Shavika Gupta

The aim of the study was to determine the nutrient composition of human milk (HM) of Indian mothers and investigate its association with maternal and infant anthropometric measures. Human milk is an ideal source of nutrition for optimum growth and development of infant. Among Indian mothers, HM composition data is scanty, especially during prolonged lactation. Mother-infant dyads (n = 50) comprising of two lactation group (0–6 m, n = 26) and (7–12 m, n = 24) residing in Delhi, India were enrolled. Height, weight, BMI, MUAC and head circumference were measured and compared with reference standard. The macronutrients and micronutrients of HM were analysed using MIRIS analyzer, ICP-AES and HPLC. Correlation plots were generated between HM nutrients and maternal, infant anthropometry. Mean BMI of mothers were 19.6 ± 2.6 (0–6 m) and 21.2 ± 3.7 (7–12 m) kg/m². Around 26% of mothers were underweight, 28% overweight. Among infants, 26% were underweight, wasted (18%), stunted (34%) and overweight (10%). The macronutrient composition of human milk were similar to reference values (means ± standard deviation). Both lactation group showed similar HM nutrient composition. Significant positive associations (r = 0.3–0.5) were found between maternal height, infant HCZ with HM energy, fat; maternal prepregnancy-weight, MUAC with retinol; maternal MUAC with crude protein.

The purpose of this systematic review was to understand Indian mothers’ milk composition and report changes in it over the past 100 years. A review was conducted in accordance with PRISMA and registered with PROSPERO (CRD42022299224). All records published between 1921 and 2021 were identified by searching databases Google Scholar, ResearchGate, PubMed, and the Cochrane Database of Systematic Reviews. All observational, interventional, or supplementation studies reporting macronutrients (protein, fat, lactose) in milk of Indian mothers, delivering term infants, were included. Publications on micronutrients, preterm, and methods were excluded. Milk was categorized into colostrum, transitional, and mature. In all, 111 records were identified, of which 34 were included in the final review. Fat ranged from 1.83 to 4.49 g/100 mL, 2.6 to 5.59 g/100 mL, and 2.77 to 4.78 g/100 mL in colostrum, transitional, and mature milk, respectively. The protein was higher in colostrum (1.54 to 8.36 g/100 mL) as compared to transitional (1.08 to 2.38 g/100 mL) and mature milk (0.87 to 2.33 g/100 mL). Lactose was lower in colostrum (4.5–6.47 g/100 mL) as compared to transitional (4.8–7.37 g/100 mL) and mature milk ranges (6.78–7.7 g/100 mL). The older studies (1950–1980) reported higher fat and protein in colostrum as compared to subsequent time points. There were variations in maternal nutritional status, diet, socioeconomic status, and regions along with study design specific differences of time or methods of milk sampling and analysis. Additionally, advancements in methods over time make it challenging to interpret time trends. The need for conducting well-designed, multicentric studies on nutrient composition of Indian mother’s milk using standardized methods of sampling and estimation for understanding the role of various associated factors cannot be undermined.