Postnatal Leptin Levels Correlate with Breast Milk Leptin Content in Infants Born before 32 Weeks Gestation
Trassanee Chatmethakul1, Mendi L Schmelzel1, Karen J Johnson1
1Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
Insights
Perinatal leptin deficiency in preterm infants may lead to obesity. Maternal milk intake, rich in leptin, supports infant blood leptin levels, suggesting breast milk as a potential obesity prevention therapy.
Area of Science:
- Neonatal nutrition
- Endocrinology
- Pediatric obesity
Background:
- Perinatal leptin deficiency and low maternal milk intake are linked to childhood obesity.
- Preterm infants exhibit reduced leptin production, increasing their risk of neonatal leptin deficiency.
- Fresh human milk contains significantly higher leptin concentrations than donor milk.
Purpose of the Study:
- To investigate the impact of switching from maternal milk to donor milk on blood leptin levels in preterm infants.
- To determine if preterm infants can absorb leptin enterally from human milk.
- To explore the potential of leptin-rich breast milk as an obesity prevention strategy.
Main Methods:
- A 21-day cross-over trial involving preterm infants (22 0/7–31 6/7 weeks gestation).
- Infants received maternal milk for days 1–7 and 15–21, and donor milk for days 8–14.
- Plasma and milk leptin levels were measured, and correlations were analyzed.
Main Results:
- Plasma leptin levels in preterm infants correlated positively with leptin levels in their milk.
- Blood leptin levels did not increase during donor milk feeding.
- A significant increase in plasma leptin was observed upon resuming maternal milk feeding (p < 0.05).
Conclusions:
- Preterm infants demonstrate enteral absorption of leptin from human milk.
- Leptin levels in maternal milk directly influence infant plasma leptin concentrations.
- Leptin-rich breast milk may serve as a targeted therapeutic approach for preventing obesity in preterm infants.
Abstract:
Perinatal leptin deficiency and reduced intake of mother’s milk may contribute to the development of childhood obesity. Preterm infants have reduced leptin production, and they are at heightened risk of neonatal leptin deficiency. Because fresh human milk contains significantly more leptin than donor milk, we used a cross-over design to determine if blood leptin levels in maternal milk-fed preterm infants fall during conversion to donor human milk. Infants born between 22 0/7 and 31 6/7 weeks gestation on exclusive maternal milk feedings were enrolled into a 21-day cross-over trial. On days 1−7 and 15−21, infants were fed maternal milk, and on days 8−14, infants were fed donor milk. On day 1, study infants had a mean postmenstrual age of 33 weeks. Plasma leptin correlated with milk leptin, and leptin levels in maternal milk far exceed the leptin levels of donor milk. Plasma leptin did not increase during donor milk administration, but it did following resumption of maternal milk (p < 0.05). In this crossover trial, preterm infant blood leptin levels correlated with milk leptin content. This suggests that preterm infants can enterally absorb leptin from human milk, and leptin-rich breast milk may be a targeted therapy for the prevention of obesity.
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