Abstract
OBJECTIVES: Previous research has demonstrated a relationship between maternal nutrition and inflammatory mediators in breast milk which may stimulate an immune response in breastfed children. The objective of this study is to explore the relationship between maternal malnutrition, breastfeeding, and child inflammation in a sample of children in India. METHODS: Data were collected from a cross-section of 401 mothers and children 12 to 23 months of age in India. Anthropometric information was collected from mothers and used to compute body mass index (BMI). Household demographics and information on breastfeeding practices were collected as part of a survey. Blood samples were drawn from mothers and children and tested for hemoglobin (mother and child) and C-reactive protein (CRP; child only). Anthropometric measurements were performed on children and used to compute length-for-age z-scores (LAZ). Logistic regression models were fit to estimate unadjusted and adjusted associations between current breastfeeding status (yes or no) and child inflammation (CRP > 3 mg/L), stratified by maternal underweight status (BMI < 18.5). The adjusted model included controls for child's age, mother's age, household wealth, a food insecurity index, and mother and child hemoglobin level. Additional models were fit to estimate associations between child inflammation and stunting (LAZ < -2). RESULTS: Among children of underweight mothers, those who were breastfed at the time of the assessment were significantly more likely to have inflammation (adjusted odds ratio (aOR) 4.08 [95% CI: 2.71, 6.16]; P < 0.001). There was no relationship between current breastfeeding and inflammation in children whose mothers were not underweight (aOR 1.18 [0.94, 1.49]; P = 0.152). Child inflammation was significant associated with stunting (aOR 1.95 [1.88, 2.01]; P < 0.001). CONCLUSIONS: Our findings suggest that breast milk from malnourished mothers may stimulate inflammation in breastfed children. Consistent with previous research, we find that inflammation is significantly associated with stunted growth in children under two years old. FUNDING SOURCES: This study was supported by grant funding from the Allen Foundation. SUPPORTING TABLES, IMAGES AND/OR GRAPHS: