Early Life Nutrition and Lifelong Health - Lactation Science and Barriers Flashcards
Is there a biological difference between breast milk and formula?
Yes, they are totally different
But 67% of people said no
72% of people do not think being formula fed has long-term consequences for health
What are the WHO guidelines for the length of breast feeding?
Exclusive for 6 months
But up to 2 years and beyond with complimentary food
What is the full duration of breastfeeding per child?
From primate studies and tribal humans
Between 4 and 7 years
How does breastfeeding differ in Western cultures?
Many mothers do not breastfeed
Most mothers stop breastfeeding by the time their child is 1 years old
1 in 200 mothers in the Western World continue to breastfeed their child after 1 year
How do milk teeth correlate with breastfeeding?
Children start to lose their milk teeth at 6 y/o
Corresponds with children weaning away from breastfeeding at this age, as their jaw and teeth structure changing
What is formula milk made up of?
Usually cow’s milk
What is a unifying factor of mammals?
All mammals have the capacity to lactate
Even if they are egg laying or placental mammals
What is the difference between cows and human milk?
Cows milk have more protein
As they are bred to have a lot of muscle mass
Infants on formula grow faster
But human breastmilk has more fatty acids - humans are better at extracting the fat from their maternal diets for their breastmilk than other mammals
How does human breast milk vary over 24 hours? How does this affect the baby?
There is a diurnal rhythm to milk
Contains typtophan, an amino acid that is found in larger quantities in the evening
Tryptophan helps the infant set a diurnal rhythm too
What else is found in human milk? How does this affect the baby?
Pluripotent stem cells - taken up and absorbed in the gut of the infants, found in all organ systems
Unknown the benefits of this
What are the benefits of human milk?
Developmental tool Epigenetic regulator Innate immunity Antimicrobial factors High fatty acid composition Pluripotent stem cells
What is a proposed theory for why human brains are different?
Infant brain growth is incredibly fast
Could be as a result of the breast being good at extracting fats
What are the broad classes of molecules in milk that have antiviral properties?
SigA Gangliosides Glycosaminoglycans Oligosaccharides Mucins Lactadherin Lewis X Lysozyme Tenascin C Cytokines Bacteriophages Extracellular vesicles Monolaurin Lactoferrin Vitamin A Oxysterols
Why do babies put things in their mouth?
Fumbling their environment - for the development of their innate immune system and gut microbiome
How does breastfeeding affect the gut microbiome?
Exposure to breast milk feeding up to 14 months that principally was responsible for patterning the immune system and gut microbiome
How does breastmilk shape the infant’s gut microbiome?
Complex oligosaccharides found in human breast milk - over 200 oligosaccharides identified
20 of these cannot be metabolised by the infants - therefore there to preferentially select the bacteria bifidobacteria and lactobacillus bacilli to grow and reproduce
What influences the components of a mother’s breast milk?
Each mother has unique fingerprint for their breast milk dependent on:
- Genetics
- Environment influences
- Local environment pathogens
- Season
What does the gut epithelium look like in infants? Why is the structure important / relevant to milk feeding?
Single cell layer
2 way process in infant’s gut - gaps between cells allows big molecules e.g. immunoglobulins (Igs), stem cells etc. to be taken up from the milk
BUT also enables dendritic cells to poke tendrils out into the lumen to sample the gut bacteria and proteins - which are then chopped and presented to the T and B cells in the gut
Allows infant’s immune system to differentiate between friend and foe
When do the gaps in the junctions close up? Why is it important?
When infant starts eating solid food - i.e. as soon as non-human protein is identified by the gut epithelium, a range of genetic signalling pathways activate to close the gaps between the cells / activate tight junctions
To stop slid food from getting through the gut walls
Also blunts the immune programming mechanism - may be a reason for friving infants towards having increased auto-immune disease risk later in life
What is a modulator of diathesis stress model?
Gut microbiome
Although genetic susceptibility and environmental stressor lead to disease outcome, aberrant microbiome is the mediator between these two
What is a primary modulator of the gut microbiome?
Infant feeding
What diseases are being implicated by poor of infant feeding?
Asthma
Obesity
T1DM (type 1 diabetes mellitus) - although not previously associated with any lifestyle factor, T1DM cases have risen by 20 fold since 40 years ago
Acute lymphoblastic leukemia
Neurological disease - dementia, parkinsons, alzheimers
Why is breast feeding very important?
Setting infants on a trajectory of health from the beginning
How is infant temperature control influenced by human milk?
Unique fatty acids (alkylglycerols) found in only human milk (And in small amounts in donkey milk) that act to keep Basch Thermogenic Adipocytes
Basch Thermogenic Adipocytes - produce a heat drive of 300x the utilisation of ATP to produce heat
Helps infants regulate their body temperature
Why do infants that are formula fed by the age of one have a significantly higher risk of being overweight?
If those unique alkylglycerols are not present, then those Basch fat cells convert into white fat cells (storage fat cells)
If infants are fed until a year and beyond, the Basch adipocytes perisst until child and adolescence - probably longer
Why has previous research into the differences in children who have and have not breast fed not been appreciated in modern research?
Methodology of all studies have been flawed - they would have two categories, ‘ever fed’ and ‘never fed’
Ever fed = large variations in infants who have been fed human milk, some may have tried it, some may have maintained it for several years etc.
What is the association between breast feeding and cancer?
Breast, ovarian, endometrial and oesophageal cancer risk is reduced by breast feeding
Triple negative breast cancers that have worse prognosis and affect younger women - breastfeeding reduced this by 20%
How much does breastfeeding reduce the risk of breast cancer in those with high risk genetic mutations e.g. BRCA1?
1yr of breastfeeding = 35-40% reduction
2yrs of breastfeeding = 55-60% reduction
What is the link between breast feeding and postnatal depression?
Reduces risk of post natal depression
How does breastfeeding affect child mortality?
Over the last few years, child mortality has halved in Brazil - largely been put down to breastfeeding
What is normal lactation?
Prolactin helps lactocytes to produce milk
Oxytocin acts on the myeopithelial cells to squeeze and eject milk into the baby’s mouth - aids with milk secretion
Baby’s only need to suckle, the milk is ejected into their mouths
Supply meets demand
The more the baby feeds the more milk is produced
What is important about breastfeeding within the first hour of birth?
Amniotic fluid on baby’s hand should not be dried as it has a similar scent to mother’s nipple - helps baby find nipple, latch on and suckle
For the same reason, mother’s nipple should not be washed before their baby breast feeds
How often do babies breastfeed in 24 hours?
8-12 times
Long feed every 3 hours
Other times, short feed for hydration
What is cluster feeding?
Feeding solidly for 6-8 hours
Ramps up the mothers supply
Establishes the mothers ability to produce a full supply
What are factors that can decrease mothers milk supply?
Supplementing with formula milk Using a dummy in the early weeks Separating mother and baby Trying to follow a routine Sleep training
What are newborn sleep patterns?
No clear circadian rhythm for sleep
Half their sleep is active (AKA REM sleep)
They active sleep for 30 mins, then quiet sleep for 50 mins
How can newborns be aroused from active sleep?
Hunger Cold Discomfort Startle reflex Unfamiliar conditions
What is responsive feeding?
Interaction between mother and child
Mother can pick up on babies signals
What is responsive feeding associated with?
Higher prolactin levels Longer duration of breastfeeding Fewer breastfeeding difficulties Increased milk supply Lower risk of overweight Later satiety responsiveness
