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What's in Breastmilk anyway?

Apr 08, 2020

Are there benefits to breastfeeding?

Let’s put it this way, there are no instances where breastfeeding is not beneficial. Let’s establish that breastfeeding has been the common way to feed since humans began. Here is a very brief history of artificial infant feeding and when it was introduced. In the Middle Ages a subtle departure began from breastfeeding. Breastfeeding was not fashionable for wealthy women. Even though these women didn’t have to leave home to work, what became popular were wet nurses and hiring other people to raise your child . Almost instantly the infant mortality rate began to rise from lack of nutrition. During the 1800’s in the American South it became fashionable to use a slave as a wet nurse who would breastfeed the baby, and when this was not possible they used a “Pap” feeder with a mix of pulpy bread and animal milk. Babies perished from bacterial infections and lack of nutrition. In 1923 Similac powder formula was introduced as well as clear glass bottles. The development of childhood diseases rose significantly during this time as formula composition lacks the composition to build a newborns microbiome and immune system.  However, formula feeding has become commonplace and accepted because it is marketed as convenient and as suitable nutrition for a baby. 

Let’s look at the core reasons breastmilk is beneficial, but let’s keep in mind that birth place, mode of delivery ( c section or vaginal birth) and the postpartum practices all affect the babies microbiome but that will be discussed in another post! Right now we are focusing on the benefits of breastfeeding. 

Breast milk is teeming with bacteria that colonize the infant’s gut, and help set the course for the baby’s growing immune system and life long metabolism. It is also the only thing your baby needs for the first year of life. Breastmilk is filled with Macronutrients and Micronutrients. Adding food to your babies diet is psychologically beneficial and helpful for motor skill development and socializing, but there are no known benefits to introducing sold food to your baby’s diet before age 1. Breastmilk is far superior to and food one could provide, at any age. Check out the book Baby Led Weaning in my Amazon store to figure out the right time your particular baby should be introduced to solid foods.

In addition to the appropriate amounts of carbohydrate, protein, and fat, breast milk provides vitamins, minerals, digestive enzymes, and hormones. Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections. Let’s take a look at those cells…

 

What Type of Cells Does Breastmilk carry? (It’s a long and amazing list, are you ready?)

 

Macrophages: Protection against infection, T-cell

activation (A macrophage is a type of white blood cell that cleans the body of unwanted microscopic particles, such as bacteria and dead cells) 

Stem cells: Regeneration and repair

Immunoglobulins

  IgA/sIgA: Pathogen binding inhibition

IgG: Anti-microbial, activation of phagocytosis

(IgG1, IgG2, IgG3); anti-inflammatory,

response to allergens 

 IgM: Agglutination, complement activation

Cytokines are multi-functional peptides that act in autocrine/paracrine fashion. Chemokines are a special class of chemotactic cytokines that induce movement of other cells. Human milk cytokines can cross the intestinal barrier, where they “communicate” with cells to influence immune activity. 

Cytokines:

IL-6: Stimulation of the acute phase response, B cell activation, pro-inflammatory

IL-7: Recruitment of neutrophils (Neutrophils are a type of white blood cell (WBC or granulocyte) that protect us from infections

IL-10: Repressing Th1-type inflammation, induction of antibody production, facilitation of tolerance

IFNγ : stimulates Th1 response (Th1 cells generate responses against intracellular parasites such as bacteria and viruses, Th2 cells produce immune responses against helminths and other extracellular parasites)

TGFβ: Anti-inflammatory, stimulation of T cell phenotype switch

TNFα: Stimulates inflammatory immune activation

 

Chemokines:

G-CSF: Trophic factor in intestines (initiate cellular growth)

MIF: Macrophage Migratory Inhibitory Factor: Prevents macrophage movement, increases

anti-pathogen activity of macrophages

 

Cytokine Inhibitors:

TNFRI and II: Inhibition of TNFα, anti-inflammatory

EGF (Epidermal Growth Factor):

EGF: Stimulation of cell proliferation and maturation

HB-EGF: Protective against damage from hypoxia and ischemia

VEGF: Promotion of angiogenesis and tissue repair

NGF: Promotion of neuron growth and maturation

IGF: Stimulation of growth and development, increased RBCs and hemoglobin (Blood Builder) 

Erythropoietin: Erythropoiesis, intestinal development (transports oxygen and carbon dioxide to and from the tissues)


Hormones: 

Calcitonin: Development of enteric neurons. The enteric nervous system (ENS) regulates many key aspects of the gastrointestinal tract including: motility, secretion and blood flow

Somatostatin: Regulation of gastric epithelial growth

 

Anti-microbial:

Lactoferrin: Acute phase protein, chelates iron, anti-bacterial, anti-oxidant

Lactadherin/MFG E8: Anti-viral, prevents inflammation by

enhancing phagocytosis of apoptotic cells

 

Metabolic hormones: 

Adiponectin:  Reduction of infant BMI and weight, anti-inflammatory

Leptin: Regulation of energy conversion and infant BMI, appetite regulation

Ghrelin: Regulation of energy conversion and infant BMI



Oligosaccharides & glycans: 

HMO: human milk oligosaccharides. The HMOS are “prebiotic” agents that selectively encourage the growth of beneficial (probiotic) organisms. In addition, the HMOS and their protein conjugates are recognized as pathogen-binding inhibitors that function as soluble “decoy” receptors for pathogens that have an affinity for binding to oligosaccharide receptors expressed on the infant’s intestinal surface.

Gangliosides: Brain development; anti-infectious

Glycosaminoglycans: Anti-infectious



Mucins: 

MUC1: Block infection by viruses and bacteria

MUC4: Block infection by viruses and bacteria

EPO: Milk contains significant quantities of Epo, which is the primary hormone responsible for increasing red blood cells (RBC)

 

(G-CSF): Granulocyte-colony stimulating factor, identified in human milk decades ago, has beneficial effects on intestinal development and the treatment of sepsis.


Breastmilk overs defense against Pathogens - Human milk sIgA-antigen complexes are taken up and processed by intestinal dendritic cells, which allows for antigen recognition while maintaining a non-inflammatory environment

 

Is pumping just as good as breastfeeding?

Is breastmilk directly from breast better than pumped breastmilk? Specifically, providing pumped breastmilk was consistently associated with multiple microbiota parameters including enrichment of potential pathogens and depletion of bifidobacteria. I will discuss this more in another blog post. 

So, is breast milk really better than formula?

This is a topic for another post, and a book to be honest, but very simply because formula lacks the ability to build the infants microbiome like breastmilk would, Infants who receive formula feedings are at a higher risk for these illnesses:

  • Acute otitis media (ear infections).

  • Asthma (a condition of the lungs that causes problems with breathing).

  • Diabetes – type 1 and 2 (a problem in controlling the body’s sugar levels).

  • Eczema (an itchy condition of the skin).

  • Lower respiratory tract (lung) infections (including increased risk of admission to the hospital).

  • Obesity (being overweight).

  • Formula is harder to digest for a new baby. It stays in the stomach longer than breast milk, which may cause your baby to feed less often and could cause a decrease in your milk production.

  • Because babies are so sleepy from Formula there is a higher chance for them to roll over in their sleep and suffocate, what known as SIDS - Sudden Infant Death Syndrome 

  • Supplementing with formula, especially from a bottle, may change your baby’s suck pattern at the breast. Latching your baby to the breast may be more difficult after your baby is fed with a firmer bottle nipple or feeds with the faster flow from a bottle.



What are the different stages of lactation?

Colostrum

  • Colostrum is the secretion produced during the first few days (1-7 days) after birth and differs from both transitional and mature milk. It contains a higher amount of protein, less fat and a number of immunizing factors for the newborn.

Transitional milk

  • It is the transition from colostrum to mature milk, where lactation is established and production of milk begins in the breast tissue. Transitional milk is produced from approximately day 8 – 20.

Mature milk

  • Mature milk is produced from 20 days after birth, onwards. It can vary in and between individuals and the energy can vary between 270 and 315 kJ per 100mL. This is largely due to the variation in the fat content, as the fat of the milk received by the infant increases as the feed progresses. Mature milk continues to provide immune factors and other important non-nutritional components to the infant.

 

What are the emotional benefits of breastfeeding?

Breastfeeding produces the naturally soothing hormones oxytocin and prolactin that promote stress reduction and positive feelings in the nursing mother. Increased confidence and self-esteem. Increased calmness. Breastfed babies cry less overall, and have fewer incidences of childhood illness.



Is it OK not to breastfeed?


The answer is, of course! There are instances where it’s not possible to breastfeed. Perhaps the primary caregiver does not have any support and must go back to work, leaving the child in the care of a center. It will be okay, however; it’s important to be informed of the potential unwanted effects a formula diet could have on the child, such as the onset of allergies, digestive issues, childhood diabetes, or potential developmental delays. There are ways to supplement the child’s diet with probiotics, healthy fats, Vitamin D and other compounds that support immunity and brain develop to ensure they are protected. Check out my post on the maternal benefits of breastfeeding. Here is the hierarchy of best nutrition for your infant: 

**Please never give your infant soy or nut based milks as a replacement for the above options.  The WHO (World Health Organization) recommends breastmilk continue to be part of the young child’s diet, a minimum of 2 years of age and beyond.

 

"Breastfeeding for 1 to 2 years of life or longer, is recognized as the normative standard for infant feeding” - Olivia Ballard, JD, PhD (candidate) and Ardythe L. Morrow, PhD, MSc

 

In summary, there are so many benefits to breastfeeding your baby. It meets the emotional, biological and nutritional needs of your child. It can be quite challenging in the beginning. Like anything else, it is a learned skill and takes time to master. It’s important to set goals such as “I plan to breastfeed for 5 months”. Once you meet that goal then you can continue to add months as you move forward. Don’t put too much pressure on yourself, but also keep in mind that there is a learning curve and once you master it, the act of breastfeeding becomes a source of deep bonding and pleasure for you and your baby.

 

Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/ Expressed (Pumped) Breastmilk

 

 

miami-birth-class-miami-doula.jpg
 

The WHO (World Health Organization) recommends breastmilk continue to be part of the young child’s diet, a minimum of 2 years of age and beyond.




Tips for Success?

Find your nearest La Leche League meeting. Even if you are not pregnant, or still pregnant you can attend to learn more about how breastfeeding will benefit both you and your baby. And please remember OBGYNS and Pediatricians are not breastfeeding experts. Seek out a Midwife, IBCLC (International Board Certified Lactation Consultant ) or CLC (Certified Lactation Consultant) in your community. I offer services online and in person to offer breastfeeding support.  You can find an excellent library of breastfeeding books, HERE

Want to dive deeper in breastfeeding and birth education? Join Uncovering Birth

 

Interested in support and guiding women? Join the Uncovering Birth Doula & Birth Keeper Training - open to everyone!



Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/

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