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La Leche League - the importance of breastfeeding

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La Leche League - the importance of breastfeeding

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First Steps Nutrition information on breastmilk and breastfeeding: 

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First Steps Nutrition information on breastmilk and breastfeeding: 

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Antibodies for Covid-19 found in breastmilk after vaccine

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Antibodies for Covid-19 found in breastmilk after vaccine

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The recommendations regarding the Covid-19 vaccine for pregnant and breastfeeding women have all pointed to a resounding "yes." However, the absence of prospective (or even retrospective) data in either of these groups means that all recommendations are based on what is presumed to be safe and effective. Early concerns that the spike protein formed in the bloodstream would mimic the placenta-binding protein, leading to pregnancy loss or infertility, were dispelled quickly. Healthcare workers who were pregnant or nursing were also recommended to go forward with the vaccine. Both the Centers for Disease Control (CDC) and the World Health Organization ( WHO) provided guidance for pregnant women, but, to date, there have not been any completed clinical trials looking at the outcomes of vaccine efficacy and safety during pregnancy. These trials have begun with the Pfizer/BioNTech vaccine, and data should be forthcoming in the months ahead.

But as many experts have stated, one cannot lump vaccine risks and efficacy in pregnant individuals with those who are lactating. The maternal transmission via the placental bloodflow to the fetus differs from the maternal transmission of ingested breast milk to the infant. In addition, as the fetus is continually changing developmental stages in utero, the time during gestation of transmission of a particular substance can have varying impact. Ingestion of breast milk into the infant's gastrointestinal tract will have different impact and effect than transmission from the placental blood supply to the fetus. The Phase 2/3 vaccine trials in pregnant women will be following pregnant mothers for 7 to 10 months after the trial to better understand the development of SARS-CoV-2 antibodies for both the mother and the infant after delivery.

Children are not yet eligible to receive any of the three available vaccines in the U.S., and likely will not be eligible for some time. But they are still at risk of contracting acute Covid-19 illness. While young children have not been a primary age group for severe illness or death, infants and young children can develop a severe inflammatory illness known as MIS-C (multisystem inflammatory syndrome in children), as a manifestation of post-coronavirus illness. Children with this syndrome present with high fever, fatigue, rash, myalgias (muscle pain), and occasionally cardiac complications. Many require hospitalization, and some have succumbed to complications secondary to MIS-C. This entity tends to be more common in infants and toddlers, who will be the last age groups to obtain approval to receive a Covid-19 vaccine.

While this season has not been focused on influenza cases, it has been well documented that lactating mothers who receive the flu vaccine can transmit protective flu antibodies via breast milk to their newborn or infant. This provides some protection from influenza illness to infants under age 6 months, who are too young to receive a flu vaccine. Studies are currently being carried out to assess whether this would be the case for SARS-CoV-2 antibodies in breast fed babies.

A recently released white paper presents a very small study looking at whether the breast milk of lactating mothers will contain protective Covid-19 antibodies after the mother receives a Covid-19 vaccination course. A group based at the Providence Portland Medical Center in Oregon enrolled six lactating women who received the Pfizer/BioNTech or Moderna Covid-19 vaccination regimen between December 2020 and January 2021. Each subject completed the two-dose vaccine course, with a 21- or 28-day interval between the first and second vaccine. Breast milk samples were obtained prior to the first vaccine dose, as well as at 11 additional time points, with the final sample collected at 14 days after the second vaccine dose.

Young adult woman receiving vaccine against Coronavirus
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The group found that by seven days after the first vaccine dose, breast milk samples demonstrated substantial IgG and IgA immunoglobulins against SARS-CoV-2. Breast milk antibody levels declined somewhat in the weeks just prior to the second vaccine dose, but rose sharply and remained elevated after the second vaccine dose was received. None of the women in the study had a history of prior Covid-19 infection. The important distinction in antibody levels in vaccinated versus previously infected lactating women is that those with prior infection demonstrated significant IgA antibodies, while immunized women's breast milk contains predominantly elevated IgG antibodies.

IgA antibodies are most widely seen in respiratory infected mucous membranes, and are commonly seen after respiratory illness. Immunoglobulin G, or IgG , is a more common blood-borne antibody, which provides systemic immunity, and is seen more readily after intramuscular injection as opposed to respiratory infection.

While this study is extremely small, and the data on duration of antibodies in breast milk remains preliminary, it provides promising news that breast-fed infants of vaccinated mothers will receive a degree of protection at a time when no Covid-19 vaccine is available for this age group.
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Antibodies For Covid-19 Found In Breast Milk After Vaccine

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The recommendations regarding the Covid-19 vaccine for pregnant and breastfeeding women have all pointed to a resounding "yes." However, the absence of prospective (or even retrospective) data in either of these groups means that all recommendations are based on what is presumed to be safe and effective.

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Antibodies are a known benefit of breastfeeding. A specific type of antibody found in breastmilk, IgA, protects infants from infections. When breast milk coats the baby's oral mucosa, nasal cavity, Eustachian tubes, and GI tract, the IgA binds to bacteria and viruses at that surface preventing them from entering the baby's system. The foreign invader stays immobile in the GI tract and is digested and excreted instead of causing sickness. IgA is not found in infant formulas, and is personalized to the environment the mom (and baby) is exposed to.

Our immune system is complex and works in many capacities. Natural antibodies are proteins that are the backbone of the immune system. It responds to viruses, bacteria, fungi, and parasites (also called pathogens) that you come across every day. They are produced specifically to recognize and attack antigens (parts of the foreign pathogen(s)) currently present in your environment. Later, some antibodies can remember the antigen and facilitate a quicker immune response the next time you are exposed to that pathogen.

Substances transfer into the breastmilk through the blood-if a substance isn't present in the blood's serum, chances are great that it will not be in the milk in relevant degrees. Some antibodies are produced by plasma cells to freely circulate in the bloodstream, allowing for the possibility of transfer into breastmilk. These free antibodies include IgG, IgM, and IgA, and are a large part of humoral immunity, linking the innate and adaptive immune systems through the activation of the complement system. For the topic of breastfeeding, cell-mediated immunity is less important as its major components are intracellular.

Your body is constantly producing new antibodies that fight new pathogens that are present in your environment. During infection, the first antibodies produced are IgM antibodies and are transiently found in the blood and lymph. Both IgM, and later IgG, initiate pathways that mount a systemic response throughout your body. The systemic response is characterized by fever, elevated white blood counts, etc. Both IgG and IgM antibodies play similar roles in destroying harmful substances that enter our bodies. IgM is the fastest antibody produced, but it is short lived. IgG antibodies are overall the most common antibody and are found in all body fluids. IgG plays an important role in fighting bacterial and viral infections, and are the only type of antibody that can cross the placenta of a pregnant woman in order to help protect the fetus.

IgA is secreted into the blood, GI tract, and mucous membranes of moms and babies. ¹ Most antibodies are too large to transfer into breastmilk in large amounts. However, IgA is transported across the lactocyte barrier into the milk. IgA plays a very different role than IgG and IgM, which explains its added benefit for breastfeeding (more to come).

Following delivery, the infant will start producing their own antibodies as they are exposed to pathogens. Conversely, the levels of maternal IgG in the infant begin to fall shortly after delivery. This "inherited" protection will deteriorate over the first six months of life (Figure 1). ² Maternal IgA consumed from a breastfeeding infant can help protect an infant through this transition as they build their own immune defenses. Because the pathogens each person encounters are unique, each person's antibodies are different than each other. A mother and her child are often in the same environments, and therefore exposed to the same pathogens. This is a huge benefit for antibodies in breastmilk-they are customized to protect the baby against the specific pathogens they are most likely to be exposed to.

Figure 1: Infant Antibody Levels Over the First 18 Months of Life ²

IgA is stabilized with a secretory component when it is transported across mucous membranes, becoming SIgA. The overall job of specific secretory immunoglobulin A (SIgA), is to inhibit initial pathogen colonization by performing immune exclusion both on the mucosal surface and within virus-infected secretory epithelial cells, all without causing tissue damage . In short, SIgA antibodies function by binding to pathogens that come in contact throughout GI tract, effectively neutralizing them. Binding these foreign substances prevents them from entering the body. In essence, you can think of SIgA antibodies as our "first line of defense."

As an infant breastfeeds, SIgA enters the infant's GI tract (mouth, esophagus, stomach) via breast milk and coats the GI tract. Occasionally, breast milk can reach throughout the oropharynx, nasopharynx, and eustachian tubes (small tubes that run between the middle ear and upper throat). While this could be concerning for other liquids, breastmilk is transporting neutralizing SIgA antibodies anywhere it travels.

Additionally, it is thought that SIgA antibodies are highly resistant to digestion by enzymes that are located in the GI tract, such as pepsin which is known to be the key digestive enzyme located in the stomach. These antibodies are unlikely to be damaged via proteolysis due to the stabilizing secretory component. ⁴

Will my child receive these antibodies via consumption of breast milk?

Maternal IgG antibodies are delivered to the fetus while in utero via the placenta

Maternal SIgA are present in breastmilk in large quantities (0.5-1.0 grams per day!)⁵

Other maternal antibodies may be present in breastmilk. How much and how useful they are is up for debate.

The presence of maternal antibodies is the biggest difference (that we know of) between formula and breastmilk. With infants that are breast-fed, SIgA is known to be found in infant feces only two days after delivery and onset of breast-feeding. In contrast, infants that are formula fed, SIgA is not found in their feces until around one month postpartum once the infant is able to synthesize their own IgA antibodies (SIgA is not found in formula). ⁴

Kaytlin Krutsch, PharmD, MBA, BCPS

1. Hoffman W, Lakkis FG, Chalasani G. B Cells, Antibodies, and More. Clin J Am Soc Nephrol. Jan 7 2016;11(1):137-54. doi:10.2215/CJN.09430915

2. Braibant M, Barin F. The role of neutralizing antibodies in prevention of HIV-1 infection: what can we learn from the mother-to-child transmission context? Retrovirology. Oct 7 2013;10:103. doi:10.1186/1742-4690-10-103

3. Brandtzaeg P. Role of secretory antibodies in the defence against infections. Int J Med Microbiol. Apr 2003;293(1):3-15. doi:10.1078/1438-4221-00241

4. Andreas NJ, Kampmann B, Mehring Le-Doare K. Human breast milk: A review on its composition and bioactivity. Early Hum Dev. Nov 2015;91(11):629-35. doi:10.1016/j.earlhumdev.2015.08.013

5. Le Doare K, Kampmann B. Breast milk and Group B streptococcal infection: vector of transmission or vehicle for protection? Vaccine. May 30 2014;32(26):3128-32. doi:10.1016/j.vaccine.2014.04.020

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Antibodies, Immune System, & Breastfeeding | InfantRisk Center

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Antibodies are a known benefit of breastfeeding. A specific type of antibody found in breastmilk, IgA, protects infants from infections. When breast milk coats the baby's oral mucosa, nasal cavity, Eustachian tubes, and GI tract, the IgA binds to bacteria and viruses at that surface preventing them from entering the baby's system.

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This is an edited excerpt from "I Contain Multitudes: The Microbes Within Us and a Grander View of Life," which will be published on August 9th by Ecco, an imprint of HarperCollins Publishers.
The Foods for Health Institute, at the University of California, Davis, has the appearance of a Tuscan villa, its terra-cotta-walled buildings overlooking a large vineyard and a garden that bursts with summer vegetables. It is led by a chemist named Bruce German, and if there were a world title in extolling the virtues of milk he would surely hold it. At our first meeting, he spent half an hour monologuing on the subject, bouncing on an exercise ball and kneading a tattered shred of bubble wrap as he spoke. Milk, he said, is a perfect source of nutrition, a superfood that is actually worthy of the label. This isn't a common view. The number of scientific publications about milk is tiny, compared with the number devoted to other bodily fluids-blood, saliva, even urine. The dairy industry has spent a fortune on extracting more and more milk from cows, but very little on understanding just what this white liquid is or how it works. Medical-funding agencies have generally dismissed it as irrelevant, German said, because "it doesn't have anything to do with the diseases of middle-aged white men." And nutritionists have looked at it as a simple cocktail of fats and sugars, one that can be easily duplicated and replaced by formulas. "People said it's just a bag of chemicals," German told me. "It's anything but that."

Milk is a mammalian innovation, common to platypuses and pangolins, humans and hippos, its ingredients varying according to what each species needs. Human milk is a particular marvel. Every mammal mother produces complex sugars called oligosaccharides, but human mothers, for some reason, churn out an exceptional variety: so far, scientists have identified more than two hundred human milk oligosaccharides, or H.M.O.s. They are the third-most plentiful ingredient in human milk, after lactose and fats, and their structure ought to make them a rich source of energy for growing babies-but babies cannot digest them. When German first learned this, he was gobsmacked. Why would a mother expend so much energy manufacturing these complicated chemicals if they were apparently useless to her child? Why hasn't natural selection put its foot down on such a wasteful practice? Here's a clue: H.M.O.s pass through the stomach and the small intestine unharmed, landing in the large intestine, where most of our bacteria live. What if they aren't food for babies at all? What if they are food for microbes?

This idea dates back to the early twentieth century, when two very different groups of scientists made discoveries that, unbeknownst to them, were closely connected. In one camp, pediatricians found that microbes called Bifidobacteria ("Bifs," to their friends) were more common in the stools of breast-fed infants than bottle-fed ones. They argued that human milk must contain some substance that nourished the bacteria-something that later scientists called the bifidus factor. Meanwhile, chemists had discovered that human milk contains carbohydrates that cow milk does not, and were gradually whittling this enigmatic mixture down to its individual components, including several oligosaccharides. The parallel tracks met in 1954, thanks to a partnership between Richard Kuhn (chemist, Austrian, Nobel laureate) and Paul Gyorgy (pediatrician, Hungarian-born American, breast-milk advocate). Together they confirmed that the mysterious bifidus factor and the milk oligosaccharides were one and the same-and that they nourished gut microbes.

By the nineteen-nineties, scientists knew that there were more than a hundred H.M.O.s in milk, but they had characterized only a few. No one knew what most of them looked like or which species of bacteria they fed. The common wisdom was that they nourished all Bifs equally, but German wasn't satisfied. He wanted to know exactly who the diners were and what dishes they were ordering. To do that, he took a cue from history and assembled a diverse team of chemists, microbiologists, and food scientists. Together they identified all the H.M.O.s, pulled them out of the milk, and fed them to bacteria. And, to the researchers' chagrin, nothing grew.

The problem soon became clear: H.M.O.s are not an all-purpose food for Bifs. In 2006, the team found that the sugars selectively nourish one subspecies, Bifidobacterium longum infantis. As long as you provide B. infantis with H.M.O.s, it will outcompete any other gut bacterium. A closely related subspecies, B. longum longum, grows weakly on the same sugars, and the ironically named B. lactis, a common fixture of probiotic yogurts, doesn't grow at all. Another probiotic mainstay, B. bifidum, does slightly better, but is a fussy, messy eater. It breaks down a few H.M.O.s and takes in the pieces it likes. By contrast, B. infantis devours every last crumb using a cluster of thirty genes-a comprehensive cutlery set for eating H.M.O.s. No other Bif has this genetic cluster; it is unique to B. infantis. Human milk has evolved to nourish the microbe, and it, in turn, has evolved into a consummate H.M.O.vore. Unsurprisingly, it is often the dominant microbe in the guts of breast-fed infants.

B. infantis earns its keep. As it digests H.M.O.s, it releases short-chain fatty acids, which feed an infant's gut cells. Through direct contact, B. infantis also encourages gut cells to make adhesive proteins that seal the gaps between them, keeping microbes out of the bloodstream, and anti-inflammatory molecules that calibrate the immune system. These changes only happen when B. infantis feeds on H.M.O.s; if it gets lactose instead, it survives but doesn't engage in any repartee with the baby's cells. In other words, the microbe's full beneficial potential is unlocked only when it feeds on breast milk. Likewise, for a child to reap the full benefits that milk can provide, she must have B. infantis in her gut. For that reason, David Mills, a microbiologist who works with German, actually sees B. infantis as part of milk, albeit a part that is not made in the breast.

It is unclear why human breast milk stands out among that of other mammals. It has five times as many types of H.M.O.s as cow's milk, and several hundred times the quantity. Even chimp milk is impoverished compared with ours. Mills suggests a couple of possible explanations for this difference. One involves our brains, which are famously large for a primate of our size, and which grow incredibly quickly during our first year of life. This fast growth partly depends on a nutrient called sialic acid, which also happens to be one of the chemicals that B. infantis releases while it eats H.M.O.s. It is possible that, by keeping this bacterium well fed, mothers can raise brainier babies. This might explain why, among monkeys and apes, social species have more milk oligosaccharides than solitary ones, and a greater range of them to boot. Living in larger groups requires remembering more social ties, managing more friendships, and manipulating more rivals. Many scientists believe that these demands drove the evolution of primate intelligence; perhaps they also fuelled the diversity of H.M.O.s.

An alternative idea involves diseases. In a group setting, pathogens can easily bounce from one host to another, so animals need better ways of protecting themselves. H.M.O.s provide one such defense. When a pathogen infects our guts, it almost always begins by latching onto glycans-sugar molecules-on the surfaces of our intestinal cells. But H.M.O.s bear a striking resemblance to these glycans, so pathogens sometimes stick to them instead. They act as decoys, drawing fire away from a baby's own cells. They can block a roll call of gut villains, including Salmonella; Listeria; Vibrio cholerae, the culprit behind cholera; Campylobacter jejuni, the most common cause of bacterial diarrhea; Entamoeba histolytica, a voracious amoeba that causes dysentery and kills a hundred thousand people every year; and many virulent strains of E. coli. H.M.O.s may even be able to obstruct H.I.V., which might explain why more than half of infants who suckle from infected mothers don't get infected, despite drinking virus-loaded milk for months. Every time scientists have pitted a pathogen against cultured cells in the presence of H.M.O.s, the cells have come out smiling.
Copyright © 2016 by Ed Yong. Reprinted by permission of the publisher.
The team at the Foods for Health Institute has set up an impressive milk-processing facility in its mock-Tuscan building. In the main lab, which Mills runs with the food scientist Daniela Barile, there are two huge steel drums in which milk is stored, a pasteurizer that looks like an espresso machine, and a riot of other equipment for filtering the liquid and breaking it down into its components. When I visited, hundreds of empty white buckets were stacked on a nearby rack. "They're normally full," Barile told me. The full buckets are kept in a huge walk-in freezer, which is chilled to an intensely uncomfortable -25.6 degrees Fahrenheit. On a nearby bench, there's a row of Wellies ("When we process, there's milk all over," Barile said), a hammer for chipping ice ("The door's not closing properly"), and, inexplicably, a ham slicer (I didn't ask). We popped our heads inside. White buckets were arrayed on pallets and shelves, containing some six hundred gallons of milk between them. A lot of this was cow's milk, donated by dairies, but a surprising amount came from humans. "Lots of women pump milk and store it, and once their kid weans, they think, Now what do we do with it? People then hear about us and we get donations," Mills said. "We got eighty litres, collected over two years, from someone random at Stanford University, who said, 'I have all this milk. Do you guys want it?' " Yes, they did. They need all the milk they can get.

About twenty miles east of the Institute, at U.C. Davis Children's Hospital, a pediatrician named Mark Underwood is making practical use of the findings of German and his team. Underwood heads the hospital's neonatal intensive-care unit, which can accommodate as many as forty-eight premature babies at a time. The youngest are born at twenty-three weeks; the lightest weigh just over a pound. They are usually delivered through C-sections, put on courses of antibiotics, and stuck in a supremely sanitized environment. Bereft of the usual pioneering microbes, they grow up with a very strange microbiome: low on the usual Bifs and high in opportunistic pathogens that grow in their place. The preemies are the epitome of microbial imbalance, or dysbiosis, and their strange internal communities put them at risk of an often fatal gut condition known as necrotizing enterocolitis. Many doctors have tried to prevent NEC by giving probiotics to premature babies, with some success. But Underwood, after talking to people like German and Mills, thinks that he can do better by infusing the infants with a combination of B. infantis and breast milk. "The food you feed these bugs is as important as the bugs themselves in getting them to grow and colonize a fairly hostile environment," he told me. If the treatment works, breast milk could do for preemies what it does for their full-term brethren, nourishing baby and bacteria, infant and infantis, and preparing them for life ahead.

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This is an edited excerpt from " I Contain Multitudes: The Microbes Within Us and a Grander View of Life ," which will be published on August 9th by Ecco, an imprint of HarperCollins Publishers.

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Researchers at Amsterdam's UMC teaching hospital and a number of other institutes have found coronavirus antibodies in the breast milk of women who have tested positive for the virus.

The research team are now looking into whether the milk could be used to prevent coronavirus infections in vulnerable people during an eventual second wave, possibly in the form of flavoured ice cubes.

They have already found that the antibodies are not destroyed by pasteurising the milk, which is necessary to make it usable by other people.

'We think when drinking the milk, the antibodies attach themselves to the surface of our mucous membranes,' Hans van Goudoever, head of the Emma children's hospital at the UMC, said. 'Then they attack the virus particles before they force their way into the body.'

The UMC has now started a campaign to find 1,000 women who are willing to donate 100ml of breast milk for the research project.

'Women who may have had coronavirus without noticing it may also have made antibodies which can be found in milk,' Van Goudoever said. 'So we are looking for mothers who may have been infected as well.' Even if this turns out not to be the case, their milk can be stored for further research, if they give permission, he said.

Women who want to take part are urged to contact covid.milk@amsterdamumc.nl.

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Dutch researchers find Covid-19 antibodies in breast milk, call for donations - DutchNews.nl

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Researchers at Amsterdam's UMC teaching hospital and a number of other institutes have found coronavirus antibodies in the breast milk of women who have tested positive for the virus. The research team are now looking into whether the milk could be used to prevent coronavirus infections in vulnerable people during an eventual second wave, possibly in the form of flavoured ice cubes.

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Pregnant women are protected by Pfizer and Moderna vaccine

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Pregnant women are protected by Pfizer and Moderna vaccine

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And pass on high levels of antibodies to their babies.

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Researchers studied 131 women who received either the Pfizer or Moderna COVID-19 vaccines.

The pregnant or lactating women had as strong an immune response as the nonpregnant women.

Their babies developed high levels of disease-fighting antibodies.

See more stories on Insider's business page.

The COVID-19 vaccines by Pfizer and Moderna are effective in pregnant women, bolstering their immune response to the disease and even passing protective antibodies to their babies, according to a new preprint study.

The study, published Thursday in the American Journal of Obstetrics and Gynecology, looked at 131 women who received one of the two vaccines between December and March, of whom 84 were pregnant and 31 were lactating.

Researchers, from centers including Harvard, MIT, and Brigham and Women's Hospital, found pregnant and lactating women had as strong an immune response to the vaccines as the 16 women who were not pregnant or lactating.

What's more, they found the vaccines were much better than exposure to the coronavirus at giving babies secondary antibodies. Testing umbilical cord blood and the placenta, they found babies born to women who received the vaccine had "strikingly higher" levels of COVID-fighting antibodies than babies born to women who previously had COVID-19, the researchers wrote.

The research supports vaccinating pregnant women

The research adds to a growing body of research that indicates getting a COVID-19 vaccine is a good idea for pregnant women.

In March, the CDC said there were no adverse results in its study on 30,000 vaccinated pregnant women.

A small peer-reviewed study in January found that pregnant women vaccinated against COVID-19 passed antibodies onto their unborn babies. In February, researchers said a baby born to a woman who had only received one of the two Moderna shots tested positive for protective antibodies.

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Pregnant women are protected by the Pfizer and Moderna vaccines - and pass high levels of disease-fighting antibodies on to their babies, study finds

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Researchers studied 131 women who received either the Pfizer or Moderna COVID-19 vaccines. The pregnant or lactating women had as strong an immune response as the nonpregnant women. Their babies developed high levels of disease-fighting antibodies. See more stories on Insider's business page.

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New understanding of how human milk affects the gut microbiome is helping to explain exactly how the benefits of human milk are achieved.
We hear a lot these days about the gut microbiome-and with good reason. Evidence suggests that the bacteria in our gut influence virtually every aspect of our functioning, from our stress and anxiety responses, to our metabolism and appetite, to the robustness of our immune system, to even our experience of gender and mating. And when our gut microbiome is out of balance, research suggests negative consequences can result: depression and anxiety, obesity, irritable bowel syndrome, Alzheimer's Disease, and asthma have all been linked to microbiome disruption.

What does the gut biome have to do with breastfeeding? A lot, as it turns out. A webinar hosted by ILCA, Jarold "Tom" Johnston, DNP, CNM, IBCLC, explores that connection. Here, based on Johnston's talk, are the 10 things lactation consultants need to know about the maternal-infant gut microbiome.

1. The microbiomes of baby and birthing parent are inextricably linked.

When a person gives birth, they pass their microbiome to their baby-first through exposure to their normal flora in the birth canal and then through their milk during breast- or chestfeeding.

2. Communication is a two-way street.

The milk ejection reflex is a muscular contraction that pushes milk out to the baby. But did you know that once the milk ejection reflex slows, muscles relax and pull baby's saliva back in? Lactocytes respond to saliva exposure by producing particular macrophages. If the baby has been exposed to an infection, at the next feeding, he will get leukocytes and antibodies to fight that specific infection.

3. Colostrum is not really food.

You read that correctly! Babies get very few calories at the breast during the first 48 hours, because the calories in colostrum are not intended for digestion. They come from immune cells, designed to populate the immune system. Rather than thinking of colostrum as calories, think of it as an immune system transfer.

4. Breastmilk sugars are more than food.

Human Milk Oligosaccharides (HMOs) play a key role in developing the infant's gut microbiome. Human milk contains more than 100 types of HMOs. (In contrast, cows' milk contains only two.) Each HMO has a specific benefit for the infant's gut microbiome. Some are prebiotics, acting to increase good bacteria in the gut. Others block the attachment of invading viruses and bacteria like RSV and e.coli by providing harmless "decoy" attachment sites. Another type coats the baby's gastrointestinal tract, preventing pathogens from sticking. But none of them are digested by baby as carbohydrates until the baby is more than four months old.

5. A breasted baby's gut microbiome is optimized for nutrition delivery.

The breastfed infant's gut contains a specialized group of bacteria known as the phosphotransferase system. This system transports lactose and makes it available for use. Breastfed babies have higher levels of phosphotransferase then formula-fed babies. This means breastfed babies can access the maximum amount of energy available in their breastmilk. This ensures a constant source of carbohydrate for the developing, glucose-dependent brain.

Breastfed babies have higher numbers of gut bacteria that produce Vitamin A, B Vitamins, Vitamin K-2, and more. When they drink breastmilk, it feeds the bacteria colonies in their gut that make these micronutrients. Are you ever asked whether breastmilk contains enough iron, Vitamin K, or other nutrients? That question is misleading! Babies actually do not "get" these important micronutrients from the breastmilk they drink; what they get from breastmilk are the ingredients to feed a microbiome that can synthesize these micronutrients.

6. There are "bonus" calories in breastmilk.

Epithelial cells in human milk (formerly thought to be dead) are actually alive, active, and functional. They form clusters (called mammospheres) in the baby's gut and continue to make more milk! This means that for every calorie of breastmilk a baby takes in, he gets bonus calories as the epithelial cells continue to generate milk inside his gut.

7. Exclusively breastfed babies have "less mature" gut microbiomes, and that is a good thing.

At birth, babies have very different proportions of specific bacteria in their gut microbiome compared to their birthing parent's. Over the first 12 months of life, the baby's microbiome shifts to strongly resemble the birthing parent's. However, this shift is accelerated by the introduction of formula or the feeding of solid foods. As soon as the baby ingests anything other than human milk, the gut microbiome changes rapidly, and it does not go back. This may explain why formula fed infants experience more auto-immune and infectious illness.

8. Birth interventions affect the microbiome.

Cesarean section birth reduces microorganism exposure. While infants born via vaginal birth show 135 of their mother's 187 bacteria strains after birth, infants born via surgical delivery show only 55. Antibiotics given to Group Beta-Strep-positive parents during birth also have an effect, since they wipe out good flora in the birth canal. Exactly how these interventions affect long-term health is not yet clear, but continuing to think carefully about birth interventions is key.

9. What about special situations?

Many of the mechanisms of microbiome transfer rely on birth and direct feeding. What about parents who exclusively pump, rely on donor milk, or induce lactation for an adopted baby? Exclusive pumping and the use of donor milk both impact the microbiome to some extent. Pasteurization of donor milk inactivates some of the living organisms in human milk, and exclusive pumping does not allow for the two-way communication discussed earlier where baby's saliva is taken into the breast and informs lactocytes of the baby's specific infection exposure. However, as you address parents' concerns, what the science tells us now is that receiving human milk is more important than how it is the baby receives the milk.

10. Microbiome science is only a baby itself.

According to Johnston, it is important to remember that our understanding of the gut microbiome is just getting started. There is a long way to go, and much more to learn. However, for those of us who work with lactating families, the exciting news is: Understanding how the unique components of human milk interact with the infant's gut organisms is helping us begin to understand how those benefits occur-they operate through the microbiome.

Want to learn more? ILCA members, access the entire webinar here. Not a member yet? Learn more about how you can access this and other continuing education at ILCA here.

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Ten Things IBCLCs Need to Know About the Gut Microbiome

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New understanding of how human milk affects the gut microbiome is helping to explain exactly how the benefits of human milk are achieved. We hear a lot these days about the gut microbiome-and with good reason.

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In the midst of debates about how to best tackle the climate crisis, breastfeeding was recently highlighted as a significant way women can help to make a difference. But while there is no doubt of the important role breastfeeding can play, there must be caution in the way such messages are communicated.

This is because telling women that breastfeeding will help save the planet just further fuels feelings of anger, grief and loss women can experience when they are unable to breastfeed. The UK, for example, has some of the lowest breastfeeding rates in the world, but that is not through lack of desire. Most women who want to breastfeed - but are unable to do so - have been affected by factors outside their control and are deeply frustrated at any message that implies they should just try harder.

Given these barriers, simply telling women that breastfeeding is important is unlikely to make any difference. Yet, there is a stark similarity in the way the climate and infant feeding crises are ineffectively communicated in the press - with emotive headlines about the need for individuals to take action.

Of course, as individuals we can all play our part, but real change is only possible with investment at a societal level. This is why government investment in breastfeeding is needed to make changes in policy, industry and the workplace to enable both a healthier planet and a healthier population.

Environmental cost

The science surrounding breastfeeding and climate change is only just being revealed. Breastfeeding uses few water or land resources, produces no carbon emissions and minimal or zero waste. It suppresses ovulation, helping to reduce family sizes and keep families healthy, which can further protects the impact of humanity on the Earth's resources.

Indeed, a recent study showed breastfeeding for six months saved 95-153kg CO₂e (carbon dioxide equivalents) per baby compared to formula feeding. If all babies were breastfed for just six months in the UK, the carbon emission savings would equate to removing between 50,000 and 77,500 cars from the road for a year. This data holds true, even when you take into consideration the small additional dietary demands of breastfeeding for the woman.

The water footprint of milk powder alone has been estimated at about 4,700 litres of water per kilo of milk powder. Formula is supplemented with multiple ingredients such as palm oil to approximate the minerals and vitamins required by babies for growth and development. Despite industry proclamations for greening of their supply chains, Nestlé's accent recent temporary suspension from the Roundtable on Sustainable Palm Oil highlights potential deficiencies in sustainability in global food production.

Read more: Palm oil boycott could actually increase deforestation - sustainable products are the solution

There are only 40-50 formula milk processing plants worldwide. The food miles consumed in transporting raw ingredients to these plants, and transporting them to consumers worldwide is as yet unknown but obviously considerable.

Formula preparation also consumes resources. Powdered infant formula is not sterile, and can only be made safely with water heated to 70°C. In the UK, the estimated energy cost of boiling this water over the first year of a baby's life equates to over 1.5m kilograms of carbon dioxide. And in terms of waste, research shows 550m infant formula cans, 86,000 tons of metal and 364,000 tons of paper are added to landfills every year - and the formula industry has more than doubled since that research was published in 2009.

Not breastfeeding also usually means a quicker return of women's periods. Considering that in the UK, on average, each woman uses 264 pads and tampons each year, breastfeeding also reduces the number of cotton fibres, polyethylene plastics and contaminants being used for their production.

More support

There are of course obvious gaps in our knowledge across the whole sector that scientists must urgently address. But it's clear that reducing our reliance on formula where possible is an important step in helping mitigate the climate crisis. But what use is that message in a system that fails to support breastfeeding mothers? Women need the right environment and support for breastfeeding to flourish. But despite continued messaging that this is how you raise breastfeeding rates, the government fails to sufficiently invest.

Shutterstock/Irina Polonina

Ultimately, highlighting the role breastfeeding can play in protecting our planet is not a message that should be aimed at individual women. It should be aimed at those with the power to make a change. And for breastfeeding rates to increase, governments must invest in greater health professional support, cut down on the reach of the breast-milk substitute industry, ensure public spaces and workplaces have policies in place to enable women to breastfeed, and increase the maternity protections women need to meet the needs of their baby.

It also means ensuring that when formula milk is needed, it leaves the lowest possible environmental footprint. Strategies such as reducing reliance on ready-made formula and disposable bottles, stepping up to prevent so many resources being used on formula milk promotion - especially that of unnecessary follow on and toddler milks - and requiring the industry to be responsible for reducing its own impact such as making products recyclable would be critical steps that protect us all, no matter how people choose to feed their babies.

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Breastfeeding can help tackle climate crisis but it's on governments, not mums to save the world

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In the midst of debates about how to best tackle the climate crisis, breastfeeding was recently highlighted as a significant way women can help to make a difference. But while there is no doubt of the important role breastfeeding can play, there must be caution in the way such messages are communicated.

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Article about breastmilk in New York Times:

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Article about breastmilk in New York Times:

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June 2019

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Breast-fed milk may nourish a baby's microbiome in ways that bottled breast milk can't.

The numbers of bacteria in breast milk are relatively low, but breast-feeding seems to have an outsize impact in populating a baby's microbiome with good bacteria. Credit... Monashee Alonso/Alamy

In the earliest days after birth, millions of bacteria make their home in a baby's body - in the skin, mouth and especially the gut. These immigrants come from the birth canal and the mother's feces (during a vaginal birth), the mother's skin and mouth as she holds and nuzzles the baby and perhaps even from the placenta, although that source is still debated.

The colonizing microbiome can have a far-reaching impact on the baby's health. Studies have suggested, for instance, that the populace of a baby's microbiome in the first two years of life may predict later risk of obesity. Children born by cesarean section are also more likely to become obese, or to develop autoimmune diseases such as type 1 diabetes and asthma.

Lately, scientists have identified another major contributor to the infant microbiome. Breast milk, it turns out, is teeming with bacteria that colonize the infant's gut, and could help set the course for the baby's growing immune system and metabolism.

Moreover, breast milk seems to be rich in beneficial bacteria only when it comes directly from the mother's breast - not even when the same milk is pumped and delivered later by bottle. Pumped milk still carries most other riches of breast milk. Nevertheless, this news about the microbiome, emerging from studies done in the past few years, taps into a fraught issue for many women: medical recommendations and societal pressure to breast-feed, combined with policies, or physical problems, that often make it all but impossible to do so.

Especially for the gut microbiome of older babies, "the number one thing that influences that composition is what they're being fed," said Meghan Azad, a pediatric researcher and epidemiologist at the University of Manitoba. "In some ways that message isn't for individual moms, but for society overall: Breast-feeding is very important."

The idea of a breast milk microbiome, and of its importance, is only just beginning to take root. The numbers of bacteria in breast milk are much lower than in stool, the usual route to sample gut bacteria, and scientists lacked the tools to analyze breast milk. As the technology has matured, researchers have found that breast-feeding seems to have an outsize impact, populating the baby's microbiome with good bacteria.

It's well known by now that babies born by cesarean section miss out on many helpful bacteria. And antibiotic use in the mother or baby can also obliterate the baby's nascent bacterial populations. Breast-feeding can compensate to some extent.

"Those instructions come very early in life," said Jed Friedman, director of the Harold Hamm Diabetes Center at the University of Oklahoma. "The problem becomes if you can't breast-feed and are switching to formula, and maybe you're getting antibiotics - if you wipe out all these sources then you'll see big changes. When you add all those together it's a triple whammy."

Color-enhanced scanning electron micrograph of Bifidobacterium animalis, a microbe found in breast milk and in the gut microbiome. Credit... SCIMAT/Science Source

A recent series of studies has cast light on a particularly beneficial type of microbe, called bifidobacteria. Groundbreaking work published in 2012 by Omry Koren, who runs the Microbiome Research Lab at Bar-Ilan University in Israel, showed that the microbiome evolves during pregnancy. Over time, it becomes similar to a state that resembles inflammation and metabolic syndrome - a condition associated with heart disease, stroke and type 2 diabetes. In April, Dr. Koren's team showed that, late in pregnancy, bifidobacteria sense a gestational hormone called progesterone and proliferate in response, as if preparing for the breast-feeding phase.

"We actually think there is a sort of evolutionary mechanism here, which basically causes bifidobacterium to grow faster," Dr. Koren said. "The fact that bacteria can sense human hormones and react to those hormones, I think that's pretty fascinating."

Bifidobacteria consume special sugars found in breast milk, called human milk oligosaccharides, that babies cannot otherwise digest. As a result, these bacteria are abundant in the guts of breast-fed infants but not of formula-fed babies.

Breast milk has long been known to contain human milk oligosaccharides, but the discovery that they're important for the microbiome to thrive has drawn attention to them. Cows make about 40 different oligosaccharides, and humans make more than 100, although each woman's breast milk contains a subset of that number.

A woman's breast milk also contains a unique mélange of hormones, antibodies and bacteria - a brew that presumably evolved to meet the needs of her child. "It's one of the unique things about human milk that's really hard to replicate," Dr. Azad said. "A formula is an attempt at making something that's one-size-fits-all, essentially."

Formula manufacturers keep up with the science on breast milk, and they strive to mimic the substance as closely as possible. But in the case of oligosaccharides, they may have jumped the gun: Some companies are adding one of the complex sugars, called 2FL, to their products (and are testing many others). However, about 20 percent of women don't produce 2FL in their breast milk. If one of these women gives her baby a formula that contains 2FL, the baby receives a sugar that it would not have received naturally, Dr. Azad said: "And is that a good thing? Is that a bad thing? We don't really know yet."

Adding just one sugar also may not provide much benefit. Research suggests that only about 10 of the sugars seem to be particularly important for a baby's health - but only when consumed in combination.

"What is the function of those components if they're isolated and not all in combination with each other?" said Dr. Andrew Bremer, a pediatric researcher at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, in Bethesda, Md. "Just adding one to a predefined formula, is that comparable to breast milk? Or, heaven forbid, is it deleterious?"

Breast milk that is pumped and delivered by bottle is generally better than formula, Dr. Azad said. But she had some additional news that some working mothers may find unsettling: Pumped breast milk may not deliver the benefits of the sugars that arrive in breast milk straight from the source.

Dr. Azad and her colleagues studied 393 Canadian mother-infant pairs and found that pumped breast milk seems to be richer in some harmful bacteria, and has few bifidobacteria. Many variables can affect the quality of pumped breast milk, including the type of pump, how the milk is stored and the cleanliness of the bottles and nipples. Dr. Azad's work suggests that direct contact between the mother's breast and the baby's mouth is important: When a baby nurses, some denizens of its oral microbiome may traverse back into the mother's breast.

In other words, the benefits of breast-feeding may derive from myriad factors, including the many microbiomes in the mother's body - in the breast milk and on the skin of the breast - and in the baby's mouth and gut.

"I don't want the message to be that expressed human milk is bad," Dr. Bremer said. "It's that there are other factors involved. When you disrupt that experience of baby sucking on the mom's breast, what do you lose? Or what's gained by that process? The science is more ripe now to start delving into those questions."

Doctors should also exercise caution when prescribing antibiotics to babies or to lactating mothers, he said. There is robust evidence that antibiotics can have a powerful negative effect on the microbiome, shifting the balance toward harmful bacteria.

For some women and babies, forgoing antibiotics is not an option. As many as one in four pregnant women are infected with group B strep bacteria, and may need intravenous antibiotics during labor to lower the risk of infecting their babies. Those women are encouraged to minimize the effects on the microbiome by several means, including vaginal delivery, exclusively breast-feeding, providing abundant skin-on-skin contact with the baby, and avoiding giving the infant scented baths, which can disrupt its microbiome.

"Those things, then, really, overwhelmingly promote a beautiful growth of healthy bacteria both on the skin of the baby and in the gut," said Sara Edwards, a researcher at Emory University's Nell Hodgson Woodruff School of Nursing.

Dr. Edwards and her colleagues are following nearly 600 pregnant women to track relationships between their antibiotic use at different stages of gestation and the long-term effects on mother and baby. No definitive patterns have emerged yet, but the changes in the mothers seem to be short-lived.

"It looks as if the body does a pretty good job," Dr. Edwards said. "Especially among people who are healthy and don't have other comorbidities and other immune issues - that there is a correction that occurs once the antibiotics are over."

Women also should exercise, avoid stress and eat foods that either contain or nourish good bacteria, including yogurt, kefir, kombucha and sauerkraut, she added.

"Things that promote wellness in the mother also produce the richest, healthiest type of diet for the babies' milk," Dr. Edwards said.

Here again, breast-feeding seems to be what's most helpful. But women who have trouble breast-feeding shouldn't despair, Dr. Azad said.

"One thing that's pretty clear is that there's a dose response, meaning that every bit counts," she said. "So even if you can't do six months of breast-feeding, if you can do partial breast-feeding, or if you can do one month, or one week, that's definitely better than none."

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Breast Milk Is Teeming With Bacteria - That's Good for the Baby (Published 2019)

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Breast-fed milk may nourish a baby's microbiome in ways that bottled breast milk can't. In the earliest days after birth, millions of bacteria make their home in a baby's body - in the skin, mouth and especially the gut.

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It's full of nutrients that feed and protect your baby, but did you know breast milk composition varies over time? Find out what's in breast milk and how it changes to meet your baby's needs

What's breast milk made of?

Here are some of the other constituents of human milk present at every feed, many of which can't be replicated:

Millions of live cells. These include immune-boosting white blood cells, as well as stem cells, which may help organs develop and

More than 1,000 that help your baby grow and develop, activate her immune system, and develop and protect neurons in her brain.

All that breast milk protein is made up of amino acids. There are more than 20 of these compounds in your milk. Some of them, called nucleotides, increase at night and scientists think they may induce

Over 200complex sugars called that act as prebiotics, feeding 'good bacteria' in your baby's gut. They also prevent infections entering her bloodstream and lower her risk of brain inflammation.

More than 40 Enzymes are catalysts that speed up chemical reactions in the body. The ones in your milk have jobs such as aiding your baby's digestion and immune system, as well as helping her absorb iron.

Growth factors that support healthy These affect many parts of your baby's body, including her intestines, blood vessels, nervous system, and her glands, which secrete hormones.

On the subject of hormones, your breast milk contains lots of These clever chemicals send messages between tissues and organs to ensure they work properly.Some helpregulate your baby's appetite and sleep patterns, and even aid the bond between you.

Vitamins and minerals -nutrientsthat support healthy growth and organ function, as well as help build your baby's teeth and

Antibodies, also known as immunoglobulins. There are five basic forms of antibodies and all of them can be found in your They protect your baby against illnesses and infections by neutralising bacteria and viruses.

You may have heard of long-chain fatty acids because they play a pivotal partin building your baby's nervous system, as well as aid healthy brain and eye And, you've guessed it, there are several of these in your milk too!

1,400 microRNAs, which are thought to regulate gene expression, as well as help prevent or halt disease development, support your baby's immune system, and play a role in remodelling the

While this is a long list, it's only some of the ingredients in your breast milk - and scientists are still discovering more. Remarkably, the levels of these ingredients can fluctuate over time, depending on your baby's age and needs.

Let's start at the beginning...

The first few days: Colostrum

The early milk your breasts produce after your baby's birth is called colostrum. This thick, sticky breast milk is often called 'liquid gold', not just because of its yellow or orangey colour, but because it's so important for nourishing and protecting your vulnerable newborn.

The composition of colostrum

Colostrum has the same ingredients that your later milk will have - it's just that the amounts of these ingredients are different, as it's tailored to your newborn's needs.

For example, colostrum is sometimes referred to as a natural vaccination because its levels of antibodies and white blood cells are so high. Your first milk needs to contain these so it can protect your baby from infections and diseases after she leaves the safety of your womb.

Colostrum's protective qualities are also important for your baby's digestive system. Babies are born with a permeable gut lining, which colostrum coats and This is particularly important if your baby is premature, as she'll be more at risk from the dangerous gut condition necrotising enterocolitis

It's also rich in minerals and vitamins, with higher concentrations of vitamins A, E and K than mature breast milk. The percentage of protein in colostrum is higher Colostrum also acts like a laxative that helps your baby pass her first poo,

The next couple of weeks: Transitional milk

From day five to 14, your milk is called As the name suggests, it's changing from colostrum to mature milk. It becomes creamier in colour and texture, and also higher in fat, calories and lactose (a natural sugar), making it the ideal food for your rapidly growing newborn.

Four weeks onwards: Mature milk

From four weeks, the nutritional content and levels of ingredients in mature milk generally remain fairly consistent. But the composition of your breast milk can still change from day to day and feed to feed.

What are foremilk and hindmilk?

Breast milk composition after six months

You may be wondering what happens to your milk if you continue breastfeeding long-term. Can your body really keep producing such high-quality mature milk for months and months, or even years? The answer is, don't underestimate your breasts!

So relax in the knowledge that you can both continue to enjoy the benefits of breastfeeding for many months to come.

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Breast milk composition: What's in your breast milk?

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It's full of nutrients that feed and protect your baby, but did you know breast milk composition varies over time? Find out what's in breast milk and how it changes to meet your baby's needs Here are some of the other constituents of human milk present at every feed, many of which can't be replicated: Millions of live cells.

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Have you heard of the term "Liquid Gold"? No, I'm not talking about Velveeta. (Eww!) I'm also not talking about bone broth (although you could argue that it's liquid gold too). Or even my Golden Milk recipe.

What I'm talking about is colostrum, baby's very first food. This special breast milk is far superior to any superfood we may find in an Amazon jungle, and in this post, I'll explain why.

What is Colostrum?

Maybe you've never heard of colostrum, or maybe you're not quite sure what it is. Colostrum doesn't get the same attention that breast milk does, but it really should-it's truly the rockstar! This precursor to breast milk and is stored and expelled in and through the breast.

It's light yellow, gold, or sometimes clear in color, and is a thick, creamy liquid. And wow, is it packed with amazing properties that protect and nourish your baby in his first days of life!

"Colostrum is rich in immunologic components such as secretory IgA, lactoferrin, leukocytes, as well as developmental factors such as epidermal growth factor. Colostrum also contains relatively low concentrations of lactose, indicating its primary functions to be immunologic and trophic rather than nutritional. Levels of sodium, chloride and magnesium are higher and levels of potassium and calcium are lower in colostrum than later milk." ( source)

Colostrum is so special, in fact, that it's sold in supplement form for adults and has been prized for its health benefits by many cultures-primarily in India-for thousands of years. ( source)

When Will I Begin to Produce Colostrum?

It varies from woman to woman. Some moms start producing colostrum as early as the first trimester. More commonly, women start producing it in the third trimester. If you're later on in your pregnancy, you can squeeze your breast (or express) and watch some liquid gold emerging from your nipple.

But don't worry if you don't see any fluid yet. It's not until after the placenta is expelled that the true hormonal shift signals the breasts to begin lactating-and produce colostrum. And it makes sense, as this enables your baby to start feeding immediately after birth. ( source)

How Long Will I Produce Colostrum?

For the first 2-5 days after birth, your body will produce only colostrum, later switching over to regular breast milk. While each woman's body is different, colostrum tends to stick around closer to 5 days.

The next stage is called "transitional milk," and this lasts for 10-14 days. Transitional milk is a blend of colostrum and breast milk, which will eventually be replaced by regular (and thinner) breast milk. ( source)

I Doesn't Feel Like I'm Feeding Baby Enough!

Your breasts won't feel very full for baby's first feeding, and it may seem like your newborn isn't getting enough.

Since baby's stomach is only about the size of a marble right after birth, she really doesn't need much to fill her up and meet her nutritional needs. Plus, colostrum is super concentrated, so a little goes a long way!

Keep in mind that most moms produce only about an ouncewithin the first 24 hours. This is actually the perfect amount though, as baby only needs about 1-1.5 teaspoons of this liquid gold per feeding.

Should I Supplement?

No. Not unless you absolutely have to.

Instead of focusing on how fast baby feeds or how full your breasts feel, monitor baby's diapers and overall mood. If baby's wetting at least 6 diapers a day and seems content, you are doing well.

You also want to make sure you're nursing baby at least 8 times a day to ensure he's getting all the wonderful benefits of this special milk.

Of course, always check in with your midwife or pediatrician if you're concerned. Even better, make an appointment with a lactation consultant. Sometimes lactation consultants are better versed in knowing when it's necessary to supplement with formula vs. when it's not needed.
Be sure to make your desires known to the hospital staff as they may supplement with or without your consent.
Easier to Establish a Latch

There's always a bit of a breastfeeding learning curve for both mama and baby the first few days, even if it's not your first time at the rodeo. ( Breastfeeding gets easier, so stick with it!)

Since your body doesn't produce a lot of colostrum, the breasts aren't very full the first few days. This makes it much easier for your baby to establish a latch immediately after birth, and sets her up for good breastfeeding habits long-term. Our bodies are pretty smart, huh?!

How is Colostrum Different From Breast milk?

Colostrum is richer than breast milk and has a different nutritional profile. In regards to composition, colostrum actually has more in common with blood than it does with breast milk since it's chock-full of white blood cells and immune-boosting properties. This liquid gold is also higher in protein, and lower in sugar and fat, so it's an easy first food to digest.

Breast milk is designed to sustain your baby, build the immune system, and contribute to development long-term. Colostrum, however, is more like, "hit it hard and fast." One study even showed that it is much higher than breast milk in cell-defending antioxidants. ( source)

The Composition of Colostrum

Is Colostrum Good for My Baby?

No, colostrum isn't good for your baby-it's actually freaking fantastic for your baby! This perfect first food contains essential nutritional components that really help prime your baby for a healthy life. It's truly a unique substance, with properties that no other food has.

Make Colostrum a Priority

It's a good idea to make sure your baby gets colostrum if you can, even if you aren't planning on breastfeeding, or if you end up supplementing later. If drugs were used during labor and delivery, or if you had an epidural, this can make baby lethargic and impair immediate nursing. If your baby can't nurse right away for whatever reason, you can always express by hand and finger feed baby. The benefits are well worth it.

What Should I Do If I'm Leaking Colostrum?

A pregnant mama posted this info on my Facebook page - love it!

I am 29 weeks pregnant and have been leaking a ton of colostrum since week 16! At my last appointment my midwife suggested that I collect the colostrum (without pumping) and freeze it for when baby's born! She said she did the same thing and it helped her son out a lot when he was born with low blood sugars. Beginning my stash now!! ^_^

I never thought to save it, I'm sure others would love to do the same if they are leaking liquid gold too lol!

Also I was told that it will only last 3-4 months in a regular freezer so I wasn't advised to start saving it until the third trimester.

Colostrum Benefits

1. Seals the gut

Babies are born with a permeable gut lining, making them more susceptible to infections and diseases without the proper care. Colostrum enters the blood stream through this lining, and then helps to plug those gut holes so to speak, paving the way for breast milk to finish the job. This process helps to prevent food allergies and other leaky gut issues later in life, like asthma, allergies, ADD, eczema, and more.
According to some lactation consultants, this sealing of the gut is so important that it's better for an infant to have only colostrum in those first several days and then switch to formula for the remaining year than to supplement with formula in the first few days (even in combination with colostrum) and then switch to exclusive breastfeeding for one year and beyond.
2. Clears the digestive tract

The first bowel movement your baby has is called meconium, a thick, greenish tar-like substance. While conventional formula infamously constipates a baby, colostrum helps flush out the digestive tract and expel the meconium. This also helps to prevent jaundice, as the colostrum flushes out excess bilirubin that causes the condition.

3. Immune prep

Colostrum contains white blood cells, antibodies, and immunoglobulins that prime your baby's immune system. One of these, immunoglobulin A, is an antibody that protects against infection of the throat, lungs, and intestines.

In fact, colostrum was the go-to for immune support before the discovery of penicillin and modern antibiotics. ( source) And its pH levels encourage the growth of good bacteria.

4. Regulates bodily functions

For 9 months, your baby has been in a protective cocoon in your womb, shielded from the outside world. Once birth occurs though, it takes some time before their body is able to fully regulate itself. Colostrum helps the infant adapt by regulating body temperature, the vascular system, glucose metabolism, and lung function, and helps maintain fluid homeostasis.

This makes early breastfeeding especially important for c-section babies. And when these first feedings are done with skin-to-skin contact, your chest also regulates baby's body temperature and heartbeat better than an incubation machine. ( source)

5. Repairs the body

Colostrum is the only known natural source of two important growth factors, alpha and beta, and insulin-like growth factors 1 and 2. These unique substances not only help a baby's little body to grow properly, but it also helps repair it in times of stress or trauma. These growth factors are phenomenal at their stellar ability to grow and repair muscles, cartilage, and the skeletal system. ( source)

6. Natural immunization

Since colostrum begins to seal the gut lining in preparation for breast milk and solid foods later on, it acts as a natural immunization. This prevents germs and other unwanted substances from entering the bloodstream and causing sickness at a time when babies are most vulnerable.

Does My Diet Affect Colostrum?

We are what we eat, so the food choices we make also affect colostrum composition. A mama's diet has been shown to alter the healthy fats and vitamin content in colostrum. This study tracked fatty acid composition changes in colostrum and breastmilk, while this study found that mothers given excess amounts of vitamin A actually saw more than a 16% decrease in colostrum vitamin E levels.

It's All About Balance

All this to say, that a healthy, balanced diet that's full of healing foods like saturated animal fats and fresh produce are beneficial for both mama and baby. Healthy fats-like grass-fed butter and ghee, coconut oil, and raw milk-are important to include in your diet for optimal milk composition and to repair your body after the stress of birth.

Sometimes dairy products, even when raw and from a good source, can cause digestive issues in sensitive babies, so be mindful of this and make changes as needed.

Supermom? Yes. Yes You Are.

Our bodies are amazingly and intricately designed to support not only ourselves, but our baby's life. Colostrum is truly a liquid wonder that helps us all be supermoms!

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Colostrum: The Mind-Blowing Superfood for Your Baby | Mama Natural

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Have you heard of the term "Liquid Gold"? No, I'm not talking about Velveeta. (Eww!) I'm also not talking about bone broth (although you could argue that it's liquid gold too). Or even my Golden Milk recipe. What I'm talking about is colostrum, baby's very first food.

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What's in breastmilk:

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What's in breastmilk, from the Dispatches TV programme

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Watch the 'science bit' from Dispatches here! - HMF

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As scientific techniques advance, our understanding of human milk is becoming more detailed. The Dispatches documentary on Channel 4 in the summer of 2018 helped highlight many of the barriers women in the UK face in breastfeeding their babies, and created an amazing scene to demonstrate the complexity of human milk.

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Lancet Breastfeeding Series

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"Increasing breastfeeding to near-universal levels for infants and young children could save over 800000 children's lives a year worldwide, equivalent to 13% of all deaths in children under two, and prevent an extra 20000 deaths from breast cancer every year."

This estimate is one of the headlines in today's publication from The Lancet Breastfeeding Series Group of a major new analysis of worldwide breastfeeding levels, the benefits of breastfeeding and the implications for the economy, the environment and, of course, for health, of not doing so.

What is the evidence?

The Series draws on a large body of published and unpublished worldwide data from 28 systematic reviews and meta-analyses, of which 22 were commissioned for the Series. Where possible, separate analyses were conducted for high-income countries (HICs) and low- and middle-income countries (LMICs) and the reviews include sub-analyses which control for confounding factors.

There are two Series papers. The first is concerned with breastfeeding trends and implications for health. For young children, they investigated mortality rates; growth; dental caries; and a number of disorders including respiratory infections and diarrhoea. For older children through to adults they looked at blood pressure; overweight and obesity; type 2 diabetes; total cholesterol; and intelligence. For mothers, lactational amenorrhoea; breast and ovarian cancer; type 2 diabetes; post-partum weight change; and osteoporosis.

The second looks at determinants of breastfeeding and the effectiveness of interventions to promote it. There is also an accompanying Commentary. Here are some key findings and messages, thinking especially about its importance for the UK.

Breastfeeding trends

Breastfeeding is one of the few positive health behaviours that is more prevalent in poor than rich countries. In HICs, better-educated women breastfeed more commonly than do those in low-income groups with fewer years of formal education.

Worldwide rates of breastfeeding are low and especially in HICs, in many of which just one in five infants is still breastfed at 12 months. The UK (<1%), Ireland (2%), and Denmark (3%) have some of the lowest rates of breastfeeding at 12 months. In the UK, a National Survey (covering 2005 to 2010) indicates a breastfeeding rate of 81% for any breastfeeding, dropping to 34% at six months of age and 0.5% at a year.

Effects of breastfeeding on children

Short-term benefits of breastfeeding include reductions in infant deaths and infectious illnesses, persisting into the second year of life. There is a large protective effect for diarrhoea and respiratory infections. A meta-analysis of six high quality studies in HICs showed that ever breastfeeding was associated with a 36% reduction in sudden infant deaths. Evidence mostly from HICs suggests a protective effect against otitis media in children under two but not for older children. There was no clear evidence of a protective effect for allergic disorders and only weak evidence of a reduction in asthma.

Long-term benefits (mostly from studies in HICs) may include a reduced risk of being overweight or obese and of developing diabetes (types 1 and 2). The evidence is not as strong as for infections but the association persists when restricted to high quality studies and to particular settings. There was no evidence of protective effects for blood pressure and cholesterol. Breastfeeding was consistently associated with higher performance in intelligence tests.

The only harmful consequence of breastfeeding detected here was an increase in tooth decay in children breastfed for more than 12 months.

Effects on the mother

Breastfeeding can improve birth spacing through longer periods of amenorrhoea. Breastfeeding is associated with lower rates of breast cancer, a 6% reduction for every 12 months of breastfeeding in a woman's lifetime. It might also reduce the risk of ovarian cancer and diabetes.

Estimating lives saved

The authors estimate that the scaling up of breastfeeding from present levels to 12 months per child in HICs and two years per child in LMICs could prevent an estimated 823 000 child deaths and 20 000 breast cancer deaths every year.

What influences the uptake of breastfeeding?

I think there won't be surprises for midwives in the list of factors determining breastfeeding, which were derived from a systematic review and from conceptual frameworks. Breastfeeding practices are, of course, affected by multiple factors, historical, cultural, socioeconomic and individual, and need supportive measures at many different levels, such as legislation, employment conditions and healthcare services.

Health systems and breastfeeding

Several healthcare-related barriers to breastfeeding were reported:

Gaps in knowledge and skills to support breastfeeding at all levels of healthcare staff (reported in studies in Australia and Lithuania)

Free samples of breastmilk substitutes

Hospital practices such as mother-infant separation

High risk pregnancies, assisted delivery and long hospital stays, maternal illness and preterm, low birthweight or ill newborns, can all result in breastfeeding starting later

Effective interventions include immediate breastfeeding support at delivery

Meta-analyses of interventions in health systems, communities and homes suggest that much can be done to improve breastfeeding practices. In healthcare settings, individual counselling or group education, immediate breastfeeding support at delivery, and lactation management were all found to be effective, increasing exclusive breastfeeding by 49% and any breastfeeding by 66%.

At the level of policy, the Series points to a failure to treat breastfeeding as "a key public health approach that can help prevent communicable and non-communicable disease, reduce infant mortality, and lessen inequity." More commonly it is confined to more narrowly-defined agendas, such as nutrition.

The impact of the breastmilk substitute industry

According to Series author Professor Cesar Victora from the Federal University of Pelotas in Brazil,

"There is a widespread misconception that breastmilk can be replaced with artificial products without detrimental consequences. The evidence outlined in the Series, contributed by some of the leading experts in the field, leaves no doubt that the decision not to breastfeed has major long-term negative effects on the health, nutrition and development of children and on women's health."

The Series highlights the negative influence of breastmilk substitute (BMS) marketing, which can be aggressive and inappropriate. The International Code of Marketing of Breastmilk Substitutes and its subsequent resolutions (the Code), adopted at the 34 th World Health Assembly in 1981, is intended to offer protection from inappropriate marketing strategies used by BMS companies, but it is inadequately implemented and monitored in the UK and elsewhere. Investigations by WHO and Save The Children find that, in contravention of the Code, some BMS companies seek to influence governments and health professionals in various ways, including through event sponsorship, incentives to promote their products and links with professional bodies. Some also promote their products directly to pregnant and breastfeeding women. Conflicts of interest and conflicting political priorities undermine efforts at all levels to support women to breastfeed.

The UK milk formula market is the 11th largest in the world and growing

It's an industry that is growing, with global sales expected to reach US$70.6 billion by 2019. In HICs, growth is expected to be driven by sales of follow-on and toddlers milk, set to increase by 15% by 2019. Among HICs, only in France and the USA are sales expected to fall, as a result of legislation, public awareness campaigns and actions by civil society in support of breastfeeding. In the UK, the milk formula market is the 11 th largest in the world and growing.

This Series underlines the importance of comprehensive national laws and regulations, properly enforced and monitored, to curb inappropriate marketing in order to protect and promote breastfeeding.

Environmental and economic impact

Not breastfeeding has environmental costs, as BMS leave an ecological footprint, needing energy for manufacture, packaging materials, fuel for transport and so on. Breastfeeding is important in terms of environmental sustainability and food security.

The Series includes economic modeling to indicate potential benefits of reduced treatment costs and of improved cognition associated with improved breastfeeding practices. Their analyses suggest that the economic benefits are likely to be substantial. The authors also say that reliable estimates of the costs and benefits of the actions needed to support breastfeeding are difficult to calculate and that more work is urgently needed.

A call to action

Six action points are proposed:

Disseminate the evidence

Foster positive societal attitudes to breastfeeding

Show political will

Regulate the breastmilk-substitute industry by better enforcement of current legislation

Scale up and monitor breastfeeding interventions and trends in breastfeeding practices

Political institutions to remove structural and societal barriers to breastfeeding

"Breastfeeding saves lives and money in all countries". Professor Victora, Lancet Series Breastfeeding Group

All 194 member states of the World Health Assembly have agreed on breastfeeding targets for 2025. The Series Group finds that these targets are realistic and could be exceeded. An important message, underpinned by the evidence presented here, is that responsibility for successful breastfeeding lies not just with the woman but with society as a whole. Scaling up interventions, policies and practices to support breastfeeding has the potential to rapidly improve uptake. Political commitment and financial investment are needed to protect, promote, and support breastfeeding at all levels-family, community, workplace, and government, say the authors.

If anyone is tempted to think that this matters less for high-income countries, Professor Victora is clear that it matters for us all:

"There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth...Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike."

New Lancet Breastfeeding Series is a call to action by Sarah Chapman is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Based on a work at www.thelancet.com/series/breastfeeding. Images are purchased from istock.com for Evidently Cochrane and are not available for reproduction.

Links:

Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC, for The Lancet Breastfeeding Series Group. Breastfeeding in the 21 st Century: epidemiology, mechanisms and lifelong effect. (Breastfeeding Series 1). Lancet 2016; 387: 475-90. Available from: www.thelancet.com/series/breastfeeding

This has been informed by the following Cochrane Reviews:

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, for The Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? (Breastfeeding Series 2). Lancet2016; 387: 491-504. Available from: www.thelancet.com/series/breastfeeding

McFadden A, Mason F, Baker J, Begin F, Dykes F, Grummer-Strawn L, Kenney-Muir N, Whitford H, Zehner E, Renfrew MJ. Spotlight on infant formula: coordinated global action needed. (Comment). Lancet 2016; 387: 413-5. Available from: www.thelancet.com/series/breastfeeding

Hansen K. Breastfeeding: a smart investment in people and economies. (Comment). Lancet 2016; 387: 416. Available from: www.thelancet.com/series/breastfeeding

Press Release:

The Lancet Press Office. The Lancet: Increasing breastfeeding worldwide could prevent over 800,000 child deaths and 20,000 deaths from breast cancer every year. [Press release]. 27 January 2016. Embargo: 23:30 [UK time] Thursday 28 January 2016. Available from: pressoffice@lancet.com

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New Lancet Breastfeeding Series is a call to action - Evidently Cochrane

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"Increasing breastfeeding to near-universal levels for infants and young children could save over 800000 children's lives a year worldwide, equivalent to 13% of all deaths in children under two, and prevent an extra 20000 deaths from breast cancer every year."

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BBC documentary on the human body, and on what's in breastmilk:

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BBC documentary on the human body, and on what's in breastmilk:

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The Human Body Secrets of Your Life Revealed S01E01 Grow (September 25, 2017)

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Over your lifetime you undergo an extraordinary change - no other animal on earth goes through such a dramatic metamorphosis. In this programme, Chris and Xand van Tulleken explore the latest understanding of how we all grow.

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If you would like to hear about the research into the remarkable properties of breastmilk, I’d recommend watching the presentation by Prof Simon Murch of Warwick Medical School, given as part of the global launch of the Lancet’s Breastfeeding Series. Prof Murch’s talk is 16 minutes into the film : 

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If you would like to hear about the research into the remarkable properties of breastmilk, I’d recommend watching the presentation by Prof Simon Murch of Warwick Medical School, given as part of the global launch of the Lancet’s Breastfeeding Series. Prof Murch’s talk is 16 minutes into the film : 

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The Lancet Breastfeeding Series Global Launch

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Presentation by Authors:Simon Murch, Professor, University of WarwickNigel Rollins, Scientist, World Health OrganizationSpecial video presentation: Cesar Victora, Emeritus Professor, Federal University of Pelotas in Brazil Moderator:Roger Thurow, Senior Fellow, The Chicago Council on Global Affairs Speakers:Susan Desmond-Hellmann, CEO, Bill & Melinda Gates FoundationSue Horton, Professor, University of WaterlooTruong Quoc Hung, Deputy Director and Assistant to the President, Vietnam Institute for Legislative StudiesWerner Schultink, Chief of Nutrition, UNICEFKatie Taylor, Deputy Child and Maternal Survival Coordinator & Deputy Administrator for the Bureau of Global Health, USAID

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Here’s an article explaining the immunological effects of breastmilk, along with a whole host of other extraordinary characteristics: 

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Here’s an article explaining the immunological effects of breastmilk, along with a whole host of other extraordinary characteristics: 

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To produce breast milk, mothers melt their own body fat. Are you with me? We literally dissolve parts of ourselves, starting with gluteal-femoral fat, aka our butts, and turn it into liquid to feed our babies.

Before and after giving birth to my daughter 10 months ago, I was inundated with urgent directives from well-meaning, very insistent health practitioners, parenting book authors, mommy bloggers, journalists, and opinionated strangers that "breast is best." The message was clear: In order to be a good mom, I had to breast-feed.

But breast-feeding is more than being a good mom. And breast milk is much more than food: It's potent medicine and, simultaneously, a powerful medium of communication between mothers and their babies. It's astonishing. And it should be-the recipe for mother's milk is one that female bodies have been developing for 300 million years.

Breast-feeding leads to better overall health outcomes for children, which is why the World Health Organization and the American Academy of Pediatrics recommend that babies be exclusively breast-fed for a minimum of six months.

Those outcomes, though, are relative: A premature infant in the neonatal intensive-care unit or a baby growing up in a rural African village with a high rate of infectious disease and no access to clean water will benefit significantly more from breast milk over artificial milk, called formula, than a healthy, full-term baby born in a modern Seattle hospital.

We're also told that breast-feeding leads to babies with higher IQs and lower rates of childhood obesity than their formula-fed counterparts. I understand why people find this appealing, but I don't plan to raise my daughter to understand intelligence in terms of a single test score, or to measure health and beauty by body mass index.

More compelling to me are the straightforward facts about breast milk: It contains all the vitamins and nutrients a baby needs in the first six months of life (breast-fed babies don't even need to drink water, milk provides all the necessary hydration), and it has many germ- and disease-fighting substances that help protect a baby from illness. Oh, also: The nutritional and immunological components of breast milk change every day, according to the specific, individual needs of a baby. Yes, that's right, and I will explain how it works in a minute. Not nearly enough information is provided by doctors, lactation counselors, or the internet about this mind-blowing characteristic of milk.

I made the choice to breast-feed around the same time I was offered a full-time job writing about food. Every morning at 7 a.m., I nurse my daughter. At the office, I pump milk two times a day. When I come home, we nurse, and then at 7 p.m., we nurse before she goes to bed. A few nights a week, I go out to dinner for work.

For six months straight, I woke up every night at 3 a.m. and pumped milk for half an hour in order keep my supply ahead of her demand. (Three a.m. is possibly the darkest, loneliest, and most quiet hour of the night, but I had the reassuring, rhythmic sound of my pale-yellow breast pump to keep me company.) For the last 10 months, there hasn't been one minute of my life when I wasn't thinking about, writing about, eating, and/or producing food.

Food points to who we are as animals-human beings with a fundamental need for nourishment, survival-but also to who we are as people: individuals with families, histories, stories, idiosyncrasies. Every day, calories, vitamins, and even clues about the culture I live in flow, drip, leak, and squirt out of my boobs, staining my clothes and making my skin sticky. And every day, I wonder what exactly goes into this miraculous substance.

"People tend to underestimate what milk is," says Katie Hinde, a biologist and associate professor at the Center for Evolution and Medicine at the School of Human Evolution & Social Change at Arizona State University. She also runs the very funny, highly informative, and deeply nerdy blog Mammals Suck... Milk!

"That's in part because you go to the store and there's an entire aisle dedicated to buying milk that is literally a homogenized, standardized food. It leads us to take mother's milk for granted."

But right now, researchers like Hinde-a mix of evolutionary biologists, dairy scientists, microbiologists, anthropologists, and food chemists-are examining milk, and the more closely they look, the more complexities they find.

Nutritionally, breast milk is a complete and perfect food, an ideal combination of proteins, fat, carbohydrates, and nutrients. Colostrum, the thick golden liquid that first comes out of a woman's breasts after giving birth (or sometimes weeks before, as many freaked-out moms-to-be will tell you) is engineered to be low in fat but high in carbohydrates and protein, making it quickly and easily digestible to newborns in urgent need of its contents. (It also has a laxative effect that helps a baby pass its momentous first poop, a terrifying black tar-like substance called meconium.)

Mature breast milk, which typically comes in a few days after a woman has given birth, is 3 to 5 percent fat and holds an impressive list of minerals and vitamins: sodium, potassium, calcium, magnesium, phosphorous, and vitamins A, C, and E. Long chain fatty acids like DHA (an omega-3) and AA (an omega-6)-both critical to brain and nervous-system development-also abound in mother's milk.

The principal carbohydrate in breast milk is lactose, which provides copious calories and energy to fuel babies' relentless round-the-clock growth. (No, new parents, you are not hallucinating-your baby did just grow out of her pajamas sometime in the middle of the night.)

Other sugars are also present, including some 150 oligosaccharides (there may be even more, scientists are really just beginning to understand them), complex chains of sugars unique to human milk. (I repeat: unique to human milk.) These oligosaccharides can't be digested by infants; they exist to feed the microbes that populate a baby's digestive system.

And speaking of microbes, there's a ton of them in breast milk. Human milk isn't sterile-it's very much alive, filled with good bacteria, much like yogurt and naturally fermented pickles and kefir, that keep our digestive systems functioning properly. So mother's milk contains not only the bacteria necessary to help a baby break down food, but the food for the bacteria themselves to thrive. A breast-feeding mother isn't keeping one organism alive-but actually hundreds of thousands of them.

Like a glass of red wine, breast milk has a straightforward color and appearance, but it possesses subtleties in flavor that reflect its terroir-the mother's body. And it turns out that like any great dish of food, mother's milk holds a variety of aromas, flavors, and textures.

The flavors of breast milk are as dynamic as a mother's diet. In the 1970s, researchers at the University of Manitoba obtained samples of breast milk from lactating women and had them evaluated by a trained panel for taste, quality of sweetness, and texture. There were variations across all samples in all categories, most notably that the milk of a woman who had recently eaten spicy food was described by tasters as being "hot" and "peppery."

The flavors of food ingested by breast-feeding mothers-kimchi, carrots, mint, blue cheese-are transmitted to their milk and, in turn, tasted by their babies.

Based on her more recent research, Julie Mennella of the Monell Chemical Senses Center in Philadelphia believes that these early breast-milk experiences help infants develop their own personal taste preferences, as well as increase their enjoyment of particular flavors.

"The types and intensity of flavors experienced in breast milk may be unique for each infant and serve to identify the culture to which the child is born," writes Mennella.

I find this thrilling. My job allows me to explore the diversity of Seattle's food scene, and my body allows my baby to discover it as well. My daughter began dabbling in solid foods at five months, and since then, much to my delight, has eagerly scarfed down pork ribs smoked by her grandfather, roasted zucchini from Local Roots Farm, lechon and bagoong at a Food & Sh*t pop-up dinner on Beacon Hill, Neah Bay king salmon at Capitol Hill's Marjorie, and deep-fried hush puppies from Jackson's Catfish Corner in Rainier Valley.

I love the idea that even before her first encounter with solid food, her taste buds had already begun telling her that she is part of a city filled with the cuisines of many nations, a household that supports local farmers, and a Filipino family with an abiding love of pork and fermented shrimp paste.

Just as exciting as the possibility that breast milk may help my daughter develop a healthy appetite in the future, though, is the reality that it is helping her live a healthier life right now, and that without my knowing it, my milk has already been adapting itself to her needs.

Breast-fed babies have lower instances of colds and viruses. When they do get sick, they are often able to recover more quickly because the mother's body produces antibodies specific to the baby's infection. This is an idea that has literally kept me up for hours at night. How exactly is my body able to write my daughter a prescription for her illness without a diagnosis?

When I ask Hinde, she pauses, looks straight through the Skype interface of her computer and directly into my eyes/soul, then says: "If I tell you, you can't unknow it. Are you sure?" (Answer: yasssssss.)

According to Hinde, when a baby suckles at its mother's breast, a vacuum is created. Within that vacuum, the infant's saliva is sucked back into the mother's nipple, where receptors in her mammary gland read its signals. This "baby spit backwash," as she delightfully describes it, contains information about the baby's immune status. Everything scientists know about physiology indicates that baby spit backwash is one of the ways that breast milk adjusts its immunological composition. If the mammary gland receptors detect the presence of pathogens, they compel the mother's body to produce antibodies to fight it, and those antibodies travel through breast milk back into the baby's body, where they target the infection.

At the same time that it is medicine, breast milk is a private conversation between mother and child. While my daughter lacks words, breast-feeding makes it possible for her to tell me exactly what she needs. The messages we are sending each other are literally made of ourselves, and they tell us about what is going on in our lives at that very moment.

Even before babies have any concept of time, breast milk helps them understand certain hours from other hours, night from day.

"Milk is so incredibly dynamic," says Hinde. "There are hormones in breast milk, and they reflect the hormones in the mother's circulation. The ones that help facilitate sleep or waking up are present in your milk. And day milk is going to have a completely different hormonal milieu than night milk."

Mother's milk informs babies of not just the present, but also the past. Returning to the maternal fat-melting thing, Hinde explains that mothers who are vegetarians in adulthood, but ate meat as teenagers, have stored fatty acids that are specific to animals. When they mobilize that fat to produce breast milk, their babies receive those nutrients.

"You have information about your whole life span that could be in your milk," says Hinde. "Milk is telling the baby about the world its mother has lived in."

But even more than the world I have lived in, I am moved by the idea that, without words, I am telling my daughter about myself, my life.

Breast milk also points to a future of exciting possibilities. Recently, researchers discovered that pluripotent stem cells, stem cells that have the ability to form any of the more than 200 different types of cells found in adult human bodies, are present in breast milk. The only other place these cells have been found is embryonic tissue.

"There are lots of ethical issues with embryonic stem cells," says Hinde. "But breast milk could become a source of stem cells that can potentially be turned into any cell in the human body. There's huge potential for regenerative medicine."

And while science is a very long way off from being able to engineer and grow replacement tissue for people with degenerative diseases, these things are being discussed because of breast milk.

"It sounds like science fiction, but these are things that are now on the table as plausible," Hinde says.

To get to that future, our society will need to place real value on breast milk. But as it stands, there are many economic, cultural, and political obstacles that stand between a baby's mouth and its mother's breast.

During the 20th century in America, feminism, aided in part by the convenience of formula, helped bring more women into the workforce. While this was a great thing for gender equality, it shifted focus away from breast milk, which meant that medical and governmental institutions turned away from it too.

"You have two generations that lost the cultural knowledge and the social capital of this information," says Hinde. "We're really grappling today with the erosion of social knowledge and social support networks that facilitate breast-feeding and information about what breast milk is."

There's a resurgence in prioritizing breast-feeding because we know for certain that it's what's best for a baby, all other things being equal.

But when is anything ever equal?

I breast-feed because I am lucky, have choices, and am physically able to. I have a supportive husband, an incredible mother who watches her granddaughter three days a week for free, and a workplace that allows me to exercise all of my breast-feeding rights as laid out by the Affordable Care Act. (For the record, mothers, you are entitled to these things: reasonable break time to express breast milk for one year after your child's birth each time you experience the need to express milk, and a place to pump, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public.)

But many women literally cannot afford to work and send their children to day care, as they can't get a job that pays enough to justify the cost. And some mothers meet with resistance when they exert their Affordable Care Act-supported rights.

We can't expect the value of breast-feeding to just trickle down to mothers in the trenches, pumping away in cramped offices and broom closets, working multiple jobs, forking over significant portions of income to day care, and, yes, tired and close to the breaking point, cursing their own desire to continue feeding their children their milk. We have to make an effort to reach all mothers, not just those actively seeking support and information.

There's much more at stake than infant health. "Breast-feeding is one of the key public-health interventions that we can actually do," says Hinde. "Because we know that a lot of our metabolism, neurobiology, and immune function are shaped in huge ways by it-and that these have lifelong influences on how our bodies function."

We know that breast-feeding can help children avoid diseases that manifest later in life, like type 2 diabetes and high cholesterol. We also know that black people are 2.2 times more likely than white people to develop type 2 diabetes, while Native Americans are 2.8 times as likely. Black and Native American people have the two lowest initiation rates of breast-feeding of all racial and ethnic groups in the United States.

Right now, we lack the societal, institutional, and cultural support structure to help mothers meet their breast-feeding goals. If we're telling women that they should breast-feed exclusively for six months, then we should give them-at minimum-the same amount, six months, of paid family leave. Seemingly everything about breast-feeding, which for the first few months easily takes up eight hours a day, is at odds with holding down full-time work.

What stories that our bodies tell each other are lost when we're forced to spend every day apart?

My daughter was born under the gray blanket of Seattle's fall, but now that she is eating solid foods, I think of her as a summer babe. She's been obsessed with Yakima nectarines and cherries, as well as the Skagit strawberries and blueberries of early summer. Her first tomato-a small, beautiful Sweet 100 plucked from our garden-was still sun-warm when she bit into it, squirting seeds and juice onto her clothing and face. She seems to like the taste of the Italian plums that our neighbor John lets us pick from his tree, purple as bruises, even more than I do.

Breast-feeding is an intense relationship, but ultimately one that lasts only a short period of time. As my daughter eats more, she breast-feeds less. We introduced her to some cow's milk the other week, and she barely seemed to notice the difference.

Last weekend, though, she developed a 101-degree fever. She was miserable, unable to sleep, and uncharacteristically disinterested in eating even the beloved blackberries we pick from the brambles a few blocks from our house. So we nursed instead.

As I held her close, her body fiery and fragile, I tried to picture her saliva entering my body, my mammary glands interpreting it, my body producing her medicine, my breasts giving some defense against what she was fighting. And while I understood that these things were happening, it didn't feel any different, just the same soft, familiar tickle of her tongue against my nipple.

From the moment my girl exited my body, I've understood that being her mother would be a lifelong process of separation, letting go. But in that moment, I pulled her closer. I leaned in, as though I might actually hear her body whispering to mine.

Hear author Angela Garbes talk about this story on this week's Blabbermouth, The Stranger 's weekly news podcast.

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The More I Learn About Breast Milk, the More Amazed I Am

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To produce breast milk, mothers melt their own body fat. Are you with me? We literally dissolve parts of ourselves, starting with gluteal-femoral fat, aka our butts, and turn it into liquid to feed our babies.

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An antibiotic developed from human breast milk could combat certain drug-resistant bacteria, British scientists have found.

Tackling antibiotic-resistant bacteria, known as superbugs, is a priority for the government. A panel set up by David Cameron forecast that they would cost 10 million lives and £700bn a year worldwide by 2050 if the problem went unchecked.

The breakthrough, by the National Physical Laboratory (NPL) and University College London, found that the minuscule fragment, less than a nanometre in width, is responsible for giving the protein its anti-microbial properties.

This is what makes breast milk so important in protecting infants from disease in their first months of life. The protein, called lactoferrin, effectively kills bacteria, fungi and even viruses on contact.

After identifying the fragment, scientists re-engineered it into a virus-like capsule that can recognise and target specific bacteria and damage them on contact, but without affecting any surrounding human cells.

Hasan Alkassem, a student who worked on the project, said: "The capsules acted as projectiles ... with bullet speed and efficiency."

The team suggested this could help the fight against antibiotic resistance by serving as "delivery vehicles" for cures. The capsules could even pave the way for treatments for previously incurable conditions such as sickle-cell disease, cystic fibrosis and Duchenne muscular dystrophy.

In an interview with the Times, Dame Sally Davies, the chief medical officer for England, said governments and experts needed to do more to tackle the antibiotics issue. "We need on average 10 new antibiotics every decade. If others do not work with us, it's not something we can sort on our own," she said. "This is a global problem. I am optimistic about this. The science is crackable. It's doable."

Colin Garner, honorary professor of pharmacology at the University of York and head of the charity Antibiotic Research UK, said the situation was too urgent to wait for international consensus. "The pipeline of new drugs had dried up and the problem was on the brink of becoming intractable, he told the Times.

"My heart sinks when I hear the term 'global initiative'. How long has it taken the world to come to a sort of consensus about climate change?" he said.

"The problem of antibiotic resistance will be at least as intractable, because each nation takes a different view of what is required."

The NPL findings are reported in the Royal Society of Chemistry journal Chemical Science.

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Breast milk protein could be used in fight against antibiotic resistance

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An antibiotic developed from human breast milk could combat certain drug-resistant bacteria, British scientists have found. Tackling antibiotic-resistant bacteria, known as superbugs, is a priority for the government. A panel set up by David Cameron forecast that they would cost 10 million lives and £700bn a year worldwide by 2050 if the problem went unchecked.

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Here’s a TED talk on breastfeeding and breastmilk: 

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Here’s a TED talk on breastfeeding and breastmilk: 

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Katie Hinde: What we don't know about mother's milk

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Breast milk grows babies' bodies, fuels neurodevelopment, provides essential immunofactors and safeguards against famine and disease -- why, then, does science know more about tomatoes than mother's milk? Katie Hinde shares insights into this complex, life-giving substance and discusses the major gaps scientific research still needs to fill so we can better understand it.

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2,187,054 views | Rob Knight • TED2014

Rob Knight is a pioneer in studying human microbes, the community of tiny single-cell organisms living inside our bodies that have a huge — and largely unexplored — role in our health. “The three pounds of microbes that you carry around with you might be more important than every single gene you carry around in your genome,” he says. Find out why.

Become a TED Member

Want to hear more great ideas like this one? Sign up for TED Membership to get exclusive access to captivating conversations, engaging events, and more!

This talk was presented at an official TED conference. TED's editors chose to feature it for you.

Rob Knight is a pioneer in studying human microbes, the community of tiny single-cell organisms living inside our bodies that have a huge — and largely unexplored — role in our health. “The three pounds of microbes that you carry around with you might be more important than every single gene you carry around in your genome,” he says. Find out why.

This talk was presented at an official TED conference. TED's editors chose to feature it for you.

About the speaker

Rob Knight explores the unseen microbial world that exists literally right under our noses -- and everywhere else on (and in) our bodies.

Learn more

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Rob Knight: How our microbes make us who we are

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Rob Knight is a pioneer in studying human microbes, the community of tiny single-cell organisms living inside our bodies that have a huge - and largely unexplored - role in our health. "The three pounds of microbes that you carry around with you might be more important than every single gene you carry around in your genome," he says.

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"Human Milk, Tailor-Made For Tiny Humans" advert

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The ad campaign was created by a collective of parents with different skills, lead by artist Claire Tchaikowski. 

We all came together for the love of helping parents and babies to breastfeed. 

The campaign has been entirely funded by team and family members giving time, skills and resources for free throughout, from the beginning in September 2014, to date.

Human Milk advert team

Founder and producer: Claire Tchaikowski, Bristol
Production Company: BURST, London
Director: Eric Trometer, London
Producer - Editor: Dana Trometer, London

Science advisors:

Natalie Shenker PhD, Imperial College London

Emma Pickett IBCLC, London, Chair of The Association of Breastfeeding Mothers UK

Laurel Wilson BS, IBCLC, CCE, CLE, Board of Directors for The United States Breastfeeding Committee, Executive Director of Lactation Programs for the Childbirth and Postpartum Professional Association USA

Olivia Bibollet-Bahena PhD, Montreal

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Here’s a good summary of the findings in the Lancet Breastfeeding Series: 

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Here’s a good summary of the findings in the Lancet Breastfeeding Series: 

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If almost every mother breastfed her children it could prevent more than 800,000 child deaths a year, yet governments are failing to promote and support breastfeeding, with rates remaining far below international targets, new research has found.

Poor government policies, lack of community support and an aggressive formula milk industry mean breastfeeding is not as widespread as it could be, according to a two-part Lancet breastfeeding series published on Thursday.

The success or failure of breastfeeding should not be seen solely as the responsibility of the woman

Dr Nigel Rollins, WHO

Children who are breastfed for longer have higher IQs, lower death rates and less risk of infection than those who are breastfed for shorter periods or not at all, the research found. Breastfeeding may also protect against diabetes and obesity later in life, while for mothers it can help with birth spacing, protect against breast cancer and may reduce the risk of ovarian cancer and type 2 diabetes.

Despite these proven benefits, however, only 37% of children aged six months and under in lower- and middle-income countries are exclusively breastfed, with women worldwide failing to receive the support they need to start, or continue, the practice.

"The success or failure of breastfeeding should not be seen solely as the responsibility of the woman," said Dr Nigel Rollins of the World Health Organisation (WHO), who co-authored the series. "Her ability to breastfeed is very much shaped by the support and the environment in which she lives. There is a broader responsibility of governments and society to support women through policies and programmes in the community."

While global data shows that nearly 80% of newborns receive breast milk, rates of exclusive breastfeeding are far below the WHO target of half of all children under six months by 2025. Women in poorer countries tend to breastfeed for longer than those in higher-income countries. Yet as income increases, the trend is away from breastfeeding towards substitute milk instead - a change that has already taken place in wealthier countries.

"In the west, when GDP per capita doubles, breastfeeding rates in children at 12 months drop by 10 percentage points," said Rollins. "Not breastfeeding is seen as the modern and sophisticated thing to do - it seems convenient, it allows women to get back to work, it's all the things you want to 'achieve'. We've seen this trajectory with developed countries and don't want it to play out a second time in low- and middle-income countries."

Campaign groups hope that the series - the most comprehensive review of breastfeeding research ever - will lead to long-lasting policy change.

"Breastfeeding is one of the most cost effective interventions for newborn health, but the support needed is too often lacking," said Brigid McConville, director of the maternal health group White Ribbon Alliance.

"Lancet's evidence will help citizen advocates push their governments to improve policies, and above all hold governments to account for their actions, making sure the policies lead to more support for new mothers and better health for their newborns."

If breastfeeding were scaled up to near universal levels, the authors found, 823,000 deaths of children under five could be prevented every year. An additional 22,000 annual deaths from breast cancer could be prevented if breastfeeding continued up to two years of age in lower- and middle-income countries, and up to 12 months in higher-income countries.

"The benefits of breastfeeding have been widely publicised yet ... it's clear that efforts are still falling far too short and the grave reality is that this is costing children's lives," said Professor Russell Viner of the Royal College of Paediatrics and Child Health.

Not breastfeeding creates a major burden on the world economy as well, costing $302bn (£210bn) globally in lost earnings, the authors found. Children who are breastfed consistently perform better in intelligence tests - in some studies by as much as seven IQ points - with higher intelligence related to higher average earnings.

Losses in poorer countries are estimated at $71bn of gross national income - with the Middle East and north Africa losing $12bn, east Asia and the Pacific $28bn, and Latin America and the Caribbean $12bn.

Governments can promote breastfeeding by raising awareness, improving maternity laws, and establishing nursing breaks and places to breastfeed in the workplace. Women who face stigma tend to stop breastfeeding earlier.

Even in countries where governments have actively encouraged breastfeeding, aggressive marketing by the formula milk industry - projected to reach $70bn by 2019 - far surpasses what governments spend to support breastfeeding.

Advertisements presenting formula milk as just as good as, if not better than, breast milk have - along with free samples - fuelled the industry in emerging markets. In Brazil, where hospitals, communities and the government all promote breastfeeding, the formula milk market is still projected to be worth $950bn within three years. The market is set to grow 7% in the Middle East and Africa, and 11% in Asia Pacific by 2019.

Promoting breast milk not only has social, medical and economic benefits, it is also environmentally friendly, the authors argue, as more than 4,000 litres of water are needed to produce a kilo of formula powder.

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Breastfeeding could prevent 800,000 child deaths, Lancet says

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If almost every mother breastfed her children it could prevent more than 800,000 child deaths a year, yet governments are failing to promote and support breastfeeding, with rates remaining far below international targets, new research has found.