Composition Of Human Milk Flashcards
Immunological component of milk
- lymphocytes
- macrophages
- T cells +B cells
- hematopoietic stem cells
- immunoglobulins
- lactoferrin
- lysosomes
- oligosaccarides
- probiotic
- cytokines
Factors that impact milk composition
- gestation
- stage of lactation
- stage of feeding
- frequency of infant demand for milk
- degree of breast fullness
Colostrum
- higher in protein and minerals
- lower in carbs, lipids, vitamins
- higher concentration of epidermal growth factor, TGF-B and colony stimulating factor
Gastric emptying time human milk vs. formula
Human milk = 48 minutes
Formula = 78 minutes
Caloric density?
Higher for males or females?
65-70kcal/dL, but wide variation, especially for pretermers
- changes over time to meet infants needs
25% higher for males
Average human milk yield
- First 24 hour
- by day 5
- By 6 months
- For multiparous women
- 37mL
- 500mL
- 800 mL
- Additional 140mL per day at one week
Normal infant weight gain
- up to 4 weeks post birth
- By end of first year
- 10g/kg/day (5-7 oz/week)
2. 1 g/kg/day (3oz/week)
Growth - formula vs. breastmilk
- No difference in length or head circumference
- Weight gain greater in breast milk for the first 3-4 months, especially SGA
- After 4 months, formula fed babies weigh more - likely overfed
Foods and medications that can change color of breast milk
- Food - carrots, sweet potatoes, beets, leafy greens
- Red/pink - Clofazimine, rifamycins, serratia marcerscens
- Green- procardia, propofol, blue green algae, iron supplements,
- Black - minocyline
Lactose
7/g/dL
Enahnces calcium absorption
Provides glucose to rapidly growing brain
Human Milk Oligosaccharides
- Not digestible
- Prebiotic- promote bacteria L. bifidus, B. Infantis
- attach to epithelial cells of pathogens and help them be eliminated through stool rather than causing disease (norovius, e.coli, rotavirus, c. Jejeuni)
Lactoferrin
- A glycoprotein important in immune health
2.higher levels in pre-term and early term milk - Antibacterial, viral, and fungal action- prevents attachment to intestinal wall and takes aware iron from pathogens
- Reduces inflammatory response
- May help prevent iron deficiency
- Growth factor for B and T cells
6.
Lysozyme
- Part of whey
- Destroys e.coli and salmonella with help of peroxide and ascorbate
- More abundant in human milk
- Increases progressively starting at 6 months after delivery
- Works with lactoferrin to kill gram positive bacteria, selectively kills bacteria (bidifus can tolerate lysozymes)
Immunoglobulin SIgA
- Produced by mother’s breast in respond to messages from gut and lungs
- Higher in mothers with babies with infections and in low income women
- Provides passive protection of entire GI tract
Lactoperoxidase
- Antimicrobial
- Anti-viral for herpes
- Kills streptococci
Cytokines
- Protein signals secreted by immune cells
- Responsible for swelling, tenderness, fever
- Chemokines signal to bring more phagocytes
- Growth and differentiation of mammary gland
Epidermal growth factor
- Growth promoting cytokine
2. strengthens mucosal barrier to antigens
Human milk growth factors (HMGF)
- 3 kinds
2. Influence growth of target tissues
Thyroxine
May stimulate growth of infant intestine
Present in small amounts of breast milk
May mask symptoms of congenital hypothyroidism
Leptin
- regulates apetite, food intake, and energy metabolism
- may impact BMI
Cholecystokinin
- enhances digestion and sedation and well being
- peaks twice after suckling - immediately after feeding and the 30-60 minutes later
Prostaglandins
- group of lipids that affect every system
- PGE2 and PGF2a - protects body from inflammation and necrosis through accumulating phospholipids in the stomach
Taurine
Brain maturation
Vitamin D
May be insufficient in breast milk
Dependent on maternal levels
Breast fed infants recommended to have vitamin D supplementation
Diseases prevented with breastmilk
- Celiac’s disease
- Diabetes
- MS
- SIDS
- Cancer
Calcium
- breast fed infants absorb twice as well as formula fed
- hypocalcemia and tetany more common in formula fed infants
- formula has high phosphorus which decreases absoprtion and increases excretion of calcium
Iron
- relatively low in breastmilk
- iron stores laid down in utero prevent deficiency
- high levels of lactose and vitamin c in human milk facilitate absorption
Whey vs casein
- Whey is softer and easier to digest
- Whey is higher in early lactatiom
- Formula is high in casein, difficult to digest- requires extra energy to digest
Pre-term milk
Nitrogen higher
Higher protein and fat
Lower levels lactose
Fat
- Provides half of milk’s calories
- varies from one mother to another
- ranges 22-62g/dL
- Independent of breastfeeding frequency
- higher during day and lower at night
