UC Davis

Lactation and breastfeeding support the short- and long-term health of both mother and infant, yet the success of these processes depend upon both individual and shared factors. Complications during pregnancy and delivery negatively affect the likelihood that a mother will be capable of breastfeeding for at least the first six months of life, as recommended by the American Academy of Pediatrics (1). Guidelines for women regarding postpartum diet and lifestyle management also fail to reflect the diversity of mother-infant pairs and their circumstances. In our analysis of the literature, we have identified a categorical deficit in modern scientific discourse regarding human lactation; namely, that postpartum involves full-body contribution of resources and thus requires the application of nutrition from a systemic perspective. These observations, combined with recent research indicating that the vitamin B3 derivative nicotinamide riboside may improve lactation success while conferring additional long-lasting benefits to the dyad, inspired a randomized-control clinical trial consisting of a small cohort of female participants who have given birth prematurely. As a consequence of the COVID-19 pandemic, recruitment for the described study has been approved by the UC Davis institutional review board but not yet begun at the time of publication. The primary aim is to determine whether supplementation with nicotinamide riboside during the immediate postpartum period has a measurable effect on milk production (i.e. its ability to act as a galactagogue). Secondary outcomes are intended to direct future hypotheses regarding the mechanistic action of this compound (i.e. its ability to act as a metabolic regulator). This contribution to the field of lactation research is significant in that it prioritizes interventions at the beginning of life that demonstrate the potential for measurable improvement in long-term health.