Maternal Milk

Immunological properties of maternal milk. Advantages and disadvantages of supplementary water and the use of formula milk in feeding of the human neonate.

Pregnancy is one of the most exciting and is fundamental in human reproductive life. Sexual reproductive is significant to pregnancy in other for human race to multipliply. Scientist has now in recent years developed other fertility method, i.e IVF for people unable to get pregnant in natural forms. Nutrition and lifestyle effects to mother are paramount to survival of the baby during and after pregnancy. Balance of innate and adaptive immune system responded very well to survival of the embryo and also protects mothers to adapt to environmental pathogens that may be harmful to baby's survival.1

Breast feeding is a recommended nutrition and sufficient method to support optimal growth and development for approximately the first six months in human neonates after birth. Foods eaten by mothers during and after pregnancy is automatically process by the enzymes that converts it to protein and rich nutrients in the body. Baby's immune system relies heavily on pregnant mothers passing immunoglobulin antibodies from breast milk through bloodstream via placenta to the fetus. Human neonates lack very strong antibodies and are often restricted in effecting immune response. Scientist have been able to prove that the antibodies transmitted to babies are not directly from the breast milk, but from a special form of yellowish fluid from the milk called colostrums. This fluid contains nutrients, fats and antibodies that help protect the baby from infections. “Mothers produce a special hormone called oxytocin immediately after newborn, the oxytocin then activate lactation process. Lactation is the milk production secreted from mammary glands within the fatty breast tissue. Hormone called prolactin controlled amount produced from the breast assisted by infant's continuous and consistencies in feeding from mother's breast.”

Source: http://www.medterms.com/script/main/art.asp?articlekey=6202

The colostrums from the breast milk, provides human neonates with passive immunity in the form of lactobacillus bifidus, lactoferrin, lysozymes and secretory IgA . They contains large number of specific and non specific immunologic factors that provide passive protection from mother to the newborn, these includes all five different types of antibodies including immunoglobulin A (IgA), immunoglobulin D (IgD), immunoglobulin E (IgE), immunoglobulin G (IgG), and immunoglobulin M (IgM). IgA are significant immunoglobulin which synthesised and stored in breast milk. It lines the epithelium protecting the mucosal against entry of pathogenic bacteria and enteroviruses. Also protects against E. coli, salmonellae, shigellae, streptococci, staphylococci, pneumococci, poliovirus and the rotaviruses. http://www.gentlebirth.org/vre/newimmun.html

Immunoglobulin G (IgG) is the primary antibody that gets transmitted via the placenta to the fetus during pregnancy. IgG antibodies presents in all body fluids are the most important immunosuppressive that makes up nearly 80% of all antibodies present in mammals. They are actively engaged in fighting against bacterial and viral infections. These antibodies protect the fetus against infections inside the womb. Antibodies received through mother's placenta generally protect neonates during pregnancy and after birth most especially antibodies from breast feeding. The intestine plays vital role in nutrients uptake by creating physical barrier against environmental pollution. Human neonate's immune system in the first few months is premature and relies on early nutrition to modulate intestinal functions preparing for environmental pathogens.

The quantities of IgG presents in baby's intenstine are equivalent to mothers or sometimes slightly higher which provide temporary passive immunity for the first months after birth. The immunological factors can be immunostimulatory that increases host defence against illness or immunosuppressive which down regulate allergy development and irritation. This helps prevent the baby from developing diseases and infections. Innate immune system cells containing macrophages, neutrophils, dendritic cells are normally presents in new born baby and are amongst the most common leucocytes presents in breast milk that surround and destroy harmful bacteria by their phagocytic activity. IgM also present in baby's intestine. While newborn immune intestinal developed rapidly during contact with dietary and antigens, they must be able to distinguish between antigens and that are tolerance at the same time eliminating potential dangerous pathogens that can cause damage to various organs. The tolerance are assisted by the B and T cells in the gut area which manufacture IgA immunoglobulin and Th2 response.2,3 Allergy related to bowel disorder, autoimmunity and poor food digestion are initiated by inability to control tolerance and active immune response in human neonate.

The purity of the colostrums depends on the mother's diet and state of health. These antibodies are very important in development of baby's immune system during the first six months. Scientist data support that breast-feeding prevents gastrointestinal and respiratory infections in human neonates.2 Breast feeding nutrients contents is reasonably stable for baby's immune development against foreign pathogens. The breast milk contains more white cells than in the blood in the first 10 days which are significant in antibodies activities. The energy content decreases significantly after the first year, while automatically adapting to baby's growth development.

Lysozyme contains in breast milk concentration is extremely higher than in cow's milk. They appear to increase during lactation and act as anti infective agent against pathogens. Lactoferrin is commonly present in breast milk but absent in cow's milk which effects the absorption of enteric iron, while blocking pathogenic E. coli from obtaining the iron needed for survival. The bifidus also in breast milk activates the growth of Gram-positive bacilli in the gut flora, particularly Lactobacillus bifidus, which prevents multiplication of pathogens. Babies who are fed on cow's milk formula have Gram-negative bacilli in their gut flora causing pathogen.

http://www.gentlebirth.org/vre/newimmun.html

Human neonates are susceptible to many foreign microorganisms and chemicals in forms of pathogens ready to attack the immune during development. These pathogens are combated by resistance from protective factors in breast milk. It is a proven factors that breast milk acts as bridge communication between maternal immune system and neonate while enlightening neonates new developing immune metabolic response to harmful pathogens. The cells in immune systems of neonates rely heavily on mother's breast milk protective factors during early postnatal growth. Newborn has acquired considerable high levels of mother's antibodies in the bloodstream through the fetus during pregnancy. If they continue to receive breast milk, the number of antibodies from mothers will amplify their immune system while developing their own innate and adaptive immune system. The antibodies from breast milk binds to harmful bacteria, virus and fungi that enters the body and trigger innate immune cells to destroy the harmful bacterias.3

Infant not fed on mother's milk within month compromise their immunity against particular pathogens invasion. The immune system having not fully develops due to lack of antibodies from colostrums may be overwhelm by invading bugs (pathogens). The immune system of the infants might misinterpret the bugs as normal present in the bloodstream. Baby fed on breast milk within few days has more potential to suddenly develop a full functioning immune system.

Infectious that have developed resistance to bacteria poses greatest risk to human neonates and can be dangerous to mother. Most of these prevalence bacteria or bugs are in the hospitals and can easily be transferred to neonates, making the infants susceptible to various diseases due to lack of effective innate immunity against the superbugs.

Even though it is optimal for neonate that breast feeding is medically beneficiary, certain condition may be of invaluable to neonates in breast feeding. Babies may be subjected to harmful substances from a mother's milk i.e; medications, excessive alcohol intake, caffeine, pesticides, mothers with tuberculosis disease, exposure to radioactive materials and under treatment (prolong radioactivity in the milk), abusive drugs and mothers with herpes simplex lesions on a breast and lead can appear in breast milk. Breast feeding is also inadvisable to neonates with classic galactosemia. http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496

Greatest risks in breastfeeding are associated with transmission of viruses to child during pregnancy in developed countries (USA). HIV infected pregnant mothers is the primary way that children become infected with HIV. Certain women transmit the virus to child in the womb unknowingly or even during breast feeding. Millions of children worldwide are affected every year through mother to child transmission alerting scientist in prevention method. Progress has been made by world health organisation (WHO) by counselling and educating pregnant mothers with HIV not to breast feed. Other measure taken is to prescribe baby with anti HIV medicine (antiretroviral) during breast feeding. This measure reduces transmission of HIV from mother to infants. More researches are still under way in vitro and vivo with government and celebrities campaigning and supporting various organisations in research and development of effective drugs.

In some countries, breast feeding is not recommended for mothers infected with HIV due to high risk of passing the virus to their baby. HIV virus is extremely detrimental to infants with high increase in death rates. The mortality risks associated with artificial feeding may outweigh the possible risks of acquiring HIV infection. Reports suggested that breast feeding in the first 3 to 6 months after child's birth by HIV-infected mothers may not risk transmission to neonates, but neonates with mixture of breast feeding and supplementary feeding pose a greater risk of contracting HIV virus compared with neonates fed exclusively on supplementary formula.

Tobacco smoking mothers posses risk to their baby. Mothers who smoke within the confines space or nearer infants expose them to toxic chemical which can cause asthma and breathing difficulties. Alcoholic beverages are concentrated in breast milk inhibiting production of nutrients needed for neonate's healthy development and antigens.

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496

Breast milk is produce from the nutrients presents in mother's bloodstream. The antibodies in breast milks changes during feeding session and gradually decreases during transfusion to neonates. Rate of maternal antibodies in infants between two to three months old decreases because healthy babies own immune system takes over production of its natural antibodies. These antibodies in infants are produced at a much slower rate compare to adults. Breast feeding and lactation's benefits to mothers include; decreased in bleeding and menstrual blood loss, earlier return to pre-pregnancy weight, decreased risk of breast cancer, decreased risk of ovarian cancer, and possibly decreased risk of hip fractures and osteoporosis in the postmenopausal period.

Supplementary foods other than breast milk adversely affect neonates at some stage; causing diarrhoea in neonates after feeding. This can be attributed to weaning of neonates attracting food borne germs of Escherichia coli. The cow milk used in supplementary food does not have the mother's natural immunological effects for neonates protection from invading pathogens. Bottles used in feeding especially the rubber teats (newborn sucks on), can easily attracts germs when not sterilised and are easily breeding ground for germs.

Formula feeding thus has its own advantages against breast feeding. It serves as conveniences for mothers with a very busy schedule. Other benefits associated with formula feeding includes its richness in bran omega 3's (DHA and AA), Richness in cholesterol, Fat digesting enzymes, lipase convenience, ions. Takes longer to digest allowing infants to feed less frequent compared to breast feeding. Mothers benefits from less worries about types of food they eat or drink. Good commercially manufactured formula milk contains ions and can be very nutritious. The ion contains in the formula milk can be credited for reduction of anaemia in infants. http://life.familyeducation.com/breastfeeding/formula-feeding/44286.html. Formula milk feeding can be control to monitor infants on certain medical condition, this is essential to measure exact amount as recommended in improving medical condition at the same time encouraging the entire family to bond in all aspect of the baby's upbringing. Supplementary formula may be added benefits to mothers unable to produce adequate breast milk due to medical condition or where infants are unable to independently breast fed due to being unwell.

In as much as formula feeding provides comforts to mothers and some added nutritional value to neonates, the downside may outweigh the advantages. Lack of antibodies in formula feeding to fight invading pathogens as against breast milk, inconsistencies of formula milk composition, gas and constipation (neonates feeding on formula milk develop more gas firmer movement in bowel), cost of purchases different types of formula milk (powder formula, ready to feed with speciality ingredients like soy milk and hypoallergenic) can be very expensive. Lack essential antibodies needed for neonate's immunity and development in first six months which is very crucial. Formula milk does not change its nutrients to adjust to baby's growth, lack cholesterol and not easily digested by the body.

Supplementary water feeding in human neonate can be controversial among various experts and different religions. Some experts argued against supplementary water while others believe in its advantages. Babies may want additional water, especially in hot weather to alleviate discomfort in clearing stomach or assist in digestion of breast milk after feeding. The water is also necessary for the formation of urine to help remove wastes from the body. http://parenting.ivillage.com/newborn/nbreastfeed/0,,441n,00.html . Baby's suffering from hiccups needs water to ease discomforts. Water contributes to fluoride improvements during teething.

Neonates benefits from cells replacements each day from various organs. Each cell in the body becomes obsolete and subsequently dies. The dead cells are washed away by water avoiding production of toxins if they remain in the body leading to poisonous and illness. Some nursing mother diet may also contain unwanted substances that may enter the breast milk posing danger to neonates. The cow milk used in formula feeding also contains DDT and other pesticides that the cow used in feeding. All these are passed on to babies during feeding leading to toxins. Water is the only primary effective forms of flushing out the unwanted toxins and dead cells. http://www.shirleys-wellness-cafe.com/sanjwatr.htm

Evident suggest that water contains no nutrients needed for rapid brain development. This is vital at this stage of neonate's life, so nutrient and calories from feeding are essentials especially neonate under one month old. Excessive water feeding within few days of birth may lead to severity of jaundice. Jaundice is caused by excessive build up of substances called bilirubin in the blood leading to skin, eyes and mouth turning pale yellow. Jaundice are not life threatening and are easily cured if necessary treatment are administered. Supplementary water can also lead to water intoxication in the body where the concentration of sodium in the bloodstream becomes diluted rendering body organs functionality abnormal. This can lead to unstable body temperature, mental dysfunctionality, seizure, imbalance electrolytes, weight loss and bloating. (Archives of Pediatrics and Adolescent Medicine. 1997;151:830-32). http://parenting.ivillage.com/newborn/nbreastfeed/0,,441n,00.html . Continuous water feeding may interfere with breast feeding leading to lethargic and sleepiness.

Conclusion:

There have been considerable advances in researches understanding of the bioactive components in mother's milk that triggered baby's immune systems providing protection and actively assisting growth development, tolerance, and an appropriate inflammatory response. Furthermore, human milk has been found to promote intestinal growth and maturation and to have immunomodulating effects beyond infancy later on in life. In conclusion, human milk represents a very valuable weapon for enhancing the immature immunologic system of the newborn and for strengthening its deficient host defence mechanisms against infective or other foreign agents. Environmental pollution can only be suppressed not by supplementary feeding but by maternal feeding.

Research provides strong evidence that breast milk feeding decreases the severity of a wide range of infectious diseases including bacterial meningitis, bacteremia, diarrhea, respiratory tract infection, necrotizing enterocolitis, urinary tract infection. In addition, post-neonatal infant mortality rates are reduced in breastfed infants.

Some studies deduced decreased rates of sudden infant death syndrome in the first year of life and reduction overweight and obesity. Hypercholesterolemia, and asthma in older children and adults who were breastfed, compared with individuals who were not breastfed. Additional research in this area is warranted.

1. Antigens presenting cells and materno fetal tolerance. An emergine role for dendritic cells.

2. http://jn.nutrition.org/cgi/content/full/135/1/1

http://www.naturalstandard.com/index-abstract.asp?create-abstract=/monographs/allergies/allergy-immunedevelopment.asp

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