Lactoferrin concentration in breast milk of mothers of low-birth-weight newborns

Abstract

Objectives: Lactoferrin (LF) is a breast milk glycoprotein with protective effects against neonatal infections, mainly in premature and low-birth-weight (LBW) neonates. The aims of this study were to determine LF concentration in breast milk of mothers of LBW infants during the first 2 months postpartum, and to identify the factors associated with LF concentration.

Study design: Prospective study conducted as a part of an ongoing clinical trial in three Neonatal Units in Peru. We included 346 mothers of neonates with a birth weight <2000 g. We measured LF concentration in four stages of lactation using a commercial enzyme-linked immunosorbent assay kit. Multivariate analysis was performed to assess the association between maternal and neonatal factors, and LF concentration.

Results: We collected 695 milk samples. LF mean concentration±standard deviation was 14.92±7.96 mg ml-1 in colostrum (n=277), 10.73±5.67 in transitional milk (n=55), 10.34±6.27 at 1 month (n=259) and 8.52±6.47 at 2 months (n=104). There was a significant difference in LF concentration between different stages of lactation (P<0.001). Mothers with higher LF concentration in colostrum had higher values in the following 2 months. High maternal income and multiple gestation were significantly associated with higher LF levels; in contrast, maternal peripartum infections and male neonatal gender were associated with lower LF levels.

Conclusions: LF concentration in breast milk of mothers of LBW infants was high and remained elevated even at 1 and 2 months postpartum. LF concentration in colostrum was higher in mothers with higher income and multiple pregnancies, and lower in mothers with peripartum infections.

Trial registration: ClinicalTrials.gov NCT01525316.

Conflict of interest statement

Conflict of Interest: The authors have no potential conflicts of interest to disclose.

Figures

Figure 1

Lactoferrin concentration according to stage of lactation. n = 695 milk samples of mothers of low-birth-weight infants (

Figure 2

Variation in LF concentration in breast milk from each individual mother over the course of lactation. Data are presented as mean LF concentrations, and are classified in three groups per initial LF concentration in colostrum. Mothers with colostrum LF concentrations between 20 and 45 mg/mL (▲) maintained relative higher concentrations at 1 month, when compared to mothers with lower colostrum LF concentrations [10 to