Breast Milk Composition Research Articles

Перинатальный период – окно возможностей для профилактики ожирения у детей

The review substantiates the understanding of the absence of melatonin production with a circadian rhythm in pregnant women associated with certain pathologies (obesity, diabetes mellitus, metabolic syndrome, gestosis of pregnancy, chronic placental insufficiency, etc.) and its role in the genesis of metabolic dysregulation in childhood and programming of health problems later in life. A new approach to assessing the risks of obesity and development of methods of its prevention in children, who did not receive maternal melatonin has been determined, with special attention to an individual selection of a milk formula that is optimally close to the breast milk composition. Key words: obesity, newborn, melatonin, circadian rhythm, breast milk, human milk oligosaccharides

A Review of the Immunomodulating Components of Maternal Breast Milk and Protection Against Necrotizing Enterocolitis.

Breast milk contains immunomodulating components that are beneficial to newborns during maturation of their immune system. Human breast milk composition is influenced by an infant’s gestational and chronological age, lactation stage, and the mother and infant’s health status. Major immunologic components in human milk, such as secretory immunoglobulin A (IgA) and growth factors, have a known role in regulating gut barrier integrity and microbial colonization, which therefore protect against the development of a life-threatening gastrointestinal illness affecting newborn infants called necrotizing enterocolitis (NEC). Breast milk is a known protective factor in the prevention of NEC when compared with feeding with commercial formula. Breast milk supplements infants with human milk oligosaccharides, leukocytes, cytokines, nitric oxide, and growth factors that attenuate inflammatory responses and provide immunological defenses to reduce the incidence of NEC. This article aims to review the variety of immunomodulating components in breast milk that protect the infant from the development of NEC.

New trends in preserving breastfeeding by use of probiotics to prevent mastitis and lactostasis in breastfeeding women

The article discusses the unique property of autonomous variability in breast milk composition under the influence of external factors, including endogenous (hormonal) and exogenous (dietary, environmental) factors. The authors presented the analysis of study findings, how the method of delivery and antibiotic prophylaxis affect the bacterial composition of milk and discuss whether there is a difference between two factors. The results of EUROMAPGROUP and HUMAP studies and an approximate estimation of antibiotics volume (in tons) used in food animal production are presented, which demonstrates one of the global problems of our time antibiotic resistance. A modern method for preventing lactational mastitis using the probiotic Lactobacillus fermentum CECT5716, which was recently launched to the Russian pharmaceutical market, is proposed to prevent the child from receiving subtherapeutic antibiotic doses with mother’s milk. The main studies on the breast milk probiotics and the prevention of mastitis and lactostasis in breastfeeding women are presented.

Breast milk and erythrocyte fatty acid composition of lactating women residing in a peri‑urban South African township

Data on breast milk fatty acid (FA) composition in South African lactating women in relation to their FA status, as well as on potential compositional changes within feed, are limited.The aim of this study was to assess the FA composition of breast milk sampled at three time points within feed, and to determine associations with red blood cell (RBC) total phospholipid FA levels in lactating South African mothers of 2–4-month-old breastfed infants.FA composition (% total FAs) was analyzed in RBC total phospholipids, and in fore-, mid-feed and hind-milk samples of lactating mothers (n = 100) of Black African descent living in a peri‑urban township.The mean age of the lactating women was 27.8 ± 6.8 years. Geometric mean (95% CI) breast milk SFA, MUFA and PUFA contents were 37.7 (37.3,38.1), 28.5 (27.9, 28.8), and 23.5 (23.2, 24.5)%, respectively. Breast milk DHA and AA contents were 0.25 (0.24, 3.71) and 0.81 (0.79, 0.83)%, respectively, in fore-, mid- and hind-milk combined. Maternal RBC EPA, DHA and AA levels were 0.37 (0.34, 0.40), 3.8 (3.6, 4.0) and 15.4 (14.8, 16.1)%, respectively. Women who reported to consume fish often (n = 3) had significantly higher RBC EPA levels than women who consumed fish sometimes (n = 56), never (n = 14) or rarely (n = 19). Breast milk DHA positively correlated with maternal RBC DHA, while no correlations were found between breast milk AA and maternal RBC AA. Breast milk ALA and DHA contents were significantly higher in mid-feed [ALA= 0.8 (0.2, 0.2), DHA=0.3 (0.2, 0.3)] and hind-milk [ALA=0.8 (0.8, 0.9), DHA=0.3 (0.3, 0.3)] than foremilk [ALA=0.8 (0.7, 0.9), DHA=0.2 (0.2, 0.3)]. In contrast, LA and AA contents remained constant within feed.In this sample of peri‑urban South African lactating mothers, breast milk was low in DHA and high in AA compared to global means. Breast milk DHA was associated with maternal RBC status, while breast milk AA was not. We further showed that breast milk ALA and DHA increased, while LA and AA remained unchanged within feed. This suggests that n-3 PUFA maybe preferentially transferred to breast milk within feed through biomagnification.

Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands

IntroductionPericonception obesity is associated with a higher risk for adverse perinatal outcomes such as gestational diabetes mellitus, preeclampsia, large for gestational age, operative delivery and preterm birth. Lifestyle interventions during...

Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms.

Air pollution is a major social, economic, and health problem around the world. Children are particularly susceptible to the negative effects of air pollution due to their immaturity and excessive growth and development. The aims of this narrative review were to: (1) summarize evidence about the protective effects of breastfeeding on the adverse health effects of air pollution exposure, (2) define and describe the potential mechanisms underlying the protective effects of breastfeeding, and (3) examine the potential effects of air pollution on breastmilk composition and lactation. A literature search was conducted using electronic databases. Existing evidence suggests that breastfeeding has a protective effect on adverse outcomes of indoor and outdoor air pollution exposure in respiratory (infections, lung function, asthma symptoms) and immune (allergic, nervous and cardiovascular) systems, as well as under-five mortality in both developing and developed countries. However, some studies reported no protective effect of breastfeeding or even negative effects of breastfeeding for under-five mortality. Several possible mechanisms of the breastfeeding protective effect were proposed, including the beneficial influence of breastfeeding on immune, respiratory, and nervous systems, which are related to the immunomodulatory, anti-inflammatory, anti-oxidant, and neuroprotective properties of breastmilk. Breastmilk components responsible for its protective effect against air pollutants exposure may be long chain polyunsaturated fatty acids (LC PUFA), antioxidant vitamins, carotenoids, flavonoids, immunoglobins, and cytokines, some of which have concentrations that are diet-dependent. However, maternal exposure to air pollution is related to increased breastmilk concentrations of pollutants (e.g., Polycyclic aromatic hydrocarbons (PAHs) or heavy metals in particulate matter (PM)). Nonetheless, environmental studies have confirmed that breastmilk’s protective effects outweigh its potential health risk to the infant. Mothers should be encouraged and supported to breastfeed their infants due to its unique health benefits, as well as its limited ecological footprint, which is associated with decreased waste production and the emission of pollutants.

Effect of breast milk microbiome on the health of mothers and newborns

The article presents updated data on the microbial composition of breast milk in healthy women and women with lactational mastitis. The authors describe the main ways of the formation of mammary gland microbiome and its effect on the maternal and newborn health. The feasibility of using probiotic agents created on the basis of strains of lactic acid bacteria isolated from breast milk is substantiated both for the treatment of lactational mastitis and for its prevention in risk groups.

Features of lactation in puerperal women with obesity

The objective: to determine the features of lactation in obese puerperas, depending on the body mass index and the therapeutic and preventive measures. Materials and methods. The analysis and evaluation of quantitative and qualitative indicators (lactose, casein, total protein, lipids, lactoferrin, transferrin, ceruloplasmin, vitamins C and E, immunoglobulins of G, A, M classes) of maternal milk in the dynamics of the postpartum period in 386 puerperas was conducted. The main group consisted of 115 women with obesity, the management of the preconception period, pregnancy and the postpartum period was carried out according to the proposed by us program, including non-drug and drug methods. The comparison group included 103 puerperas with obesity, the management of which was carried out in accordance with the Order No. 417 of the Ministry of health of Ukraine dated 15.07.2011. The control group consisted of 53 primiparous with normal body weight. Results. Analysis of the state of lactation revealed hypogalactia and pathological changes in the qualitative composition of breast milk, manifested in women with obesity and lower levels of lactose and lactoferrin by 1.6 times, total protein, ceruloplasmin by 2.2 times, lipids by 2.1 times, transferrin by 1.4 times, casein by 1,5 times, vitamin C by 1,8 times and E by 1,5 times, and the content of IgG by 2.1 times, IgM by 1.9 times, IgA by 2.2 times. The stage of hypogalactia severity and pathological changes in the quality of breast milk increase due to the body mass index growth. Conclusion. The proposed pathogenetically justified program of therapeutic and preventive measures contributed to the increase in the volume of breast milk and its quality improve. Key words: postpartum period, lactation, obesity.

Macronutrient Analysis of Modified-Fat Breast Milk Produced by 3 Methods of Fat Removal.

Infants with chylothorax after congenital heart disease surgery are commonly treated using modified-fat breast milk. The effect of fat removal on breast milk macronutrients remains unclear. We compared macronutrient content of breast milk with breast milk skimmed using 3 methods, including a novel device, a cream separator. Thawed frozen breast milk samples from 30 women were defatted using refrigerated centrifuge, cream separator, and manual separation after refrigeration. We used standard assays to measure energy, protein, and fat content of breast milk samples. All fat removal methods yielded skimmed breast milk with substantially lower fat and energy content. Mean energy content in breast milk skimmed by centrifuge (36.7 [SD 3.6] kcal/100mL) was similar to that from cream separator (38.8 [3.5] kcal/100mL). Both centrifuge and cream separator methods removed almost all fat and substantially more fat than the manual fat removal method. For unprocessed milk, energy and fat content estimated by creamatocrit was similar to reference method measurements; in skimmed milk, the creamatocrit significantly overestimated fat content. Mean protein content of skimmed breast milk was similar to unprocessed breast milk (mean 1.25 [0.31] g/100mL). Breast milk fat removal did not significantly alter protein levels. In skimmed breast milk, the overestimation of fat content using creamatocrit method suggests a need for more accurate bedside methods to assess macronutrient content. The similar macronutrient composition of breast milk skimmed by cream separator and centrifuge suggests the potential for cream separator use as a new, portable defatting method for hospitals and families.

ASSESMENT OF THE LACTATION IN PUERPERAL WOMEN WITH METABOLIC SYNDROM

The article presents the results of assessing the state of lactation in puerperas with metabolic syndrome on the background of obesity.The aim of research: to assess the state of lactation in puerperas with metabolic syndrome, depending on body mass index and therapeutic and preventive measures taken.Material and methods: the analysis and evaluation of quantitative and qualitative indicators of maternal milk in the dynamics of the postpartum period in 386 puerperas was conducted. The main group consisted of 115 women with metabolic syndrome and obesity, the management of the preconception period, pregnancy and the postpartum period was carried out according to the proposed by us program, including non-drug and drug methods. The comparison group included 103 puerperas with obesity, the management of which was carried out in accordance with the Order No. 417 of the Ministry of health of Ukraine dated 15.07.2011. The control group consisted of 53 primiparous with normal body weight.Results and discussion: analysis of the state of lactation revealed hypogalactia and pathological changes in the qualitative composition of breast milk, manifested in women with obesity and lower levels of lactose and lactoferrin by 1,6 times, total protein, ceruloplasmin by 2,2 times, lipids by 2,1 times, transferrin by 1,4 times, casein by 1,5 times.Conclusion: The stage of hypogalactia severity and pathological changes in the quality of breast milk increase due to the body mass index growth. The proposed pathogenetically justified program of therapeutic and preventive measures contributed to the increase in the volume of breast milk and its quality improve.

Association of breast milk gamma-linolenic acid with infant anthropometric outcomes in urban, low-income Bangladeshi families: a prospective, birth cohort study

Background/ObjectivesInfant linear-growth faltering remains a major public health issue in low- and middle-income countries and suboptimal breast milk composition may be a local, population-specific risk factor. The relationship between early post-natal breast milk fatty acid (FA) composition and infant growth at 1 and 2 years of age was investigated prospectively in 563 families in Dhaka, Bangladesh.Subjects/MethodsA maternal breast milk sample drawn before infant age 6 weeks was analyzed for percentage composition of 26 FAs, and infant length for age Z score (LAZ) was measured longitudinally to infant age 2 years. Individual FAs were tested as predictors of the infant growth outcomes.ResultsOf 26 tested FAs, %gamma-linolenic acid (%GLA) was mostly significantly associated with increase in LAZ from 6 to 52 weeks (ΔLAZ(52−6w)), and also to 104 weeks. The association was consistent over all breast milk stages with estimated effect size of +0.05 ΔLAZ(52−6w) per 20% change in %GLA (p value = 3 × 10−6), and stronger for ΔLAZ(104−6w) at +0.06 (p value = 8 × 10−7), explaining 1% of the outcome variance. Infant serum zinc measurements at 6 and 18 weeks of age were included in adjusted analyses, suggesting at least partial independence of infant zinc levels. The association was strongest in 417/563 (74.1%) families with %GLA <0.2%. Breast milk arachidonic acid fraction was within normal range with weaker evidence of association in early breast milk stages.ConclusionsThis study found that %GLA in breast milk was independently associated with infant linear growth, albeit with small effect size, in a predominantly slum-dwelling, low-income, Bangladeshi cohort.

Microbial Composition of Breast Milk Collected From Healthy Turkish Women

Microbial Composition of Breast Milk Collected From Healthy Turkish Women

Heavy metals and physico-chemical composition of Maternal breast milk and colostrum

Heavy metals and physico-chemical composition of Maternal breast milk and colostrum

Macronutrient analysis of preterm human milk using mid-infrared spectrophotometry.

Background Human milk is the optimal source of nutrition for preterm infants. However, breast milk alone is often not sufficient to satisfy the high nutritional needs for growth and development in preterm infants. Fortified human breast milk is the best way to meet the nutritional needs of preterm infants. Human breast milk is fortified according to the estimated nutrient content of mature breast milk; however, because the content of breast milk is highly variable, the macronutrient support may be more or less than needed. The goal of this study was to analyze the macronutrient content of preterm human milk during the first 6 weeks of lactation. Methods The study included 32 mothers of preterm infants with a gestational age of ≤32 weeks. Breast milk was collected in 24-h cycles and analyzed daily using mid-infrared (MIR) spectroscopy. We measured protein, fat and lactose concentrations in the breast milk, and the energy content was calculated. Results The protein content was high during the first weeks of lactation, but decreased as lactation progressed. The fat, energy and lactose contents of the breast milk were low during the first 2 weeks of lactation, increased as lactation progressed and remained constant thereafter. In women with high body mass index (BMI), higher protein levels were found in transitional milk. In women who had high income level, higher fat and energy levels were found in transitional milk. Conclusion Our findings indicate that the macronutrient content of preterm breast milk changes throughout the course of lactation, with BMI and income level. Knowledge of the macronutrient composition of breast milk is necessary to ensure that preterm infants receive the appropriate types and quantities of nutrients to promote optimal growth, and to ensure that breast milk is fortified according to individual needs. Our findings may be useful for the provision of optimal nutritional support for preterm infants.

Developmental Programming of Body Composition: Update on Evidence and Mechanisms.

A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental programming." A common phenotype in humans and animal models is altered body composition, with reduced muscle and bone mass, and increased fat mass. In this review, we summarize the recent literature linking prenatal factors to future body composition and explore contributing mechanisms. Many prenatal exposures, including intrauterine growth restriction, extremes of birth weight, maternal obesity, and maternal diabetes, are associated with increased fat mass, reduced muscle mass, and decreased bone density, with effects reported throughout infancy and childhood, and persisting into middle age. Mechanisms and mediators include maternal diet, breastmilk composition, metabolites, appetite regulation, genetic and epigenetic influences, stem cell commitment and function, and mitochondrial metabolism. Differences in body composition are a common phenotype following disruptions to the prenatal environment, and may contribute to developmental programming of obesity and diabetes risk.

Do maternal morbidities change the nutritional composition of human milk? A systematic review.

This paper aims to identify the effects of maternal morbidities on the nutritional composition of human milk. This systematic review of the literature employed a PRISMA's protocol for searching, selecting, and extracting data. The flowchart proposed for bibliographic search resulted in 1,582 papers, of which 14 were selected for this work. The papers selected for this review were published between 1987 and 2016. Nine studies found significant differences in the nutritional composition of the milk of mothers with diabetes mellitus, arterial hypertension, or overweight compared to the control group. Most studies have shown that the presence of chronic diseases leads to changes in the nutritional composition of human milk. The main results showed a lower concentration of lactose and fat in the milk of women with diabetes mellitus. Concerning hypertension, higher levels of total protein were found in colostrum and mature milk. A higher fat and energy content was observed in overweight mothers. It is imperative that these women have continuous nutritional monitoring to minimize the impact of these morbidities on the nutritional composition of breast milk.

Positive relationship between consumption of specific fish type and n-3 PUFA in milk of Hong Kong lactating mothers.

Residents of Hong Kong have undergone a dietary transition from a traditional Chinese diet that is high in seafood to a more Western diet. This may have affected the nutritional composition of breast milk of Hong Kong mothers. The present study aims to investigate the relationship between the dietary pattern and the fatty acid profile of the breast milk of lactating women in Hong Kong. Seventy-three volunteering healthy Hong Kong lactating mothers participated in the study. Their dietary intakes were assessed by using a 3-d dietary record and FFQ. The mean n-3 fatty acid levels were approximately 0·4 % (EPA) and 0·9 % (DHA) of total fatty acids in the breast milk of lactating mothers who had exclusively breastfed their infants aged 2-6 months. Maternal dietary intakes of n-3 fatty acids were positively associated with their levels in the breast milk. The levels of maternal intakes of freshwater and saltwater fish, especially the consumption of salmon, croaker and mandarin, were significantly correlated with the content of DHA in breast milk. The present study is among the very few in the literature to determine the fatty acid profile of breast milk in Hong Kong populations and verify certain dietary factors that influence this profile. High levels of n-3 PUFA, especially DHA, were observed in the breast milk of Hong Kong lactating women. The findings may serve as a dietary reference for lactating mothers to optimise the fatty acid profile of their breast milk.

Human Milk Oligosaccharide Composition of Breast Milk from Lactating Women in Dhaka, Bangladesh (P11-040-19)

ObjectivesWe aimed to describe the human milk oligosaccharide (HMO) composition of breast milk from Bangladeshi women, overall and by galactoside 2-alpha-L-fucosyltransferase 2 (FUT 2) secretor status, and to estimate the effect of prenatal and postpartum vitamin D3 supplementation on HMO composition. MethodsIn a sub-study of the Maternal Vitamin D for Infant Growth trial in Dhaka, Bangladesh, we selected 96 participants from the placebo group and 96 who were administered 28,000 IU/week vitamin D3 from 17–24 weeks gestation to 6-months postpartum. Breast milk collected at 13 ± 1 week(s) postpartum were analyzed by high-performance liquid chromatography to determine absolute concentrations, relative abundancies of 19 HMOs and total amount HMOs, summarized using medians (interquartile range (IQR)). Associations between each HMO and selected maternal factors (e.g., age, parity, breastfeeding pattern) were estimated by multiple linear regression, adjusting for vitamin D group. ResultsTotal median HMO concentration was 16.8 mmol/mL (IQR 9.5-18.7) overall, but varied by secretor status: 18.0 mmol/mL (IQR 16.9-19.2) in secretors (66%) and 9.2 mmol/mL (IQR 8.9-9.5) in non-secretors (34%). Individual HMO concentrations also varied within secretor groups: 2’FL, the most abundant HMO among secretors, ranged from 1.3 to 15.8 mmol/mL among secretors and LNFP II, most abundant among non-secretors, ranged from 0.02 to 4.3 mmol/mL among non-secretors. Vitamin D3 supplementation did not affect total or individual HMO concentration. Other maternal factors were not significantly associated with secretor status, total or individual HMO concentration; however, breastmilk collected during winter had a significantly higher concentration of 3’FL compared to breastmilk collected during spring. The proportion of secretors in Bangladesh was similar to cohorts in Africa and North America. Relative HMO concentrations within secretor groups were similar to other international cohorts. ConclusionsThe HMO composition of breast milk from Bangladeshi women is predominantly determined by secretor status, similar to other countries worldwide. Further research is required to understand the effect of variations in HMO composition on infant health outcomes. Funding SourcesThe Bill and Melinda Gates Foundation.

The investigation of fatty acid composition of breast milk and its relationship with dietary fatty acid intake in 5 regions of China.

To investigate the relationship between dietary fatty acid (FA) intake and the lactate FA levels in Chinese women.A total of 2007 samples from 5 regions of China were collected, including 431 in Shandong, 402 in Changchun, 419 in Chongqing, 398 in Guangzhou, and 357 women in Hohhot. All participants were mothers of healthy full-term newborns, collecting the foremilk from day 1 to day 7 and the mature breast milk on day 42 after delivery. The FA composition of the breast milk was analyzed by high resolution capillary gas chromatography.The total FA content of mature breast milk in Shandong was the highest (34.95 g/L), and that was the lowest in Guangzhou (29.72 g/L). The saturated FA content of breast milk was increased from 1 to 7 days after delivery and decreased in mature breast milk. The saturated FA content of breast milk in Hohhot was the highest (37.43%), but that was the lowest in Changchun (32.80%). Maternal dietary FA composition was positively correlated with saturated FAs (SFA), polyunsaturated FAs (PUFA), and docosahexaenoic acid (DHA) (P < .001), and negatively with monounsaturated FAs (MUFA) (P > .05) in breast milk.The FA content of breast milk is different in different regions of China, which was affected by maternal dietary FA composition. Lactating women in China should consume more foods rich in polyunsaturated FAs to ensure the growth of infant.

Bioanalytical assays in support of tanezumab developmental and reproductive toxicity studies: challenges and learnings.

Bioanalytical challenges were encountered during developmental and reproductive toxicity studies of tanezumab in cynomolgus monkeys. Possible changes in breast milk composition over the postpartum period potentially complicated assessment of tanezumab concentration in this matrix, requiring validation of the quantification assay across different time intervals. Immunogenicity assessment in maternal serum was complicated by apparent increases in the incidence of antidrug antibody-positive results in treatment-naive samples as pregnancy progressed that were due to changes in the concentration of nerve growth factor, tanezumab's target protein. This was overcome by employing gestational day-specific cut points throughout pregnancy.Researchers should recognize potential challenges associated with dynamic matrices/physiological conditions and anticipate that assays developed under normal conditions may require adaptation for specialized situations.