Literature-based human milk nutrient composition values for use in North American food composition databases

Authors: HOPPERTON, KATHRYN - Health Canada; THAVARAJAH, SAMADHI - National Institutes Of Health (NIH); AHUJA, JASPREET - Retired ARS Employee; CASAVALE, KELLIE - Food And Drug Administration(FDA); CHAKRABARTI, SUBHADEEP - Health Canada; GIBBS, KIMBERLEA - National Institutes Of Health (NIH); IRRER, TINA - Food And Drug Administration(FDA); PARNEL, SOPHIE - Health Canada; Pehrsson, Pamela; STANTON, MELANIE - Health Canada; ANDERSON-VILLALUZ, DENNIS - US Department Of Health & Human Services; ZANETTI, KRISTA - National Institutes Of Health (NIH); VARGAS, ASHLEY - National Institutes Of Health (NIH)

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/20/2026
Publication Date: 4/7/2026
Citation: Hopperton, K., Thavarajah, S., Ahuja, J., Casavale, K., Chakrabarti, S., Gibbs, K., Irrer, T., Parnel, S., Pehrsson, P.R., Stanton, M., Anderson-Villaluz, D., Zanetti, K., Vargas, A. 2026. Literature-based human milk nutrient composition values for use in North American food composition databases. The American Journal of Clinical Nutrition. 5(123). Article 101252. https://doi.org/10.1016/j.ajcnut.2026.101252.
DOI: https://doi.org/10.1016/j.ajcnut.2026.101252

Interpretive Summary: The profile for human milk nutrient composition jointly used by Canada and the United States [Standard Reference, Legacy] is largely based on >40-year-old studies. In 2018, it was deemed unsuitable by the U.S. Department of Agriculture for estimating current nutrient exposures. This work aims to develop an interim human milk nutrient values (iHMNut) based on recent literature that may be used until more comprehensive profiles are established. Methods: U.S. and Canadian data for mature, term human milk were combined as weighted means and pooled standard deviations from two recent literature reviews (1980-2022) and the Canadian Maternal-Infant Research on Environmental Chemicals Study. Collection and analytical methods were evaluated against inclusion criteria of a 2020 scanning review from the National Academies of Sciences Engineering and Medicine [NASEM] conducted to inform updates to Dietary Reference Intake values for infants. External validity was assessed by comparison with values from other high- and middle-income countries. Data were identified for many macronutrients, vitamins, minerals, or fatty acids, including components previously assumed to be zero (0) in SR Legacy, or estimated based on other foods. Concentrations for iHMNut differed by >20% from values in the Legacy Reference for total fat, iron, manganese, and most identified vitamins and fatty acids. In many cases, the iHMNut data aligned more closely with other recent international literature. Eligible data from the source reviews were lacking for niacin, B6, B9, B12, vitamin C, vitamin D, vitamin E, and amino acids; and were only available from single studies with <20 participants for riboflavin, thiamin, and cholesterol. These findings demonstrate an opportunity for an interim profile for nutrients in human milk that may be used until a more comprehensive set of profiles can be developed. They also highlight gaps in the literature that must be addressed by future studies.

Technical Abstract: Background The profile for human milk (HM) nutrient composition jointly used by Canada and the United States [Standard Reference (SR), legacy] is largely based on >40-y-old studies. In 2018, it was deemed unsuitable by the United States Department of Agriculture for estimating current nutrient exposures. Objectives To review data available in the literature to develop interim HM nutrient profile data values. Methods Two reviewers screened and extracted data from 3 recent systematic reviews covering the period from 1980'2022 and 1 large Canadian biomonitoring study. Eligible studies: reported quantitative concentrations of =1 component of interest (energy, macronutrients, vitamins, minerals, or fatty acids), included data specific to United States or Canadian participants, reported on mature milk (>21 d postpartum) for term-born infants (>37 wk of gestation), had samples collected within the first 6 mo of lactation, and used appropriate methods for milk collection and nutrient analysis. Studies were combined as weighted means and pooled standard deviations and compared with the existing SR and international literature. Results Updated data were identified for >40 HM components, including some that had previously been assigned 0 in SR legacy (e.g., DHA), or estimated from other foods (e.g., vitamin K). Concentrations for interim HM nutrient profile data differed by >20% from values in the SR legacy for total fat, iron, manganese, and most vitamins and fatty acids. Eligible data were lacking for niacin, vitamin B-12, vitamin C, and total vitamin D, and were only available from single studies for manganese, ß-carotene, thiamin, riboflavin, pantothenic acid, vitamin B6, total choline, 25-hydroxyvitamin D, vitamin E, cholesterol, and some fatty acids. Conclusions These findings summarize data available to develop an interim nutrient profile for North American HM that could be used until an empirically measured profile can be developed. They also highlight gaps in the literature to be addressed by future studies.