Currently Happening Presently Now: BREAST-FEEDING

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Hanson LA Session 1: Feeding and infant development breast‐feeding and immune function. Proc Nutr Soc. 2007 Aug;66(3):384‐96.

The newborn receives, via the placenta, maternal IgG antibodies against the microbes present in its surroundings, but such antibodies have a pro-inflammatory action, initiating the complement system and phagocytes. Although the host defence mechanisms of the neonate that involve inflammatory reactivity are somewhat inefficient, this defence system can still have catabolic effects. Breast-feeding compensates for this relative inefficiency of host defence in the neonate by providing considerable amounts of secretory IgA antibodies directed particularly against the microbial flora of the mother and her environment. These antibodies bind the microbes that are appearing on the infant’s mucosal membranes, preventing activation of the pro-inflammatory defence. The major milk protein lactoferrin can destroy microbes and reduce inflammatory responses. The non-absorbed milk oligosaccharides block attachment of microbes to the infant’s mucosae, preventing infections. The milk may contain anti- secretory factor, which is anti-inflammatory, preventing mastitis in mothers and diarrhoea in infants. Numerous additional factors in the milk are of unknown function, although IL-7 is linked to the larger size of the thymus and the enhanced development of intestinal Tgd lymphocytes in breast-fed compared with non-breast-fed infants. Several additional components in the milk may help to explain why breast-feeding can reduce infant mortality, protecting against neonatal septicaemia and meningitis. It is therefore important to start breast feeding immediately. Protection is also apparent against diarrhoea, respiratory infections and otitis media. There may be protection against urinary tract infections and necrotizing enterocolitis, and possibly also against allergy and certain other immunological diseases, and tumours. In conclusion, breast-feeding provides a very broad multifactorial anti-inflammatory defence for the infant.

Newburg DS. Innate immunity and human milk. J Nutr. 2005 May;135(5):1308‐12.

Human neonates are born with an immature and naıve acquired immune system, and many of the innate components of mucosal immunity are not fully developed. Thus, the innate immune system of human milk is an important complement to the mucosal barrier of the developing gut. The nursing mother provides her infant many protective agents through milk, a growing number of which have been identified as isolates of milk in laboratory models of infection. The number, the potency, and the importance of these protective agents are probably greater than previously thought. For example, many potent protective agents are not found in milk until digestion releases antimicrobial agents such as fatty acids and peptides. An alternate conformer of lactalbumin forms from milk in the stomach and inhibits cancer cells. Many of the protective constituents of human milk inhibit different aspects of a pathogenic process, creating a synergy, where much lower concentrations of each component become protective. Some components have a temporal and a spatial specificity that would cause their protective role to go unrecognized by most laboratory models of infection. Some protective components had remained underappreciated because of technical challenges in their isolation and testing. Recent reports suggest that human milk contains a highly potent mixture of protective agents that constitute an innate immune system, whereby the mother protects her infant from enteric and other diseases. These human-milk components may represent a rich source of novel classes of therapeutic agents against human pathogens.

Isaacs Charles, Human Milk Inactivates Pathogens, Individually, Additively and Synergistically. J Nut. May 2005 135, 5 pp1286‐88.

Breast-feeding can reduce the incidence and the severity of gastrointestinal and respiratory infections in the suckling neonate by providing additional protective factors to the infant’s mucosal surfaces. Human milk provides protection against a broad array of infectious agents through redundancy. Protective factors in milk can target multiple early steps in pathogen replication and target each step with more than one antimicrobial compound. The antimicrobial activity in human milk results from protective factors working not only individually but also additively and synergistically. Lipid-dependent antimicrobial activity in milk results from the additive activity of all antimicrobial lipids and not necessarily the concentration of one particular lipid. Antimicrobial milk lipids and peptides can work synergistically to decrease both the concentrations of individual compounds required for protection and, as importantly, greatly reduce the time needed for pathogen inactivation. The more rapidly pathogens are inactivated the less likely they are to establish an infection. The total antimicrobial protection provided by human milk appears to be far more than can be elucidated by examining protective factors individually.

Hassiotou F Breastmilk is a novel source of stem cells with multilineage differentiation potential. Stem Cells. 2012 Oct;30(10):2164‐74.

The mammary gland undergoes significant remodeling during pregnancy and lactation, which is fuelled by controlled mammary stem cell (MaSC) proliferation. The scarcity of human lactating breast tissue specimens and the low numbers and quiescent state of MaSCs in the resting breast have hindered understanding of both normal MaSC dynamics and the molecular determinants that drive their aberrant self-renewal in breast cancer. Here, we demonstrate that human breastmilk contains stem cells (hBSCs) with multilineage properties. Breastmilk cells from different donors displayed variable expression of pluripotency genes normally found in human embryonic stem cells (hESCs). These genes included the transcription factors (TFs) OCT4, SOX2, NANOG, known to constitute the core self-renewal circuitry of hESCs. When cultured in the presence of mouse embryonic feeder fibroblasts, a population of hBSCs exhibited an encapsulated ESC-like colony morphology and phenotype and could be passaged in secondary and tertiary clonogenic cultures. While self-renewal TFs were found silenced in the normal resting epithelium, they were dramatically upregulated in breastmilk cells cultured in 3D spheroid conditions. Furthermore, hBSCs differentiated in vitro into cell lineages from all three germ layers. These findings provide evidence that breastmilk represents a novel and noninvasive source of patient-specific stem cells with multilineage potential and establish a method for expansion of these cells in culture. They also highlight the potential of these cells to be used as novel models to understand adult stem cell plasticity and breast cancer, with potential use in bioengineering and tissue regeneration. (yikes!)

Smoke, Mirrors, and the “Disappearance” of Polio
by Suzanne Humphries, MD, Internist and Nephrologist speaking on Polio at the Association of Natural Health Conference, November 2012.

Inhibitory Effect of Breast Milk on Infectivity of Live Oral Rotavirus Vaccines
Pediatr Infect Dis J. 2010 October ; 29(10): 919–923.

"The lower immunogenicity and efficacy of rotavirus vaccines in poor developing countries could be explained, in part, by higher titers of IgA and neutralizing activity in breast milk consumed by their infants at the time of immunization that could effectively reduce the potency of the vaccine. Strategies to overcome this negative effect, such as delaying breast-feeding at the time of immunization, should be evaluated."

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Full breastfeeding and paediatric cancer

J Paediatr Child Health. Jan 2008; 44(0): 10–13.

Breastfeeding was inversely associated with PC, the protection increasing with the duration of full breastfeeding. Additional research on possible mechanisms of this association may be warranted. Meanwhile, breastfeeding should be encouraged among mothers.
The protective effect of breastfeeding is important in overall paediatric cancer.
The degree of protection conferred by breastfeeding increases with the duration of full breastfeeding.
The protective effect of breastfeeding on paediatric cancer is observed even for relatively short periods of breastfeeding.


Longer breast-feeding and protection against childhood leukaemia and lymphomas
European Journal of Cancer Volume 37, Issue 2 , Pages 234-238, January 2001.

The role of breast-feeding in protecting against childhood acute leukaemia and lymphomas is uncertain. We investigated this issue in a case–control study comprising 117 patients, aged 2–14 years, with acute lymphocytic leukaemia (ALL), Hodgkin's (HL) and non-Hodgkin's lymphoma (NHL), as well as 117 controls matched for age, sex and ethnicity. Information was collected via a telephone interview of the mothers. The median duration of breast-feeding among patients was significantly shorter than among controls, 7 (range 0–23) and 10 (range 0–20) months, respectively (P<0.0001). Breast-feeding of 0–6 months' duration, when compared with feeding of longer than 6 months, was associated with increased odds ratios (OR) for ALL (OR=2.47, 95% confidence interval (CI) 1.17–5.25), HL (OR=3.75, 95% CI 0.80–18.69), NHL (OR=4.06, 95% CI 0.82–22.59), and overall (OR=2.79, 95% CI 1.54–5.05). In the patient group, there were a significantly higher number of children and people per family, and patients were of a higher birth order than controls. In multivariate analysis, breast-feeding duration continues to be an independent predictor of lymphoid malignancies (P=0.015). In conclusion, breast-feeding lasting longer than 6 months may protect against childhood acute leukaemia and lymphomas.

Smith, L. J. (2007), Impact of Birthing Practices on the Breastfeeding Dyad. Journal of Midwifery & Women’s Health, 52: 621–630

For breastfeeding to start and continue, the newborn must be able to suck, swallow, and breathe; the mother must be able and willing to let her infant breastfeed; and surroundings must support the biological unit: the mother–baby dyad. This article reviews how birth practices, including epidural anesthesia, cesarean surgery, forceps, and vacuum extraction, can affect the newborn's ability to feed, the mother's motivation and lactation capacity, and the mother–baby relationship.

“Because ‘failure to breastfeed' is not recognized as a possible harmful effect of medication, there are few methodological precedents in this area. The complex, but under researched, physiological processes involved in establishing lactation are not generally considered vulnerable to pharmacological influences. The transitory nature and 'ordinariness' of 'switching to bottle feeding' render the usual algorithms for identifying adverse drug reactions inadequate, inapplicable, or even irrelevant. Susceptibility to bottle feeding is often regarded as determined exclusively by socio-cultural factors. The possibility of an additional dose-related impact of medication has not previously been explored in this context.”

Low Breastfeeding Rates and Public Health in the United States

Am J Public Health. 2003 December; 93(12): 2000–2010.

While the initiation of breastfeeding appears to be unaffected by a mother’s employment status, breastfeeding duration is decidedly influenced by full-time maternal employment, not unlike a century ago. Only 10% of full time working mothers breastfeed their 6-month-olds compared with almost 3 times that number of stay-at-home mothers. This association between maternal employment and decreased breastfeeding duration is evident across all ethnic, education, and age groups. The current Family and Medical Leave Act, mandating only 12 weeks of maternity leave, unpaid no less, is only one example of the failure of contemporary American society to recognize the reality of mothers' lives and their need for social support in order to meet the nutritional, immunologic, psychological, developmental, and cognitive needs of their babies.

Bedsharing Promotes Breastfeeding
Pediatrics Vol. 100 No. 2 August 1, 1997, pp. 214-219.

Objective. Because breastfeeding is thought to be protective against sudden infant death syndrome (SIDS), environmental or child care factors that promote breastfeeding might reduce infant vulnerability to SIDS. The effect of mother-infant bedsharing on nocturnal breastfeeding behavior was studied in 20 routinely bedsharing and 15 routinely solitary sleeping Latino mother-infant pairs when the infants were 3 to 4 months old.
Methodology.  All pairs were healthy and exclusively breastfeeding at night. The videotape portion of all-night laboratory polysomnographic studies was used for the analyses. For each pair, an adaptation night was followed by one night each of bedsharing and solitary sleeping.
Results. The most important finding is that when tested in their usual sleeping conditions, routinely bedsharing infants breastfed approximately three times longer during the night than infants who routinely slept separately: this reflected a two-fold increase in the number of breastfeeding episodes and 39% longer episodes. Breastfeeding was also facilitated on the bedsharing night relative to the solitary night within the routinely bedsharing group: the number and total duration of breastfeeding episodes were significantly larger on the bedsharing night.
Conclusions. We suggest that, by increasing breastfeeding, bedsharing might be protective against SIDS, at least in some contexts. Furthermore, maternal reproductive physiology could be impacted because nursing frequency affects ovulation. This is the first study to directly measure nocturnal breastfeeding behavior in any cultural group.

The Effect of Maternity Leave Length and Time of Return to Work on Breastfeeding
Pediatrics. Jun 2011; 127(6)

There was no variation in the duration of any or predominant breastfeeding according to total or paid maternity leave length; nevertheless, the highest proportion of mothers continuing to breastfeed beyond 6 months was among women who had not yet returned to work by the 9-month interview (46.7%) and the lowest proportion was among women returning within 7 to 12 weeks (30.1%.0001)

Studies in Canada and the United States support the notion that an increase in maternity leave length mandates in the United States would likely result in a greater proportion of women staying at home longer after delivery.

If new mothers delay their time of return to work, then duration of breastfeeding among US mothers may lengthen.


Schwab, M. G. (1996). Mechanical Milk: An Essay on the Social History of Infant Formula. Childhood, 3(4), 479-497.

This article describes how the infant formula, originally designed to save babies' lives, ended up responsible for perhaps millions of their deaths. It reaches back 300 years into the idea of the body as a machine, the rise of science and industrial capitalism, the emergence of nutrition and pediatrics, the growth of the formula industry and resistance to it. It shows how the formula became an icon of modernity, whose promise was truth and happiness through technology, work and the production of goods, but whose reality was, for most people, exploitation, colonialism and the destruction of `vernacular' ways of life.


 


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