title: A narrative review of the associations between six bioactive components in breast milk and infant adiposity.
abstract: This narrative review examines six important non-nutritive substances in breast milk, many of which were thought to have little to no biological significance. The overall objective is to provide background on key bioactive factors in breast milk believed to have an effect on infant outcomes (growth and body composition).
  
  
  
  The evidence for the effects of the following six bioactive compounds in breast milk on infant growth outcomes are reviewed: insulin, leptin, adiponectin, ghrelin, interleukin-6, and tumor necrosis factor-α.
  
  
  
  The existing literature on the effects of breast milk insulin, ghrelin, interleukin-6, and tumor necrosis factor-α and their associations with infant growth and adiposity is sparse. Of the bioactive compounds reviewed, leptin and adiponectin are the most researched. Data reveal that breast milk adiponectin has negative associations with growth in infancy.
  
  
  
  There is a need for innovative, well-designed studies to improve causal inference and advance our understanding in the effects of breast milk and its components on offspring growth and body composition. The recommendations provided, along with careful consideration of both known and unknown factors that affect breast milk composition, will help improve, standardize, and ultimately advance this emergent field.
authors.affiliation: Department of Pediatrics, Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fields
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Camille R
authors.initials: CR
authors.lastname: Schneider
authors.affiliation: Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Pavela
mesh_terms: D050154:Adiposity; D015992:Body Mass Index; D001942:Breast Feeding; D002657:Child Development; D005260:Female; D005947:Glucose / Q000032:analysis*; D006801:Humans; D007223:Infant; D007328:Insulin / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis*; D020738:Leptin / Q000032:analysis*; D039382:Maternal Nutritional Physiological Phenomena; D008895:Milk, Human / Q000737:chemistry*; D009765:Obesity / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D005947:Glucose