Martin M Mulinge, Hellen K Abisi, Hellen M Kabahweza, Lydia Okutoyi, Dalton C Wamalwa, Ruth W Nduati
{"title":"The Role of Maternal Secretor Status and Human Milk Oligosaccharides on Early Childhood Development: A Systematic Review and Meta-Analysis.","authors":"Martin M Mulinge, Hellen K Abisi, Hellen M Kabahweza, Lydia Okutoyi, Dalton C Wamalwa, Ruth W Nduati","doi":"10.1089/bfm.2023.0274","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. <b><i>Aims:</i></b> To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. <b><i>Study Design:</i></b> A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. <b><i>Results:</i></b> The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, <i>I</i><sup>2</sup> = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; <i>p</i> = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. <b><i>Conclusions:</i></b> According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breastfeeding Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/bfm.2023.0274","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. Aims: To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. Study Design: A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. Results: The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, I2 = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; p = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. Conclusions: According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.
期刊介绍:
Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols.
Breastfeeding Medicine coverage includes:
Breastfeeding recommendations and protocols
Health consequences of artificial feeding
Physiology of lactation and biochemistry of breast milk
Optimal nutrition for the breastfeeding mother
Breastfeeding indications and contraindications
Managing breastfeeding discomfort, pain, and other complications
Breastfeeding the premature or sick infant
Breastfeeding in the chronically ill mother
Management of the breastfeeding mother on medication
Infectious disease transmission through breast milk and breastfeeding
The collection and storage of human milk and human milk banking
Measuring the impact of being a “baby-friendly” hospital
Cultural competence and cultural sensitivity
International public health issues including social and economic issues.