Breast Milk: A Postnatal Link Between Maternal Life Choices and the Prevention of Childhood Obesity

The prevention of diabetes and obesity in the young starts with the prevention and treatment of modifiable maternal risk factors encompassing the period from before conception until weaning. Major modifiable variables are characteristics and behaviors that include prepregnancy weight, gestational weight gain, glycemia, and intensity and duration of breastfeeding. Much of the early programming of resistance or vulnerability to age-related diseases is influenced by the integrated balance of maternal hormones transferred to the offspring by milk. This whole-body programming/reprogramming of milk recipient (infant) and milk donor (mother) may be involved in the dose effect of human milk on a healthier body composition and metabolic function in the mother–infant pair following the period of exposure. The pattern and trajectory of weight and metabolic characteristics vary between the active period of exposure and postexposure. In addition, the optimal hormone ranges in maternal circulation and milk need to be determined beyond the observation that extremely high and extremely low concentrations may be detrimental for the mother–infant pair. This commentary discusses the metabolic implications of breastfeeding for this pair.