Circadian Variation in Human Milk Composition, a Systematic Review

Merel F Italianer, Eva F G Naninck, Jorine A Roelants, Gijsbertus T J van der Horst, Irwin K M Reiss, Johannes B van Goudoever, Koen F M Joosten, Inês Chaves, Marijn J Vermeulen, Merel F Italianer, Eva F G Naninck, Jorine A Roelants, Gijsbertus T J van der Horst, Irwin K M Reiss, Johannes B van Goudoever, Koen F M Joosten, Inês Chaves, Marijn J Vermeulen

Abstract

Background: Breastfeeding is considered the most optimal mode of feeding for neonates and mothers. Human milk changes over the course of lactation in order to perfectly suit the infant's nutritional and immunological needs. Its composition also varies throughout the day. Circadian fluctuations in some bioactive components are suggested to transfer chronobiological information from mother to child to assist the development of the biological clock. This review aims to give a complete overview of studies examining human milk components found to exhibit circadian variation in their concentration.

Methods: We included studies assessing the concentration of a specific human milk component more than once in 24 h. Study characteristics, including gestational age, lactational stage, sampling strategy, analytical method, and outcome were extracted. Methodological quality was graded using a modified Newcastle-Ottawa Scale (NOS).

Results: A total of 83 reports assessing the circadian variation in the concentration of 71 human milk components were included. Heterogeneity among studies was high. The methodological quality varied widely. Significant circadian variation is found in tryptophan, fats, triacylglycerol, cholesterol, iron, melatonin, cortisol, and cortisone. This may play a role in the child's growth and development in terms of the biological clock.

Keywords: biorhythms; breast milk; chrono-nutrition; circadian clock; diurnal variations; lactation.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of a study selection based on the inclusion and exclusion criteria.
Figure 2
Figure 2
Circadian variation in human milk components. Schematic presentation of estimated circadian curves based on peak and trough values reported in the literature. Circadian variation curves are shown for the following components: (a) tryptophan [18,43], (b) total fats, triglycerides, cholesterol [25,32,47,48,50,51,52,53,55,56,58,59], (c) iron [53,67,70,71], (d) melatonin [41,82,83,84,85,86,87,88,89], and (e) glucocorticoids [24,89,90,91,92,93,94].

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