Substances In Breast Milk Research Articles

Effect of Nicotinamide Mononucleotide Concentration in Human Milk on Neurodevelopmental Outcome: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

(1) Background: Breast milk is the only source of nutrition for breastfed infants, but few studies have examined the relationship between breast milk micronutrients and infant neurodevelopmental outcome in exclusively breastfed infants. The aim of this study was to characterize the association between nicotinamide adenine dinucleotide (NAD)-related compounds in the breast milk of Japanese subjects and infant neurodevelopmental outcome. (2) Methods: A total of 150 mother-child pairs were randomly selected from the three-generation cohort of the Tohoku Medical Megabank in Japan. Infants were exclusively breastfed for up to 6 months. Breast milk was collected at 1 month postpartum, and the quantity of NAD-related substances in the breast milk was quantified. The mothers also completed developmental questionnaires at 6, 12, and 24 months. The relationship between the concentration of NAD-related substances in breast milk and developmental indicators was evaluated via ordinal logistic regression analysis. (3) Results: Nicotinamide mononucleotide (NMN) was quantified as the major NAD precursor in breast milk. The median amount of NMN in the breast milk was 9.2 μM. The NMN concentration in breast milk was the only NAD-related substance in breast milk that showed a significant positive correlation with neurodevelopmental outcome in infants at 24 months. (4) Conclusions: The results suggest that NMN in human milk may be an important nutrient for early childhood development.

Carotenoids in maternal and cord blood, breast milk and their association with maternal dietary intake: a longitudinal study in Shanghai, China.

Carotenoids are important bioactive substances in breast milk, the profile of which is seldom studied. This study aimed to explore the profile of carotenoids in breast milk and maternal/cord plasma of healthy mother-neonate pairs in Shanghai, China, and their correlation with dietary intake. Maternal blood, umbilical cord blood and breast milk samples from five lactation stages (colostrum, transitional milk and early-, mid- and late-term mature milk) were collected. Carotenoid levels were analysed by HPLC. Carotenoid levels in breast milk changed as lactation progressed (P < 0·001). β-Carotene was the primary carotenoid in colostrum. Lutein accounted for approximately 50 % of total carotenoids in transitional milk, mature milk and cord blood. Positive correlations were observed between five carotenoids in umbilical cord blood and maternal blood (P all < 0·001). β-Carotene levels were also correlated between maternal plasma and three stages of breast milk (r = 0·605, P < 0·001; r = 0·456, P = 0·011, r = 0·446; P = 0·013, respectively). Dietary carotenoid intakes of lactating mothers also differed across lactation stages, although no correlation with breast milk concentrations was found. These findings suggest the importance of exploring the transport mechanism of carotenoids between mothers and infants and help guide the development of formulas for Chinese infants as well as the nutritional diets of lactating mothers.

Occurrence and infant exposure assessment of per and polyfluoroalkyl substances in breast milk from South Africa

The exposure of infants to per and polyfluoroalkyl substances (PFAS) through breast-feeding is of global concern owing to their numerous detrimental health effects. This study investigated the occurrence of eleven perfluorocarboxylic acids (PFCAs) and four perfluorosulfonates (PFSAs) in breast milk of nursing mothers from South Africa. The concentrations of PFAS in these samples were measured by using a validated UHPLC – MS/MS method. The median concentrations of Σ15 PFAS ranged from <LOQ – 0.420 ng mL−1, with PFCAs frequently detected in breast milk than PFSAs. However, perfluoropentanoic acid (PFPeA) accounted for 28% of total PFAS concentrations in all samples, the median concentrations of PFUdA, PFDoA and PFTrDA were at par with those of PFOA. The estimated feeding frequency and infant sex but not birth weight and gestation period, were strongly correlated with the body-burden of some short- and long-chain PFAS in breastmilk. On the average, the EDI and HQ of PFOA and Σ4 PFAS (PFOA, PFNA, PFHxS & PFOS) but not PFOS present significant risk to exclusively breastfed infants in South Africa. The results of this study reflect the widespread occurrence of short chain (i.e., C < 6) and long chain (i.e., C11 – C13) PFAS and provide preliminary data for future human biomonitoring of PFAS and other persistent organic pollutants in South Africa, and indeed the African continent.

Effects of in-hospital breast feeding on brain function development in preterm infants in China: study protocol for a prospective longitudinal cohort study

IntroductionDue to immature brain development, preterm infants are more likely to develop neurological developmental defects compared with full-term infants. Most preterm infants without neurodevelopmental damage can eventually reach the same...

HPLC-MS/MS method for the determination of perfluoroalkyl substances in breast milk by combining salt-assisted and dispersive liquid-liquid microextraction.

The widespread use of perfluoroalkyl substances has resulted in the universal exposure of humans to these endocrine-disrupting chemicals, including the exposure of neonates through breastfeeding. The objective of this study was to develop a method to determine 10 perfluoroalkyl substances in breast milk (1-mL aliquot) by combining salt-assisted liquid-liquid extraction with dispersive liquid-liquid microextraction and using high-performance liquid chromatography-tandem mass spectrometry. Chemometric strategies were applied to optimize experimental parameters. The limit of quantification was 20pgmL-1 for all analytes, and inter-day variability (evaluated as relative standard deviation) ranged from 8.2 to 13.8%. The method was validated by a recovery assay with spiked samples. Percentage recoveries ranged from 85.9 to 110.8%. The method was satisfactorily applied to assess target compounds in 20 breast milk samples from donors. Perfluorooctanoic acid, perfluorooctane sulfonate, and perfluorohexanoic acid were the most frequently detected analytes. This analytical procedure can provide useful information on newborn's exposure to these xenobiotics.

COVID-19 ve Anne Sütü ile Beslenme

Aralık 2019’da Çin’den başlayarak tüm dünyaya yayılan COVID-19 enfeksiyonu doğumdan itibaren yaşamın her evresini etkileyen bir enfeksiyondur. Küçük çocukların çoğunda asemptomatik ya da hafif şiddette seyrettiği bildirilen COVID-19 enfeksiyonuna yakalanan gebe ve çocuk sayısı giderek artmaktadır. Olağanüstü koşullarda sağlığın korunması ve sürdürülmesinde anne sütü ile beslenme çok önemlidir. Anne sütünün hem anne hem de bebek için kısa ve uzun vadede pek çok olumlu etkisi olduğu bilinmektedir. Yenidoğan gereksinimlerine göre düzenlenebilen eşsiz besleyici özelliği yanı sıra anne sütü içinde bulunan biyoaktif maddeler, büyüme ve gelişmeyi etkileyen hormon ve büyüme faktörleri, immün sistemi düzenleyen faktörler ve antienflamatuvar maddeler bebeği enfeksiyonlardan korumaktadır. Ayrıca maternal enfeksiyonda 7 gün içinde anne sütünde saptanan antikorlar da bebekte enfeksiyon riskini azaltmaktadır. Bu sayede anne sütü ile beslenen bebeklerde otitis media, alt solunum yolu enfeksiyonları, gastroenterit ve prematüre bebeklerde nekrotizan enterokolit nadir görülmektedir. Bu zamana kadar yapılan çalışmalarda anne sütünden bebeğe COVID-19 enfeksiyonu bulaştığı bildirilmemiştir. DSÖ anne sütünün yararlarını, formül sütle beslenmenin zararlarını da hesaba katarak COVID-19 enfekte annelerin maske ve el hijyenine dikkat ederek ten temasını ve anne sütüyle beslenmeyi önermektedir. Sağlık personelleri bu önerilerin rehberliğinde emzirmeyi başlatma ve sürdürme konusunda anne-bebek çiftine destek olmalıdır.

Perfluoroalkyl substances in Breast milk, infant formula and baby food from Valencian Community (Spain)

Environmental and human exposures to perfluoroalkyl substances (PFASs) are of emerging concern since they are persistent and bioaccumulative. The present study reports PFASs levels in human milk, infant formulas and baby food (dry cereals and pots) from the Valencian Community (Spain) in order to evaluate the infant exposure to these substances through the diet. The results show that perfluorobutanoic acid (PFBA) and perfluorooctanoic acid (PFOA) were in all the samples of the four selected matrices (except PFOA in one sample of dry cereal baby food). Perfluoroheptanoic acid (PFHpA) and perfluorodecanoic acid (PFDA) were also detected in 70% of the breast milk samples. In infant formulas, PFDA and perfluorooctanesulfonate (PFOS) were detected in 75% and 69%, respectively. In dry cereals baby food, PFBA was in 100% of the samples while PFOA and PFOS in 92%. In baby food pots, PFDA was also detected in 83% of the samples. Estimated daily intakes (EDIs) of PFOA (maximum 32.2ngkg−1day−1) and PFOS (9.0ngkg−1day−1) are lower than tolerable daily intakes (TDIs) established for PFOA (1500ngkg−1day−1) and PFOS (150ngkg−1day−1).

A narrative review of the associations between six bioactive components in breast milk and infant adiposity.

This narrative review examines six important non-nutritive substances in breast milk, many of which were thought to have little to no biological significance. The overall objective is to provide background on key bioactive factors in breast milk believed to have an effect on infant outcomes (growth and body composition). The evidence for the effects of the following six bioactive compounds in breast milk on infant growth outcomes are reviewed: insulin, leptin, adiponectin, ghrelin, interleukin-6, and tumor necrosis factor-α. The existing literature on the effects of breast milk insulin, ghrelin, interleukin-6, and tumor necrosis factor-α and their associations with infant growth and adiposity is sparse. Of the bioactive compounds reviewed, leptin and adiponectin are the most researched. Data reveal that breast milk adiponectin has negative associations with growth in infancy. There is a need for innovative, well-designed studies to improve causal inference and advance our understanding in the effects of breast milk and its components on offspring growth and body composition. The recommendations provided, along with careful consideration of both known and unknown factors that affect breast milk composition, will help improve, standardize, and ultimately advance this emergent field.

Review of the state of the art of human biomonitoring for chemical substances and its application to human exposure assessment for food safety

Review of the state of the art of human biomonitoring for chemical substances and its application to human exposure assessment for food safety

Maternal Psychosocial Factors that Affect Breastfeeding Adaptation and Immune Substances in Human Milk.

This study was to identify relationships of maternal psychosocial factors including mother's mood state, childcare stress, social support and sleep satisfaction with breastfeeding adaptation and immune substances in breast milk, especially secretory immunoglobulin A (sIgA) and transforming growth factor-beta 2 (TGF-beta2). Data were collected from 84 mothers who delivered full-term infants by natural childbirth. Structured questionnaires and breast milk were collected at 2~4 days and 6 weeks postpartum. Data were analyzed using descriptive statistics, Pearson's correlation, multiple linear regression, and generalized estimating equation (GEE). Scores for the breastfeeding adaptation scale were significantly related with child care stress, mood state and social support. Mother's anger was positively correlated with the level of sIgA in colostrum (p<.01). Immune substances of breastmilk was significantly influenced by time for milk collection (p<.001) and the type of breastfeeding (sIgA, p<.001, TGF-beta2, p=.003). Regression analysis showed that breastfeeding adaptation could be explained 59.1% by the type of breastfeeding, childcare stress, the Profile of Mood States, emotional support and sleep quality (F=16.67, p<.001). The findings from this study provide important concepts of breastfeeding adaptation program and explanation of psychosocial factors by immune substances in breast milk. Future research, specially, bio-maker research on breast milk should focus on the ways to improve breastfeeding adaptation.

Organochlorine compounds, nitro musks and perfluorinated substances in breast milk – Results from Bavarian Monitoring of Breast Milk 2007/8

The aim of the Bavarian Monitoring of Breast Milk (BAMBI) project was to examine 10 organochlorine pesticides (OPs), 3 nitro musks, 6 indicator polychlorinated biphenyls (PCBs), 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), 12 dioxin-like PCBs (dl-PCBs) and several perfluorinated alkyl compounds in breast milk samples. A total of 516 breast milk samples were collected from seven regions in Bavaria and were analyzed by means of GC/ECD, GC/HRMS, and LC/MS-MS.Concerning the OPs, only hexachlorobenzene and a metabolite of DDT, 1,1-dichloro-2,2-bis(4-chlorophenyl) ethylene (p,p′-DDE), could be quantified in all samples (median: 16ngg−1 lipid and 63ngg−1 lipid, respectively). Median concentrations of 150ngg−1 lipid (range: 3–1900ngg−1 lipid) were found for the sum of the indicator PCBs. The concentrations of the PCDDs/PCDFs and the dl-PCBs ranged from 0.8 to 15.1 (median 5.7) pg WHO-TEQ1998g−1 lipid and from 1.5 to 18.9pg (median 6.4) WHO-TEQ1998g−1 lipid, respectively. The median perfluorooctane sulfonate concentration was 0.05μgL−1 (range: <0.02–0.26μgL), while the other PFCs were observed only in a subset of samples.On the basis of the median and 95th percentile concentration, “medium” and “high” intake levels were estimated for a 3-month-old exclusively breastfed infant. In particular, “medium” and “high” intake levels were calculated of 69 and 133pg WHO1998 TEQkg−1 b.w. for PCDDs/PCDFs, 8 and 21ngkg−1 b.w. for dl-PCBs, and 6 and 25ngkg−1 b.w. for perfluorooctane sulfonate, respectively.The calculated intake for perfluorinated substances is clearly below the tolerable daily intake (TDI), while the established TDI values are still clearly exceeded for PCDDs/PCDFs and dl-PCBs.

Occurrence of perfluorinated alkylated substances in breast milk of French women and relation with socio-demographical and clinical parameters: Results of the ELFE pilot study

A previously developed and validated methodology based on liquid chromatography coupled to high resolution mass spectrometry was used for determine the concentration levels of 14 perfluoroalkylated substances (PFASs) in a set of 48 breast milk samples collected from French women in the frame of the ELFE pilot study. In accordance with other similar studies conducted at european and international levels, PFOS, PFOA, and PFHxS were detected and quantified in most of the analyzed samples (90%, 98% and 100%, respectively), and appeared as major contributors to the total PFAS exposure (38%, 37%, 25%, respectively), whereas the other targeted PFAS were very rarely, if not, found at the limits of detection of the method. Also in agreement with other published data, the concentration levels measured for the detected substances varied from <0.05 to 0.33μg/L for PFOS (median=0.079), from <0.05 to 0.22μg/L for PFOA (median=0.075), and from 0.04 to 0.07μg/L for PFHxS (median=0.050). On the basis of this relatively limited data set, no statistically significant relation was observed between these exposure levels and developmental outcomes, in particular the weight at birth. Similarly, no relation was observed between the measured PFAS levels and various socio-demographical parameters including the consumption of seafood, alcohol, smoking, or socio-economical level. These results suggest a need for further research and better knowledge regarding the sources, pharmacokinetics, and factors of exposure for other substances belonging to this class of emerging contaminants.

Breast Milk as the Gold Standard for Protective Nutrients

In this introductory overview, I explore the observation that breast milk is the gold standard for protective nutrients fed to newborn infants and present clinical evidence of its strong protective effect against age-related infectious gastroenteritis. The composition of breast milk changes according to the newborn infant's needs for passive protection. In addition, substances in breast milk can actively stimulate development of the newborn's host defenses to provide continued mucosal protection after breastfeeding is terminated. Later I present several specific examples of the development of intestinal host defenses due to breastfeeding. An important function of early breastfeeding is its anti-inflammatory effect on the immature, excessive inflammatory response in newborns. Several components of breast milk can reduce the inflammatory response to stimuli in the newborn intestine. These include transforming growth factor (TGF)-beta, interleukin (IL)-10, erythropoietin, and lactoferrin. These components of breast milk can act individually or in concert to contain the neonatal immature anti-inflammatory response.

Association Between Stress-Related Substances in Saliva and Immune Substances in Breast Milk in Puerperae

We examined the association between biochemical parameters of stress in puerperae and immune substances in breast milk. The participants were 22 mothers 2 weeks after delivery, with normal pregnancy/delivery and a normal puerperal course. We measured the levels of secretory immunoglobulin A (SIgA) and cortisol in saliva and the level of SIgA and the leukocyte count in breast milk and investigated their association. There was a positive correlation between the salivary and breast milk levels of SIgA (r = .536, p < .05). However, there were no correlations among the salivary level of cortisol and the level of SIgA and leukocyte count in breast milk. The only association found in our study was between the salivary and breast milk SIgA. The lack of association among SIgA and cortisol may be related to a variety of factors such as production site, diurnal rhythms, and the interval between stress stimulation in mothers and the response of the biomarker.

Assessing levels of contaminants in breast milk: methodological issues and a framework for future research

To assess the scale of the possible exposure by the breast-fed infant to potentially harmful substances in breast milk, methodologically robust studies are essential. Many studies in this field, however, do not report details of crucial issues such as recruitment and milk sampling. The aims of the study reported here were to develop robust methods for the study of contaminants in breast milk, and to develop a framework for future research and population monitoring. Three cohorts of women and babies were recruited by midwives from five sites in northern England. Cohort 1 (cross-sectional, n = 322) were asked to provide two milk samples, one at one week following birth and one at a subsequent time point. Cohort 2 (longitudinal, n = 54) were asked to provide five samples at specified time points over the first 12-16 weeks after birth. Cohort 3 (convenience, n = 18), mothers of babies in the Special Care Unit, were asked to donate surplus breast milk. A novel method of analysing fat concentration in small volumes was developed and tested. A randomly selected set of samples from different donors and stages of lactation was screened for organochlorine pesticide residues, polychlorinated biphenyls, dioxins/furans, phthalates and heavy metals. A total of 453 samples were donated. Cohort 3 was the least successful route of recruitment. Cohorts 1 and 2 combined were most representative of the population. Sample collection, transport and storage procedures, and the collection of data on life style and diet, were robust and acceptable to women. Midwifery involvement in recruitment was an essential component. This study offers a framework both for the conduct of future research studies, and for the establishment of regional and national monitoring mechanisms for contaminants in breast milk. Similar work on contaminants in formula as fed to babies is needed to inform risk assessment methods.

Cows' Milk in Complementary Feeding

If breastfeeding is continued at a high rate into the second year of life, and if the complementary diet contains reasonable amounts of animal protein from meat, fish, or eggs, most infants will thrive without cows' milk. This is the situation in some traditional societies, where milk is not available or where there is no tradition for feeding cows' milk. However, in most populations in the world there is a strong tradition of using cows' milk as an important part of the complementary diet. This article will discuss different aspects of the use of cows' milk in complementary feeding (Table 1) and will highlight areas where there is a need for further research. The use of infant formula and follow-up formula will not be covered, despite the fact that they are usually based on cows' milk. View this table: Table 1. Positive and Negative Aspects of the Use of Cows' Milk During the Period of Complementary Feeding ### Homemade Infant Formula There is universal agreement that homemade formula based on unmodified cows' milk should not be used as a breast milk substitute, especially during early infancy because the composition differs considerably from breast milk. Homemade formula is used in some populations because of economic constraints or tradition, and is less harmful than unmodified cows' milk. For this reason, the recipe for making a homemade formula is given in the recent Canadian …

Transmission of human immunodeficiency virus type 1 through breast-feeding: how can it be prevented?

One-third to two-thirds of maternal transmission of human immunodeficiency virus type 1 (HIV-1) infection to breast-fed infants can be attributed to ingestion of breast milk. The presence of HIV-1 as cell-free and as cell-associated virus in milk has been documented. Several substances in breast milk may be protective against transmission, including maternal anti-HIV antibodies, vitamin A, lactoferrin, and secretory leukocyte protease inhibitor. The portal of virus entry in the infant's gastrointestinal tract is unknown but may involve breaches in mucosal surfaces, transport across M cells, or direct infection of other epithelial cells, such as enterocytes. Timing of transmission of HIV-1 during lactation should be further clarified. An early rebound of plasma viremia after withdrawal of antiretrovirals was recently detected. This rebound may reduce the benefit of antiretroviral prophylaxis when women breast-feed their infants. Interventions should be viewed from the public health perspective of risks of infant morbidity and mortality associated with breast-feeding versus risks from formula-feeding.

Cellular and Humoral Immune Factors in Colostrum of HIV-Infected Lactating Mothers † 878

Human milk and colostrum are known to contain significant amounts of cellular and humoral protective factors. Since post partum transmission of HIV can occur through breast milk, it has been postulated that the transmission could be favoured by infected cells or by deficiency of anti-infective substances in breast milk. In the present study, we investigated cellular and humoral immune factors in colostrum of HIV seronegative (Control Group) and seropositive lactating mothers (Study Group). Colostrum was collected from 130 asymptomatic women, 62 HIV seropositives (study group) and 68 HIV seronegatives (control group). Fifteen ml. colostrum was collected in sterile siliconised glass test tubes, and leukocytes were isolated for cellular studies by Ficoll-Hypaque density gradient centrifugation. The results of cellular factors are in the table at the bottom. There was a statistically significant decrease in the phagocytic activity of macrophages and “T” cell number (p < 0.001)

Breast milk and the prevention of neonatal and preterm gastrointestinal disease states: a new perspective.

In this review of the protective properties of human breast milk, a new perspective is taken to underscore the passive and active protection properties of breast milk in providing specific protection against selective gastrointestinal disease affecting the neonate and preterm infant. The normal protective properties of the gastrointestinal epithelial barrier (immunologic and nonimmunologic) are considered as is the development of barriers to antigen absorption in the immature infant human intestine as a background for considering three accelerated gastrointestinal diseases-necrotizing enterocolitis, intestinal allergy, and bacterial gastroenteritis. In each of these conditions, the developmental protective defect is considered and the role of breast milk plays in filling the protective void discussed. Besides considering passive protection of breast milk including the new roles assigned to nutrients such as lactoferrin and nucleotides, and importance of active substances in breast milk such as growth factors, cytokines and hormones are discussed in the context of actively stimulating the infant's own intestinal defenses to function as a protective barrier. Future studies at the cellular and molecular level should be helpful in designing both preventative and treatment strategies to deal with these diseases.

Infective and anti-infective properties of breastmilk from HIV-1-infected women

Human immunodeficiency virus type 1 (HIV-1) is transmitted mainly by cell-to-cell contact. We postulated that transmission of HIV-1 through breastmilk could be favoured by the presence of infected cells, by deficiency of anti-infective substances in breastmilk, or both factors. 215 HIV-1-infected women were enrolled at delivery in Kigali, Rwanda; milk samples were collected 15 days, 6 months, and 18 months post partum. HIV-1 IgG, secretory IgA, and IgM were assayed by western blot, for the latter two after removal of IgG with protein G. In the 15-day and 6-month samples, we sought viral genome in milk cells by a double polymerase chain reaction with three sets of primers ( gag, pol, and env). HIV-1 infection in the offspring was defined according to serological and clinical criteria. At 15 days, 6 months, and 18 months post partum, HIV-1 specific IgG was detected in 95%, 98%, and 97% of breastmilk samples, IgA in 23%, 28%, and 41%, and IgM in 66%, 78%, and 41%. In children who survived longer than 18 months, the probability of infection was associated with lack of persistence of IgM and IgA in their mothers' milk (adjusted χ 2 for trend, p=0·01 for IgM and p=0·05 for IgA). The presence of HIV-1-infected cells in the milk 15 days post partum was strongly predictive of HIV-1 infection in the child, by both univariate (p<0·05) and multivariate analysis (p=0·01). The combination of HIV-1-infected cells in breastmilk and a defective IgM response was the strongest predictor of infection. HIV-1 infection in breastfed children born to infected mothers is associated with the presence of integrated viral DNA in the mothers' milk cells. IgM and IgA anti-HIV-1 in breastmilk may protect against postnatal transmission of the virus.