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Breast milk
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Breast milk refers to the milk produced by a mother to feed her baby. It provides the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed. The baby nursing from its own mother is the most ordinary way of obtaining breastmilk, but the milk can be pumped and then fed by baby bottle, cup and/or spoon, supplementation drip system, and nasogastric tube.
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Breast milk refers to the milk produced by a mother to feed her baby. It provides the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed. The baby nursing from its own mother is the most ordinary way of obtaining breastmilk, but the milk can be pumped and then fed by baby bottle, cup and/or spoon, supplementation drip system, and nasogastric tube. Breastmilk can be supplied by a woman other than the baby's mother; either via donated pumped milk (for example from a milk bank), or when a woman nurses a child other then her own at her breast - this is known as wetnursing.
The World Health Organization recommends exclusive breastfeeding until six months of age, with solids gradually being introduced around this age when signs of readiness are shown. Breastfeeding is recommended for at least two years and should continue as long as mother and child wish. Breastfeeding continues to offer health benefits into and after toddlerhood. These benefits include; reduced risk of Sudden Infant Death Syndrome (SIDS), increased intelligence, reduced likelihood of contracting middle ear infections and cold and flu bugs, reduced risk of some cancers such as childhood leukemia, lower risk of childhood onset diabetes, reduced risk of asthma and eczema, fewer dental problems, and reduced risk of obesity later in life .
Breastfeeding also provides health benefits for the mother. It assist the uterus to return to its pre-pregnancy size and reduces post-partum bleeding as well as assisting the mother to return to her pre-pregnancy weight. Breastfeeding also reduces the risk of breast cancer later in life..
Production
Under the influence of the hormones prolactin and oxytocin, women produce milk after childbirth to feed the baby. The initial milk produced is often referred to as colostrum, which is high in the immunoglobulin IgA, which coats the gastrointestinal tract. This helps to protect the newborn until its own immune system is functioning properly, and creates a mild laxative effect, expelling meconium and helping to prevent the build up of bilirubin (a contributory factor in jaundice).
There are many reasons a mother may not produce enough breast milk. Some of the most common are an improper latch (i.e. the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including the contraceptive pill), illness, and dehydration. A rarer reason is Sheehan's syndrome, also known as postpartum hypopituitarism, which is associated with prolactin deficiency; this syndrome may require hormone replacement. Malnourishment of the mother is a significant problem for women in developing countries, as malnourished women are often unable to produce breast-milk.
Lack of supply can be addressed by nursing and/or pumping more frequently. The more the mother nurses her baby, or pumps, the more milk is produced. It is very helpful to nurse on demand - to nurse when the baby wants to nurse rather than on a schedule. If pumping; it is helpful to have an electric high grade pump so that all of the milk ducts are stimulated. Some mothers try to increase their milk supply in other ways - by taking the herb fenugreek, used for hundreds of years to increase supply ("Mother's Milk" teas contain fenugreek as well as other supply-increasing herbs); there are also prescription medications that can be used, such as Domperidone (off-label use) and Reglan. Increasers of milk supply are known as galactagogues.
Composition
Composition of human breast milk| Fat | | total (g/100 ml) | 4.2 | | fatty acids - length 8C (% ) | trace | | polyunsaturated fatty acids (%) | 14 | | Protein (g/100 ml) | | total | 1.1 | | casein 0.4 | 0.3 | | a-lactalbumin | 0.3 | | lactoferrin | 0.2 | | IgA | 0.1 | | IgG | 0.001 | | lysozyme | 0.05 | | serum albumin | 0.05 | | ß-lactoglobulin | - | | Carbohydrate (g/100 ml) | | lactose | 7 | | oligosaccharides | 0.5 | | Minerals (g/100 ml) | | calcium | 0.03 | | phosphorus | 0.014 | | sodium | 0.015 | | potassium | 0.055 | | chlorine | 0.043 |
The exact integrated properties of breast milk are not entirely understood, but the nutrient content after this period is relatively consistent and draws its ingredients from the mother's food supply. If that supply is found lacking, content is obtained from the mother's bodily stores. The exact composition of breast milk varies from day to day, depending on food consumption and environment, meaning that the ratio of water to fat fluctuates. Foremilk, the milk released at the beginning of a feed, is watery, low in fat and high in carbohydrates relative to the creamier hindmilk which is released as the feed progresses. The breast can never be truly "emptied" since milk production is a continuous biological process.
Human milk contains 0.8% to 0.9% protein, 3% to 5% fat, 6.9% to 7.2% carbohydrates and 0.2% ash (minerals). Carbohydrates are mainly lactose; several lactose-based oligosaccharides have been identified as minor components. The principal proteins are casein homologous to bovine beta-casein, alpha-lactalbumin, lactoferrin, IgA, lysozyme and serum albumin. Non-protein nitrogen-containing compounds, making up 25% of the milk's nitrogen, include urea, uric acid, creatine, creatinine, amino acids and nucleotides. Breast milk has circadian variations; some of the nucleotides have acrophases during the night, others during the day.
Mother's milk has been shown to supply a type of endocannabinoid (the natural neurotransmitters which marijuana simulates), 2-Arachidonoyl glycerol.
Though it now is almost universally prescribed, in some countries in the 1950s the practice of breastfeeding went through a period where it was out of vogue and the use of infant formula was considered superior to breast milk. However, it is now universally recognized that there is no commercial formula that can equal breast milk. In addition to the appropriate amounts of carbohydrate, protein and fat, breast milk also provides vitamins, minerals, digestive enzymes and hormones - all of the things that a growing infant will require. Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections. The immune function of breastmilk is individualized, as the mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby and consequently her body makes the appropriate antibodies and immune cells.
Women who are breastfeeding should consult with their physician regarding substances that can be unwittingly passed to the infant via breast milk, such as alcohol, viruses (HIV or HTLV-1) or medications.
Most women who do not breastfeed use infant formula, but breast milk donated by volunteers to human milk banks can be obtained by prescription. Cow's milk is recommended as a substitute, but only for children over one year of age.
Comparison to other milks
All mammal species produce milk, but the composition of milk for each species varies widely and other kinds of milk are often very different from human breast milk. As a rule, the milk of mammals that nurse frequently (including human babies) is less rich, or more watery, than the milk of mammals whose young nurse less often. Human milk is noticeably thinner and sweeter than cow's milk. Left in a cup, the cream will rise and form a thin layer.
Whole cow's milk does not contain sufficient vitamin E, iron, or essential fatty acids, which can make infants fed on cow's milk anemic. Whole cow's milk also contains excessive amounts of protein, sodium, and potassium which may put a strain on an infant's immature kidneys. In addition, the proteins and fats in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk. Evaporated milk may be easier to digest due to the processing of the protein but is still nutritionally inadequate. A significant minority of infants are allergic to one or more of the constituents of cow's milk, most often the cow's milk protein. These problems can also affect infant formulas derived from cow's milk.
Extraordinary consumption
In the ancient world, breast milk was sometimes consumed by fertility cults, and in other religious ceremonies.
Spanish king Alfonso XIII visited the backward region of Las Hurdes in 1922 in order to display the concern of the crown. The king and his retinue lived in military tents planted near the town of Casares de las Hurdes. During the king's visit a strange incident took place: A local village chief, concerned that the king was drinking only black coffee (a consequence of the king's aides distrusting the quality of the local milk owing to unsanitary conditions in the area) served the king a small jug of milk saying, "Your Majesty rest assured that this milk is totally trustworthy,", which turned out to be breast milk from his wife who had recently given birth. The king became aware of this fact only after having had his café con leche.
Preliminary research indicates that breast milk can induce apoptosis in some types of cancer cells . Adults with GI disorders and organ donation recipients can also benefit from the immunologic powers of human breast milk. More research is needed in these areas.
In Costa Rica, there have been trials to produce cheese and custard from human milk as an alternative to weaning.
A controversial Swiss restaurateur has created a menu based around foods cooked in human breast milk .
See also
External links
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- - including comparison of human and cow's milk ones
- Human Milk Storage Information
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- from Seattle's Children's Hospital and Regional Medical Center
- , Janine DeFao, San Francisco Chronicle, 9 April 2006. An article about the market on human milk.
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