Human milk nutritional composition across lactational stages in Central Africa

Title: Human milk nutritional composition across lactational stages in Central Africa

Authors: Violeta Moya-Alvarez et al.
Published: 2023


This publication ‘Human milk nutritional composition across lactational stages in Central Africa” measures the evolution of Human Milk (HM) nutrient content of Central African mothers over a 6-month period.

This study is the second stage of the MITICA cohort and aimed to investigate the role of mothers’ malnutrition in priming conditions for child intestinal dysbiosis. The first stage showed a high association between food insecurity and depleted nutrient concentrations in HM, as well as a high nutritional burden in the region with unvaried maternal diet.

The study distinguishes HM typology by looking at the HMO markers of maternal Secretor (Se) and Lewis (Le) status, resulting in four human milk specimens: HM-type I, HM-type II, HM-type III and HM-type IV. The distribution of these genotypes varies geographically, which may partially explain differences in HM observed in MITICA. The study discovers a rare predominance of HM-type III (Se+ Le-) among the MITICA subjects in contrast to the uncontested abundance of HM-type I (Se+ Le+) in Europe.

Most nutrient markers showed a decreasing trend in concentrations and diversity. Total HMOs, amino acids, and fatty acids decreased and showed significant variations across HM-types. Lactose levels increased over time independent on HM-type.

Results from Central African women were also compared with HM cohorts from other regions with significant outcomes. Total HMO levels were found to be lower in MITICA subjects than cohorts from 31 countries, although following a similar decreasing pattern over 6 months.

Significant differences were found in the evolution of the lipid content across lactation. The lipid fraction of HM represents the main source of energy intake for infants, representing approximately 44% of energy supply. Total fatty acid concentration in MITICA was lower than in European women and failed to increase over time to meet higher energy requirement during infant growth, remaining constant over 6 months.

The nutritional deficiencies, paired with outcomes of HM analysis, prove that indeed food insecurity and maternal diet has a significant influence on HM composition. Depleted nutrient levels may translate into differences in infant gut microbiota and development as energetic demands and immunological development of the child are not supported.

The final stage of the MITICA cohort will examine infant growth in relation to food insecurity, maternal diet and human milk composition.

Find the study here: Frontiers | Human milk nutritional composition across lactational stages in Central Africa (

Herewith the findings of the first MITICA publication: Food insecurity and maternal diet influence human milk composition between the infants’ birth and 6 months after birth in Central-Africa | Danone Research & Innovation

These findings from European Human Milk Cohort Studies may also be of interest: Human Milk Cohort Studies – Infographic | Danone Nutricia Research