Peer-reviewed article
The prospective associations of fetal growth-related pregnancy complications with subsequent breastfeeding duration and markers of human milk production.
Wei Wei Pang, Donna T Geddes, Ching-Tat Lai, Navin Michael, Jonathan Huang et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed over 950 mothers in Singapore to understand whether pregnancy complications affecting fetal growth influence how long mothers breastfeed and the quality of their milk. Mothers who had high blood pressure during pregnancy or delivered small babies were more likely to stop breastfeeding earlier than mothers with uncomplicated pregnancies. Mothers with high blood pressure during pregnancy also produced milk with lower zinc levels, which is important for infant development.
Key points
- Mothers with hypertensive disorders of pregnancy (HDP) were 61% more likely to cease breastfeeding earlier than those with uncomplicated pregnancies
- Mothers who delivered small-for-gestational-age (SGA) infants were 45% more likely to stop breastfeeding earlier
- Mothers with HDP produced milk with significantly lower zinc concentrations compared to those with uncomplicated pregnancies
- SGA alone was not associated with changes in other human milk biomarkers (protein, lactose, citrate, sodium, potassium)
- Fetal growth deceleration and elevated umbilical artery resistance were not significantly associated with breastfeeding duration
Limitations
The study measured milk composition at only one time point (3 weeks postpartum), so changes over time are unknown. The sample for milk biomarker analysis was relatively small (180 dyads), which may limit the generalizability of findings about milk quality.
Abstract
BACKGROUND: The development of the breast for lactation occurs throughout pregnancy. It is unknown whether pregnancy complications resulting in poor fetal growth can affect breastfeeding (BF) success. OBJECTIVES: We examined whether fetal growth-related pregnancy complications were associated with earlier BF cessation and changes in the concentrations of human milk biomarkers of low milk production. METHODS: We used data from the Growing Up in Singapore Toward healthy Outcomes study (n = 954). Human milk concentrations of protein, lactose, citrate, sodium, potassium, and zinc at 3 wk postpartum were available for 180 mother-infant dyads. We examined the associations of fetal growth measures, including term infants born small-for-gestational-age (SGA) (<10th percentile), pregnancies complicated by fetal growth deceleration (second to third trimester fetal growth dropped between major centiles), elevated umbilical artery resistance (>90th percentile) or hypertensive disorders of pregnancy (HDP) with 1) risk of ceasing BF (Cox regression) and 2) concentrations of human milk components (weighted linear regression). RESULTS: Adjusting for maternal education, smoking exposure, BF intentions, and prepregnancy BMI (in kg/m2), individuals who delivered SGA infants and those with HDP were more likely to breastfeed for a shorter duration when compared to those with uncomplicated pregnancies {adjusted hazard ratio [95% confidence interval (CI)]: 1.45 (1.11, 1.89) and 1.61 (1.14, 2.29), respectively}; associations were nonsignificant for fetal growth deceleration and umbilical artery resistance. SGA was not associated with concentrations of human milk biomarkers, but compared to participants with uncomplicated pregnancies, milk produced by those with HDP contained lower zinc concentrations [adjusted β coefficient (95% CI): -0.56 mg/L (-1.08, -0.04) mg/L]. CONCLUSIONS: Individuals with HDP and those with SGA infants tend to breastfeed for a shorter duration; however, only HDP appear to be associated with biomarkers of compromised milk production. Further research and support are needed to help individuals with HDP and SGA achieve their BF goals. This trial was registered at clinicaltrials.gov as NCT01174875.