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Composition of breast milk

How much of the composition of breast milk depends on the mother’s diet is conditioned by all aspects of it, which are not only food, but also supplements, variety and value of certain foods.

Breast milk is composed of the constituents of blood plasma:

  1. Breast milk is synthesized from substances that enter the mammary gland with the blood stream.
  2. Substances (nutrients)enter the bloodstream from the gastrointestinal GI tract.
  3. The gastrointestinal tract breaks down food into simple particles from which all cells of internal organs and biologically active substances that these cells create are then synthesized.

The function of the mammary gland is to synthesize a woman’s breast milk.

Thus, breast milk and mother’s nutrition are interrelated.

The benefits of breastfeeding are in the best possible provision for the baby’s needs and the programming of its future health and development. The composition of breast milk adapts to the individual baby. As the baby grows and develops, breastfeeding, like the mother’s nutrition by month, will also change.

The benefits of breast milk

After studying the beneficial properties of breast milk, scientists have recognized it as the «gold standard» of nutrition for children in the first year of life. No food product, even approximately, can replace it.

There is a special bond between mother and baby when breastfeeding. Breast milk production occurs in accordance with the changing needs of the baby.

Mother’s milk is also beneficial in that its constituents have an impact on the baby not only during the breastfeeding period, but also for many years to come.

Beneficial effects of breastfeeding according to the WHO:

  • Normalization of blood pressure levels;
  • Normalize the level of cholesterol in the blood;
  • Reduced risk of obesity;
  • Reducing the risks of insulin resistance and the development of type 2 diabetes;
  • Improved development of cognitive functions.

The advantages of breast milk compared to any adapted formula is due to the fact that the substances in the milk of a nursing mother:

  • regulate metabolic processes;
  • ensure the prevention of infectious and somatic diseases;
  • contribute to the formation of the central nervous system, hearing, vision;
  • form an adequate intestinal microflora.

The benefit of breast milk is that during lactation the milk covers the mucosa of the nasopharynx and does not allow bacteria to attach to the mucosa. These properties of breast milk are provided by substances called oligosaccharides.

Women’s breast milk contains all components of immunity and non-specific immunological defense factors, all classes of immunoglobulins, including SIgA, which provides local immunity of the gastrointestinal tract and respiratory tract. Colostrum is especially rich in them. That is why it is so important to attach the newborn to the mother’s breast immediately after birth.

The benefits of breast milk are determined by:

  • the uniqueness of the nutrients;
    • ensuring the normal formation of the immune system of the child;
    • optimal formation of psychosocial bonds later on;
    • better adaptation of the child to adverse environmental influences;
    • prevention of atherosclerosis, diabetes and cancer.

What are the benefits of breast milk for the baby:

  • Perfect nutrition for baby;
    • The composition and volume adjusts to the baby;
    • Easy to digest;
    • Protects against infections naturally;
    • Promotes brain and intellectual development;
    • Always available; Does not require additional financial expenses;
    • Breast milk temperature, corresponds to the body temperature inside, (37-38 degrees);
    • Does not require cooking time, heating, always fresh.

Conclusion: breastfeeding with mother’s milk is the most important factor in programming the physical development, immune system formation and overall health of the child for many years.

What does breast milk consist of?

The total amount of milk secreted, the ratio Protein: Fats: Carbohydrates change slightly, their composition is quite stable to the diet of the mother. Worrying that your mammary gland is not producing nutritious breast milk is not worth it. However, it is better to know how you can improve the nutritional quality of breast milk.

Breast milk is living tissue that contains many living cells and bioactive substances that help your baby adapt to life outside the mother’s body. Changes in the composition of milk from the earliest days of life are intended to make it easier for the baby to adapt to life outside of the mother.

If you take a closer look at what is in breast milk, it is clear that most of the components are unique. Therefore, it is not possible to artificially recreate the composition of breast milk.

Let’s look at what mother’s milk is made up of. The composition of breast milk. What is breast milk made up of?

Let’s look at what mother’s milk is made up of.

The chemical composition of breast milk:

  • Water — 87-88%;
  • Fat — 3.8-4%;
  • Carbohydrates (lactose) — 7%;
  • Protein — 1%;
  • Other — 0, 2%;
  • Vitamins;
  • Minerals.

Water in breast milk.

Thanks to such a large amount of water, breast milk fully meets the fluid needs of an infant during the first months of life. Therefore, there is no need to feed the babies with water until they are six months old and complementary foods are introduced, except in special cases.

The fat content of milk does not depend on the mother’s diet, but changes the composition of the fat content of milk. Dairy products with normal fat content, improve the composition of milk, and skimmed cottage cheese, kefir and milk — reduce the value.

Fats in Breast Milk.

The percentage of fat in breast milk is about 4%, from 21 to 52 g/L, The fat content of breast milk varies over the course of a day and over the course of a single feeding. The fat content of women’s milk increases toward the last portion of each feeding. In terms of fatty acid composition, breast milk is relatively stable and contains about 57% unsaturated fatty acids and about 42% saturated fatty acids. The percentage fat content of breast milk varies with the degree of maturity of the milk and is about 2% in colostrum and about 4-4.5% in mature milk.

Chemical composition of fats in breast milk:

  • Triglycerides 95-98% (of which PUFAs Omega 3 and Omega 6-15%);
    • Cholesterol — 0.4%;
    • Phospholipids — 0, 3 -4%;
    • Sterols;
    • Sphingolipids;
    • Diglycerides;
    • Free fatty acids.

Fat of women’s milk is formed in the form of fat globules, which contain 60% protein, 30% fat and minerals -Ca, Mn, Mg, Cu, Mo, Zn, Se, Na.

The biological role of phospholipids and other lipids in these fat globules is that they:

  • Protect the integrity of the intestinal barrier
    • Reduce the risk of rotavirus infection
    • Protect against a range of diarrheal bacterial infections
    • Have an effect on a child’s brain development and cognitive function.

Essential polyunsaturated fatty acids (PUFAs), arachidonic, docosahexaenoic (DHA) and eicosopentaenoic (EPA) acids make up 15% of all triglycerides. Polyunsaturated fatty acids in breast milk are mainly long-chain PUFAs, which are involved in the myelination of nerve fibers and brain development.

OMEGA 3, docosahexaenoic acid, DHA, has a positive effect on the development of the child’s brain. Its amount increases in the mother’s milk after 4 days from the beginning of the intake of fish oil or oily fish.

According to the composition of fats in breast milk can be judged on the effect of nutrition on breast milk. The fat content of milk in gv is ensured by the inclusion of healthy fats:

  • butter;
    • dairy products of normal fat content;
    • vegetable oils;
    • fatty fish.

It is fats that have a factor of food satiety regulator, so it is not recommended to limit the time the baby is at the breast. The caloric value of breast milk is also provided by fats.

Protein in breast milk.

Mother’s milk contains proteins that are not found in the milk of other mammals. While the amount of total protein is constant, the ratio of whey proteins to casein, varies with diet. The ratio of whey proteins to casein varies during the lactation period from 80:20 in colostrum, to about 50:50 by the end of lactation. In mature women’s milk this ratio is 60:40, whereas in cow’s milk the ratio is 20:80.

None of the proteins in women’s milk are identical to those in cow’s milk.

Protein in breast milk is the main nutrient in breast milk that regulates infant growth. Protein in breast milk is 1% and is not only a building block for an infant’s growth.

How much protein is in breast milk per liter is related to species objectives. The average is 0.9-1.3 g/l, less than in the milk of domestic animals.

The task of a calf or goat is to get on its feet and run on its own faster. The task of an infant is primarily to develop the intellect, the brain and establish immune defenses.

Breast milk proteins can be divided into three groups:

  1. Nutritive or nutritive (providing nutrition and digestion);
    1. Immunological;
    1. Influencing growth.

Nutritional:

  • Alpha lactoglobulin;
    • Casein;
    • Serum albumin;
    • Lactase;
    • Amylase.

Of the protein that comes with a woman’s milk, digestion, and therefore nutrition, accounts for 0.8%. Alpha-lactoglobulin makes up 25-35% of the total protein in women’s milk, while it is only 2-5% in cow’s milk. It is part of the enzymes involved in the synthesis of lactose from glucose, binds calcium and zinc, and accelerates their absorption. The enzymes in breast milk lactase and amylase are involved in the breakdown of carbohydrates.

Immunological:

  • Lactoferrin;
  • Lysozyme;
  • Secretory SIgA;
  • Immunoglobulins;
  • Fat globule membrane proteins;
  • Cytokines(interleukins).

SIgA suppresses allergies to food antigens and promotes the formation of normal gut flora. Women’s milk contains all classes of T-lymphocytes, they «protect» the baby from viral and cancerous diseases.

Non-specific protective factors in breast milk are represented by lysozyme, lactoferrin, interferon, complement components, bifidus factor, parenteral resistance factor, Lysozyme is an enzyme that stops the growth of a huge number of pathogenic bacteria, and stimulates the growth of L. Bifidum, indirectly stimulates phagocytes. Lysozyme is contained in colostrum about 90 mg/liter. In mature milk it is much higher, 200-300 mg/l

Bifidus factor is an oligosaccharide that promotes the growth of L. bifidus in the baby’s intestines. Lactoferrin carries iron and zinc from mother to child and has antibacterial activity.

Growth-affecting proteins in breast milk:

  • Hormones:
    • Glucocorticoids;
    • Thyrotropic hormones;
    • Leptin;
    • Insulin;
    • Ghrelin;
  • Growth and developmental factors.

Child growth during the first two years of life is regulated by insulin-like growth factor 1, a hormone whose concentration in the child’s blood depends on the amount of protein in his diet, particularly in mother’s milk. Numerous hormones in breast milk take part in the regulation of metabolism.

Carbohydrates in Breast Milk

The carbohydrates in breast milk are 90% lactose, about 5-8 grams per 100 ml of milk and oligosaccharides. In the small intestine, lactose is broken down to glucose and galactose. Galactose is involved in the synthesis of cerebrosides, substances responsible for the formation of neural connections of the developing child’s brain, ensuring the child’s adaptation to the outside world.

In the large intestine, under the influence of L. Bifidum, lactose is broken down to lactic acid. The benefit is that it increases the acidity of the large intestine and suppresses the growth of pathogenic flora in it.

Unlike milk from other mammals, women’s milk contains not only the carbohydrate lactose, but also an enzyme for its processing — lactase. This enzyme is mainly found in the back of the milk, which is rich in fat; only those babies who suckle «back milk» receive it.

Breast milk oligosaccharides (BMO) are part of the mother’s milk, ranking third among the components, after fat and lactose. Scientists have deciphered the chemical composition of more than 200 oligosaccharides; the estimated number of their varieties is in the thousands. The composition of oligosaccharides is different for each breastfeeding woman and depends on a number of factors, even including age and race. The difference in oligosaccharide composition determines the individuality of the microbiota of the mother and her baby.

Scientific studies in recent years have proven that breast milk oligosaccharides:

  • Promote the selective growth of beneficial bifidobacteria for the baby;
    • Create an acidic environment in the colon that prevents pathogens from developing;
    • Able to bind bacteria, toxins and viruses, preventing them from attaching to the cells of the intestinal mucosa;
    • Positively affect the absorption of calcium.

The maximum amount of OGM are contained in colostrum and transitional milk (20-25 g/l), in mature milk they are less — 5-15 g/l. OHM represent nutrition for beneficial intestinal microflora.

The energy value of breast milk is provided by the optimal combination of fats and carbohydrates.

Vitamins in breast milk.

The vitamin composition of breast milk directly depends on the content of water-soluble vitamins (C, B1, B2, B6, B12) in the daily diet of nursing mothers. If the mother’s diet is low in vitamins, the baby will suffer first, and then the mother.

Including foods rich in Vitamin A and carotenoids increases the concentration of Vitamin A in the GM. Also, the concentration of Vitamin D in breast milk is positively affected by taking high doses of Vitamin D (2000-6400 IU per day).

All vitamins are present in breast milk and perform a myriad of different biological tasks in the baby’s body. The presence of fat-soluble vitamins in milk is also related to the mother’s diet.

The difficulty in providing breastfeeding women with micronutrients from conventional foods is due to the fact that since the last century there has been a decrease in the vitamin and mineral content of plants and foods from 30 to 84%. At present, only supplemental intake of vitamin and mineral complexes in doses of 50 to 100% of the daily requirement, and the inclusion of functional foods, can solve this problem.

Minerals in breast milk

Calcium, phosphorus, magnesium, zinc, copper and iron. The mineral composition of a woman’s milk is virtually unrelated to their intake by the nursing woman. According to studies, the content of Ca, P, Zn, Fe, Mg in GM does not depend on the maternal supply. When they are deficient in the diet, the mother’s health suffers first of all. Part of the minerals is taken from the bone tissue, destroying it. Therefore, pregnant and lactating women often suffer and lose teeth and hair. If the supply of minerals is not established, the internal organs begin to suffer further, and only a total deficit affects the health of the child.

Calcium and phosphorus in mother’s milk are less than in cow’s milk, but they are absorbed much better. The absorption of iron from mother’s milk, for example, is 5 times higher than from cow’s milk.

According to medical statistics, most nursing mothers suffer from poly-deficiency of vitamins and minerals, they must be taken in addition to the recommended daily amount. This ensures the adequate availability of vitamins and minerals in mother’s milk, increases its value and improves the baby’s supply.

Nutrients and protective immune system proteins are not all that breast milk consists of.

The cellular composition of breast milk.

Together with the mother’s milk, the baby receives immune protection in the form of special proteins, and immune system cells. Their number reaches 1 million in one ml of colostrum, up to 200,000 in mature milk.

Together with milk, the baby receives stem cells and immune cells:

  • Neutrophilic leukocytes (which protect the body from bacterial and fungal infections);
    • Macrophages — eater cells that actively capture and destroy not only bacteria, but all unnecessary or toxic substances that come their way;
    • Lymphocytes — important immune cells that ensure a complete immune response (humoral and cellular immunity).

Breast milk also includes Microbiome. Women’s milk was thought to be sterile. Today, up to 700 species of beneficial bacteria that breast milk contains have been isolated. The composition of microorganisms varies from colostrum to women’s milk, which contains useful representatives of the microflora that normally live in the child’s mouth. The most important for the formation of normal intestinal function is bifidobacteria and lactobacilli, up to 10 ³ /ml.

Their benefits:

  • Antibacterial properties (suppression of the reproduction of a variety of pathogenic bacteria);
    • Immunomodulatory properties;
    • Contribute to the formation of food tolerance and absorption of nutrients;
    • Prevent the development of obesity.

TOTAL: This is what mother’s milk is made of:

  • Millions of living cells;
    • Thousands of unique proteins (not found in other types of milk);
    • Over 200 complex sugars — oligosaccharides;
    • More than 40 enzymes and enzymes;
    • Growth Factors;
    • Hormones;
    • Vitamins and minerals;
    • Antibodies, or immunoglobulins;
    • Long-chain polyunsaturated fatty acids, Omega 3 and Omega 6 PUFAs.

Summarizing all the scientific research that has determined the multicomponent composition of breast milk, the WHO strongly recommends establishing breastfeeding for all infants from 0 to 6 months of age.

In the first days: the composition of breast milk is colostrum

The composition of colostrum

Feeding colostrum to a newborn

The process of breast milk formation begins with the production of colostrum, in the last trimester of pregnancy. The breast secretes colostrum immediately after delivery and for a few more days (3-5) Female colostrum is a thick liquid of yellow-white color, resembling the consistency of fresh cream. Colostrum, transitional and mature milk are produced to better adapt the newborn baby.

In the first 24 hours the baby’s stomach can only hold a volume of 5-7 ml, which is how much colostrum is secreted for each feeding. Gradually the baby’s stomach increases, so does the synthesis of breast milk by the mammary gland.

The amount of colostrum produced in women can vary, from 10 to 100 ml per day. The composition of colostrum and breast milk are also different.

The biochemical composition of colostrum per 100 ml:

  • Protein — 2.2 g
  • Fat — 2.5 g
  • Carbohydrates — 5,7 g
  • Energy value — 54 kcal

The composition of colostrum is 4-7% richer in protein. Moreover, protein is represented mainly by protective factors — immunoglobulins, hormones and enzymes. Colostrum does not contain casein, it has less water-soluble vitamins, lactose, it is less sweet, contains more cholesterol (up to 40 mg%) than breast milk, and it has more fat-soluble vitamins.

Colostrum has many glycoproteins, which are involved in the formation of the intestinal mucosa. Also colostrum contains high concentrations of growth factors, which contribute to the optimal maturation of organs and systems and, above all, the mucosa. Immunoglobulins in colostrum protect the intestinal mucosa from the penetration of microorganisms and large protein molecules. The protein lysozyme also protects against germs — it contains about 90 mg/l

With the total number of immune system cells in colostrum from 100,000 to 1 million in 1 ml of female milk, the cellular composition of colostrum, is as follows:

  • Neutrophils (protecting against bacteria) 45-50%;
    • Macrophages (eaters of bacteria, toxins and all foreign particles) -50%;
    • Lymphocytes (providing cellular and humoral immunity) — 5-10%.

Microflora of colostrum is represented mainly by bifido-lacto bacteria, in smaller amounts there are staphylococci, streptococci and other bacteria.

Colostrum is nutrition and protection for the newborn, helps the immune system and stimulates the adaptation of the newborn to extrauterine life. To deprive a newborn baby of colostrum is an emergency situation, allowed only for medical reasons.

Transitional milk

By day 4-5 of lactation, the casein protein fraction begins to be produced, the content of protective proteins, particularly lysozyme, increases, and transitional milk is formed. Transitional milk is an intermediate version between colostrum and mature milk: gradually, each day the amount of protein decreases and the amount of fats and carbohydrates increases. Early transitional is 5-7 days postpartum; late transitional is 8-15 days postpartum.

Approximate composition of transitional milk per 100 ml:

  • Protein — 2.2g;
    • Fat — 2.5 g;
    • Carbohydrates — 5.7 g;
    • Energy value — 54.5 kcal.

Mature milk

Matured milk the breast begins to produce about 15 days. Within a week, its composition may vary, but later in the quantitative content of the main components will not change dramatically. Will change only the qualitative composition in accordance with the needs of the baby and the mother’s diet.

The composition of mature breast milk per 100 ml:

  • Lactose — 6, 8g;
    • Fats — 3, 5 g;
    • Oligosaccharides — 1.2-1, 5 g;
    • Protein — 0.9-1, 3 g;
    • Energy value -74 kcal.

In mature milk, the cell composition is different from colostrum and intermediate milk, in 1 ml contains from 100,000 to 200,000 cells of the immune system. However, the total volume of milk the baby drinks is increasing, so the baby gets more immune system cells.

As a percentage, they are distributed as follows:

  • Neutrophils — 5%;
    • Macrophages — 85%;
    • Lymphocytes — 10%.

The older the child’s age, and the more nutrition he receives from outside. The more the protective function of macrophages becomes demanded. Thus, lysozyme in mature mother’s milk (starting at 6 months of age) is 200-300 mg/l.

Compared with colostrum and transitional milk, mature milk may seem liquid and insufficiently nutritious to the mother. Mature milk requires more volume and longer feeding time. Therefore, mature milk differs in composition and timing from the breast during feeding into foremilk and backmilk.

What is «front» and «back» milk?

The composition of breast milk changes even during a single feeding. Breast milk is conventionally divided into front and back milk. Mom’s milk is formed all the time, and it accumulates in the breast between feedings. If the interval between feedings is from 3 to 3, 5 hours, it is divided into fractions. The thicker and greasier, like cream, settles on the walls of the ducts, the more fluid is directly in the ducts.

Front milk

  • is the one the baby starts to get with the first sips. It is less fatty and sweeter, has more water, water-soluble vitamins, and more lactose (milk sugar).

As milk is secreted during lactation, it moves along the ducts, washing the oily cream from their walls, and the fat content of the milk being sucked begins to increase.

Back milk

  • is that which the baby receives towards the end of the feeding, the composition of the breast milk becomes more saturated with fats, fat-soluble vitamins.

Rear and front milk differ in the presence of different hormones, Front milk contains more ghrelin. Ghrelin is an appetite-stimulating hormone that sets the baby up to be active in milk production. Rear milk contains more of the hormone leptin, which is responsible for satiety. This is how nature regulates the baby’s appetite during breastfeeding, adjusting the duration and volume of feeding.

Galactose, obtained by breaking down lactose, provides new associative connections between neurons and improves the baby’s perception of the world around him. Both early and late milk are required for normal growth and development of the baby. Therefore, it is important not to tear a suckling baby from the breast before he is satiated.

Composition of breast milk after six months

For children weighing up to 40 kg, the maximum daily intake of caffeine should be 2.5 mg per kilogram of body weight

The composition of breast milk changes depending on the age of the baby. After 6 months of age the baby begins complementary foods, and his contact with the outside world, including through the gastrointestinal tract, becomes more frequent and intensifies. And with them the risk of infection with viral and bacterial microorganisms. At this time, the amount of antibodies and immunoglobulins in mother’s milk increases. As the baby becomes more active, begins to sit up, roll over, he needs more energy and, therefore, the fat content of milk increases.

When the baby is sick, the mother’s body reads the information and the mammary gland begins to produce substances to help cope with the painful symptoms and antibodies to protect against infections.

Демченко Елена
Elena Demchenko

Elena Demchenko graduated from Donetsk Medical Institute named after M. Gorky with a degree in pediatrics.

Work experience in medicine: district pediatrician, neonatologist of the department of nursing extremely premature babies, joint stay of mother and child, resuscitation and intensive care of newborns.

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