Effect Of Human Milk Research Articles

Effects of human milk on body composition and growth in very low birthweight infants.

To compare body composition and growth in very low birthweight infants according to their source of human milk: maternal expressed breast milk (MEBM) versus donor breast milk (DBM). We hypothesized that infants fed predominately MEBM would exhibit reduced body fat percentage compared to those fed predominately DBM. Premature infants weighing ≤1500 g on an exclusive human milk diet were enrolled in a single-center study between 2017 and 2021. Demographic data and anthropometric measurements were collected. All infants underwent body composition analysis via dual energy x-ray absorptiometry at 36 weeks corrected post menstrual age. A total of 60 infants were enrolled and 48 were included in the primary analysis. No differences were detected in percent body fat (14 vs. 12%, p = 0.7) or fat-free mass (2050 vs. 2130 g, p = 0.7). Both groups displayed similar growth and anthropometric measurements. Caloric and macronutrient intake between groups was similar. In the cohort of patients studied, no differences were observed in percent body fat based on primary human milk type intake in the first 28 postnatal days. Further investigation is required in a larger population of exclusive human milk fed preterm infants to determine if body composition differences exist based on an infant's primary human milk source. Premature infants are at risk for altered body composition at term corrected age, specifically increased body fat percentage, which may have implications for the future. To our knowledge this is the first study exploring body composition outcomes based on an infant's primary human milk source. Infants fed exclusive human milk (e.g., donor vs. maternal) displayed similar percent body fat and growth outcomes.

Effect of human milk and other neonatal variables on lung function at three months corrected age

To evaluate the impact of human milk and different neonatal variables on tidal breathing flow-volume loop (TBFVL) parameters within three months' corrected age (CA) in infants born ≤32 wks or weighing <1500 g. We retrospectively studied 121 infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) <1500 gr who had lung function assessment within three months' CA by TBFVL analysis between June 2009 and April 2018. We investigated the impact of GA, gender, being Small for GA (SGA), sepsis, days of mechanical ventilation (MV) and human milk feeding (HMF) on later respiratory function, both in the entire group and according to BW ( ≤1000 g and >1000 g). The mean(SD) z-score for tidal volume (Vt) and time to peak expiratory flow to expiratory time (tPTEF/tE) were respectively -4.3 (2.5) and -0.8 (2.0) for the overall population with no significant differences between infants <1000 g or ≥1000 g. The mean(SD) Vt standardized for body weight was 6.2(2.0) ml/kg. Being female was associated with better Vt/Kg, whereas longer MV or being born SGA were associated with worst tPTEF/tE. For infants with BW < 1000 gr, tPTEF/tE was positively associated with HMF. An early TBFVL assessment within three months' CA already reveals lung function alteration in preterm infants. Being female is associated with better Vt/Kg, while longer duration of MV or being born SGA negatively affect tPTEF/tE. The positive association between HMF and better tPTEF/tE in infants with BW <1000 g has emerged, which deserves further investigation.

An Observational Study on Effect of High Human Milk Intake on Oxidative Status of VLBW Infants

Background: Preterm infants are at high risk of oxidative stress injuries from various conditions such as low antioxidant capacity, relatively hyperoxia state outside utero, and possible immaturity of many organs. Human milk is an ideal nutrition and medication for these infants. It has antioxidative effects from both enzymatic and non-enzymatic constituents. Objective: To evaluate the beneficial effects of human milk on oxidative status and antioxidant capacity in very-low birth weight infants. Materials and Methods: The present research was a prospective cohort study conducted between January and December 2017. Preterm birthweight less than 1,500 grams were enrolled. Infants were divided into two groups based on breastmilk intake proportion, more than 50% or less than 50% of milk intake. Oxidative status was assessed using plasma malondialdehyde (MDA), and total antioxidant status (TAS) was assessed using Trolox equivalent antioxidant capacity (TEAC). Results: Nineteen (19) VLBW infants were enrolled. Six infants (32%) were in low breastmilk intake group and 13 infants (68%) received breastmilk 50% or more of total enteral intake. Plasma MDA at D1, D7, and D28 were 6.49±5.76, 9.49±6.77, and 6.96±4.84 μM in the low breastmilk intake group, and 8.68±4.44, 8.82±5.01, and 5.71±2.74 in the high breastmilk intake group (p&gt;0.05). Plasma TAS at D1, D7, and D28 were 4.06±0.87, 6.73±2.07, and 7.59±2.03 mmol of Trolox equivalence/L in the low breastmilk intake group, and 8.2±1.55, 7.4±2.29, and 6.58±1.9 mmol of Trolox equivalence/L in the high breastmilk intake group (p&gt;0.05). There was no difference in patient characteristics regarding gender, gestational age, birthweight, mode of delivery, surfactant use, duration of mechanical ventilation, or duration of oxygen supplementation. Conclusion: The present study was unable to demonstrate the differences of plasma MDA and total antioxidant capacity in VLBW infants. Therefore, further studies using more sensitive markers were suggested. Keywords: VLBW, Very low birth weight, Preterm, Oxidative stress, Human milk

The Potential Effects of Human Milk on Morbidity in Very-Low-Birth-Weight Preterm Infants

Improvements in quality of care have led to a significant reduction in mortality and morbidity in preterm infants, especially very-low-birth-weight (VLBW) infants [...].

Mothers of Infants With Congenital Diaphragmatic Hernia Describe "Breastfeeding" in the Neonatal Intensive Care Unit: "As Long as It's My Milk, I'm Happy".

Very little is known about the breastfeeding experience of mothers of infants born with congenital anomalies and cared for in the neonatal intensive care unit (NICU). Often, studies related to breastfeeding and lactation in the NICU setting are focused on the mothers of late preterm, preterm, low-birth-weight, and very-low-birth-weight infants. Congenital diaphragmatic hernia (CDH) is an anatomic malformation of the diaphragm and affects 1 in every 2,000 to 4,000 live births. Currently, there are no studies examining the health outcomes of infants with CDH and the effect of human milk. Research aim: This study aimed to describe the breastfeeding experience of mothers of infants with CDH cared for in the NICU. A prospective, longitudinal qualitative descriptive design was used. Phased interviews were conducted with a purposive sample of 11 CDH infant-mother dyads from a level 3 NICU in a children's hospital. Six themes emerged from the data: (a) hopeful for breastfeeding, (b) latching on . . . to the pump, (c) we've already worked so hard, (d) getting the hang of it-it's getting easier, (e) a good safety net, and (f) finding a way that works for us. For this population of CDH infant-mother dyads, the term breastfeeding is not exclusive to direct feeding at the breast and the mothers emphasized the significance of providing their own mother's milk through a combination of feeding mechanisms to their infants with CDH.

Normal Thymic Size and Low Rate of Infections in Human Donor Milk Fed HIV-Exposed Uninfected Infants from Birth to 18 Months of Age

Objective. To evaluate the immune function in HIV-exposed uninfected (HIV-EU) infants fed human donor milk. Methods. Ultrasound-obtained thymic index (Ti), T-lymphocyte subsets, and the number of infections were examined from birth to 18 months of age in 18 HIV-EU infants. The infants were compared to a cohort of 47 term, HIV-unexposed breastfed or formula-fed infants. Results. The thymic size at 12 months of age was not significantly different between the HIV-EU group and the control infants (P = 0.56). At 4 months of age, the HIV-EU infants had significantly fewer infections than the control infants (P < 0.001). Furthermore, in the control group, the infants exclusively breastfed at 4 months of age had significantly fewer infections at 8 months when compared to age-matched formula-fed infants (P = 0.001). Conclusion. HIV-EU infants fed human donor milk have normal growth of thymus and contract fewer infections than other healthy infants. This finding along with fewer infections in exclusively breastfed infants compared to formula-fed infants supports the beneficial effect of human milk on the immune system. We suggest, when breastfeeding is not possible, that providing human donor milk to vulnerable groups of infants will be beneficial for their maturing immune system.

P07-10. Natural compounds in bodily fluids which bind DC-SIGN and prevent HIV-1 capture and transfer to CD4 cells

Methods We have studied the effects of human milk (HM) and seminal plasma (SP) on interfering with the capture of HIV-1 through binding to DC-SIGN on dendritic cells and prevent the subsequent transfer of HIV-1 to CD4 cells. HM and SP were tested in Raji-DC-SIGN and immature dendritic cell transfer assays to determine interference with HIV-1 capture and transfer. Fractionation and MALDI-TOF biochemical analysis was utilized to identify proteins with DC-SIGN binding activity.

Oligosaccharides from Milk1,

Feeding infants breast milk of healthy mothers is associated with a lower incidence of infectious and allergic diseases. Although this effect is of multifactorial origin, it is widely accepted that the entire intestinal flora of breast-fed infants provides antiinfective properties and is an important stimulating factor for the postnatal development of the immune system. The effect of human milk on the postnatal development of the intestinal flora cannot be attributed to a single ingredient. It is generally accepted, however, that human milk oligosaccharides play a key role in this matter. Apart from their prebiotic effects, there is also evidence that human milk oligosaccharides act as receptor analogs to inhibit the adhesion of pathogens on the epithelial surface and interact directly with immune cells. Because of their complexity, oligosaccharides with structures identical to human milk oligosaccharides are not yet available as dietary ingredients. In the current search for alternatives, non-milk-derived oligosaccharides have gained much attention. As 1 example, a mixture of neutral galacto-oligosaccharides and long chain fructo-oligosaccharides have been identified as effective prebiotic ingredients during infancy. Furthermore, another class of oligosaccharides with a potential physiological benefit could be those found in animal milks. Most of the oligosaccharides detected in domestic animal milks have some structural features in common with human milk oligosaccharides. One important fact is the occurrence of sialic acids such as N-acetylneuraminic acids. However, total amounts and individual structures are still different from those in human milk oligosaccharides. Although these structural similarities between animal milk and human milk oligosaccharides are promising, further studies are needed to proove the equivalence of their function.

Effects of Human Milk on Adhesion of Streptococcus mutans to Saliva-Coated Hydroxyapatite in vitro

Adhesion of bacteria to pellicle-coated tooth surfaces is the first step in biofilm formation on teeth. The aim of this study was to explore whether human milk prevents or promotes adhesion of cariogenic Streptococcus mutans to saliva-coated hydroxyapatite (HA) using an in vitromodel system. S. mutans binding to HA coated with human parotid saliva (s-HA) or human milk was studied, in addition to binding inhibition to s-HA by human milk. S. mutans did not bind to HA coated with milk. S. mutans binding to s-HA was inhibited by milk from 15 (71 %) of 21 women, whereas milk from the remaining 6 mothers enhanced binding of S. mutans to s-HA. Inhibition of S. mutans binding correlated with bacterial binding to s-HA (r = 0.76). Human milk does not mediate adhesion of S. mutans to HA in vitro, but affects adhesion in an individually varying fashion. Phenotypic variations in milk and saliva glycosylation may explain the inhibitory capacity and possibly affect susceptibility to colonization by S. mutans in childhood.

Bactericidal activity of human milk: stability during storage

Human milk provides infants with defensive factors against many illnesses. This study aims to analyse global bactericidal activity in fresh human milk and evaluate its stability in relation to milk manipulation and its possible alteration following refrigeration. Nineteen milk samples (mature milk) from 19 healthy women are analysed. Viability testing involving a strain of Escherichia coli NCTC 9111, serovar O111:K58(B4):H– was used to determine the bactericidal effect of human milk. Degree of bacteriolysis is calculated as the difference between E. coli counts in controls and in milk samples, expressed as a percentage of the control sample counts. An evaluation of the effect of refrigeration at 4–6˚C after 24, 48 and 72 hours, and at –20˚C for seven days on bactericidal capacity is made. Bactericidal activity was detected in all milk samples analysed (77.33±15.14%). This activity persisted after refrigeration for 48 hours and after freezing for 10 days, but showed a significant decrease after refrigeration for 72 hours. In conclusion, maternal milk has bactericidal capacity, providing defence and protection against infection for newborn infants. This property can be altered during the storage of milk. Consequently, if storage in excess of 48 hours is required, freezing is preferable to refrigeration.

Effects of Human Milk and Spermine on Hydrogen Peroxide‐Induced Oxidative Damage in IEC‐6 Cells

Oxidative stress is intimately involved in the pathologic processes of serious diseases in the perinatal period. Human milk (HM) contains various bioactive substances, some of which are known as antioxidants, including polyamines such as spermine (SPM). We examined the antioxidative properties of HM and SPM in an intestinal epithelial cell line. Confluent Intestinal Epithelial Cells-6 (IEC-6) cells were preincubated with 100-fold dilutions of defatted HM, bovine milk, or three artificial milks for 24 hours, followed by hydrogen peroxide (H2O2) challenge (0.5 mM, 30 min) for oxidative stress. Cells were preincubated with either HM or increasing concentrations (within the range of HM) of SPM for 24 hours followed by an H2O2 challenge (0.25 mM, 30 min). HM-treated cells showed the highest survival rate (50%) compared with no pretreatment (27%), bovine milk-treated (6%), or artificial formula-treated (13-16%) cells. Significantly higher survival rates were observed in the cells treated with HM (44.0%) and in those treated with 0.5, 1, or 5 microM of SPM (12.6, 13.1, or 22.2%, respectively) in comparison with the nontreated cells (7.0%). Our results demonstrated that HM and SPM alleviated H2O2-induced oxidative damage in IEC-6 cells, whereas bovine milk and artificial formula did not show any antioxidative capacity. These results suggest that HM acts as an antioxidant in the gastrointestinal tract of infants and that SPM plays an important role in the antioxidative properties of HM.

Human milk supplementation for preterm infants

Nutrition support of the premature infant must be designed to compensate for metabolic and gastrointestinal immaturity, immunologic compromise, and associated medical conditions. The beneficial effects of human milk extend to the feeding of premature infants. However, nutritional concerns arise because the quantity of nutrients in human milk may not meet the great nutrient needs of the premature infant born weighing less than 1500 g. Human milk fortifiers are available to provide optimum nutrition. This review summarizes the benefits and limitations of human milk for the premature infant.

Prebiotics and immune responses.

Feeding breast milk of healthy mothers is associated with a lower incidence of infectious and allergic diseases. Although this effect is of multifactorial origin, it is widely accepted that the entire intestinal flora of breastfed infants provides anti-infective properties and is an important stimulating factor for the postnatal development of the immune system. Clearly, the effect of human milk on the postnatal development of the intestinal flora cannot be attributed to a single ingredient. It is generally accepted, however, that human milk oligosaccharides play a key role in this matter (1). The composition of human milk oligosaccharides is very complex. As they are resistant against digestion, they can be detected in the faeces as well as in the urine of breast-fed infants (2). This low or absent digestibility is a prerequisite for prebiotic activities of dietary compounds (3). Apart from their prebiotic effects, there is also evidence that human milk oligosaccharides act as receptor analogues to inhibit the adhesion of pathogens on the epithelial surface (1) and interact directly with immune cells (Eiwegger Th, et al., unpublished data). Due to their complexity, oligosaccharides with structures indentical with human milk oligosaccharides are not available as dietary ingredients. Searching for alternatives, a mixture of neutral galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS) have been identified as effective prebiotic ingredients during infancy (5). More recently, also acidic oligosaccharides such as pectin hydrolysate are under investigation (6). In several clinical trials it could be demonstrated that feeding a formula supplemented with a mixture of GOS and long-chain FOS results in an entire intestinal flora similar to that found in breast fed infants (7). Comparable to human milk oligosaccharides, GOS and FOS stay present during the whole gastrointestinal passage and are therefore detectable in the faeces of infants fed a GOS/FOS supplemented formula. With regard to stool characteristics, there was a significant influence of GOS/FOS in preterm as well as term infants: feeding the oligosaccharides-supplemented formula increased the stool frequency and softened the stool consistency in comparison to a standard formula so that stool characteristics could be achieved which were very similar to those of human milk fed infants (5). In a study in term infants the effect of different concentrations of the GOS/FOS mixture was tested in parallel by a traditional plating technique and a modern molecular biologic technique (7). Whereas with the plating technique, only living bacteria can be detected, all bacteria are counted with the molecular biologic technique. The results obtained by the two methods are shown in Figure 1. They clearly indicate that with the use of the GOS/FOS mixture, the number of bifidobacteria increases and the effect is much more pronounced for the living bacteria than for the total number of bacteria. Short-chain fatty acids (SCFA) are an important marker of the bacterial metabolism in the intestine. Invitro experiments focusing on the short SCFA synthesis by the faecal flora could demonstrate that the SCFA synthesis from GOS/FOS mixture was comparable to the synthesis from a quantitatively equivalent neutral human milk oligosaccharides fraction (7). Similar results were obtained in-vivo by measuring the fatty acid pattern in faeces from infants fed a formula supplemented with GOS/FOS: The faecal SCFA pattern was similar to that observed in breast fed infants (8). The results are in line with the observation that during a 28-day feeding period the faecal pH decreased in a group of term infants fed a GOS/FOS supplemented formula similar to breast fed infants, whereas the faecal pH in infants fed a nonsupplemented standard formula increased (5). Increased numbers of bifidobacteria and a decreased faecal pH are contributing to a reduction of clinically relevant pathogens, either expressed in absolute numbers or as percentage of total bacteria. In an animal study using the mouse vaccination model as recommended by international governmental guidelines (6), feeding GOS/FOS significantly stimulated the cellular (i.e., Th1/Th2) immune balance. In an animal model for allergic hypersensitivity using ovalbumin as allergen, dietary GOS/FOS inhibited the allergic inflammation (7). In summary, the data demonstrate that an infant formula supplemented with a mixture of GOS/FOS stimulates the entire intestinal flora and results in the production of physiologically important bacterial metabolites as well as a faecal pH similar to influences of human milk feeding. These effects are accompanied by stool characteristics close to those of breast-fed infants and by a Address correspondence and reprint requests to Prof. Gunther Boehm, Director Infant Nutrition Research Germany, Milupa GmbH & Co, KG Bahnstrasse 14-30, D-61381 Friedrichsdorf; Fax: 0049-6172991862 (e-mail: guenther.bohem@milupa.de). Journal of Pediatric Gastroenterology and Nutrition 39:S772–S773 © June 2004 Lippincott Williams & Wilkins, Philadelphia

Effects of human milk and formula on expression of MDR1, MRP2, and CYP3A in the C2BBE1 intestinal cell model

Purpose The development of drug elimination mechanisms in the intestine is not well understood, posing significant challenges to pediatric therapeutics. In particular, effects of feeding on the ontogeny of drug metabolizing enzymes and transporters remain virtually unknown. Since human milk is rich in bioactive substances known for their effects on expression of enzymes and transporters, we hypothesized that human milk and formula have different activities in this regard. As a first step, we examined effects of human milk and formula on expression of CYP3A, and drug transporters, MDR1 and MRP2. Methods C2BBe1 cells, a subclone of Caco2 cells, were characterized for the protein expression time courses. They were incubated with cow milk-based formula and human milk. RT-PCR and Western blotting were used to analyze the mRNA and protein expression. Results The C2BBe1 cells showed time-dependent increase in CYP 3A4 and MRP2 expression, and decrease in CYP3A7 and MDR1. Using the time window with expression-stable culture, we observed that 72-hr exposure to 10-20% human milk induced MRP2 mRNA/protein by more than 2–fold, and MDR1 protein without apparent change at the mRNA level. Human milk had the tendency to inhibit CYP3A4 expression but there was no statistical change. Formula had no effect. Conclusion Compared to formula, human milk causes transcriptional induction of MRP2, and post-transcriptional induction of MDR1 in the intestinal cell model. Clinical Pharmacology & Therapeutics (2004) 75, P51–P51; doi: 10.1016/j.clpt.2003.11.191

Induction of cytochrome P450 1A by formula: a comparative study between human milk and formula

Purpose Human milk reportedly contains higher levels of environmental pollutants. Many of them are potent inducers of CYP1A and exert toxic effects ranging from mutagenic effects to hormonal disruption via aryl hydrocarbon receptor (AhR) activation. Paradoxically, the elimination of caffeine, a CYP1A2 substrate used to treat neonatal apnea, is 3-fold slower in breast-fed infants than in formula-fed infants. In this study, we determined the effects of human milk and formula on AhR activity and CYP1A expression. Methods HepG2 CYP1A mRNA, protein expressions and mouse Cyp1a1 mRNA were measured. Using a luciferase reporter construct containing Cyp1a promoter, we examined HepG2 AhR activity, and determined the toxic equivalents (TEQs) of milk and formula. Results Formula but not human milk induced CYP1A mRNA and protein. Formula induced fetal mouse hepatic Cyp1a1 expression. Both cow milk-based and soy formula but not human milk showed AhR activation. The lipid fraction of formula retained the active effect on AhR. Moreover, the co-treatment of 3,4-dimethoxyflavone, an AhR antagonist, abolished formula's effect on AhR and CYP1A mRNA. Formula milk activated AhR with TEQs up to 6.4 pg TCDD/g, nearly 100-fold higher than the reported values. Conclusion Formula may increase infant drug metabolism by increasing CYP1A expression via AhR activation. Human milk does not elicit the same effect despite reported higher levels of environmental pollutants. Clinical Pharmacology & Therapeutics (2004) 75, P50–P50; doi: 10.1016/j.clpt.2003.11.190

Effect of human milk and colostrum on Entamoeba histolytica.

Many defense factors of the mother's colostrum or milk protect infants from intestinal, respiratory and systemic infections. In the present study, we investigated the effect of colostrum and mature human milk on E. histolytica parasites in vitro. Samples of human milk were collected from 5 healthy lactating mothers. The medium with human milk at concentrations of 2%, 5% and 10% was obtained. The lethal effect of E. histolytica on the medium supplemented with different concentrations of both colostrum and mature human milk was significant during the first 30 min. We also detected that the results of colostrum and mature human milk were similar. No statistically significant differences were found between same concentrations of colostrum and mature human milk at the same times. Colostrum and mature human milk have significant lethal effect on E. histolytica and protect against its infection in breast fed children.

Effects of human milk and infant formula on the development of gastric myoelectrical activity in preterm infants

Effects of human milk and infant formula on the development of gastric myoelectrical activity in preterm infants

Effects of human milk and infant formula on the development of gastric myoelectrical activity in preterm infants

Effects of human milk and infant formula on the development of gastric myoelectrical activity in preterm infants

Lactoferrin and free secretory component of human milk inhibit the adhesion of enteropathogenic Escherichia coli to HeLa cells.

Diarrhoea caused by Escherichia coli is an important cause of infant morbidity and mortality in developing countries. Enteropathogenic Escherichia coli (EPEC) is considered one of the major causes of diarrhoea in children living in developing countries. The ability of diarrhoeagenic strains of E. coli to adhere to and colonize the intestine is the first step towards developing the disease. EPEC strains adhere to enterocytes and HeLa cells in a characteristic pattern known as localized adherence. Many epidemiological studies of diarrhoea have shown that breast-feeding protects infants from intestinal infections. Both immunoglobulin and non-immunoglobulin elements of human milk are thought to contribute to the protection from diarrhoeal agents. The effects of human milk and its protein components on the localized adherence of EPEC were investigated. Non-immunoglobulin components of human milk responsible for the inhibition of EPEC adhesion to HeLa cells were isolated by chromatographic fractionation of human whey proteins. Besides secretory immunoglobulin A, which has been previously reported to affect the adhesion of EPEC, free secretory component (fSC) and lactoferrin (Lf) were isolated. Even in concentrations lower than those usually found in whole milk, fSC and Lf were able to inhibit the adhesion of EPEC. alpha-lactalbumin was also isolated, but showed no activity on EPEC adhesion. This study demonstrated that the immunoglobulin fraction, the free secretory component and lactoferrin of human milk inhibit EPEC adhesion to HeLa cells. These results indicate that fSC and Lf may be important non-specific defence factors against EPEC infections.

Overview: the future of research in human milk.

In 1987, Drs. Armond Goldman and Cutberto Garza wrote inPediatric Researchthat “although the survival of the species… has been dependent on breast-feeding, there has been comparatively little scientific interest in human lactation and the composition and biological effects of human milk” (Goldman & Garza 1987). They commented, however, that the scientific climate was in the process of changing to an increasing awareness of research in this field. Observations from the numerous chapters of this book indicate that opportunities for research in this field have mushroomed in the years since that report. Excerpts of studies illustrating the diversity of research areas covered by the young, emerging investigators in the field are included in this report.