• Lijun Liu, Qianying Guo, Mingxuan Cui, Jufen Liu, Chen Yang, Xuening Li, Peng Liu, and Linlin Wang.
• Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health; School of Public Health, Peking University, Beijing, China.
• Nutrition. 2022 Jan 1; 93: 111500.

ObjectiveLactoferrin supplementation is a promising strategy to prevent infections in neonates. Exploring whether maternal nutritional status in early pregnancy and maternal diet during lactation are associated with lactoferrin concentrations in mature human milk can provide early warning and allow timely adjustment.MethodsIn this follow-up cohort study, 206 participants were recruited at Peking University People's Hospital from June 2018 to June 2019. The levels of albumin and thyroid-stimulating hormones (TSH) were determined as nutritional indicators during early pregnancy. Information on maternal diet during lactation was collected with a semiquantitative food frequency questionnaire, and the lactoferrin concentrations in breast milk were examined at around 42 d postpartum.ResultsThe median level (interquartile range) of lactoferrin in breast milk was 2844.2 (2568.1, 3103.1) μg/mL. Overall, 5.5% of participants had lower albumin (<40 g/L), and 21.6% had elevated TSH (>2.5 mIU/L), respectively. The concentration of lactoferrin was higher (216.8 [13.4, 420.2] μg/mL) in women with lower albumin levels than in those with normal levels, and elevated TSH had no effect. A 1 g increase in egg intake led to a 0.3 (0.0, 0.6) μg/mL increase in lactoferrin concentration. Lactoferrin levels were also affected by intake of energy, protein, cholesterol, and vitamin A.ConclusionsWomen with lower albumin levels in early pregnancy had higher levels of lactoferrin in mature breast milk. TSH was not related to lactoferrin levels. Intake of energy, protein, cholesterol, and vitamin A may have contributed to lactoferrin concentrations in milk, and egg intake was positively associated with lactoferrin.Copyright © 2021 Elsevier Inc. All rights reserved.

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