Early Human‐Milk Metabolome in Cases of Intrauterine Growth–Restricted and Macrosomic Infants.

Background: Abnormal fetal growth is associated with short‐term and long‐term metabolic dysregulation and susceptibility to obesity‐related disorders. Maternal milk, the ideal source of infantile nutrition, protects from metabolic diseases in adulthood. By applying nuclear magnetic resonance (NMR) metabolomics, this study investigated the metabolic profile of early human milk/colostrum (EHM/C) at the extremes of fetal‐growth conditions, which could affect its nutritional value. Methods: From 98 mothers delivering 60 appropriate‐for‐gestational‐age (AGA), 19 large‐for‐gestational‐age (LGA), and 19 intrauterine growth–restricted (IUGR) full‐term neonates, milk samples collected on the third to fourth day post partum were examined by NMR spectroscopy. Multivariate data analysis elicited information from NMR spectra and probed to metabolic signatures of EHM/C. Results: LGA and IUGR EHM/C samples depicted increased content in lactose, citric acid, choline, phosphocholine, and N‐acetylglutamine. AGA samples exhibited increased isoleucine and valine. Metabolic pathways involved were valine, leucine/isoleucine biosynthesis and degradation, glycerophospholipid metabolism, aminoacyl–transfer RNA biosynthesis, and citrate cycle. Orthogonal projections to latent structures discriminant analysis models were validated. Conclusion: This holistic metabolomics study framed an increased content of certain essential nutrients in EHM/C samples following the birth of LGA and IUGR infants prone to short‐ and long‐term metabolic disorders, thus stressing additional benefits of early breastfeeding. Assessing the metabolic profile of EHΜ/C enables evaluation of its nutrition value, adjusted to fetal growth, and introduction of appropriate dietary interventions. [ABSTRACT FROM AUTHOR]