Nutritional Composition of Breast Milk

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Nutritional Composition of Breast Milk

• Shannon Black
• Colleen Poling

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Human Milk Facts

• Isotonic Solution
• milk and plasma are of similar ion concentration
• Designed to protect infants chronic childhood
  diseases.
• T-lymphocytes, B-lymphocytes, neutrophils,
  macrophages and epithelial cells aid in
  protection
• Two forms of breast milk are colostrum and mature
  milk.

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Lactogenesis

• Lactogenesis is the production of human milk.
• Three phases
• Lactogenesis I, II, III

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Colostrum in Human Milk

• Thick, yellow fluid
• Produced during lactogenesis II (2-3 days after
  birth)
• Provides 58-70 cal/100 ml
• High in protein, electrolytes, sodium, potassium,
  chloride and vitamin A
• Low in fat and carbohydrate
• Lactobacillus bifidus factor

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Mature Human Milk

• Thin and watery texture
• Forms during lactogenesis III
• Provides 2,730-2,940 cal/L
• High in linoleic acid and cholesterol content for
  brain development
• High in fat content and lactose
• Docosahexaenoic acids (DHA)
• Long chain omega-3 fatty acids.
• Used for synthesis of brain tissues, central
  nervous system and eyes
• DHA and cholesterol not found in human milk
  substitutes

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Mature Human Milk- PRO

• Protein
• Low content
• Dependent on infants age
• Antiviral and antimicrobial effects
• Casein
• Major protein in mature milk
• Casein, calcium phosphate, and other ions such as
  magnesium and citrate is what makes milk appear
  white.

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Mature Human Milk- CHO

• Lactose
• Disaccharide of galactose and glucose.
• Dominant carbohydrate in human milk.
• Enhances calcium absorption.
• Other carbohydrates
• Monosaccharides
• Glucose
• Polysaccharides
• Contribute calories
• Stimulate the growth of bifidus bacteria in the
  gut
• Inhibit the growth of E. coli and other bacteria

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Specific Nutrients in Human Milk
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Change in Milk Composition During Feeding

• Foremilk
• Released first
• Higher in carbohydrate
• Lower in fat
• Hindmilk
• Resembles cream
• Higher in fat
• Lower in carbohydrate
• Released 10-20 minutes into the feeding

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Milk Supply and Demand

• First month postpartum
• About 2.5 cups per day of milk is produced
• 4-5 months postpartum
• About 3 cups produced per day
• Variations in milk production
• 1.8-5 cups per day for women nursing one infant
• Infant weight, caloric density of milk and
  infants age contributes infants demand for milk.

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Related Hormones

• Oxytocin
• This hormone causes the alveoli to contract and
  lets the milk flow.
• This is called the let down reflex

• Prolactin
• This hormone uses the alveoli to take the
  nutrients from the bloodstream and make it into
  milk.

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http//www.breastfeedingpartners.org/about_breastf
eeding/aagstobaby.html
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Effects on breast milk composition

• Alcohol
• Nicotine
• Caffeine
• Marijuana and other drug abuse
• Environmental Exposures
• Genes

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Alcohol

• The alcohol transfers to the breast milk.
• If the mother consumes a lot of alcohol the baby
  will be directly affected.
• Slows let down reflex
• Not recommended

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Nicotine

• The nicotine in the milk is 1.5-3 times higher
  than in the blood.
• 10-20 cigarettes per day.4-.5 mg of nicotine/L
  in blood
• No evidence of a health risk to the infant.
• Over time the infant could metabolize it in the
  liver and emit nicotine into kidneys
• Not recommended

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Caffeine

• A cup of coffee results in only low levels in the
  breast milk.
• It is ok to drink in moderation

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Marijuana and other drug abuse

• Marijuana, Amphetamines, cocaine, heroin and
  phencyclidine hydrochloride (PCP).
• Directly affect the infant directly and
  negatively.
• Also very harmful for mother
• Harmful because the contents of these substances
  are not uniform
• Each drug may include different amounts of
  bacteria, heavy metals, pesticides.

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Environmental Exposures

• Not routinely checked for environmental
  exposures.
• Being exposed to chemicals will most likely
  absorb and become part of the breast milk.
• Benefits outweigh the exposures.
• Avoid eating swordfish, king mackerel, rile fish,
  and shark from freshwaters that are contaminated,
  (reported by health agencies).
• Avoid exposure to paints, non-water based glues,
  furniture strippers, nail polish and gas fumes.

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Genes

• Different variations of Apolipoproteins can
  effect the amount of fat absorbed into the
  bloodstream and fat metabolism.
• These different variants effect the breast milk
  composition
• ApoA4 variants 347S and 347T (fat absorption)
• ApoE variant E4 (fat metabolism)

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Benefits

• Breast fed babies vs. formula fed babies
• Positive health affects on mother
• Weight loss
• Delays menstruation
• Lower iron loss
• Decreasing risk of breast cancer
• Butyric Acid
• Cost and convenience

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Class Discussion

• What are the two forms of human milk?
• What form of milk is DHA most prevalent and what
  is its function?
• What is the main form of CHO in human milk and
  what is its function?
• What are the two main hormones involved with
  human milk production?
• What are some effects on human milk composition?

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Summary

• Lactogenesis
• Macronutrients of Colostrum
• Macronutrients of Human Milk
• Two major hormones and function
• Effects on human milk composition
• Benefits of breast feeding

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References

• http//www.news-medical.net/?id10194
• http//jds.fass.org/cgi/reprint/82/6/1339.pdf
• Brown, J. E. (2005). Nutrition Through the Life
  Cycle. Belmont, California Thompson Learning,
  Inc..