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Breast milk

Breast milk (sometimes spelled as breastmilk) or mother's milk is milk produced by mammary glands located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates (lactose and human milk oligosaccharides) and variable minerals and vitamins.[citation needed] Breast milk also contains substances that help protect an infant against infection and inflammation, whilst also contributing to healthy development of the immune system and gut microbiome.[1]

Two 25-milliliter samples of human breast milk. The left-hand sample is the first milk produced by the mother while the right-hand sample was produced later during the same pumping.

Uses and methods of consumption edit

 
Pumped breast milk
 
Breast feeding latch

The World Health Organization recommends exclusive breastfeeding for the first six months of life,[2] with solids gradually being introduced around this age when signs of readiness are shown.[3][4] Supplemented breastfeeding is recommended until at least age two and then for as long as the mother and child wish.[4]

Some newborn babies that are alert and healthy have the ability to latch on to the mother's breast within one hour of birth,[5] however, on a global level, 3/5 babies are not breast fed within the first hour of being born.[4][6] Breast milk can also be pumped from the mother using a breast pump and fed by baby bottle, cup and/or spoon, supplementation drip system, or nasogastric tube.[7] For infants who are born early (preterm birth) and do not have the ability to suck right away, the use of cups to feed expressed milk and other supplements is reported to result in better breastfeeding extent and duration compared with bottles and tube feeding.[7][8]

For women who do not produce sufficient amounts of breast milk, donor human breast milk that is pasteurized may be effective.[9] If pasteurized donor breast milk is not available, commercial formula is suggested as a second alternative.[9] Breast milk supplied by a woman other than the baby's mother that is not pasteurized and informal breast milk sharing is associated with a risk of transmitting bacteria and viruses from the donor mother to the baby and is not considered a safe alternative.[9][10]

Benefits edit

Breastfeeding offers health benefits to mother and child even after infancy.[11] These benefits include proper heat production and adipose tissue development,[12] a 73% decreased risk of sudden infant death syndrome,[13] increased intelligence,[14] decreased likelihood of contracting middle ear infections,[15] cold and flu resistance,[16] a tiny decrease in the risk of childhood leukemia,[17] lower risk of childhood onset diabetes,[18] decreased risk of asthma and eczema,[19] decreased dental problems,[19] decreased risk of obesity later in life,[20] and a decreased risk of developing psychological disorders, including in adopted children.[21] In addition, feeding an infant breast milk is associated with lower insulin levels and higher leptin levels compared feeding an infant via powdered-formula.[22] Many of the infection-fighting and immune system related benefits are associated with human milk oligosaccharides.[23]

Breastfeeding also provides health benefits for the mother. It assists the uterus in returning to its pre-pregnancy size and reduces post-partum bleeding, through the production of oxytocin (see Production). Breastfeeding can also reduce the risk of breast cancer later in life.[24][25] Lactation may also reduce the risk for both mother and infant from both types of diabetes.[26] Lactation may protect the infant from specifically developing Type 2 diabetes, as studies have shown that bioactive ingredients in human breast milk could prevent excess weight gain during childhood via contributing to a feeling of energy and satiety. A lower risk of child-onset diabetes may be more applicable to infants who were born from diabetic mothers.[22] The reason is that while breastfeeding for at least the first six months of life minimizes the risk of type 1 diabetes from occurring in the infant, inadequate breastfeeding in an infant prenatally exposed to diabetes was associated with a higher risk of the child developing diabetes later.[22] However, it can be argued that human breastfeeding may contribute to protective effects against the development of type 1 diabetes because the alternative of bottle-feeding may expose infants to unhygienic feeding conditions.[27]

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.[28] However, it is now universally recognized that there is no commercial formula that can substitute breast milk. In addition to the appropriate amounts of carbohydrate, protein, and fat, breast milk provides vitamins, minerals, digestive enzymes,[29] and hormones.[29] Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections.[30] The immune function of breast milk is individualized, as the mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby, and, as a consequence, her body makes the appropriate antibodies and immune cells.[31]

At around four months of age, the internal iron supplies of the infant, held in the hepatic cells of the liver, are exhausted. The American Academy of Pediatrics recommends that at this time that an iron supplement should be introduced.[32] Other health organisations such as the NHS in the UK have no such recommendation.[33] Breast milk contains less iron than formula, but the iron is more bioavailable as lactoferrin, which carries more safety for mothers and children than ferrous sulphate.[34]

Both the AAP[35] and the NHS recommend vitamin D supplementation for breastfed infants.[33] Vitamin D can be synthesised by the infant via exposure to sunlight; however, many infants are deficient due to being kept indoors or living in areas with insufficient sunlight. Formula is supplemented with vitamin D for this reason.[33][35]

Production edit

Under the influence of the hormones prolactin and oxytocin, women produce milk after childbirth to feed the baby.[36] The initial milk produced is 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. It also creates a mild laxative effect, expelling meconium and helping to prevent the build-up of bilirubin (a contributory factor in jaundice[37]). Male lactation can occur; the production or administration of the hormone prolactin is necessary to induce lactation (see male lactation).

Actual inability to produce enough milk is rare, with studies showing that mothers from malnourished regions still produce amounts of milk of similar quality to that of mothers in developed countries.[38] There are many reasons a mother may not produce enough breast milk.[39] Some of the most common reasons 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 and may require hormone replacement.

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.[40][41][42] It is beneficial to nurse when the baby wants to nurse rather than on a schedule. A Cochrane review came to the conclusion that a greater volume of milk is expressed whilst listening to relaxing audio during breastfeeding, along with warming and massaging of the breast prior to and during feeding. A greater volume of milk expressed can also be attributed to instances where the mother starts pumping milk sooner, even if the infant is unable to breastfeed.[43]

Sodium concentration is higher in hand-expressed milk, when compared with the use of manual and electric pumps, and fat content is higher when the breast has been massaged, in conjunction with listening to relaxing audio. This may be important for low birthweight infants.[43] If pumping, it is helpful to have an electric, high-grade pump so that all of the milk ducts are stimulated. Galactagogues increase milk supply, although even herbal variants carry risks. Non-pharmaceutical methods should be tried first, such as pumping out the mother's breast milk supply often, warming or massaging the breast, as well as starting milk pumping earlier after the child is born if they cannot drink milk at the breast.[43][44][45][46]

Composition edit

Composition of human breast milk[47]
Fat (g/100 ml)
total 4.2
fatty acids – length 8C
polyunsaturated fatty acids 0.6
cholesterol 0.016
Protein (g/100 ml)
total 1.1
casein 0.4
a-lactalbumin 0.3
lactoferrin (apo-lactoferrin) 0.2
IgA 0.1
IgG 0.001
lysozyme 0.05
serum albumin 0.05
β-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

Breast milk contains complex proteins, lipids, carbohydrates (lactose and human milk oligosaccharides) and other biologically active components.[48] The composition changes over a single feed as well as over the period of lactation.[49] Changes are particularly pronounced in marsupials.[50]

 
Colostrum vs breastmilk

During the first few days after delivery, the mother produces colostrum. This is a thin yellowish fluid that is the same fluid that sometimes 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.[citation needed]

Colostrum will gradually change to become mature milk. In the first 3–4 days it will appear thin and watery and will taste very sweet; later, the milk will be thicker and creamier. Human milk quenches the baby's thirst and hunger and provides the proteins, sugar, minerals, and antibodies that the baby needs.

In the 1980s and 1990s, lactation professionals (De Cleats) used to make a differentiation between foremilk and hindmilk. But this differentiation causes confusion as there are not two types of milk. Instead, as a baby breastfeeds, the fat content very gradually increases, with the milk becoming fattier and fattier over time.[51]

The level of Immunoglobulin A (IgA) in breast milk remains high from day 10 until at least 7.5 months post-partum.[52]

Human milk contains 0.8–0.9% protein, 4.5% fat, 7.1% carbohydrates, and 0.2% ash (minerals).[53] Carbohydrates are mainly lactose; several lactose-based oligosaccharides (also called human milk oligosaccharides) have been identified as minor components.[54] The fat fraction contains specific triglycerides of palmitic and oleic acid (O-P-O triglycerides), and also lipids with trans bonds (see: trans fat). The lipids are vaccenic acid, and conjugated linoleic acid (CLA) accounting for up to 6% of the human milk fat.[55][56]

The principal proteins are alpha-lactalbumin, lactoferrin (apo-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.[citation needed] This is thought to contribute to the protection of breastfed babies against cancer.[57]

Non-protein nitrogen-containing compounds, making up 25% of the milk's nitrogen, include urea, uric acid, creatine, creatinine, amino acids, and nucleotides.[58][59] Breast milk has circadian variations; some of the nucleotides are more commonly produced during the night, others during the day.[60]

Mother's milk has been shown to supply endocannabinoids (the natural neurotransmitters that cannabis simulates) 2-arachidonoylglycerol,[61] anandamide,[62][63] oleoylethanolamide,[64] palmitoylethanolamide,[64] N-arachidonoyl glycine,[64] eicosapentaenoyl ethanolamide,[64] docosahexaenoyl ethanolamide,[64] N-palmitoleoyl-ethanolamine,[64] dihomo-γ-linolenoylethanolamine,[64] N-stearoylethanolamine,[64] prostaglandin F2alpha ethanolamides[64] and prostaglandin F2 ethanolamides,[64] Palmitic acid esters of hydroxy-stearic acids (PAHSAs).[65] They may act as an appetite stimulant, but they also regulate appetite so infants do not eat too much. That may be why formula-fed babies have a higher caloric intake than breastfed babies.[66]

Breast milk is not sterile, but contains as many as 600 different species of various bacteria, including beneficial Bifidobacterium breve, B. adolescentis, B. longum, B. bifidum, and B. dentium, which contribute to colonization of the infant gut.[67] As a result, it can be defined as a probiotic food, depending on how one defines "probiotic".[68] Breast milk also contains a variety of somatic cells and stem cells and the proportion of each cell type differs from individual to individual.[69][70] The somatic cells are mainly lactocytes and myoepithelial cells derived from the mother's mammary glands.[71] The stem cells found in human breast milk have been shown to be able to differentiate into a variety of other cells involved in the production of bodily tissues and a small proportion of these cross over the nursing infant's intestinal tract into the bloodstream to reach certain organs and transform into fully functional cells.[72] Because of its diverse population of cells and multifarious functions, researchers have argued that breast milk should be considered a living tissue.[69]

Breast milk contains a unique type of sugars, human milk oligosaccharides (HMOs), which were not present in traditional infant formula, however they are increasing added by many manufacturers. HMOs are not digested by the infant but help to make up the intestinal flora.[73] They act as decoy receptors that block the attachment of disease causing pathogens, which may help to prevent infectious diseases.[74] They also alter immune cell responses, which may benefit the infant. As of 2015 more than a hundred different HMOs have been identified; both the number and composition vary between women and each HMO may have a distinct functionality.[75]

The breast milk of diabetic mothers has been shown to have a different composition from that of non-diabetic mothers. It may contain elevated levels of glucose and insulin and decreased polyunsaturated fatty acids. A dose-dependent effect of diabetic breast milk on increasing language delays in infants has also been noted, although doctors recommend that diabetic mothers breastfeed despite this potential risk.[76]

Women 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.[77] Even though most infants infected with HIV contract the disease from breastfeeding, most infants that are breastfed by their HIV positive mothers never contract the disease.[78] While this paradoxical phenomenon suggests that the risk of HIV transmission between an HIV positive mother and her child via breastfeeding is small, studies have also shown that feeding infants with breast milk of HIV-positive mothers can actually have a preventative effect against HIV transmission between the mother and child.[78] This inhibitory effect against the infant contracting HIV is likely due to unspecified factors exclusively present in breast milk of HIV-positive mothers.[78]

Most women that do not breastfeed use infant formula, but breast milk donated by volunteers to human milk banks can be obtained by prescription in some countries.[79] In addition, research has shown that women who rely on infant formula could minimize the gap between the level of immunity protection and cognitive abilities a breastfed child benefits from versus the degree to which a bottle-fed child benefits from them.[80] This can be done by supplementing formula-fed infants with bovine milk fat globule membranes (MFGM) meant to mimic the positive effects of the MFGMs which are present in human breast milk.[81]

Storage of expressed breast milk edit

 
Bottle of pumped breast milk

Expressed breast milk can be stored. Lipase may cause thawed milk to taste soapy or rancid due to milk fat breakdown. It is still safe to use, and most babies will drink it. Scalding it will prevent rancid taste at the expense of antibodies.[82] It should be stored with airtight seals. Some plastic bags are designed for storage periods of less than 72 hours. Others can be used for up to 12 months if frozen. This table describes safe storage time limits.[83]

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 edit

All mammalian 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 contains too little iron, retinol, vitamin E, vitamin C, vitamin D, unsaturated fats or essential fatty acids for human babies.[84][85][86][87] Whole cow's milk also contains too much protein, sodium, potassium, phosphorus and chloride which may put a strain on an infant's immature kidneys. In addition, the proteins, fats and calcium in whole cow's milk are more difficult for an infant to digest and absorb than the ones in breast milk.[85][88][89]

The composition of marsupial and monotreme milk contains essential nutrients, growth factors and immunological properties to support the development of joeys and puggles.[50]

Comparing milks (per cup)[90][91]
Nutrient Human milk Cow milk (3.25% fat) Goat milk
Calories (Kcal) 172 146 168
Water (g) 215 215 212
Protein (g) 2.5 7.9 8.7
Fat (g) 10.8 7.9 10.1
Saturated fat (g) 4.9 4.6 6.5
Monounsaturated fat (g) 4.1 2.0 2.7
Polyunsaturated fat (g) 1.2 0.5 0.4
Omega-3 fatty acids (mg) 128 183 97.6
Omega-6 fatty acids (mg) 920 293 266
Cholesterol (mg) 34.4 24.4 26.8
Carbohydrate (g) 17.0 11.0 10.9
Sugars (g) 17.0 11.0 10.9
Vitamin A (IU) 522 249 483
Vitamin C (mg) 12.3 0 3.2
Vitamin D (IU) * 9.8 97.6 29.3
Vitamin E (mg) 0.2 0.1 0.2
Vitamin K (mcg) 0.7 0.5 0.7
Thiamin (mg) 0.0 0.1 0.1
Riboflavin (mg) 0.1 0.4 0.3
Niacin (mg) 0.4 0.3 0.7
Vitamin B6 (mg) 0.0 0.1 0.1
Folate (mcg) 12 12 2
Vitamin B12 (mcg) 0.1 1.1 0.2
Pantothenic acid (mg) 0.5 0.9 0.8
Choline (mg) 39.4 34.9 39.0
Calcium (mg) 79 276 327
Iron (mg) 0.07 0.07 0.12
Magnesium (mg) 7.4 24.4 34.2
Phosphorus (mg) 34.4 222 271
Potassium (mg) 125 349 498
Sodium (mg) 42 98 122
Zinc (mg) 0.4 1.0 0.7
Copper (mg) 0.1 0.0 0.1
Manganese (mg) 0.1 0.0 0.0
Selenium (mcg) 4.4 9.0 3.4

* Note: Milk is generally fortified with vitamin D in the U.S. and Canada. Non-fortified milk contains only 2 IU per 3.5 oz.

Effects of medications and other substances on milk content edit

Almost all medicines pass into breastmilk in small amounts by a concentration gradient.[92] The amount of drug bound by maternal plasma proteins, the size of the drug molecule, the pH of the drug, and the lipophilicity of the drug determine whether the medication will pass into breastmilk.[93] Medications that are non-protein bound, low in molecular weight, or highly lipid-soluble are more likely to enter the breast milk in larger quantities.[94] Some have no effect on the baby and can be used while breastfeeding, while other medications may be harmful to the infant.[95][94]

Some generally safe medications that the mother can use while breastfeeding include:

Examples of Safe Medications for Breastfeeding Mothers
Condition Medication Side Effects/Notes
ADHD Methylphenidate (Ritalin), Dextroamphetamine May cause irritability and problems putting on weight[96]
Allergic Rhinitis Beclomethasone (Beconase)
Pseudoephedrine (Sudafed) May cause decreased milk production
Diphenhydramine (Benadryl)[94] May cause tiredness or irritability in infants
Anesthetics (Inhalation) Isoflurane, Sevoflurane[97] Short maternal half-life
Anesthetics (local) Lidocaine, Bupivacaine[97]
Anesthetics (systemic), muscle relaxants Propofol, Rocuronium, Thiopental, Succinylcholine[97]
Antibiotics Penicillins, Cephalosporins, Aminoglycosides, Macrolides May cause diarrhea and thrush in the infant[97]
Tetracycline antibiotics (Tetracycline, Doxycycline, Minocycline, Oxytetracycline) May affect bone growth as well as enamel staining in infants. It may be used for short-term situations where there are no other alternatives.[97]
Antipsychotics Risperidone, Quetiapine, Olanzapine
Asthma Fluticasone (Flovent)[94]
Prednisone (Deltasone)[94]
Cardiovascular Beta Blockers Different beta blockers vary widely in the amount excreted into breast milk. For example, Atenolol, Nadolol, and Sotalol are excreted in higher amounts and may lead to low blood pressure or low heart rate in the infant.[94]
Calcium Channel Blockers
Diabetes Insulin
Glyburide (Micronase), Glipizide (Glucotrol)
Depression SSRIs Sertraline (Zoloft) is one of the most studied antidepressants in breastfeeding women.
SNRIs
GERD Famotidine (Pepcid), Ranitidine (Zantac), Omeprazole (Prilosec), Pantoprazole (Protonix)
Hypertension ACEi As of 2013, enalapril and captopril are the most studied ACEi. ACEi are preferred over ARBs for treatment of hypertension due to the lack of data on ARBs in breastfeeding women.[96]
Pain Ibuprofen (Motrin)
Morphine, Codeine, Hydrocodone[94]
Acetaminophen (Tylenol)[98]
Sedation Lorazepam, Temazepam, Oxazepam With midazolam, mothers should wait at least 4 hours before breastfeeding. Diazepam should be avoided because it can cause sedation in the infant.[97]

On the other hand, there are medications that may be toxic to the baby while breastfeeding and thus should not be used in breastfeeding mothers, such as:

Examples of Medications To Avoid in Breastfeeding Mothers[94][93]
Medication Side Effects/Notes
Amiodarone Long half-life, may affect thyroid of infant
Anticancer drugs Causes bone marrow suppression
Bromocriptine (Parlodel) Causes milk suppression in mother[99]
Cyclosporine (Sandimmune) Possible immune suppression[100]
Lithium Need close therapeutic monitoring
Methotrexate (Rheumatrex) Possible immune suppression[100]

Furthermore, drugs of abuse, such as cocaine, amphetamines, heroin, and marijuana cause adverse effects on the infant during breastfeeding. Adverse effects include seizures, tremors, restlessness, and diarrhea.[100]

To reduce infant exposure to medications used by the mother, use topical therapy or avoid taking the medication during breastfeeding times when possible.[92]

Hormonal products and combined oral contraceptives should be avoided during the early postpartum period as they can interfere with lactation.[96]

There are some medications that may stimulate the production of breast milk. These medications may be beneficial in cases where women with hypothyroidism may be unable to produce milk.[101][102] A Cochrane review looked at the drug domperidone (10 mg three times per day) with results showing a significant increase in volume of milk produced over a period of one to two weeks.[103] However, another review concluded little evidence that use of domperidone and metoclopramide to enhance milk supply works. Instead, non-pharmacological approaches such as support and more frequent breastfeeding may be more efficacious.[93]

Finally, there are other substances besides medications that may appear in breast milk. Alcohol use during pregnancy carries a significant risk of serious birth defects, but consuming alcohol after the birth of the infant is considered safe.[104] High caffeine intake by breastfeeding mothers may cause their infants to become irritable or have trouble sleeping.[93] A meta-analysis has shown that breastfeeding mothers who smoke expose their infants to nicotine, which may cause respiratory illnesses, including otitis media in the nursing infant.[100]

Market edit

There is a commercial market for human breast milk, both in the form of a wet nurse service and as a milk product.

As a product, breast milk is exchanged by human milk banks, as well as directly between milk donors and customers as mediated by websites on the internet. Human milk banks generally have standardized measures for screening donors and storing the milk, sometimes even offering pasteurization, while milk donors on websites vary in regard to these measures. A study in 2013 came to the conclusion that 74% of breast milk samples from providers found from websites were colonized with gram-negative bacteria or had more than 10,000 colony-forming units/mL of aerobic bacteria.[105] Bacterial growth happens during transit.[105] According to the FDA, bad bacteria in food at room temperature can double every 20 minutes.[106]

Human milk is considered to be healthier than cow's milk and infant formula when it comes to feeding an infant in the first six months of life, but only under extreme situations do international health organizations support feeding an infant breast milk from a healthy wet nurse rather than that of its biological mother.[107] One reason is that the unregulated breast milk market is fraught with risks, such as drugs of abuse and prescription medications being present in donated breast milk.[107] The transmission of these substances through breast milk can do more harm than good when it comes to the health outcomes of the infant recipient.[107]

Older consumption edit

A 2015 CBS article cites an editorial led by Dr. Sarah Steele in the Journal of the Royal Society of Medicine, in which they say that "health claims do not stand up clinically and that raw human milk purchased online poses many health risks." CBS found a study from the Center for Biobehavioral Health at Nationwide Children's Hospital in Columbus that "found that 11 out of 102 breast milk samples purchased online were actually blended with cow's milk." The article also explains that milk purchased online may be improperly sanitized or stored, so it may contain food-borne illness and infectious diseases such as hepatitis and HIV.[108]

Restaurants and recipes edit

A minority of people, including restaurateurs Hans Lochen of Switzerland and Daniel Angerer of Austria, who operates a restaurant in New York City, have used human breast milk, or at least advocated its use, as a substitute for cow's milk in dairy products and food recipes.[109][110] An Icecreamist in London's Covent Garden started selling an ice cream named Baby Gaga in February 2011. Each serving cost £14. All the milk was donated by a Mrs Hiley who earned £15 for every 10 ounces and called it a "great recession beater".[111] The ice cream sold out on its first day. Despite the success of the new flavour, the Westminster Council officers removed the product from the menu to make sure that it was, as they said, "fit for human consumption."[112] Tammy Frissell-Deppe, a family counsellor 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.[113] Human breast milk is not produced or distributed industrially or commercially, because the use of human breast milk as an adult food is considered unusual to the majority of cultures around the world, and most disapprove of such a practice.[114]

In Costa Rica, there have been trials to produce human cheese, and custard from human milk, as an alternative to weaning.[115]

Bodybuilders edit

While there is no scientific evidence that shows that breast milk is advantageous for adults, according to several 2015 news sources, breast milk is being used by bodybuilders for its nutritional value. In a February 2015 ABC News article, one former competitive body builder said, "It isn't common, but I've known people who have done this. It's certainly talked about quite a bit on the bodybuilding forums on the Internet." Calling bodybuilders "a strange breed of individuals", he said, "Even if this type of thing is completely unsupported by research, they're prone to gym lore and willing to give it a shot if there is any potential effect." At the time the article was written, in the U.S., the price of breast milk procured from milk banks that pasteurize the milk, and have expensive quality and safety controls, was about $10 per US fluid ounce ($0.34/ml), and the price in the alternative market online, bought directly from mothers, ranges from $1–$4 per US fluid ounce ($0.03–$0.14/ml), compared to cow's milk at about $3.44 per US gallon ($0.0269/US fl oz; $0.0009/ml).[116][117]

Breast milk contamination edit

Breast milk is oftentimes used as an environmental bioindicator given its ability to accumulate certain chemicals, including organochlorine pesticides.[118] Research has found that certain organic contaminants such as PCBs, organochlorine pesticides, PCDDs, PBDEs, and DDT can contaminate breastmilk.[119] According to research done in 2002, the levels of the organochlorine pesticides, PCBs, and dioxins have declined in breast milk in countries where these chemicals have been banned or otherwise regulated, while levels of PBDEs are rising.[119]

Pesticide contamination in breastmilk edit

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 in particular 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.[120]

The CDC has provided some resources for breastfeeding mothers to reference for safe medication use, including LactMed, Mother to Baby, and The InfantRisk Center.[121]

See also edit

References edit

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  6. ^ Gartner, Lawrence; Eidelman, Arthur I.; Schanler, Richard J.; Johnston, Margreete; Landers, Susan; Noble, Larry; Szucs, Kinga; Viehmann, Laura (2012-03-01). "Breastfeeding and the Use of Human Milk". Pediatrics. 129 (3): e827–e841. doi:10.1542/peds.2011-3552. ISSN 0031-4005. PMID 22371471.
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  8. ^ Abouelfettoh, Amel M.; Dowling, Donna A.; Dabash, Soheir A.; Elguindy, Shadia R.; Seoud, Iman A. (2008-11-21). "Cup versus bottle feeding for hospitalized late preterm infants in Egypt: A quasi-experimental study". International Breastfeeding Journal. 3 (1): 27. doi:10.1186/1746-4358-3-27. ISSN 1746-4358. PMC 2635351. PMID 19025602.
  9. ^ a b c Pound, Catherine; Unger, Sharon; Blair, Becky (December 2020). "Pasteurized and unpasteurized donor human milk". Paediatrics & Child Health. 25 (8): 549–550. doi:10.1093/pch/pxaa118. ISSN 1205-7088. PMC 7739531. PMID 33365109.
  10. ^ Society, Canadian Paediatric. "Pasteurized and unpasteurized donor human milk | Canadian Paediatric Society". cps.ca. Retrieved 2022-04-28.
  11. ^ . Archived from the original on January 8, 2012.
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External links edit

  • Drug Interactions with Human Milk
  • Human milk and lactation by Carol L. Wagner (Overview article, eMedicine, December 14, 2010)
  • – including comparison of human and cow's milk ones
  • and
  • Meigs, EB (August 30, 1913) The comparative composition of human milk and of cow's milk, J.Biol.Chem 147–168

breast, milk, mother, milk, redirects, here, other, uses, mother, milk, disambiguation, sometimes, spelled, breastmilk, mother, milk, milk, produced, mammary, glands, located, breast, human, female, primary, source, nutrition, newborns, containing, protein, ca. Mother s milk redirects here For other uses see Mother s Milk disambiguation Breast milk sometimes spelled as breastmilk or mother s milk is milk produced by mammary glands located in the breast of a human female Breast milk is the primary source of nutrition for newborns containing fat protein carbohydrates lactose and human milk oligosaccharides and variable minerals and vitamins citation needed Breast milk also contains substances that help protect an infant against infection and inflammation whilst also contributing to healthy development of the immune system and gut microbiome 1 Two 25 milliliter samples of human breast milk The left hand sample is the first milk produced by the mother while the right hand sample was produced later during the same pumping Contents 1 Uses and methods of consumption 2 Benefits 3 Production 4 Composition 5 Storage of expressed breast milk 6 Comparison to other milks 7 Effects of medications and other substances on milk content 8 Market 9 Older consumption 9 1 Restaurants and recipes 9 2 Bodybuilders 10 Breast milk contamination 10 1 Pesticide contamination in breastmilk 11 See also 12 References 13 External linksUses and methods of consumption edit nbsp Pumped breast milk nbsp Breast feeding latchThe World Health Organization recommends exclusive breastfeeding for the first six months of life 2 with solids gradually being introduced around this age when signs of readiness are shown 3 4 Supplemented breastfeeding is recommended until at least age two and then for as long as the mother and child wish 4 Some newborn babies that are alert and healthy have the ability to latch on to the mother s breast within one hour of birth 5 however on a global level 3 5 babies are not breast fed within the first hour of being born 4 6 Breast milk can also be pumped from the mother using a breast pump and fed by baby bottle cup and or spoon supplementation drip system or nasogastric tube 7 For infants who are born early preterm birth and do not have the ability to suck right away the use of cups to feed expressed milk and other supplements is reported to result in better breastfeeding extent and duration compared with bottles and tube feeding 7 8 For women who do not produce sufficient amounts of breast milk donor human breast milk that is pasteurized may be effective 9 If pasteurized donor breast milk is not available commercial formula is suggested as a second alternative 9 Breast milk supplied by a woman other than the baby s mother that is not pasteurized and informal breast milk sharing is associated with a risk of transmitting bacteria and viruses from the donor mother to the baby and is not considered a safe alternative 9 10 Benefits editBreastfeeding offers health benefits to mother and child even after infancy 11 These benefits include proper heat production and adipose tissue development 12 a 73 decreased risk of sudden infant death syndrome 13 increased intelligence 14 decreased likelihood of contracting middle ear infections 15 cold and flu resistance 16 a tiny decrease in the risk of childhood leukemia 17 lower risk of childhood onset diabetes 18 decreased risk of asthma and eczema 19 decreased dental problems 19 decreased risk of obesity later in life 20 and a decreased risk of developing psychological disorders including in adopted children 21 In addition feeding an infant breast milk is associated with lower insulin levels and higher leptin levels compared feeding an infant via powdered formula 22 Many of the infection fighting and immune system related benefits are associated with human milk oligosaccharides 23 Breastfeeding also provides health benefits for the mother It assists the uterus in returning to its pre pregnancy size and reduces post partum bleeding through the production of oxytocin see Production Breastfeeding can also reduce the risk of breast cancer later in life 24 25 Lactation may also reduce the risk for both mother and infant from both types of diabetes 26 Lactation may protect the infant from specifically developing Type 2 diabetes as studies have shown that bioactive ingredients in human breast milk could prevent excess weight gain during childhood via contributing to a feeling of energy and satiety A lower risk of child onset diabetes may be more applicable to infants who were born from diabetic mothers 22 The reason is that while breastfeeding for at least the first six months of life minimizes the risk of type 1 diabetes from occurring in the infant inadequate breastfeeding in an infant prenatally exposed to diabetes was associated with a higher risk of the child developing diabetes later 22 However it can be argued that human breastfeeding may contribute to protective effects against the development of type 1 diabetes because the alternative of bottle feeding may expose infants to unhygienic feeding conditions 27 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 28 However it is now universally recognized that there is no commercial formula that can substitute breast milk In addition to the appropriate amounts of carbohydrate protein and fat breast milk provides vitamins minerals digestive enzymes 29 and hormones 29 Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections 30 The immune function of breast milk is individualized as the mother through her touching and taking care of the baby comes into contact with pathogens that colonize the baby and as a consequence her body makes the appropriate antibodies and immune cells 31 At around four months of age the internal iron supplies of the infant held in the hepatic cells of the liver are exhausted The American Academy of Pediatrics recommends that at this time that an iron supplement should be introduced 32 Other health organisations such as the NHS in the UK have no such recommendation 33 Breast milk contains less iron than formula but the iron is more bioavailable as lactoferrin which carries more safety for mothers and children than ferrous sulphate 34 Both the AAP 35 and the NHS recommend vitamin D supplementation for breastfed infants 33 Vitamin D can be synthesised by the infant via exposure to sunlight however many infants are deficient due to being kept indoors or living in areas with insufficient sunlight Formula is supplemented with vitamin D for this reason 33 35 Production editSee also Low milk supply Under the influence of the hormones prolactin and oxytocin women produce milk after childbirth to feed the baby 36 The initial milk produced is 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 It also creates a mild laxative effect expelling meconium and helping to prevent the build up of bilirubin a contributory factor in jaundice 37 Male lactation can occur the production or administration of the hormone prolactin is necessary to induce lactation see male lactation Actual inability to produce enough milk is rare with studies showing that mothers from malnourished regions still produce amounts of milk of similar quality to that of mothers in developed countries 38 There are many reasons a mother may not produce enough breast milk 39 Some of the most common reasons 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 and may require hormone replacement 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 40 41 42 It is beneficial to nurse when the baby wants to nurse rather than on a schedule A Cochrane review came to the conclusion that a greater volume of milk is expressed whilst listening to relaxing audio during breastfeeding along with warming and massaging of the breast prior to and during feeding A greater volume of milk expressed can also be attributed to instances where the mother starts pumping milk sooner even if the infant is unable to breastfeed 43 Sodium concentration is higher in hand expressed milk when compared with the use of manual and electric pumps and fat content is higher when the breast has been massaged in conjunction with listening to relaxing audio This may be important for low birthweight infants 43 If pumping it is helpful to have an electric high grade pump so that all of the milk ducts are stimulated Galactagogues increase milk supply although even herbal variants carry risks Non pharmaceutical methods should be tried first such as pumping out the mother s breast milk supply often warming or massaging the breast as well as starting milk pumping earlier after the child is born if they cannot drink milk at the breast 43 44 45 46 Composition editFurther information Anti inflammatory agents in breast milk and Human milk immunity Composition of human breast milk 47 Fat g 100 ml total 4 2fatty acids length 8Cpolyunsaturated fatty acids 0 6cholesterol 0 016Protein g 100 ml total 1 1casein 0 4a lactalbumin 0 3lactoferrin apo lactoferrin 0 2IgA 0 1IgG 0 001lysozyme 0 05serum albumin 0 05b lactoglobulin Carbohydrate g 100 ml lactose 7oligosaccharides 0 5Minerals g 100 ml calcium 0 03phosphorus 0 014sodium 0 015potassium 0 055chlorine 0 043Breast milk contains complex proteins lipids carbohydrates lactose and human milk oligosaccharides and other biologically active components 48 The composition changes over a single feed as well as over the period of lactation 49 Changes are particularly pronounced in marsupials 50 nbsp Colostrum vs breastmilkDuring the first few days after delivery the mother produces colostrum This is a thin yellowish fluid that is the same fluid that sometimes 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 citation needed Colostrum will gradually change to become mature milk In the first 3 4 days it will appear thin and watery and will taste very sweet later the milk will be thicker and creamier Human milk quenches the baby s thirst and hunger and provides the proteins sugar minerals and antibodies that the baby needs In the 1980s and 1990s lactation professionals De Cleats used to make a differentiation between foremilk and hindmilk But this differentiation causes confusion as there are not two types of milk Instead as a baby breastfeeds the fat content very gradually increases with the milk becoming fattier and fattier over time 51 The level of Immunoglobulin A IgA in breast milk remains high from day 10 until at least 7 5 months post partum 52 Human milk contains 0 8 0 9 protein 4 5 fat 7 1 carbohydrates and 0 2 ash minerals 53 Carbohydrates are mainly lactose several lactose based oligosaccharides also called human milk oligosaccharides have been identified as minor components 54 The fat fraction contains specific triglycerides of palmitic and oleic acid O P O triglycerides and also lipids with trans bonds see trans fat The lipids are vaccenic acid and conjugated linoleic acid CLA accounting for up to 6 of the human milk fat 55 56 The principal proteins are alpha lactalbumin lactoferrin apo 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 citation needed This is thought to contribute to the protection of breastfed babies against cancer 57 Non protein nitrogen containing compounds making up 25 of the milk s nitrogen include urea uric acid creatine creatinine amino acids and nucleotides 58 59 Breast milk has circadian variations some of the nucleotides are more commonly produced during the night others during the day 60 Mother s milk has been shown to supply endocannabinoids the natural neurotransmitters that cannabis simulates 2 arachidonoylglycerol 61 anandamide 62 63 oleoylethanolamide 64 palmitoylethanolamide 64 N arachidonoyl glycine 64 eicosapentaenoyl ethanolamide 64 docosahexaenoyl ethanolamide 64 N palmitoleoyl ethanolamine 64 dihomo g linolenoylethanolamine 64 N stearoylethanolamine 64 prostaglandin F2alpha ethanolamides 64 and prostaglandin F2 ethanolamides 64 Palmitic acid esters of hydroxy stearic acids PAHSAs 65 They may act as an appetite stimulant but they also regulate appetite so infants do not eat too much That may be why formula fed babies have a higher caloric intake than breastfed babies 66 Breast milk is not sterile but contains as many as 600 different species of various bacteria including beneficial Bifidobacterium breve B adolescentis B longum B bifidum and B dentium which contribute to colonization of the infant gut 67 As a result it can be defined as a probiotic food depending on how one defines probiotic 68 Breast milk also contains a variety of somatic cells and stem cells and the proportion of each cell type differs from individual to individual 69 70 The somatic cells are mainly lactocytes and myoepithelial cells derived from the mother s mammary glands 71 The stem cells found in human breast milk have been shown to be able to differentiate into a variety of other cells involved in the production of bodily tissues and a small proportion of these cross over the nursing infant s intestinal tract into the bloodstream to reach certain organs and transform into fully functional cells 72 Because of its diverse population of cells and multifarious functions researchers have argued that breast milk should be considered a living tissue 69 Breast milk contains a unique type of sugars human milk oligosaccharides HMOs which were not present in traditional infant formula however they are increasing added by many manufacturers HMOs are not digested by the infant but help to make up the intestinal flora 73 They act as decoy receptors that block the attachment of disease causing pathogens which may help to prevent infectious diseases 74 They also alter immune cell responses which may benefit the infant As of 2015 more than a hundred different HMOs have been identified both the number and composition vary between women and each HMO may have a distinct functionality 75 The breast milk of diabetic mothers has been shown to have a different composition from that of non diabetic mothers It may contain elevated levels of glucose and insulin and decreased polyunsaturated fatty acids A dose dependent effect of diabetic breast milk on increasing language delays in infants has also been noted although doctors recommend that diabetic mothers breastfeed despite this potential risk 76 Women 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 77 Even though most infants infected with HIV contract the disease from breastfeeding most infants that are breastfed by their HIV positive mothers never contract the disease 78 While this paradoxical phenomenon suggests that the risk of HIV transmission between an HIV positive mother and her child via breastfeeding is small studies have also shown that feeding infants with breast milk of HIV positive mothers can actually have a preventative effect against HIV transmission between the mother and child 78 This inhibitory effect against the infant contracting HIV is likely due to unspecified factors exclusively present in breast milk of HIV positive mothers 78 Most women that do not breastfeed use infant formula but breast milk donated by volunteers to human milk banks can be obtained by prescription in some countries 79 In addition research has shown that women who rely on infant formula could minimize the gap between the level of immunity protection and cognitive abilities a breastfed child benefits from versus the degree to which a bottle fed child benefits from them 80 This can be done by supplementing formula fed infants with bovine milk fat globule membranes MFGM meant to mimic the positive effects of the MFGMs which are present in human breast milk 81 Storage of expressed breast milk edit nbsp Bottle of pumped breast milkExpressed breast milk can be stored Lipase may cause thawed milk to taste soapy or rancid due to milk fat breakdown It is still safe to use and most babies will drink it Scalding it will prevent rancid taste at the expense of antibodies 82 It should be stored with airtight seals Some plastic bags are designed for storage periods of less than 72 hours Others can be used for up to 12 months if frozen This table describes safe storage time limits 83 Place of storage Temperature Maximum storage timeIn a room 25 C 77 F Six to eight hoursInsulated thermal bag with ice packs Up to 24 hoursIn a refrigerator 4 C 39 F Up to five daysFreezer compartment inside a refrigerator 15 C 5 F Two weeksA combined refrigerator and freezer with separate doors 18 C 0 F Three to six monthsChest or upright manual defrost deep freezer 20 C 4 F Six to twelve monthsComparison to other milks editAll mammalian 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 contains too little iron retinol vitamin E vitamin C vitamin D unsaturated fats or essential fatty acids for human babies 84 85 86 87 Whole cow s milk also contains too much protein sodium potassium phosphorus and chloride which may put a strain on an infant s immature kidneys In addition the proteins fats and calcium in whole cow s milk are more difficult for an infant to digest and absorb than the ones in breast milk 85 88 89 The composition of marsupial and monotreme milk contains essential nutrients growth factors and immunological properties to support the development of joeys and puggles 50 Comparing milks per cup 90 91 Nutrient Human milk Cow milk 3 25 fat Goat milkCalories Kcal 172 146 168Water g 215 215 212Protein g 2 5 7 9 8 7Fat g 10 8 7 9 10 1Saturated fat g 4 9 4 6 6 5Monounsaturated fat g 4 1 2 0 2 7Polyunsaturated fat g 1 2 0 5 0 4Omega 3 fatty acids mg 128 183 97 6Omega 6 fatty acids mg 920 293 266Cholesterol mg 34 4 24 4 26 8Carbohydrate g 17 0 11 0 10 9Sugars g 17 0 11 0 10 9Vitamin A IU 522 249 483Vitamin C mg 12 3 0 3 2Vitamin D IU 9 8 97 6 29 3Vitamin E mg 0 2 0 1 0 2Vitamin K mcg 0 7 0 5 0 7Thiamin mg 0 0 0 1 0 1Riboflavin mg 0 1 0 4 0 3Niacin mg 0 4 0 3 0 7Vitamin B6 mg 0 0 0 1 0 1Folate mcg 12 12 2Vitamin B12 mcg 0 1 1 1 0 2Pantothenic acid mg 0 5 0 9 0 8Choline mg 39 4 34 9 39 0Calcium mg 79 276 327Iron mg 0 07 0 07 0 12Magnesium mg 7 4 24 4 34 2Phosphorus mg 34 4 222 271Potassium mg 125 349 498Sodium mg 42 98 122Zinc mg 0 4 1 0 0 7Copper mg 0 1 0 0 0 1Manganese mg 0 1 0 0 0 0Selenium mcg 4 4 9 0 3 4 Note Milk is generally fortified with vitamin D in the U S and Canada Non fortified milk contains only 2 IU per 3 5 oz Effects of medications and other substances on milk content editAlmost all medicines pass into breastmilk in small amounts by a concentration gradient 92 The amount of drug bound by maternal plasma proteins the size of the drug molecule the pH of the drug and the lipophilicity of the drug determine whether the medication will pass into breastmilk 93 Medications that are non protein bound low in molecular weight or highly lipid soluble are more likely to enter the breast milk in larger quantities 94 Some have no effect on the baby and can be used while breastfeeding while other medications may be harmful to the infant 95 94 Some generally safe medications that the mother can use while breastfeeding include Examples of Safe Medications for Breastfeeding Mothers Condition Medication Side Effects NotesADHD Methylphenidate Ritalin Dextroamphetamine May cause irritability and problems putting on weight 96 Allergic Rhinitis Beclomethasone Beconase Pseudoephedrine Sudafed May cause decreased milk productionDiphenhydramine Benadryl 94 May cause tiredness or irritability in infantsAnesthetics Inhalation Isoflurane Sevoflurane 97 Short maternal half lifeAnesthetics local Lidocaine Bupivacaine 97 Anesthetics systemic muscle relaxants Propofol Rocuronium Thiopental Succinylcholine 97 Antibiotics Penicillins Cephalosporins Aminoglycosides Macrolides May cause diarrhea and thrush in the infant 97 Tetracycline antibiotics Tetracycline Doxycycline Minocycline Oxytetracycline May affect bone growth as well as enamel staining in infants It may be used for short term situations where there are no other alternatives 97 Antipsychotics Risperidone Quetiapine OlanzapineAsthma Fluticasone Flovent 94 Prednisone Deltasone 94 Cardiovascular Beta Blockers Different beta blockers vary widely in the amount excreted into breast milk For example Atenolol Nadolol and Sotalol are excreted in higher amounts and may lead to low blood pressure or low heart rate in the infant 94 Calcium Channel BlockersDiabetes InsulinGlyburide Micronase Glipizide Glucotrol Depression SSRIs Sertraline Zoloft is one of the most studied antidepressants in breastfeeding women SNRIsGERD Famotidine Pepcid Ranitidine Zantac Omeprazole Prilosec Pantoprazole Protonix Hypertension ACEi As of 2013 enalapril and captopril are the most studied ACEi ACEi are preferred over ARBs for treatment of hypertension due to the lack of data on ARBs in breastfeeding women 96 Pain Ibuprofen Motrin Morphine Codeine Hydrocodone 94 Acetaminophen Tylenol 98 Sedation Lorazepam Temazepam Oxazepam With midazolam mothers should wait at least 4 hours before breastfeeding Diazepam should be avoided because it can cause sedation in the infant 97 On the other hand there are medications that may be toxic to the baby while breastfeeding and thus should not be used in breastfeeding mothers such as Examples of Medications To Avoid in Breastfeeding Mothers 94 93 Medication Side Effects NotesAmiodarone Long half life may affect thyroid of infantAnticancer drugs Causes bone marrow suppressionBromocriptine Parlodel Causes milk suppression in mother 99 Cyclosporine Sandimmune Possible immune suppression 100 Lithium Need close therapeutic monitoringMethotrexate Rheumatrex Possible immune suppression 100 Furthermore drugs of abuse such as cocaine amphetamines heroin and marijuana cause adverse effects on the infant during breastfeeding Adverse effects include seizures tremors restlessness and diarrhea 100 To reduce infant exposure to medications used by the mother use topical therapy or avoid taking the medication during breastfeeding times when possible 92 Hormonal products and combined oral contraceptives should be avoided during the early postpartum period as they can interfere with lactation 96 There are some medications that may stimulate the production of breast milk These medications may be beneficial in cases where women with hypothyroidism may be unable to produce milk 101 102 A Cochrane review looked at the drug domperidone 10 mg three times per day with results showing a significant increase in volume of milk produced over a period of one to two weeks 103 However another review concluded little evidence that use of domperidone and metoclopramide to enhance milk supply works Instead non pharmacological approaches such as support and more frequent breastfeeding may be more efficacious 93 Finally there are other substances besides medications that may appear in breast milk Alcohol use during pregnancy carries a significant risk of serious birth defects but consuming alcohol after the birth of the infant is considered safe 104 High caffeine intake by breastfeeding mothers may cause their infants to become irritable or have trouble sleeping 93 A meta analysis has shown that breastfeeding mothers who smoke expose their infants to nicotine which may cause respiratory illnesses including otitis media in the nursing infant 100 Market editMain article human milk bank There is a commercial market for human breast milk both in the form of a wet nurse service and as a milk product As a product breast milk is exchanged by human milk banks as well as directly between milk donors and customers as mediated by websites on the internet Human milk banks generally have standardized measures for screening donors and storing the milk sometimes even offering pasteurization while milk donors on websites vary in regard to these measures A study in 2013 came to the conclusion that 74 of breast milk samples from providers found from websites were colonized with gram negative bacteria or had more than 10 000 colony forming units mL of aerobic bacteria 105 Bacterial growth happens during transit 105 According to the FDA bad bacteria in food at room temperature can double every 20 minutes 106 Human milk is considered to be healthier than cow s milk and infant formula when it comes to feeding an infant in the first six months of life but only under extreme situations do international health organizations support feeding an infant breast milk from a healthy wet nurse rather than that of its biological mother 107 One reason is that the unregulated breast milk market is fraught with risks such as drugs of abuse and prescription medications being present in donated breast milk 107 The transmission of these substances through breast milk can do more harm than good when it comes to the health outcomes of the infant recipient 107 Older consumption editA 2015 CBS article cites an editorial led by Dr Sarah Steele in the Journal of the Royal Society of Medicine in which they say that health claims do not stand up clinically and that raw human milk purchased online poses many health risks CBS found a study from the Center for Biobehavioral Health at Nationwide Children s Hospital in Columbus that found that 11 out of 102 breast milk samples purchased online were actually blended with cow s milk The article also explains that milk purchased online may be improperly sanitized or stored so it may contain food borne illness and infectious diseases such as hepatitis and HIV 108 Restaurants and recipes edit A minority of people including restaurateurs Hans Lochen of Switzerland and Daniel Angerer of Austria who operates a restaurant in New York City have used human breast milk or at least advocated its use as a substitute for cow s milk in dairy products and food recipes 109 110 An Icecreamist in London s Covent Garden started selling an ice cream named Baby Gaga in February 2011 Each serving cost 14 All the milk was donated by a Mrs Hiley who earned 15 for every 10 ounces and called it a great recession beater 111 The ice cream sold out on its first day Despite the success of the new flavour the Westminster Council officers removed the product from the menu to make sure that it was as they said fit for human consumption 112 Tammy Frissell Deppe a family counsellor 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 113 Human breast milk is not produced or distributed industrially or commercially because the use of human breast milk as an adult food is considered unusual to the majority of cultures around the world and most disapprove of such a practice 114 In Costa Rica there have been trials to produce human cheese and custard from human milk as an alternative to weaning 115 Bodybuilders edit While there is no scientific evidence that shows that breast milk is advantageous for adults according to several 2015 news sources breast milk is being used by bodybuilders for its nutritional value In a February 2015 ABC News article one former competitive body builder said It isn t common but I ve known people who have done this It s certainly talked about quite a bit on the bodybuilding forums on the Internet Calling bodybuilders a strange breed of individuals he said Even if this type of thing is completely unsupported by research they re prone to gym lore and willing to give it a shot if there is any potential effect At the time the article was written in the U S the price of breast milk procured from milk banks that pasteurize the milk and have expensive quality and safety controls was about 10 per US fluid ounce 0 34 ml and the price in the alternative market online bought directly from mothers ranges from 1 4 per US fluid ounce 0 03 0 14 ml compared to cow s milk at about 3 44 per US gallon 0 0269 US fl oz 0 0009 ml 116 117 Breast milk contamination editBreast milk is oftentimes used as an environmental bioindicator given its ability to accumulate certain chemicals including organochlorine pesticides 118 Research has found that certain organic contaminants such as PCBs organochlorine pesticides PCDDs PBDEs and DDT can contaminate breastmilk 119 According to research done in 2002 the levels of the organochlorine pesticides PCBs and dioxins have declined in breast milk in countries where these chemicals have been banned or otherwise regulated while levels of PBDEs are rising 119 Pesticide contamination in breastmilk edit 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 in particular 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 120 The CDC has provided some resources for breastfeeding mothers to reference for safe medication use including LactMed Mother to Baby and The InfantRisk Center 121 See also editBlocked milk duct Breastfeeding in public Breast milk jewelry Human milk banking in North America La Leche League International Lactation room Lactivism Mary Rose TullyReferences edit Association Australian Breastfeeding 2017 07 03 Breastmilk composition Australian Breastfeeding Association Retrieved 2021 01 29 Exclusive breastfeeding for six months best for babies everywhere www who int Retrieved 2022 04 28 Lipson Charles 2011 Cite right a quick guide to citation styles MLA APA Chicago the sciences professions and more University of Chicago Press ISBN 978 0 226 48463 1 OCLC 642001837 a b 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December 2015 Easter M 2015 02 19 Bodybuilders Are Drinking Human Breast Milk Are They Insane or Super Insane Men s Health Retrieved 4 December 2015 Mekonen Sablework Ambelu Argaw Wondafrash Mekitie Kolsteren Patrick Spanoghe Pieter 2021 Exposure of infants to organochlorine pesticides from breast milk consumption in southwestern Ethiopia Scientific Reports 11 1 22053 Bibcode 2021NatSR 1122053M doi 10 1038 s41598 021 01656 x PMC 8585979 PMID 34764390 a b Solomon Gina M Weiss Pilar M June 2002 Chemical contaminants in breast milk time trends and regional variability Environmental Health Perspectives 110 6 A339 47 doi 10 1289 ehp 021100339 ISSN 0091 6765 PMC 1240888 PMID 12055065 Silent Snow The Slow Poisoning of the Arctic by Marla Cone Grove Press CDC 2018 Prescription Medication Use Centers for Disease Control and Prevention Retrieved 2019 08 02 External links editDrug Interactions with Human Milk Human milk and lactation by Carol L Wagner Overview article eMedicine December 14 2010 United Nations University Centre Constituents of human milk including comparison of human and cow s milk ones Children s Health Topics Breastfeeding A comparison between human milk and cow s milk and The composition of cow s milk Meigs EB August 30 1913 The comparative composition of human milk and of cow s milk J Biol Chem 147 168 Retrieved from https en wikipedia org w index php title Breast milk amp oldid 1201806958, wikipedia, wiki, book, books, library,

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