Metabolic Conditions Including Obesity, Diabetes, and Polycystic Ovary Syndrome: Implications for Breastfeeding and Breastmilk Composition

Abstract

Breastfeeding is internationally recognized as the recommended standard for infant nutrition, informed by evidence of its multiple benefits for both mother and baby. In the context of common metabolic conditions such as polycystic ovary syndrome, diabetes (type 1, type 2, and gestational), and obesity, breastfeeding may be particularly beneficial for both mother and infant. However, there is evidence of delayed lactogenesis and reduced breastfeeding rates and duration in women with these conditions, and the effects of altered maternal metabolic environments on breastmilk composition (and potentially infant outcomes) are incompletely understood. In this review, we explore the relationships between maternal metabolic conditions, lactogenesis, breastfeeding, and breastmilk composition. We examine relevant potential mechanisms, including the central role of insulin both in lactogenesis and as a milk-borne hormone. We also describe the bioactive and hormonal components of breastmilk and how these may link maternal and infant health.

Keywords

lactation - breastfeeding - gestational diabetes - type 1 diabetes - type 2 diabetes - polycystic ovary syndrome - lactogenesis - insulin

Authors' Contributions

K.R. reviewed and synthesized the literature, wrote the first draft of the manuscript, and revised and edited the manuscript. A.M., A.J., and H.J.T. reviewed and edited the manuscript. All authors contributed substantial intellectual input to the manuscript in line with ICMJE criteria for authorship and approved the final version for publication.

Publication History

Article published online:
25 August 2021

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