Semin Reprod Med 2021; 39(03/04): 111-132
DOI: 10.1055/s-0041-1732365
Review Article

Metabolic Conditions Including Obesity, Diabetes, and Polycystic Ovary Syndrome: Implications for Breastfeeding and Breastmilk Composition

1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
2   Department of Diabetes, Monash Health, Melbourne, Australia
Aya Mousa
1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
Anju Joham
1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
2   Department of Diabetes, Monash Health, Melbourne, Australia
1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
2   Department of Diabetes, Monash Health, Melbourne, Australia
› Author Affiliations
Funding and Support This work received no specific external funding. K.R. is supported by an emerging researcher fellowship from Monash Health and a postgraduate research scholarship from the National Health and Medical Research Council (NHMRC) of Australia. A.M. is supported by a biomedical research fellowship from the NHMRC A.J. is supported by an NHMRC CRE fellowship. H.J.T. is a NHMRC Medical Research Future Fund (MRFF) practitioner fellow.


Breastfeeding is internationally recognized as the recommended standard for infant nutrition, informed by evidence of its multiple benefits for both mother and baby. In the context of common metabolic conditions such as polycystic ovary syndrome, diabetes (type 1, type 2, and gestational), and obesity, breastfeeding may be particularly beneficial for both mother and infant. However, there is evidence of delayed lactogenesis and reduced breastfeeding rates and duration in women with these conditions, and the effects of altered maternal metabolic environments on breastmilk composition (and potentially infant outcomes) are incompletely understood. In this review, we explore the relationships between maternal metabolic conditions, lactogenesis, breastfeeding, and breastmilk composition. We examine relevant potential mechanisms, including the central role of insulin both in lactogenesis and as a milk-borne hormone. We also describe the bioactive and hormonal components of breastmilk and how these may link maternal and infant health.

Authors' Contributions

K.R. reviewed and synthesized the literature, wrote the first draft of the manuscript, and revised and edited the manuscript. A.M., A.J., and H.J.T. reviewed and edited the manuscript. All authors contributed substantial intellectual input to the manuscript in line with ICMJE criteria for authorship and approved the final version for publication.

Publication History

Article published online:
25 August 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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