Breastfeeding: Unraveling the Mysteries of Mother's Milk

, Georgetown University Medical Center

Disclosures

Medscape General Medicine. 1996;1(1) 

In This Article

Abstract and Introduction

Abstract

Most of the major progress in understanding the unique and complex features of human breast milk has emerged in just the past 2 decades. Since the late 1970s, key research has examined such aspects as the composition of breast milk, effects of maternal and environmental factors on human milk, and the effect of human milk on the infant, including the protection against disease that breast milk can confer on the newborn. The composition of human breast milk includes growth factors, hormones, enzymes, and other substances that are immune-protective and foster proper growth and nutrition in the newborn. Research suggests that lactation is robust and that a mother's breast milk is adequate in essential nutrients, even when her own nutrition is inadequate. Mature breast milk usually has constant levels of about 7g/dL carbohydrate and about 0.9g/dL proteins. But the composition of fats essential for neonatal growth, brain development, and retinal function varies according to a woman's intake, the length of gestation, and the period of lactation. Vitamins and minerals also vary according to maternal intake. But even when these nutrients are lower in breast milk than in formulas, their higher bioactivity and bioavailability more nearly meet the complete needs of neonates than do even the best infant formulas. Also, in many instances human milk components compensate for immature function, such as a neonate's inability to produce certain digestive enzymes, immunoglobulin A (IgA), taurine, nucleotides, and long-chain polyunsaturated fatty acids.

Introduction

Even when a mother's own supply of nutrients and energy is limited, she still is able to produce breast milk of sufficient quantity and quality to support the growth and health of her infant. This finding that "lactation is robust" is one of several discoveries to emerge in recent years.[1] The quest to better understand the complex features of human breast milk has been building in the past 2 decades, as evidenced by the growing number of international meetings, expert work groups, and publications focusing on human breast milk. Since the late 1970s, key research has addressed such topics as analyzing human milk,[2,3,4] identifying how maternal and environmental factors affect breast milk,[5] and determining the effect of human milk on the infant,[6,7] including the protection against disease that breast milk can confer on the newborn.[8]

Human milk, like the milk of many other mammals, is specifically adapted to the needs of the newborn. Before birth, the mother transfers nutrients and bioactive components through the placenta[9]; after birth, these substances are transferred through colostrum and milk. In contrast to infant formula, human milk offers the infant nutrients with high bioavailability as well as a large number of bioactive components that confer immune and nonimmune protection against pathogens in the infant's environment. Also, in many instances human milk components compensate for immature function, such as a neonate's inability to produce certain digestive enzymes, immunoglobulin A (IgA), taurine, nucleotides, and long-chain polyunsaturated fatty acids (LC-PUFA), among other substances. Because many of these components remain intact during pasteurization, it is more advisable to feed pasteurized human donor milk to infants whose mothers are unable to nurse than it is to substitute formula.[1] Its bioactive components make human milk superior to even the best infant formulas.

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