The Mothers, Infants, and Lactation Quality (MILQ) Study: A Multi-Center Collaboration

Lindsay H Allen, Daniela Hampel, Setareh Shahab-Ferdows, Maria Andersson, Erica Barros, Andrew M Doel, Kamilla Gehrt Eriksen, Sophie Hilario Christensen, Munirul Islam, Gilberto Kac, Farhana Khanam Keya, Kim F Michaelsen, Daniela de Barros Mucci, Fanta Njie, Janet M Peerson, Sophie E Moore, Lindsay H Allen, Daniela Hampel, Setareh Shahab-Ferdows, Maria Andersson, Erica Barros, Andrew M Doel, Kamilla Gehrt Eriksen, Sophie Hilario Christensen, Munirul Islam, Gilberto Kac, Farhana Khanam Keya, Kim F Michaelsen, Daniela de Barros Mucci, Fanta Njie, Janet M Peerson, Sophie E Moore

Abstract

Little valid information is available on human milk nutrient concentrations, especially for micronutrients (MNs), and there are no valid reference values (RVs) across lactation. In this multi-center collaborative study, RVs will be established for human milk nutrients across the first 8.5 mo postpartum. Well-nourished, unsupplemented women in Bangladesh, Brazil, Denmark, and The Gambia (n = 250/site) were recruited during the third trimester of pregnancy. Milk, blood, saliva, urine, and stool samples from mothers and their infants are collected identically at 3 visits (1-3.49, 3.5-5.99, 6.0-8.49 mo postpartum). Milk analyses include macronutrients, selected vitamins, trace elements and minerals, iodine, metabolomics, amino acids, human milk oligosaccharides, and bioactive peptides. We measure milk volume; maternal and infant diets, anthropometry, and morbidity; infant development, maternal genome, and the infant and maternal microbiome. RVs will be constructed based on methods for the WHO Child Growth Standards and the Intergrowth-21st Project. This trial was registered at clinical trials.gov as NCT03254329.

Keywords: composition; human milk; macronutrients; micronutrients; reference values.

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

Figures

FIGURE 1
FIGURE 1
Mothers, Infants, and Lactation Quality Study timeline, questionnaires, and data and sample collection form schedule. 13rd trimester. 2Late 3rd trimester, not done in Bangladesh. 3Maternal stool samples are not collected in Bangladesh. 4Not collected in Denmark. 5Only at visit 4 in The Gambia.
FIGURE 2
FIGURE 2
Mothers, Infants, and Lactation Quality Study participant flow chart, for all 4 study sites. 1Denmark will use 24-h test weighing, instead of the Dose-to Mother deuterium method and saliva collections, for milk volume measurements. C, child; DBS, dried blood spots; M, mother.
FIGURE 3
FIGURE 3
Hypothetical graphical illustration of reference values that may result for a micronutrient.

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