ESPE Abstracts

Introduction: Accumulating evidence indicates various but significant effects of human breast milk IGF1 (HMIGF1) on infantile linear growth and weight gain.

Objectives and Methods: We performed electronic literature systematic review using PubMed, Google Scholar, and Web of Sciences with the aim to provide an update on various effects of HMIGF1 on infantile and childhood growth. We reviewed 12 studies (n= 941 infants) fitting the search criteria. 

Results: Breast milk IGF1 was significantly higher in Obese and overweight infants (n= 40) versus normal-weight infant. A study on 103 mother-infant pairs (for 3 months) showed that the breast milk consumed by the infants with high weight gain contained higher levels of IGF-1 than that consumed by those with low weight gain at all periods studied (P= 0.032 at 3 months of lactation). In obese infants, HMIGF1 levels were correlated with infant's weight for length z-score at 2 months (r -0•476; P= 0•034). Breast milk from mothers of moderate-late Preterm Infants (169 mothers of 191 preterm infants) showed that higher HMIGF1 concentrations on day 5 after birth was associated with greater infant fat-free mass at 4 months' corrected age. HMIGF1 concentrations at 4 months were positively associated with both fat mass and fat-free mass at 4 months in boys but not girls. A study on 60 LBW infants discharged from NICU (35 infants (AGA) and 25 (SGA) showed that serum IGF-1 was positively correlated with HMIGF-I (r= 0.5, P= 0.003). Both serum and breast milk levels of IGF-1 were correlated positively with various parameters of growth. Milk levels of IGF-1 were higher in mothers whose infants attained catch up growth compared to those who didn't attain catch up growth. In a large cohort study (501 mothers and the respective 507 infants) higher HMIGF-1 was associated with higher infant weight at 13 months (P= 0.004) but lower weight at 3 (P= 0.011) and 5 years of age (P= 0.049). Higher cyclic glycine-proline (cGP),(a metabolite of IGF-1) in milk, was associated with lower weight across the 5 years (P= 0.019) but with higher BMI at 5 years (P= 0.021).

Conclusion: These data provide evidence that the ingested milk-borne IGF-1 can affect the postnatal growth of infants and influence catch-up growth of LBW. Future work should expand on these findings and further explore the link between hormonal profiles in human milk and infant outcomes.