Human Milk Oligosaccharides in Antenatal Colostrum: A Case Study

Breastfeed Med. 2024 May 3. doi: 10.1089/bfm.2024.0048. Online ahead of print.

Abstract

Introduction/Background: Some women produce antenatal colostrum during pregnancy and feed it to their baby after birth. However, the composition of antenatal colostrum and how it compares to postnatal colostrum and mature milk are not well described. In fact, there are currently no data on the composition of antenatal colostrum when it comes to human milk oligosaccharides (HMOs), the third most abundant solid human milk component after lactose and lipids. Case Presentation: We report a case of a single healthy donor who collected antenatal colostrum and urine from 19 weeks of gestation all the way to mature milk at 3 months postpartum. We analyzed all samples for HMO composition using high-performance liquid chromatography and for lactose concentrations using an enzymatic assay. Results: The entire spectrum of HMOs typical of a nonsecretor was already present in antenatal colostrum at 19 weeks gestation with a total concentration of 7.5 mg/mL. The HMO concentration further increased to over 12.5 mg/mL at 30 weeks gestation and then declined throughout the remainder of pregnancy and continued to decline in the postpartum period with concentrations of less than 5 mg/mL at 12 weeks postpartum. Concentrations of some of the individual HMOs as well as lactose changed significantly at the time of birth. HMO composition in antenatal colostrum was different in time-matched urine samples. Conclusion: Measuring HMOs in maternal urine does not fully capture the composition of HMOs in antenatal colostrum. Feeding antenatal colostrum to the newborn baby provides the entire set of different HMOs at high concentrations.

Keywords: antenatal colostrum; human milk oligosaccharides; lactation; mammary gland; pregnancy.