was a high milk protein content (mean 1.25 g/dl, reference 0.8 g/dl).
Conclusions:
A very high protein supply in infancy has been previously shown to increase plasma concentrations of the growth factors insulin and IGF-1, weight gain, and later obesity. We speculate that interindividual variations in human milk adiponectin and protein contents may contribute to modulation of the growth of fully breast-fed infants and in this case may have contributed to excessive weight gain during full breast-feeding. This hypothesis merits being tested in future cohort studies.
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