Maternal weight and excessive weight gain during pregnancy modify the immunomodulatory potential of breast milk

INTRODUCTION: Breast milk is an optimal source of nutrition for infants. It contains bioactive components including bacteria that support the microbial colonization and immune system development of the infant. The determinants of human milk composition remain poorly understood, although maternal nutritional and immunological status as well as lifestyle and dietary habits seem to have an impact. METHODS: The subjects selected were women from a prospective follow-up study categorized by BMI. Milk samples were taken after delivery and at 1 and 6 mo later for analysis of composition in regard to transforming growth factor (TGF)-beta 2, soluble CD14 (sCD14), cytokines, and microbiota. RESULTS: TGF-beta 2 and sCD14 levels in the breast milk of overweight mothers tended to be lower than the levels in that of normal-weight mothers. Also, higher levels of Staphylococcus group bacteria and lower levels of Bifidobacterium group bacteria were detected in overweight mothers as compared with normal-weight ones. The prevalence of Akkermansia muciniphila-type bacteria was also higher in overweight mothers, and the numbers of these bacteria were related to the interleukin (IL)-6 concentration in the colostrum, which was in turn related to lower counts of Bifidobacterium group bacteria in the breast milk of overweight women. DISCUSSION: Complex interactions of cytokines and microbiota in breast milk guide the microbiological, immunological, and metabolic programming of infant health. Our data may indicate the presence of an additional mechanism that may explain the heightened risk of obesity for infants of overweight and excessive weight gain mothers.