The Wonderment of Breast Milk

Mother’s milk may be one of the most important panaceas of all time – a true miracle maker with research showing breast milk helps prevent blindness, necrotizing enterocolitis, sepsis, and death in premature infants. Amazing, right? And there’s an urban tale and long held belief that had the fanTAZtic musical genius Stevie Wonder, been given breast milk as a baby, he may have retained his vision.¹

Retinopathy of prematurity is the leading cause of blindness in infants, which is when the blood vessels in their retinas grow out of control, the retinas can detach and cause blindness in the most severe cases. Breast milk protects against this condition, reducing the odds of developing retinopathy of prematurity by 89%.²

Back to Stevie, because Stevie Wonder, in fact, was born premature and developed retinopathy that led to blindness. Breast milk might very well have made all of the difference for him. ¹

Breast milk protects against abnormal neurological outcomes in preemies too. Susan Landers, a neonatologist in Austin points out that “Retinal tissue is just like neural tissue embryologically; it grows from the same immature cells.”¹

Which is probably why the American Academy of Pediatrics recommends human milk above formula for all premature infants. If mother’s milk isn’t available for the preemie, then pasteurized donor human milk is recommended.

Why? Well because breast milk improves long-term growth and neurodevelopment³ and protects preemies from:

• Retinopathy of prematurity (blindness)
• Necrotizing enterocolitis
• Sepsis
• Death

Breast milk reduces the risk of necrotizing enterocolitis in premature infants – in proportion to the amount of breast milk received. Necrotizing enterocolitis is the death of intestinal tissue in formula-fed, premature infants. It causes mucosal injury, perforation of the intestinal tract, and carries a 50% mortality rate. When mother’s milk isn’t available to preterm infant, pasteurized donor human milk is used over formula in this population.⁴

Breast milk doesn’t just do wonders for premature infants, of course. There’s a huge list of benefits, which is why The World Health Organization (WHO) and American Academy of Pediatrics (AAP) suggest exclusive breastfeeding – not even water – for the first six months of life in term infants. Thereafter, AAP recommends continued breastfeeding until one year old and WHO suggests breastfeeding our young until two years of age, and beyond.

So what exactly is in this stuff that fortifies the youngest and weakest?

Antioxidants

The components in breast milk believed to protect preemies from blindness are its antioxidants and immune-modulating substances. Breast milk contains vitamin C, vitamin E, and B-carotene and has more antioxidant activity than formula.² These are particularly important for retinal health.

Immune-boosters

Breast milk is packed with immune-boosting proteins including secretory IgA, lactoferrin, lysozyme, oligosaccharides, cytokines, and antioxidant enzymes.² Lactoferrin and lysozyme can prevent the spread of pathogenic bacteria. IgA can destroy bacteria and protect the gastric mucosa.⁵ Developmental and immune-promoting factors such as these are thought to protect the newborn both actively and passively from intestinal inflammation.⁴

Microbes

Breastfeeding plays an instrumental role in acquisition of the gastrointestinal microbiome.⁴ Seeding the newborn gut with mother’s bacteria promotes a healthy response to inflammation, to commensal bacteria, and initiates the development of host defense. ⁴ Studies showing that probiotics can reduce necrotizing enterocolitis, suggest that the microbial components of breast milk might be one of the factors protecting infants from this devastating and lethal condition.⁴

Bioavailable Nutrients

Breast milk is 87% water, 3.8% fat, 1.0% protein, and 7% lactose. The composition of breast milk changes depending on the stage of lactation, making this a truly individualized medical food. For example, glutamine is 20 times higher in mature breast milk than in colostrum. It fuels the Krebs cycle and is a major energy substrate for intestinal cells.⁵

The fat in breastmilk serves as an energy substrate and helps develop the central nervous system. Triglycerides make up 95% of the total lipids. Saturated fats make up nearly half of breast milk, with 23% as palmitic acid. Oleic acid is the highest monounsaturated fatty acid in human milk (36%). Human milk contains linoleic acid at 15% and alpha-linolenic acid at .35%. Breast milk concentrations of arachidonic acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are closely related to maternal diet.⁵

The fat content of milk makes it a carrier of not only fat-soluble nutrients, but also fat-soluble toxins.  Polychlorinated biphenyls (PCBs) are passed to the infant in breast milk⁶as well as phthalates.⁷ Mothers, preferably before conception, should avoid foods containing fat-soluble toxins such as farmed salmon, which are high in PCBs. A nutritious diet, organic foods, and avoidance of potential toxic exposures in foods can help ensure the healthiest quality breast milk.

For more on breast milk composition, see this free article online.

To wrap up…

Breast milk is truly a wonder and nourishes babies that in earlier times would never have survived. It reduces the risks of blindness, gut necrosis, sepsis, and death in preemies. It promotes neurodevelopment and improves long-term growth.  We may never know all of the health-promoting mechanisms of this “liquid gold” but its high antioxidant content, rich nutrition, immune-modulating components, and probiotic starter-pack are just a few we know of. Likely, there are important synergistic interactions between these components. For mothers who cannot breastfeed, human donor milk is available and is a preferable second choice.

References

1. Haelle T. Mother’s Milk May Help Prevent Blindness in Preemies. 2015; https://www.npr.org/sections/health-shots/2015/11/16/456209017/mothers-milk-may-help-prevent-blindness-in-preemies?sc=17&f=&utm_source=iosnewsapp&utm_medium=Email&utm_campaign=app. Accessed Jan 10, 2018.
2. Zhou J, Shukla VV, John D, Chen C. Human Milk Feeding as a Protective Factor for Retinopathy of Prematurity: A Meta-analysis. Pediatrics. 2015;136(6):e1576-1586.
3. Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2014;9(4):184-190.
4. Gregory KE, Samuel BS, Houghteling P, et al. Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants. Microbiome. 2016;4(1):68.
5. Martin CR, Ling PR, Blackburn GL. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients. 2016;8(5).
6. Brucker-Davis F, Ducot B, Wagner-Mahler K, et al. [Environmental pollutants in maternal milk and cryptorchidism]. Gynecologie, obstetrique & fertilite. 2008;36(9):840-847.
7. Frederiksen H, Skakkebaek NE, Andersson AM. Metabolism of phthalates in humans. Molecular nutrition & food research. 2007;51(7):899-911.