Misplaced Pages

This is an old revision of this page, as edited by Maxschmelling (talk | contribs) at 14:49, 11 June 2009 (Reverted to revision 295095823 by Dkam; no reason given for huge deletions--vandalism?. (TW)). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Human 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 than 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; lowered risk of Sudden Infant Death Syndrome (SIDS), increased intelligence, decreased likelihood of contracting middle ear infections, cold, and flu bugs, decreased risk of some cancers such as childhood leukemia, lower risk of childhood onset diabetes, decreased risk of asthma and eczema, decreased dental problems, and decreased risk of obesity later in life, decreased risk of developing psycologicial disorders .

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.

The amount of supply depend on how often the mother nursing and/or pumping; 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

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, 10% to 15% 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 in some countries.

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.

See also

• Lactation
• Lactation room
• Male lactation
• Breast pump
• Human milk banking in North America
• Infant formula
• Donor Expressed Breast Milk

References

This article includes a list of references, related reading, or external links, but its sources remain unclear because it lacks inline citations. Please help improve this article by introducing more precise citations. (January 2008) (Learn how and when to remove this message)

1. http://www.drpaul.com/breastfeeding/colostrum.html
2. ^ http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/
3. World Health Organization breast feeding recommendations.
4. WHO and UNICEF call for renewed commitment to breast-feeding
5. breastfeeding prevents obesity later in life - study
6. usbreastfeeding.org benefits of breastfeeding
7. womenshealth - breastfeeding benefits mom and baby
8. http://www.mayoclinic.com/health/breast-feeding/FL00120
9. http://www.llli.org/FAQ/increase.html
10. http://www.askdrsears.com/html/2/T022800.asp
11. http://parenting.ivillage.com/newborn/nbreastfeed/0,,456z,00.html
12. http://www.babies.sutterhealth.org/breastfeeding/bf_production.html
13. http://pediatrics.about.com/library/breastfeeding/blbreastfeedingza.htm
14. Constituents of human milk United Nations University Centre
15. Jenness R (1979). "The composition of human milk". Seminars in Perinatology. 3 (3): 225–239. PMID 392766. {{cite journal}}: Unknown parameter |month= ignored (help)
16. Thorell L (1996). "Nucleotides in human milk: sources and metabolism by the newborn infant". Pediatric Research. 40 (6): 845–852. doi:10.1203/00006450-199612000-00012. PMID 8947961. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
17. Sanchez CL; et al. (2009). "The possible role of human milk nucleotides as sleep inducers" (Abstract). Nutr Neurosci. 12 (1): 2–8. doi:10.1179/147683009X388922. {{cite journal}}: Explicit use of et al. in: |author= (help)
18. Fride E, Bregman T, Kirkham TC. (2005). "Endocannabinoids and food intake: newborn suckling and appetite regulation in adulthood" (PDF). Experimental Biology and Medicine. 230 (4): 225–234. doi:10.1371/journal.pbio.0020286. PMID 15792943. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
20. MedlinePlus Medical Encyclopedia: Cow's milk for infants and children
21. "Some patients with lactose intolerance may believe they are allergic to milk or milk products. A milk allergy, however, is related to the proteins in milk rather than the lactose." Lactose Intolerance, National Institute of Child Health and Human Development (NICHD)

External links

• The Case against breastfeeding
• Comparison of Human Milk and Formula
• United Nations University Centre - Constituents of human milk - including comparison of human and cow's milk ones
• La Leche League Human Milk Storage Information
• Children's Health Topics: Breastfeeding
• Infant nutrition information from Seattle's Children's Hospital and Regional Medical Center
• Moms pay big for other mothers' milk, Janine DeFao, San Francisco Chronicle, 9 April 2006. An article about the market on human milk.

• Breast
• Breastfeeding
• Body fluids
• Breast milk