title: Influence of maternal and socioeconomic factors on breast milk fatty acid composition in urban, low-income families.
abstract: The lipid composition of breast milk may have a significant impact on early infant growth and cognitive development. Comprehensive breast milk data is lacking from low-income populations in the Indian subcontinent impeding assessment of deficiencies and limiting development of maternal nutritional interventions. A single breast milk specimen was collected within 6 weeks postpartum from two low-income maternal cohorts of exclusively breastfed infants, from Dhaka, Bangladesh (n = 683) and Kolkata, India (n = 372) and assayed for percentage composition of 26 fatty acids. Mature milk (>15 days) in Dhaka (n = 99) compared to Kolkata (n = 372) was higher in total saturated fatty acid (SFA; mean 48% vs. 44%) and disproportionately lower in ω3-polyunsaturated fatty acid (PUFA), hence the ω6- and ω3-PUFA ratio in Dhaka were almost double the value in Kolkata. In both sites, after adjusting for days of lactation, increased maternal education was associated with decreased SFA and PUFA, and increasing birth order or total pregnancies was associated with decreasing ω6-PUFA or ω3-PUFA by a factor of 0.95 for each birth and pregnancy. In Dhaka, household prosperity was associated with decreased SFA and PUFA and increased ω6- and ω3-PUFA. Maternal height was associated with increased SFA and PUFA in Kolkata (1% increase per 1 cm), but body mass index showed no independent association with either ratio in either cohort. In summary, the socioeconomic factors of maternal education and household prosperity were associated with breast milk composition, although prosperity may only be important in higher cost of living communities. Associated maternal biological factors were height and infant birth order, but not adiposity. Further study is needed to elucidate the underlying mechanisms of these effects.
authors.affiliation: Center for Public Health Genomics, University of Virginia, Charlottesville, 22908, Virginia, USA.
authors.forename: Uma
authors.initials: U
authors.lastname: Nayak
authors.affiliation: National Institute of Cholera and Enteric Diseases, Kolkata, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Kanungo
authors.affiliation: Center for Public Health Genomics, University of Virginia, Charlottesville, 22908, Virginia, USA.
authors.forename: Dadong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Medicine and Vaccine Testing Center, University of Vermont College of Medicine, Burlington, Vermont, USA.
authors.forename: E
authors.initials: E
authors.lastname: Ross Colgate
authors.affiliation: Department of Medicine and Vaccine Testing Center, University of Vermont College of Medicine, Burlington, Vermont, USA.
authors.forename: Marya P
authors.initials: MP
authors.lastname: Carmolli
authors.affiliation: International Vaccine Institute, Seoul, South Korea.
authors.forename: Ayan
authors.initials: A
authors.lastname: Dey
authors.affiliation: International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Masud
authors.initials: M
authors.lastname: Alam
authors.affiliation: National Institute of Cholera and Enteric Diseases, Kolkata, India.
authors.forename: Byomkesh
authors.initials: B
authors.lastname: Manna
authors.affiliation: National Institute of Cholera and Enteric Diseases, Kolkata, India.
authors.forename: Ranjan Kumar
authors.initials: RK
authors.lastname: Nandy
authors.affiliation: International Vaccine Institute, Seoul, South Korea.
authors.forename: Deok Ryun
authors.initials: DR
authors.lastname: Kim
authors.affiliation: Dr. B.C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India.
authors.forename: Dilip Kumar
authors.initials: DK
authors.lastname: Paul
authors.affiliation: Dr. B.C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India.
authors.forename: Saugato
authors.initials: S
authors.lastname: Choudhury
authors.affiliation: Dr. B.C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata, India.
authors.forename: Sushama
authors.initials: S
authors.lastname: Sahoo
authors.affiliation: OmegaQuant Analytics, Sioux Falls, South Dakota, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Harris
authors.affiliation: International Vaccine Institute, Seoul, South Korea.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Wierzba
authors.affiliation: International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: Department of Medicine and Vaccine Testing Center, University of Vermont College of Medicine, Burlington, Vermont, USA.
authors.forename: Beth D
authors.initials: BD
authors.lastname: Kirkpatrick
authors.affiliation: International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.affiliation: Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, 22908, Virginia, USA.|Department of Pathology, University of Virginia, Charlottesville, Virginia, USA, 22908.
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
authors.affiliation: Center for Public Health Genomics, University of Virginia, Charlottesville, 22908, Virginia, USA.|Department of Public Health Sciences, University of Virginia, Charlottesville, 22908, Virginia, USA.
authors.forename: Josyf C
authors.identifier: 0000-0003-2595-0005
authors.initials: JC
authors.lastname: Mychaleckyj
mesh_terms: D000328:Adult; D001459:Bangladesh; D015992:Body Mass Index; D015525:Fatty Acids, Omega-3 / Q000032:analysis*; D043371:Fatty Acids, Omega-6 / Q000032:analysis*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007774:Lactation; D008895:Milk, Human / Q000737:chemistry*; D011247:Pregnancy; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: anthropometry; breast milk; infant growth; low-income countries; polyunsaturated fatty acids; socioeconomic factors