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Longitudinal changes in human milk lactoferrin during the first year: a prospective cohort study

Pediatric Research (2025)Cite this article

Abstract

Background

Lactoferrin (Lf) is an important bioactive protein in human milk involved in diverse biological functions. Concentrations of milk Lf are tightly regulated during lactation. This study aims to investigate the longitudinal changes in human milk Lf concentrations during the first year postpartum and identify the factors associated with these changes.

Methods

This prospective cohort study recruited 160 dyads of healthy mothers and their full-term newborns in Wuqiang, Hebei province, China. Maternal and infant characteristics were collected using a structured questionnaire. Milk Lf concentrations were measured using an ELISA. A linear mixed model was employed to examine the longitudinal changes in Lf concentrations and identify associated factors.

Results

The mean milk Lf concentrations were 7.17 g/L, 4.02 g/L, 2.95 g/L, 2.19 g/L, and 2.43 g/L at 0–7 days, 30 days, 3 months, 6 months, and 12 months postpartum, respectively. The frequency of breastfeeding in the prior 24 h was negatively associated with Lf concentrations (P = 0.017). Prenatal mean corpuscular volume (MCV) status may influence the longitudinal changes in milk Lf (PMCV*time = 0.011).

Conclusions

Milk Lf concentrations decrease during the first 6 months and increase from 6 to 12 months, with these changes potentially associated with breastfeeding frequency and prenatal MCV status.

Impact

  • This study represents one of the largest cohort investigations of the dynamic changes and influencing factors of human milk Lf concentration in China.

  • The study investigated the relationship between maternal red blood cell indexes and milk Lf concentrations.

  • Milk Lf concentrations dynamically change throughout lactation, decreasing during the first 6 months and potentially increasing from 6 to 12 months.

  • The concentrations and longitudinal changes of milk Lf were impacted by the frequency of breastfeeding and maternal mean corpuscular volume.

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Fig. 1: Changes of human milk Lf concentration across lactation periods.

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Data availability

The datasets analyzed in this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors appreciate Dr. Judith Hills for critical reading of the manuscript. This study was conducted as part of the Taicang and Wuqiang Mother-Child Cohort Study (TAWS) by the National Institute for Nutrition and Health. We are grateful to all the staff of the TAWS, whose hard work has made this study possible. We would like to thank all the study participants and their families for their voluntary participation and ongoing support for the TAWS.

Funding

This study was funded by the National Health Commission of China (2017–2021) and supported by Beijing Natural Science Foundation (S160002).

Author information

Authors and Affiliations

  1. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China

    Yang Zhou, Yifan Duan, Shan Jiang, Yuwen Zhang, Muxue Liu, Zhenyu Yang & Jianqiang Lai

  2. Liangping District Center for Disease Control and Prevention, Chongqing, China

    Yang Zhou

  3. Arla foods Visby, Gotland, Sweden

    Muxue Liu

  4. Wuqiang County Center for Disease Control and Prevention, Hebei, China

    Xuyang Gu, Ying Li & Ning Zhang

  5. University of California, Davis, CA, USA

    Rulan Jiang

  6. Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, 100050, China

    Zhenyu Yang

  7. Key Laboratory of Public Nutrition and Health, National Health Commission of the People’s Republic of China, Beijing, 100050, China

    Jianqiang Lai

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  1. Yang Zhou
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  2. Yifan Duan
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  3. Shan Jiang
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Contributions

Jianqiang Lai, Zhenyu Yang, and Yifan Duan designed the study. Xuyang Gu, Ying Li, and Ning Zhang were responsible for the acquisition of data and samples. Shan Jiang, Yuwen Zhang, Muxue Liu, and Yang Zhou were responsible for the experimental determination. Yang Zhou wrote the manuscript. Zhenyu Yang and Rulan Jiang reviewed the manuscript. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Zhenyu Yang.

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The authors declare no competing interests.

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Informed consent was obtained from all subjects involved in the study.

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Zhou, Y., Duan, Y., Jiang, S. et al. Longitudinal changes in human milk lactoferrin during the first year: a prospective cohort study. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04109-7

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  • DOI: https://doi.org/10.1038/s41390-025-04109-7

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