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"Breast milk Analysis"
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Nutrition during lactation
Book discusses who breastfeeds in United States, the nutritional status and usual dietary intake of lactating women, milk volume, milk composition and pesticide residues implications, infant outcomes of lactation composition and volume, maternal health effects of breastfeeding, meeting maternal needs during lactation, and research recommendations focusing primarily on growth and health of the infant
eBook
Caffeine, Paraxanthine, Theophylline, and Theobromine Content in Human Milk
This study aimed to assess the content of caffeine and its metabolites—paraxanthine, theophylline, and theobromine—in breast milk according to selected factors. Samples of human milk were collected from 100 women living in the east–northeast region of Poland. Information on the consumption of beverages and foods containing caffeine was collected using a 3 day food record. The determination of caffeine and its metabolite content was performed using liquid chromatography–mass spectrometry (LC–MS/MS). This study research showed that more caffeine was found in the milk of women living in cities, with secondary education, aged 34–43, and also in milk from the 3rd and 4th lactation periods (p ≤ 0.05). Factors such as place of residence, level of education, age, and stage of lactation influenced the nutritional choices of breastfeeding women, which had an impact on the level of caffeine and its metabolites in breast milk. A positive correlation was found between the consumption of caffeine with food and drinks and its level in human milk.
Journal Article
Composition of breast milk from mothers of premature and full-term infants and its influence in Z-Scores for infant physical growth
Background
Breast milk contains various crucial nutrients and biologically active substances and is ideal for newborns. This study aimed to analyze the composition of breast milk from mothers of premature and full-term infants and its influences on the growth of infants.
Methods
Infant-mother dyads examined at our Hospital (March 2016 to May 2017) were included. Milk was collected at 0–1 month, 2–3 months, and 5–6 months and analyzed using a MIRIS human milk analyzer. Z-scores of weight-for-length (WLZ), weight-for-age (WAZ), and length-for-age (LAZ) were calculated.
Results
This study included full-term (> 37 weeks of gestation,
n
= 177) and premature (< 37 weeks,
n
= 94) infant-mother dyads. The premature infants showed higher ΔWAZ, ΔLAZ, and ΔWLZ from infancy to toddlerhood for the physical growth speed, compared with term infants (
P
< 0.001). All proteins and true protein components of breast milk decreased with infants’ age (
P
< 0.001). For premature and full-term infants, differences in ΔWAZ and ΔLAZ from birth to infancy and the difference in ΔLAZ, WAZ, and LAZ in toddlerhood were positively associated with non-protein nitrogen (NPN) (all
P
< 0.05), while the Z-score differences in ΔWLZ from birth to infancy were negatively associated with NPN (all
P
< 0.05). For premature babies, from birth to infancy stage, ΔWAZ was positively correlated with NPN and carbohydrates while negatively correlated with dry matter (all
P
< 0.05), and ΔLAZ correlated with NPN (β = 0.428,
P
= 0.005).
Conclusion
Breastfeeding helped premature infants compensatory growth when compared to term infants. Whileduring early infancy stage ΔWLZ gain was negatively associated with increased amounts of NPN in breast milk. This might mean although NPN increase the Z-scores of weight-for-age and length-for-age, with no rise in adipose tissue mass.
Journal Article
Worldwide Variation in Human Milk Metabolome: Indicators of Breast Physiology and Maternal Lifestyle?
Human milk provides essential substrates for the optimal growth and development of a breastfed infant. Besides providing nutrients to the infant, human milk also contains metabolites which form an intricate system between maternal lifestyle, such as the mother’s diet and the gut microbiome, and infant outcomes. This study investigates the variation of these human milk metabolites from five different countries. Human milk samples (n = 109) were collected one month postpartum from Australia, Japan, the USA, Norway, and South Africa and were analyzed by nuclear magnetic resonance. The partial least squares discriminant analysis (PLS-DA) showed separation between either maternal countries of origin or ethnicities. Variation between countries in concentration of metabolites, such as 2-oxoglutarate, creatine, and glutamine, in human milk, between countries, could provide insights into problems, such as mastitis and/or impaired functions of the mammary glands. Several important markers of milk production, such as lactose, betaine, creatine, glutamate, and glutamine, showed good correlation between each metabolite. This work highlights the importance of milk metabolites with respect to maternal lifestyle and the environment, and also provides the framework for future breastfeeding and microbiome studies in a global context.
Journal Article
Maternal and Infant Characteristics and Pumping Profiles of Women That Predominantly Pump Milk for Their Infants
Background: Whilst it is inconvenient and time-intensive, predominantly (PP) and exclusively pumping (EP) mothers rely on breast expression to provide milk for their infants and to ensure continued milk supply, yet these populations are poorly understood. Methods: We assessed and characterised Western Australian PP mothers (n = 93) regarding 24 h milk production (MP) and infant milk intake and demographics, perinatal complications and breastfeeding difficulties, the frequencies of which were compared with published general population frequencies. Pumping efficacy and milk flow parameters during a pumping session in PP mothers (n = 32) were compared with those that pump occasionally (reference group, n = 60). Results: PP mothers had a higher frequency of pregnancy complications and breastfeeding difficulties than the general population. Exclusive pumping did not impact the 24 h MP and the amount of milk available to the infant. PP mothers had more milk ejections, longer active flow duration and lower milk removal efficacy ratios; however, responsiveness to pump (time to first milk ejection), total flow duration, time to stop pumping, percentage of available milk removed and comfort parameters were not different to the reference group. Conclusions: Despite the reported challenges, when an effective pump is used, predominant or exclusive pumping does not negatively affect the 24 h MP and the amount of milk available to the infant. Increasing awareness of the impacts of perinatal and breastfeeding complications on women may assist health professionals in early identification of mothers at high risk for early cessation of breastfeeding, escalating early postpartum intervention and targeted breastfeeding support.
Journal Article
Oral administration of bovine milk-derived extracellular vesicles induces senescence in the primary tumor but accelerates cancer metastasis
The concept that extracellular vesicles (EVs) from the diet can be absorbed by the intestinal tract of the consuming organism, be bioavailable in various organs, and in-turn exert phenotypic changes is highly debatable. Here, we isolate EVs from both raw and commercial bovine milk and characterize them by electron microscopy, nanoparticle tracking analysis, western blotting, quantitative proteomics and small RNA sequencing analysis. Orally administered bovine milk-derived EVs survive the harsh degrading conditions of the gut, in mice, and is subsequently detected in multiple organs. Milk-derived EVs orally administered to mice implanted with colorectal and breast cancer cells reduce the primary tumor burden. Intriguingly, despite the reduction in primary tumor growth, milk-derived EVs accelerate metastasis in breast and pancreatic cancer mouse models. Proteomic and biochemical analysis reveal the induction of senescence and epithelial-to-mesenchymal transition in cancer cells upon treatment with milk-derived EVs. Timing of EV administration is critical as oral administration after resection of the primary tumor reverses the pro-metastatic effects of milk-derived EVs in breast cancer models. Taken together, our study provides context-based and opposing roles of milk-derived EVs as metastasis inducers and suppressors.
Dietary extracellular vesicles (EVs) could potentially be absorbed by the intestinal tract of the host and exert multiple phenotypic changes. Here, the authors isolate and characterize EVs from raw and commercial bovine milk and show orally administered EVs to have a context specific role in promoting or suppressing primary tumor growth and metastasis in multiple mouse tumor models.
Journal Article
The relationship of early expressed milk quantity and later full breastmilk feeding after very preterm birth: A cohort study
When infants cannot directly breastfeed after birth, mothers are advised to initiate lactation through mechanical expression. Families are recommended to target an expression volume of at least 500–750 mL by Day 14 after birth, as this is considered a ‘critical window’ to establish milk supply. This is challenging for many mothers after a very preterm birth. This article explores the relationship of early milk quantity and later full breastmilk feeding as a ‘gold standard’ outcome, using statistical techniques designed for diagnostic tests. A cohort of 132 mothers of infants born at 23 + 0 to 31 + 6 weeks' gestational age submitted expressing logs on Day 4, 14 and 21 after birth and provided later feeding outcome. Using receiver operating characteristic (ROC) analysis, the following 24‐h milk quantities were identified as associated with high probability of full breastmilk at 36 weeks' post‐menstrual age (PMA): on Day 4, ≥250 g (specificity 88%; positive predictive value 88%) and on Day 21 ≥650 g (specificity 88%; positive predictive value 91%). The following values were identified as associated with low probability of full breastmilk at 36 weeks' PMA: on Day 4 <50 g (sensitivity 92%; negative predictive value 72%) and on Day 21 <250 g (sensitivity 90%; negative predictive value 70%). Participants exceeding the high thresholds had 3–4 times increased likelihood of full breastmilk, whereas those below the low thresholds had 3–5 times lower likelihood. These thresholds have potential as targets for families, to provide individualised prognostic information and to help clinicians target more intensive lactation support. In this observational study, we identified a series of thresholds for early expressed milk quantity that risk stratified long‐term full breastmilk feeding after very preterm birth. These thresholds have potential as targets for families, to provide individualised prognostic information and to help clinicians direct more intensive lactation support. Key messages Mothers of very preterm infants who expressed at least 250 g at day four after birth had a high probability of providing later full breastmilk: 88% (95% CI: 72%–97%). This was similar for those who expressed at least 650 g at Day 21: 91% (95% CI: 77%–98%). Mothers of very preterm infants who expressed less than 50 g at day four after birth had a low probability of providing later full breastmilk: 28% (95% CI: 10%–53%). This was similar for those who expressed less than 250 g at Day 21: 30% (95% CI: 12%–54%). These thresholds may be useful for families to understand their lactation trajectories and for clinicians to target support.
Journal Article
Human Milk Lipids
Human milk lipids provide the infant with energy and essential vitamins, polyunsaturated fatty acids, and bioactive components. Adding complex lipids and milk fat globule membranes to vegetable oil-based infant formula has the potential to enhance infant development and reduce infections. Cholesterol provision with breastfeeding modulates infant sterol metabolism and may induce long-term benefits. Some 98–99% of milk lipids are comprised by triacylglycerols, whose properties depend on incorporated fatty acids. Attention has been devoted to the roles of the longchain polyunsaturated fatty acids docosahexaenoic (DHA) and arachidonic (ARA) acids. Recent studies on gene-diet interaction (Mendelian randomization) show that breastfeeding providing DHA and ARA improves cognitive development and reduces asthma risk at school age particularly in those children with a genetically determined lower activity of DHA and ARA synthesis. It appears prudent to follow the biological model of human milk in the design of infant formula as far as feasible, unless conclusive evidence for the suitability and safety of other choices is available. The recent European Union legislative stipulation of a high formula DHA content without required ARA deviates from this concept, and such a novel formula composition has not been adequately evaluated. Great future opportunities arise with significant methodological progress for example in lipidomic analyses and their bioinformatic evaluation, which should enhance understanding of the biology of human milk lipids. Such knowledge might lead to improved dietary advice to lactating mothers as well as to further opportunities to enhance infant formula composition.
Journal Article
Transcriptional changes in the mammary gland during lactation revealed by single cell sequencing of cells from human milk
Under normal conditions, the most significant expansion and differentiation of the adult mammary gland occurs in response to systemic reproductive hormones during pregnancy and lactation to enable milk synthesis and secretion to sustain the offspring. However, human mammary tissue remodelling that takes place during pregnancy and lactation remains poorly understood due to the challenge of acquiring samples. We report here single-cell transcriptomic analysis of 110,744 viable breast cells isolated from human milk or non-lactating breast tissue, isolated from nine and seven donors, respectively. We found that human milk largely contains epithelial cells belonging to the luminal lineage and a repertoire of immune cells. Further transcriptomic analysis of the milk cells identified two distinct secretory cell types that shared similarities with luminal progenitors, but no populations comparable to hormone-responsive cells. Taken together, our data offers a reference map and a window into the cellular dynamics that occur during human lactation and may provide further insights on the interplay between pregnancy, lactation and breast cancer.
Human mammary tissue remodelling that takes place during pregnancy and lactation remains poorly understood. Here the authors characterize cells in human milk, identifying epithelial cells resembling luminal progenitors and immune cells, contributing insights into this process.
Journal Article