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 journalArticlepeer-review

14 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


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