Biology Assignment 1 Introduction: Due to a variety of possible reasons, a mother may not be able to or want to breastfeed their child. The child will still require the nutrients that milk provides thus mother began searching for alternative solutions. Wet nursing was the first but the prospect garnered a negative image in the eyes of society at large. Stevens (2009) noted that the creation of infant formula was only possible due to advancements in other areas. Composition of Breastmilk: Breastmilk is not like most other liquids because it is alive and as such, it has a constantly changing composition. The values that will be used here are only averages taken from certain time periods after the mother has given birth.
Mammalian milk consists of variable amounts of water, triglyceride fats, a large number of carbohydrates (primarily lactose, that is, milk sugar), proteins, vitamins (A, C, and B complexes), omega-3 fatty acids, and the minerals calcium and phosphate, which are all essential nutrients. Milk contains about 750 calories per litre. Harley, John PBreast milk contains approximately 3–5% of lipids, 98% of which are triacylglycerols (fats and oils), and they comprise an essential part of young infants’ diet. The key benefits that are provided to the baby by human milk fat (HMF) relate to1.Energy: almost 50% of the energy required by the fast-growing young infant originates from fat.2.Physical protection: a layer of stored body fat protects the infant against internal injuries while it starts to explore the world and it acts as an insulant to maintain body heat.3.
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Development: HMF provides essential fatty acids required for healthy development of the brain function and visual development, it helps develop and support the immune system, and is an essential component of body tissues and many organs. Furthermore, its hydrophobic nature allows the absorption of fat-soluble vitamins (A, D, E, and K), and therefore HMF is a well-matched vehicle by which vitamins are provided to the infant. ? R.P.
Happe (2016).The first fluid produced by mothers after delivery is colostrum, which is distinct in volume, appearance and composition. Colostrum, produced in low quantities in the first few days postpartum, is rich in immunologic components 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.
As tight junction closure occurs in the mammary epithelium, the sodium to potassium ratio decreases and lactose concentration increases, indicating secretory activation and the creation of transitional milk. The timing of secretory activation (lactogenesis stage II) varies among women, but usually happens over the first few days postpartum. Delayed onset of lactogenesis is defined as onset >72 hours after delivery and appears to occur more often with preterm delivery and maternal obesity, and may be predicted by markers of metabolic healthTransitional milk shares some of the properties of colostrum but represents a period of “ramped up” milk production to support the nutritional and developmental needs of the rapidly growing infant, and typically occurs from 5 days to two weeks postpartum, after which milk is considered largely mature as described by R.P Happe (2016). By four to six weeks postpartum, human milk is considered fully mature. In contrast to the dramatic shift in composition observed in the first month of life, human milk remains relatively similar in composition, although subtle changes in milk composition do occur over the course of lactation.
Breast milk also has immunological properties and these are what make it unique. It contains a variety of antibodies, immune cells and other chemicals that ward off disease. The colostrum makes up for what it lacks in essential nutrients by, as John P (2015) writes, having higher concentrations of proteins and immunoprotective elements.
The lymphocytes breastmilk carry can also destroy foreign micro-organisms outright. This helps with protecting the child against any pathogens that may invade its gastrointestinal system ensuring that it will always be able to take milk.Table 1Macronutrient (g/dL) and energy (kcal/dL) composition of human milk from specified references Author (year), n Protein Fat Lactose Energy Mean (± 2 SD) Mean (± 2 SD) Mean (± 2 SD) Mean (± 2 SD) Term infants, 24-hour collection, mature milk Nommsen et al (1991), n=58 1.2 (0.
9, 1.5) 3.6 (2.2, 5.
0) 7.4 (7.2, 7.7) 70 (57, 83) Donor human milk samples Wojcik et al (2009), n=415 1.2 (0.7, 1.7) 3.2 (1.
2, 5.2) 7.8 (6.0, 9.6) 65 (43, 87) Michaelsen et al (1990), n=2553 a 0.
9 (0.6, 1.4) a 3.6 (1.8, 8.
9) a 7.2 (6.4, 7.6) a 67 (50,115) Representative values of mature milk, term infants Reference standard 0.
9 3.5 6.7 65 to 70 Preterm, 24-hour collection, first 8 weeks of life Bauer & Gerss (2011) Born <29 weeks, n=52 2.2 (1.3, 3.3) 4.4 (2.
6, 6.2) 7.6 (6.4, 8.8) 78 (61, 94) Born 32-33 weeks, n=20 1.
9 (1.3, 2.5) 4.8 (2.8, 6.8) 7.5 (6.5, 8.
5) 77 (64, 89) Preterm donor milk Hartmann (2012), n=47 1.4 (0.8, 1.9) 4.2 (2.
4, 5.9) 6.7 (5.5, 7.9) 70 (53, 87) 2013 Feb; 60(1): 49–74Olivia Ballard(2013) Bibliography Ballard, O. (2014).
Human Milk Composition: Nutrients and Bioactive Factors. HHS Author Manuscripts, 49-74. Dupont, C.
(2003). Protein requirements during the first year of life1,2,3,4. The American Journal of Clinical Nutrition, 1544S-1549S. Harley, J. P. (2015). Breast milk as a functional food.
In AccessScience. . Breast milk as a functional food. In AccessScience. , 1-1.
Kelishadi, R. (2012). A study on lipid content and fatty acid of breast milk and its association with mother’s diet composition. J Res Med Sci.
, 824-827. R.P. Happe, L. G. (2015). Sir.
In L. G. R.
P. Happe, A volume in Woodhead Publishing Series in Food Science, Technology and Nutrition (pp. 285–315). Wormerveer: Woodhead Publishing.
Stevens, E. (2009). A History of Infant Feeding. The Journal of Perinatal Education, 32-39.
V.H. Holsinger(1, ). R.
(1935). Milk pasteurisation and safety:. A brief history and update, 441-452.
Breastmilk provides essential nutrients necessary for the child to develop well but it also provides more to bolster the child.TABLE 3-1Unique Factors in Human Milk That Positively Affect Nutritional Status and Somatic Growth Ingredient Class of Ingredient Function Reference Amylase Enzyme Polysaccharide digestion Howell et al., 1986 Epidermal growth factor Growth factor/hormone Gastrointestinal growth/ differentiation Donovan and Odle, 1994; Dvorak et al., 2003; Howell et al., 1986 Erythropoietin Growth factor/hormone Red cell production; possible growth factor for gut and central nervous system Kling, 2002 Insulin Growth factor/hormone Anabolic hormone promotes carbohydrate, protein, and fat accretion Donovan and Odle, 1994 Insulin-like growth factor-I Growth factor/hormone Primary growth hormone of late fetal/neonatal period Donovan and Odle, 1994 Insulin-like growth factor-II Growth factor/hormone Unknown function; thought to be weak growth hormone Donovan and Odle, 1994 Lactoferrin Carrier protein Increases efficiency of iron delivery Howell et al., 1986 Lipase Enzyme Triglyceride hydrolysis Howell et al.
, 1986 Nerve growth factor Growth factor/hormone Neuronal growth/ differentiation Donovan and Odle, 1994 Proteases Enzyme Unknown if active in protein hydrolysis Howell et al., 1986 Relaxin Growth factor/hormone Regulates morphological development of the nipple Donovan and Odle, 1994 Transforming growth factor-alpha Growth factor/hormone Gastrointestinal growth Donovan and Odle, 1994; Dvorak et al., 2003 Olivia Ballard2013 History of Infant Formula: Infant formula (IF) are manufactured foods that mimic human milk, are intended to feed babies up to 1 year of age, and can safely be used to partially or completely replace breastfeeding. V.H. Holsinger (1991) states that the nineteenth century was a century filled with technological improvements ranging from the perfection of pasteurisation by Henri Nestlé through the invention of pasteurisation to the creation of rubber teats for bottles. R.
P Happe (2016) explains that this was the first key breakthrough in feeding devices and significantly reduced health issues caused by microbial contamination of feeding bottles. In 1865, the first commercial infant formula was developed. This chief advancement was the basic foundation of the present-day formula for new-born babies. Comparative chemical analyses of cow’s milk and human milk by Johann Franz Simon created the awareness that there were significant differences between the two milks; for example, in protein and carbohydrate levels and type. It gave an explanation for the fact that, despite the improvements in the hygiene standards, babies fed with diluted animal milk products, available at that time, did not grow as well as breastfed babies. This was responsible for the initiating the search for a suitable alternative to breastmilk that was chemically formulated. There weren’t many affordable alternatives to cow’s milk as condensed milk suffered from the same deficiencies as well as causing diabetes.
It was later on that evaporated milk was invented and that became the basis for what infant formula is today. The same as condensed milk according to R.P Happe (2016) but easier to store and it did not cause diabetes unlike condensed milk with its high sugar content. A man named Thomas Morgan Bosch started adding various constituents to the evaporated milk to match what breastmilk provides. This was known as ‘percentage feeding’. It was a complex process that had become routine in the development of infant formula in the twentieth century. Bosch then added oils to attempt to match the fatty acid composition of human breastmilk. Though the improvements made were substantial, it still was suboptimal when compared to breastmilk.
Around the same time a man named Justus von Liebig (1803–1873) made the first commercially accessible infant formula. It was based off of wheat and malt flour. Henri Nestlé noticed the success and produced his own version at half the price. It was also dissolved in water instead of cow’s milk like the first iteration of infant formula. Since his company was more successful and internationally recognised, he is often regarded as the “godfather” of infant formula as noted by R.P Happe (2016). Soon after, legions of imitators flooded the market. They raced to create the perfect infant formula.
Nowadays, access to breastfeeding no longer implies a matter of life and death. Later on, in 1959, the formula was fortified with iron covering another deficiency with formula. Then, 25 years later, it was fortified with taurine which is a conditionally essential amino acid. They base of infant formula was also switched from wheat and malt flour to whey protein as it more closely mimicked the chemical composition of breastmilk.Infant Formula Composition: Today’s infant formula is a multifaceted mixture of some 30 to over 50 components and hundreds, if not, thousands of different recipes exist worldwide. However, the basic composition of infant formula products is largely the same: a simple combination of five constituents: fat, protein, carbohydrates, vitamins, and minerals. Infant food is segmented into stages. Stage 1 food targets new-borns from birth up to 6 months of age, and the products are referred to as infant formula (IF).
Stage 2, or follow-on formula (FOF), is intended to be used for babies from 6 up to 12 months. The main difference between stage 1 and stage 2 formulas is that stage 2 formulas are somewhat less energy dense because babies start eating other easily digestible foods (fruits, vegetables, potatoes, bread, etc.). Figure 1Supermarkets today offer a wide variety of IFs and each one competes for nutritional superiority. They also accommodate different stages and different allergies like a child that is lactose intolerant. The ultimate goal of infant formula is to mimic breastmilk but that is difficult as its composition can change drastically depending on the time that has passed since birth and the diet of the mother. For example; during lactation changes are seen in the fatty acid profile when comparing the milk obtained just after birth (colostrum), transitional milk, and mature milk (López-López et al., 2002).
Table 3.Fatty acid composition (in wt%) and relative sn-2 of palmitic acid (in %) as determined in human breast milk fat from mothers on a Western or non-Western diet FA Name Western mean range Non-Western mean range C10:0 Capric 1.4 0.1–2.2 1.0 0.0–1.
7 C12:0 Lauric 5.7 2.0–11.8 6.
1 1.6–12.2 C14:0 Myristic 6.6 2.3–11.
7 7.2 4.3–17.7 C16:0 Palmitic 21.6 12.9–27.
5 19.6 16.1–29.8 C18:0 Stearic 6.0 3.5–10.
7 5.9 5.0–11.
0 C18:1 Oleic 31.1 23.6–55.3 27.1 21.5–39.
2 C18:2 Linoleic (LA) 11.7 5.8–27.6 18.
1 9.3–32.7 C18:3 ?-Linolenic (?-LA) 1.1 0.
3–1.9 2.1 0.2–3.
0 C20:4 Arachidonic (ARA) 0.4 0.1–0.9 0.9 0.
3–1.12 C20:5 Eicosapentaenoic (EPA) 0.1 0.0–0.
7 0.5 0.0–1.07 C22:6 Docosahexaenoic (DHA) 0.5 0.0–1.0 0.
9 0.0–2.7 sn-2 (fraction of C16:0 esterified in the sn-2 position) 59–88 Comparison: The principal dietary carbohydrates available to humans are glucose and fructose (which are simple sugars), sucrose and lactose (which are disaccharides), and glycogen and starch (which are polysaccharides).
Lactose is the carbohydrate constituent of milk, notes Doudoroff, Michael (2013), and hence one of the primary sources of food during infancy. The disaccharides and polysaccharides that cannot be absorbed directly from the intestine are first digested and hydrolysed by enzymes (glycosidases) secreted into the alimentary canal. This process is aided by the enzymes that breastmilk provides. – The protein content of formulas was a consideration from about 1935 onward. Early estimates of human-milk protein levels were higher than is now known, and it was believed that cow-milk protein was far inferior to human-milk protein as remarked by Christopher Dupont. Formulas thus included high levels of protein (3.
3–4.0 g/100 kcal). In the 1960s renal solute load began to be considered in the design of infant formulas, although infant formula regulations permit higher loads than are currently recommended by expert panels (no greater than 30 mosm/100 kcal) (Fomon, 2001). These values are still significantly greater than what is given by breastmilk as seen in Table 1.
Nucleotides were added to formulas with both compositional and efficacy claims in the late 1990s. They may act as growth factors and may have immunomodulating effects on immune defences however this pales in comparison to what breastmilk does for the immune system as shown below.TABLE 3-2Unique Factors in Human Milk with Anti-Infective or Immunological Properties Ingredient Class of Ingredient Function Reference Antiproteases (e.g., secretary immunoglobulin A and trypsin inhibitor) Enzyme Inhibits breakdown of anti-infective immunoglobulins and enzymes Howell et al., 1986; IOM, 1991 Arylsulfatase Enzyme Degrades leukotrienes Hanson et al., 1988 Catalase Enzyme Degrades hydrogen peroxide; protects against bacterial breeches of intestinal barrier Lindmark-Mansson and Akesson, 2000 Fibronectin Opsonin May present debris to macrophages IOM, 1991; Mestecky et al., 1990 Free fatty acids Lipids Antiviral (coronavirus); antiparasitic (Giardia, Entamoeba) Mestecky et al.
, 1990 Granulocyte-colony stimulating factor Cytokine Causes endothelial cell migration and proliferation Wallace et al., 1997 Hemagglutinin inhibitor Opsonin Prevents bacterial adherence Neeser et al., 1988 Histaminase Enzyme Degrades histamine Hanson et al.,1988 Immunoglobulin G Immunoglobin Immune protection Howell et al., 1986; IOM, 1991 Interleukin-1-beta Cytokine Activates T-cells Mestecky et al., 1990 Interleukin-6 Cytokine Enhances immunoglobulin A and C-reactive protein production Mestecky et al., 1990 Interleukin-8 Cytokine Chemotaxis Maheshwari et al., 2002 Interleukin-10 Cytokine Decreases inflammatory cytokine synthesis Goldman et al.
, 1996 Lactadherin Protein Prevents rotavirus binding Peterson et al., 2001 Lactoferrin Carrier Anti-infective; may prevent iron from being bioavailable to microbes Howell et al., 1986; IOM, 1991 Leukocytes Live cell Cytokine production by T-cells; direct in vivo roles of B-cells, macrophages, and neutrophils IOM, 1991; Mestecky et al., 1990 Lipases Enzyme Releases bacteriostatic and bacteriocidal free fatty acids Howell et al.
, 1986; IOM, 1991 Lysozyme Enzyme Bactericidal Howell et al., 1986; IOM, 1991 Macrophage colony stimulating factor Cytokine Macrophage proliferation Goldman et al., 1986 Mucin Protein Inhibits E. coli binding to gut epithelium Peterson et al.
, 2001 Oligosaccharides, polysaccharides, gangliosides Carbohydrates, glycoconjugates Receptor analogs block binding of enteric bacteria; growth promoters for Lactobacillus Coppa et al., 1999; IOM, 1991; Rivero-Urgell and Santamaria-Orleans, 2001 Peroxidases Enzyme Bactericidal Howell et al., 1986; IOM, 1991 Platelet activating acetyl hydrolase factor Enzyme Catabolizes platelet activator factor Furukawa et al., 1993 Prostaglandin E2, F2-alpha Prostaglandin Intestinal cytoprotection Howell et al., 1986 Ribonuclease Enzyme Prevents viral replication Nevinsky and Buneva, 2002 Secretory immunoglobulin A Immunoglobulin Immune protection (broad spectrum antiviral, antibacterial, antiparasitic) Howell et al., 1986; IOM, 1991 Soluble intracellular adhesion molecule-1 Cytokine Alters adhesion of viral or other molecules to intestinal epithelium Xyni et al., 2000 Transforming growth factor-beta Cytokine Produces immunoglobulin A and activates B-cells Bottcher et al., 2000 Tumor necrosis factor-alpha Cytokine Mobilizes amino acids Mestecky et al.
, 1990 Uric acid Small molecular-weight nitrogenous compound Antioxidant Van Zoeren-Grobben et al., 1994 We have come to the conclusion that infant formula is somewhat useful and a more than suitable alternative to breastmilk. It provides the necessary nutrients when it comes to fatty acids, oils, proteins and carbohydrates required by the child at different stages of infancy. With all this being said, we still believe that breastmilk is the superior option if available as it provides all the necessary nutrients, in the right amounts, as well as several other important constituents that IF cannot. HMF’s greatest advantage over IF is it immunological properties sheltering the vulnerable child from disease that may affect its ability to ingest nutrients. HMF also provides hormones that speed up growth. All these factors combined result in HMF being the optimal source of nutrition for infants.
It is worth noting that although, as highlighted by Roya Kelishadi (2012), the diet of the mother may not always provide enough nutrients, supplementing the milk with a change in diet to foods that promote healthier milk can remedy this. Bibliography Ballard, O. (2014). Human Milk Composition: Nutrients and Bioactive Factors.
HHS Author Manuscripts, 49-74. Dupont, C. (2003). Protein requirements during the first year of life1,2,3,4. The American Journal of Clinical Nutrition, 1544S-1549S. Harley, J. P. (2015).
Breast milk as a functional food. In AccessScience. . Breast milk as a functional food. In AccessScience. , 1-1. Kelishadi, R. (2012).
A study on lipid content and fatty acid of breast milk and its association with mother’s diet composition. J Res Med Sci., 824-827. R.P. Happe, L.
G. (2015). Sir.
In L. G. R.P.
Happe, A volume in Woodhead Publishing Series in Food Science, Technology and Nutrition (pp. 285–315). Wormerveer: Woodhead Publishing.
Stevens, E. (2009). A History of Infant Feeding. The Journal of Perinatal Education, 32-39. V.H.
Holsinger(1, ). R. (1935). Milk pasteurisation and safety: A brief history and update, 441-452.