gms | German Medical Science

Background: Breastfeeding, in general, has been shown to prevent childhood overweight and obesity. However, the concentrations of specific constituents of human milk, such as adipokines, may play an additional role and have rarely been considered.

Objectives: We assessed the role of adiponectin and leptin in human milk in childhood overweight within a large population-based group of ever breastfed infants in Germany.

Methods: Between November 2000 and November 2001 all mothers and their newborns were recruited after delivery at the University of Ulm, Germany. Milk samples were collected 6 weeks post-partum. Adiponectin and leptin levels were determined by commercially available ELISAs. Active follow-up was performed at age 12 months and at age 24 months.

Results: Of the 674 included breastfed children 56 (8.3%) were overweight at the age of two. Median adiponectin and leptin levels in milk were 10.9 ng/ml, and 174.5 pg/ml, respectively. Risk for overweight at age two increased with increasing milk adiponectin and leptin levels, respectively (adjusted odds ratio (OR) with 95 % confidence interval (CI) per standard deviation (SD) increase of adiponectin (10.1 ng/ml) and of leptin (380.9 pg/ml): 1.30 (1.04; 1.62), and 1.34 (1.05; 1.73), respectively). These associations became even stronger with prolonged breastfeeding. Among children who were exclusively breastfed for ³ 6 months, adjusted ORs (95% CI) were 1.56 (1.10; 2.22) per SD increase of adiponectin, and 1.82 (1.11; 2.98) per SD increase of leptin.

Conclusions: High levels of adiponectin and leptin in human milk seem to be risk factors for childhood overweight, especially among prolonged breastfed children. Therefore, breastfed children may benefit most from prolonged breastfeeding with respect to prevention of obesity when milk contains low levels of these adipokines.