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male lactation is so rare (only found in transsexuals) that even many research medical scientists yet don't know so-called male milk, as it does not exist and therefore has no relation to this topic.
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== External links ==
== External links ==
* [http://www.funfok.com/breast-tips/get-bigger-boobs-without-surgery.html Get Bigger Boobs without Surgery]
* [http://www.funfok.com/breast-tips/tips-for-growing-breasts.html Tips for Growing Breasts]
* [http://www.funfok.com/breast-tips/make-your-boobs-look-bigger.html Make Your Boobs Look Bigger]
* [http://www.askdrsears.com/html/2/T021600.asp ''Comparison of Human Milk and Formula'']
* [http://www.askdrsears.com/html/2/T021600.asp ''Comparison of Human Milk and Formula'']
* [http://www.unu.edu/unupress/food/8F174e/8F174E04.htm United Nations University Centre - Constituents of human milk] - including comparison of human and cow's milk ones
* [http://www.unu.edu/unupress/food/8F174e/8F174E04.htm United Nations University Centre - Constituents of human milk] - including comparison of human and cow's milk ones

Revision as of 08:05, 29 November 2010

Two 25ml samples of human breast milk. The left hand sample is foremilk, the watery milk coming from a full breast. The right hand sample is hindmilk, the creamy milk coming from a nearly empty breast.[1]

Human breast milk refers to the milk produced by a human mother to feed her baby. It provides the primary source of nutrition for newborns before they are able to eat and digest other foods; older infants and toddlers may continue to be breastfed.

The baby nursing from its own mother is the most ordinary way of obtaining breastmilk, but the milk can be pumped and then fed by baby bottle, cup and/or spoon, supplementation drip system, and nasogastric tube. Breastmilk can be supplied by a woman other than the baby's mother; either via donated pumped milk (for example from a milk bank), or when a woman nurses a child other than her own at her breast - this is known as wetnursing.

The World Health Organization recommends exclusive breastfeeding for the first six months of life, with solids gradually being introduced around this age when signs of readiness are shown. Supplemented breastfeeding is recommended until at least age two, as long as mother and child wish.[2]

Breastfeeding continues to offer health benefits into and after toddlerhood.[3] These benefits include; lowered risk of Sudden Infant Death Syndrome (SIDS),[4] increased intelligence[citation needed], decreased likelihood of contracting middle ear infections, cold, and flu bugs, decreased risk of some cancers such as childhood leukemia, lower risk of childhood onset diabetes, decreased risk of asthma and eczema, decreased dental problems, decreased risk of obesity later in life, and decreased risk of developing psychological disorders.[5][6][dubious – discuss]

Breastfeeding also provides health benefits for the mother. It assists the uterus in returning to its pre-pregnancy size and reduces post-partum bleeding, as well as assisting the mother in returning to her pre-pregnancy weight. Breastfeeding also reduces the risk of breast cancer later in life.[7]

Production

Under the influence of the hormones prolactin and oxytocin, women produce milk after childbirth to feed the baby. The initial milk produced is often referred to as colostrum, which is high in the immunoglobulin IgA, which coats the gastrointestinal tract. This helps to protect the newborn until its own immune system is functioning properly, and creates a mild laxative effect, expelling meconium and helping to prevent the build up of bilirubin (a contributory factor in jaundice).

There are many reasons a mother may not produce enough breast milk. Some of the most common are an improper latch (i.e. the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including estrogen-containing hormonal contraceptives), illness, and dehydration. A rarer reason is Sheehan's syndrome, also known as postpartum hypopituitarism, which is associated with prolactin deficiency; this syndrome may require hormone replacement. Malnourishment of the mother is a significant problem for women in developing countries, as malnourished women are often unable to produce breast milk.[citation needed]

The amount of milk produced depends on how often the mother is nursing and/or pumping; the more the mother nurses her baby, or pumps, the more milk is produced.[8][9][10][11][12] It is very helpful to nurse on demand - to nurse when the baby wants to nurse rather than on a schedule. If pumping, it is helpful to have an electric high grade pump so that all of the milk ducts are stimulated. Some mothers try to increase their milk supply in other ways - by taking the herb fenugreek, used for hundreds of years to increase supply[13] ("Mother's Milk" teas contain fenugreek as well as other supply-increasing herbs); there are also prescription medications that can be used, such as Domperidone (off-label use) and Reglan.[citation needed] Increasers of milk supply are known as galactagogues.

Composition

Composition of human breast milk[14]
Fat
total (g/100 ml) 4.2
fatty acids - length 8C (% ) trace
polyunsaturated fatty acids (%) 14
Protein (g/100 ml)
total 1.1
casein 0.4 0.3
a-lactalbumin 0.3
lactoferrin 0.2
IgA 0.1
IgG 0.001
lysozyme 0.05
serum albumin 0.05
ß-lactoglobulin -
Carbohydrate (g/100 ml)
lactose 7
oligosaccharides 0.5
Minerals (g/100 ml)
calcium 0.03
phosphorus 0.014
sodium 0.015
potassium 0.055
chlorine 0.043

The exact integrated properties of breast milk are not entirely understood[citation needed], but the nutrient content after this period[citation needed] is relatively consistent and draws its ingredients from the mother's food supply. If that supply is found lacking, content is obtained from the mother's bodily stores. The exact composition of breast milk varies from day to day, depending on food consumption and environment, meaning that the ratio of water to fat fluctuates.

During the first few days after delivery the breast produce colostrum. This is a thin yellowish fluid which is the same fluid that leaks from the breasts during pregnancy. It is rich in protein and antibodies that provide passive immunity to the baby (the baby's immune system is not fully developed at birth). Colostrum also helps the newborn's digestive system to grow and function properly.

After 3 to 4 days breasts will begin producing milk that is thin, watery, and sweet. This quenches the baby's thirst and provides the proteins, sugar, and minerals the baby needs. Over time the milk changes and becomes thick and creamy. This satisfies the baby's hunger.[15]

Foremilk, the milk released at the beginning of a feed, is watery, low in fat and high in carbohydrates relative to the creamier hindmilk which is released as the feed progresses. The breast can never be truly "emptied" since milk production is a continuous biological process.

The level of Immunoglobilin A (IgA) in breast milk remains high from day 10 until at least 7.5 months post-partum.[16]

Human milk contains 0.8% to 0.9% protein, 4.5% fat, 7.1% carbohydrates and 0.2% ash (minerals)[17] . Carbohydrates are mainly lactose; several lactose-based oligosaccharides have been identified as minor components. The fat fraction contains specific triglycerides of palmitic and oleic acid (O-P-O triglycerides) and also quite a large quantity of lipids with trans bonds (see: trans fat) that are considered to have a health benefit. They are vaccenic acid, and Conjugated linoleic acid (CLA) accounting for up to 6% of the human milk fat [18][19].

The principal proteins are casein (homologous to bovine beta-casein), alpha-lactalbumin, lactoferrin, IgA, lysozyme and serum albumin. In an acidic environment such as the stomach, alpha-lactalbumin unfolds into a different form and binds oleic acid to form a complex called HAMLET that kills tumor cells. This is thought to contribute to the protection of breastfed babies against cancer.[20]

Non-protein nitrogen-containing compounds, making up 25% of the milk's nitrogen, include urea, uric acid, creatine, creatinine, amino acids and nucleotides.[21][22] Breast milk has circadian variations; some of the nucleotides have acrophases during the night, others during the day.[23]

Mother's milk has been shown to supply a type of endocannabinoid (the natural neurotransmitters which marijuana simulates), 2-Arachidonoyl glycerol.[24]

Though it now is almost universally prescribed, in some countries in the 1950s the practice of breastfeeding went through a period where it was out of vogue and the use of infant formula was considered superior to breast milk. However, it is now universally recognized that there is no commercial formula that can equal breast milk. In addition to the appropriate amounts of carbohydrate, protein and fat, breast milk also provides vitamins, minerals, digestive enzymes and hormones - all of the things that a growing infant will require. Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections. The immune function of breastmilk is individualized, as the mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby and consequently her body makes the appropriate antibodies and immune cells.

Women who are breastfeeding should consult with their physician regarding substances that can be unwittingly passed to the infant via breast milk, such as alcohol, viruses (HIV or HTLV-1) or medications.

Most women who do not breastfeed use infant formula, but breast milk donated by volunteers to human milk banks can be obtained by prescription in some countries.[25]

Storage of expressed breast milk

Breast milk storage containers.

Expressed breast milk can be stored for later use. It is recommended that the milk is stored in hard-sided containers with airtight seals. Some plastic bags specifically manufactured for the storage of expressed breast milk are designed for storage periods of less than 72 hours - others can be used for up to 6 months if frozen.[26] The amount of time that it can be safely stored for use by infants in a home-based situation is given in this table.[27]

Place of storage Temperature Maximum storage time
In a room 25°C 77°F Six to eight hours
Insulated thermal bag with ice packs Up to 24 hours
In a refrigerator 4°C 39°F Up to five days
Freezer compartment inside a refrigerator -15°C 5°F Two weeks
A combined refrigerator and freezer with separate doors -18°C 0°F Three to six months
Chest or upright manual defrost deep freezer -20°C -4°F Six to twelve months

Comparison to other milks

All mammal species produce milk, but the composition of milk for each species varies widely and other kinds of milk are often very different from human breast milk. As a rule, the milk of mammals that nurse frequently (including human babies) is less rich, or more watery, than the milk of mammals whose young nurse less often. Human milk is noticeably thinner and sweeter than cow's milk.

Whole cow's milk does not contain sufficient vitamin E, iron, or essential fatty acids, which can make infants fed on cow's milk anemic. Whole cow's milk also contains excessive amounts of protein, sodium, and potassium which may put a strain on an infant's immature kidneys. In addition, the proteins and fats in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk.[28] Evaporated milk may be easier to digest due to the processing of the protein but is still nutritionally inadequate. A significant minority of infants are allergic to one or more of the constituents of cow's milk, most often the cow's milk protein.[29] These problems can also affect infant formulas derived from cow's milk.

Alternative uses for breast milk

Assertions that breast milk consumption is of benefit to adult humans are questionable because many of its components undergo digestion in the adult stomach, including antibodies and other proteins.[citation needed]

In addition to providing essential nourishment to infants, human milk; i.e., breast milk, has a number of valuable uses, especially medicinal uses, for both children and adults. It has been used medicinally for thousands of years.[30] The antibacterial and healing properties[citation needed] of breast milk are often overlooked, even by the nursing mothers themselves.[31] Breast milk, if properly expressed and stored, is a sterile solution and can be used in a variety of ways to promote healing and clean wounds. Breast milk contains strong antibodies and antitoxins that many people believe promote healing and better overall health. However, breast milk lacks sterile and antiseptic properties if a nursing mother is infected with certain communicable diseases, such as HIV and various bacterial infections like Group B streptococcus, as breast milk can transmit such diseases to infants and other people.[32]

Breast milk has been used as a home remedy for minor ailments, such as conjunctivitis, insect bites and stings, contact dermatitis, and infected wounds, burns, and abrasions. Breast milk has also been used alternatively to boost the immune system of ill persons having viral gastroenteritis, influenza, the common cold, pneumonia, etc., because of its immunologic properties. However, breast milk should never be seen or construed as a "cure all". Some medical experts are convinced that breast milk can induce apoptosis in some types of cancer cells, however, more research and evidence are needed in this area of cancer treatment.[33][dead link]

A minority of people, including restaurateur Hans Lochen of Switzerland, have used human breast milk, or at least advocated its use, as a substitute for cow's milk in dairy products and food recipes[34]. Tammy Frissell-Deppe, a family counselor specialized in attachment parenting, published a book, titled A Breastfeeding Mother's Secret Recipes, providing a lengthy compilation of detailed food and beverage recipes containing human breast milk[35]. The animal rights organization known as PETA ignited a firestorm of criticism when it urged a dairy company to replace the cow's milk they use in their ice cream products with human breast milk as a way to stop cattle abuse[36][37]. Human breast milk is not produced or distributed industrially or commercially, because the use of human breast milk as a dairy food or recipe ingredient is considered bizarre and counterintuitive to the vast majority of cultures around the world, and most disapprove of such a practice, as it has never been widely accepted historically[38].

Attempts to formulate soap from breast milk have also been made, and those who use it claim that its effectiveness as a cleanser is greater than, or equal to, that of traditional soaps.[39]

Passing of unwanted substances

Despite the risk of substances transmitting from the mother to the child through breast milk, breastfeeding has far more advantages than infant formulas, and, with few exceptions, the WHO recommends exclusive breastfeeding for the first 6 months of life.[40]

The milk producing cells are most permeable to drugs during the first postpartum week.[41]

Drug characteristics that increase excretion in milk include:[41]

  1. Not plasma protein binding
  2. Non-ionized
  3. Low molecular weight
  4. Lipid solubility rather than water solubility
  5. Weakly alkaline rather than weak acid

Drugs are transferred from blood plasma across ductal cells to the milk by diffusion or active transport. The latter may result in higher concentration of the drug in the breast milk than in the plasma of the mother.[41]

The amounts of most drugs in milk do not exceed 2% of the total ingested dose.[41]

Medications

Medications considered safe regarding content in milk are:

  • Aspirin[42]
  • Acetaminophen[42]
  • Many antibiotics[42] except those common ones such as fluoroquinolones (e.g. ciprofloxacin, levofloxacin, moxifloxacin, and other similar drugs used to treat a broad range of infections including those of urinary tract and respiratory tract), sulfa drugs (e.g. sulfamethoxizole), tetracyclines (e.g. minocycline, doxycycline), and chloramphenicol
  • Antihistamines[42] (allergy and cold preparations)

Still, consultation with a health care provider is reasonable for a breastfeeding woman before taking any medications.[42]

Medication requiring some caution are:

Alcohol and caffeine are safe if taken in small amounts.[42] Nicotine, on the other hand, passes to the child through breast milk and may cause serious medical problems.[42]

Medications that are harmful to the breast-fed infant, and should be avoided if possible, are:

If they can not be avoided or substituted for medical reasons, breast-feeding should be temporarily discontinued.[42]

Prolonged use of the following medications should only be done under direct supervision of a physician:

Environmental pollutants

Environmental pollutants found in breast milk are usually not harmful, and should only be considered when environmental levels are unusually high. In addition, there has been a decrease in environmental levels, also resulting in a decrease breast-milk levels. Pollutants that are of most concern are pesticides, organic mercury and lead. DDT and dieldrin are unavoidable, and can also be detected in infant formulas.[42] Pesticides and other toxic substances bioaccumulate, i.e. creatures higher up the food chain will store more of them in their body fat. This is an issue particularly for the Inuit, whose traditional diet is predominantly meat. Studies are looking at the effects of polychlorinated biphenyls and persistent organic pollutants in the body; the breast milk of Inuit mothers is extraordinarily high in toxic compounds.[43]

Extraordinary consumption

In the ancient world, breast milk was sometimes consumed by fertility cults, and in other religious ceremonies.[citation needed]

Spanish king Alfonso XIII visited the region of Las Hurdes in 1922 in order to display the concern of the crown. The king and his retinue lived in military tents planted near the town of Casares de las Hurdes. During the king's visit a strange incident took place: A local village chief, concerned that the king was drinking only black coffee (a consequence of the king's aides distrusting the quality of the local milk owing to unsanitary conditions in the area) served the king a small jug of milk saying, "Your Majesty rest assured that this milk is totally trustworthy,"[44] which turned out to be breast milk from his wife who had recently given birth. The king became aware of this fact only after having had his café con leche.[45]

Preliminary research indicates that breast milk can induce apoptosis in some types of cancer cells.[46] Adults with GI disorders and organ donation recipients can also benefit from the immunologic powers of human breast milk.

In Costa Rica, there have been trials to produce cheese and custard from human milk as an alternative to weaning.[47]

A controversial Swiss restaurateur has created a menu based around foods cooked in human breast milk.[48]

See also

References

  1. ^ http://www.drpaul.com/breastfeeding/colostrum.html
  2. ^ http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/
  3. ^ World Health Organization breast feeding recommendations.
  4. ^ WHO and UNICEF call for renewed commitment to breast-feeding
  5. ^ breastfeeding prevents obesity later in life - study
  6. ^ usbreastfeeding.org benefits of breastfeeding
  7. ^ womenshealth - breastfeeding benefits mom and baby
  8. ^ http://www.mayoclinic.com/health/breast-feeding/FL00120
  9. ^ http://www.llli.org/FAQ/increase.html
  10. ^ http://www.askdrsears.com/html/2/T022800.asp
  11. ^ http://parenting.ivillage.com/newborn/nbreastfeed/0,,456z,00.html
  12. ^ http://www.babies.sutterhealth.org/breastfeeding/bf_production.html
  13. ^ http://pediatrics.about.com/library/breastfeeding/blbreastfeedingza.htm
  14. ^ Constituents of human milk United Nations University Centre
  15. ^ Your Pregnancy & Birth fourth edition (2005) The American College of Obstetricians and Gynecologists
  16. ^ Rechtman, DJ and Ferry, B. and Lee, ML and Chapel, H. 2002. International Journal of Infectious Diseases 6, pS58.
  17. ^ Belitz, H Food Chemistry, 4th Edition, p.501 table 10.5
  18. ^ Precht, D and J.Molkentin C18:1, C18:2, and C8:3 trans and cis fatty acid isomers including conjugated cis delta 9, trans delta 11 linoleic acid (CLA) as well as total fat composition of German human milk lipids, Nahrung 1999 43(4) 233-244
  19. ^ Friesen, R, and S.M. Innis, Trans Fatty acids in Human milk in Canada declined with the introduction of trans fat food labeling, J. Nut 2006, 136 2558-2561
  20. ^ Svanborg, C (2003). "HAMLET kills tumor cells by an apoptosis-like mechanism--cellular, molecular, and therapeutic aspects". Advances in Cancer Research. 88: 1–29. doi:10.1016/S0065-230X(03)88302-1. PMID 12665051. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |unused_data= ignored (help)
  21. ^ Jenness R (1979). "The composition of human milk". Seminars in Perinatology. 3 (3): 225–239. PMID 392766. {{cite journal}}: Unknown parameter |month= ignored (help)
  22. ^ Thorell L (1996). "Nucleotides in human milk: sources and metabolism by the newborn infant". Pediatric Research. 40 (6): 845–852. doi:10.1203/00006450-199612000-00012. PMID 8947961. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  23. ^ Sanchez CL; et al. (2009). "The possible role of human milk nucleotides as sleep inducers" (Abstract). Nutr Neurosci. 12 (1): 2–8. doi:10.1179/147683009X388922. PMID 19178785. {{cite journal}}: Explicit use of et al. in: |author= (help)
  24. ^ Fride E, Bregman T, Kirkham TC. (2005). "Endocannabinoids and food intake: newborn suckling and appetite regulation in adulthood" (PDF). Experimental Biology and Medicine. 230 (4): 225–234. doi:10.1371/journal.pbio.0020286. PMID 15792943. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  25. ^ [1]
  26. ^ [2] Medela.
  27. ^ Protocol #8: Human milk storage information for home use for healthy full-term infants. Academy of Breastfeeding Medicine Protocol.
  28. ^ MedlinePlus Medical Encyclopedia: Cow's milk for infants and children
  29. ^ "Some patients with lactose intolerance may believe they are allergic to milk or milk products. A milk allergy, however, is related to the proteins in milk rather than the lactose." Lactose Intolerance, National Institute of Child Health and Human Development (NICHD)
  30. ^ Newsvine.com. The Milk Of Human Kindness: Uses For Human Breast Milk http://daniel-slack.newsvine.com/_news/2009/04/26/2733785-the-milk-of-human-kindness-uses-for-human-breast-milk
  31. ^ Bella Online: Medicinal Uses of Breastmilk http://www.bellaonline.com/articles/art41924.asp
  32. ^ New England Journal of Medicine Breast Milk & Risk of CMV 1980 http://content.nejm.org/cgi/content/citation/302/19/1073
  33. ^ WFAA.com. Breast Milk Used to Treat Cancer Patients http://www.wfaa.com/sharedcontent/dws/news/localnews/tv/stories/wfaa080215_lj_breastmilk.c618de8d.html[dead link]
  34. ^ New York Daily News: Restaurant Drops Plan to Cook with Breast Milk http://www.nydailynews.com/money/2008/09/18/2008-09-18_restaurant_drops_plan_to_cook_with_breas.html
  35. ^ Tammy Frissell-Deppe. A Breastfeeding Mother's Secret Recipes: Breastmilk Recipes, Fun Food for Kids and Quick Dishes!. Dracut, MA: JED Publishing, 2002
  36. ^ PETA.org: The Breast Is Best! PETA Asks Ben & Jerry's to Dump Dairy and Go With Human Milk Instead http://www.peta.org/mc/NewsItem.asp?id=11993
  37. ^ WPTZ.com: PETA Urges Ben & Jerry's To Use Human Milk
  38. ^ Jelliffe, Derrick B., and E. F. Patrice Jelliffe. Human Milk in the Modern World. Oxford and New York: Oxford University Press, 1978.
  39. ^ The Traditional Midwife: Mother's Milk Soap http://traditionalmidwife.com/mothersmilksoap.html
  40. ^ Secretariat, World Health Organization (24 November 2001). Infant and Young Child Nutrition: Global strategy for infant and young child feeding (PDF). World Health Organization. WHO Executive Board 109th Session provisional agenda item 3.8 (EB109/12).
  41. ^ a b c d breastfeedingbasics.org - a site for parents developed by pediatricians --> Breastfeeding & Drugs: Does the medication pass into the breast milk? Retrieved on June 19, 2009
  42. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab kidsgrowth.org --> Drugs and Other Substances in Breast Milk Retrieved on June 19, 2009
  43. ^ Silent Snow: The Slow Poisoning of the Arctic by Marla Cone, Grove Press.
  44. ^ "Le aseguro a Su Majestad que esta leche es de toda confianza"
  45. ^ First Royal visit to Las Hurdes
  46. ^ Hallgren O, Aits S, Brest P, Gustafsson L, Mossberg AK, Wullt B, Svanborg C (2008). "Apoptosis and tumor cell death in response to HAMLET (human alpha-lactalbumin made lethal to tumor cells". Adv Exp Med Biol. 606: 217–40. doi:10.1007/978-0-387-74087-4_8. PMID 18183931.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  47. ^ Clínica busca cómo hacer queso de leche materna, Nación, 17 June 2007
  48. ^ "Swiss restaurant to serve meals cooked with human breast milk A Swiss gastronomist has stirred a controversy in the tranquil Alpine republic after announcing that he will serve meals cooked with human breast milk". The Daily Telegraph. London. 2008-09-17. Retrieved 2010-04-26. {{cite news}}: horizontal tab character in |title= at position 64 (help)
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