Lipid-based nutrient supplements during pregnancy and lactation did not affect human milk oligosaccharides and bioactive proteins in a randomized trial

Josh M. Jorgensen, Charles Arnold, Per Ashorn, Ulla Ashorn, David Chaima, Yin Bun Cheung, Jasmine C.C. Davis, Yue Mei Fan, Elisha Goonatilleke, Emma Kortekangas, Chiza Kumwenda, Carlito B Lebrilla, Kenneth Maleta, Sarah M. Totten, Lauren D. Wu, Kathryn G. Dewey

Research output: Contribution to journalArticle

6 Scopus citations


Background: Human milk oligosaccharides (HMOs) and bioactive proteins are beneficial to infant health. Recent evidence suggests that maternal nutrition may affect the amount of HMOs and proteins in breast milk; however, the effect of nutrient supplementation on HMOs and bioactive proteins has not yet been well studied. Objective: We aimed to determine whether lipid-based nutrient supplements (LNSs) affect milk bioactive protein and HMO concentrations at 6 mo postpartum in women in rural Malawi. These are secondary outcomes of a previously published randomized controlled trial. Methods: Women were randomly assigned to consume either an iron and folic acid capsule (IFA) daily from #20 wk gestation until delivery, followed by placebo daily from delivery to 6 mo postpartum, or amultiplemicronutrient (MMN) capsule or LNS daily from ≤20 wk gestation to 6 mo postpartum. Breast milk concentrations of total HMOs, sialylated HMOs, fucosylated HMOs, lactoferrin, lactalbumin, lysozymes, antitrypsin, immunoglobulin A, and osteopontin were analyzed at 6 mo postpartum (n = 647). Between-group differences in concentrations and in proportions of women classified as having low concentrations were tested. Results: HMO and bioactive protein concentrations did not differ between groups (P > 0.10 for all comparisons). At 6 mo postpartum, the proportions of women with low HMOs or bioactive proteins were not different between groups except for osteopontin. A lower proportion of women in the IFA group had low osteopontin compared with the LNS group after adjusting for covariates (OR: 0.5; 95% CI: 0.3, 0.9; P = 0.016). Conclusion: The study findings do not support the hypothesis that supplementation with an LNS or MMN capsule during pregnancy and postpartum would increase HMO or bioactive milk proteins at 6 mo postpartum among Malawian women. This trial was registered at as NCT01239693.

Original languageEnglish (US)
Pages (from-to)1867-1874
Number of pages8
JournalJournal of Nutrition
Issue number10
StatePublished - Oct 1 2017



  • Bioactive breast milk proteins
  • Human milk oligosaccharides
  • Lactation
  • Lipid-based nutrient supplements
  • Multiple micronutrient supplements
  • Postpartum

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Jorgensen, J. M., Arnold, C., Ashorn, P., Ashorn, U., Chaima, D., Cheung, Y. B., Davis, J. C. C., Fan, Y. M., Goonatilleke, E., Kortekangas, E., Kumwenda, C., Lebrilla, C. B., Maleta, K., Totten, S. M., Wu, L. D., & Dewey, K. G. (2017). Lipid-based nutrient supplements during pregnancy and lactation did not affect human milk oligosaccharides and bioactive proteins in a randomized trial. Journal of Nutrition, 147(10), 1867-1874.