Tag Archive for: A laktáció biológiája

Breast Milk as the Gold Standard for Protective Nutrients

Walker A.
J Pediatr. 2010 Feb;156(2 Suppl):S3-7.

In this introductory overview, I explore the observation that breast milk is the gold standard for protective nutrients fed to newborn infants and present clinical evidence of its strong protective effect against age-related infectious gastroenteritis.

The composition of breast milk changes according to the newborn infant’s needs for passive protection. In addition, substances in breast milk can actively stimulate development of the newborn’s host defenses to provide continued mucosal protection after breastfeeding is terminated. Later I present several specific examples of the development of intestinal host defenses due to breastfeeding. An important function of early breastfeeding is its anti-inflammatory effect on the immature, excessive inflammatory response in newborns.
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The Mucosal Immune System and Its Integration with the Mammary Glands

Per Brandtzaeg
J Pediatr. 2010 Feb;156(2 Suppl):S8-15.


Mucosal immunity reduces the need for elimination of penetrating exogenous antigens by proinflammatory systemic immunity. The adult gut mucosa contains some 80% of the body’s activated B cells—differentiated to plasmablasts and plasma cells (PCs). Most mucosal PCs produce dimeric immunoglobulin A (IgA), which, along with pentameric immunoglobulin M (IgM), can be exported by secretory epithelia expressing the polymeric immunoglobulin receptor. Immune exclusion of antigens is performed mainly by secretory IgA in cooperation with innate defenses, but, in newborns and in IgA deficiency, secretory IgM is important.

In the gut, induction and regulation of mucosal immunity occurs primarily in gut-associated lymphoid tissue—particularly the Peyer’s patches—and also in mesenteric lymph nodes.
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Characteristics and potential functions of human milk adiponectin

Newburg DS, Woo JG, Morrow AL.
J Pediatr. 2010 Feb;156(2 Suppl):S41-6.


Adiponectin is a protein hormone produced by adipose tissue, whose circulating levels are inversely related to adiposity and inflammation. Adiponectin circulates as oligomers, from the low-molecular-weight trimer to the high-molecular-weight octodecamer (18 mer). Each oligomer has distinct biological activities, which include enhancement of insulin sensitivity and metabolic control and suppression of inflammation. Adiponectin occurs in human milk at higher concentrations than leptin.

The adiponectin in human milk is almost entirely of the high-molecular-weight form, the form with the highest activity in controlling many types of metabolic processes. Human adiponectin fed to infant mice is transported across the intestinal mucosa into the serum.
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Three-dimensional ultrasound imaging of mammary ducts in lactating women: a feasibility study.

Gooding MJ, Finlay J, Shipley JA, Halliwell M, Duck FA.
J Ultrasound Med. 2010 Jan;29(1):95-103.


OBJECTIVE: The main function of the breast is to produce milk for offspring. As such, the ductal system, which carries milk from the milk-secreting glands (alveoli) to the nipple, is central to the natural function of the breast. The ductal system is also the region in which many malignancies originate and spread. In this study, we aimed to assess the feasibility of manual mapping of ductal systems from 3-dimensional (3D) ultrasound data and to evaluate the structures found with respect to conventional understanding of breast anatomy and physiology.
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Serotonin Transport and Metabolism in the Mammary Gland Modulates Secretory Activation and Involution

Aaron M. Marshall, Laurie A. Nommsen-Rivers, Laura L. Hernandez, Kathryn G. Dewey, Caroline J. Chantry, Karen A. Gregerson and Nelson D. Horseman
J Clin Endocrinol Metab. 2010 Feb;95(2):837-46.


Context: Serotonin [5-hydroxytryptamine (5-HT)] is an important local regulator of lactation homeostasis; however, the roles for the serotonin reuptake transporter and monoamine oxidase have not been known.

Objective: The aim of the study was to determine whether drugs that impact 5-HT affect human lactation physiology.

Design and Setting: We conducted laboratory studies of human and animal models and an observational study of the onset of copious milk secretion in postpartum women at a university medical center.
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Fatty Acid Profile Comparisons in Human Milk Sampled From the Same Mothers at the Sixth Week and the Sixth Month of Lactation.

Szabó E, Boehm G, Beermann C, Weyermann M, Brenner H, Rothenbacher D, Decsi T.
J Pediatr Gastroenterol Nutr. 2010 Jan 27. [Epub ahead of print]

OBJECTIVES: To compare fatty acid composition of human milk at 2 different stages of lactation and investigate the relation between trans isomeric and long-chain polyunsaturated fatty acids (LCPUFAs) in human milk at the sixth month of lactation.

SUBJECTS AND METHODS: We investigated human milk samples obtained at the sixth week and sixth month of lactation from 462 mothers who participated in a large birth cohort study. Fatty acid composition of human milk lipids was determined by high-resolution capillary gas-liquid chromatography.
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Effects of Sucking and Skin-to-Skin Contact on Maternal ACTH and Cortisol Levels During the Second Day Postpartum—Influence of Epidural Analgesia and Oxytocin in the Perinatal Period

Handlin L, Jonas W, Petersson M, Ejdebäck M, Ransjö-Arvidson AB, Nissen E, Uvnäs-Moberg K.
Breastfeed Med. 2009 Dec;4(4):207-20.


BACKGROUND AND AIMS: In this study we made a detailed analysis of the mothers’ release pattern of adrenocorticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol.

METHODS: Sixty-three primiparae were included in the study.
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Effect of Domperidone on the Composition of Preterm Human Breast Milk

Campbell-Yeo ML, Allen AC, Joseph KS, Ledwidge JM, Caddell K, Allen VM, Dooley KC.
PEDIATRICS Vol. 125 No. 1 January 2010, pp. e107-e114 (doi:10.1542/peds.2008-3441)


Objective Domperidone is increasingly prescribed to improve breast milk volume despite a lack of evidence regarding its effects on breast milk composition. We examined the effect of domperidone on the nutrient composition of breast milk.

Patients and Methods Forty-six mothers who had delivered infants at <31 weeks’ gestation, who experienced lactation failure, were randomly assigned to receive domperidone or placebo for 14 days. Protein, energy, fat, carbohydrate, sodium, calcium, and phosphate levels in breast milk were measured on days 0, 4, 7, and 14, serum prolactin levels were measured on days 0, 4, and 14, and total milk volume was recorded daily.
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Protection of the Neonate by the Innate Immune System of Developing Gut and of Human Milk

Newburg, DS.; Walker, WA.
Pediatr Res 61: 2–8, 2007


The neonatal adaptive immune system, relatively naïve to foreign antigens, requires synergy with the innate immune system to protect the intestine. Goblet cells provide mucins, Paneth cells produce antimicrobial peptides, and dendritic cells (DCs) present luminal antigens. Intracellular signaling by Toll-like receptors (TLRs) elicits chemokines and cytokines that modulate inflammation. Enteric neurons and lymphocytes provide paracrine and endocrine signaling. However, full protection requires human milk. Breast-feeding reduces enteric infection and may reduce chronic disease in later life. Although human milk contains significant secretory immunoglobulin A (sIgA), most of its protective factors are constitutively expressed.
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Retention of the Immunological Proteins of Pasteurized Human Milk in Relation to Pasteurizer Design and Practice

Czank C, Prime DK, Hartmann B, Simmer K, Hartmann PE.
Pediatr Res. 2009 Oct;66(4):374-9.


Pasteurizing donor human milk inactivates bacteria that may be of concern to the preterm infant. However, current practice for Holder Pasteurization (62.5 degrees C for 30 min) is detrimental to the bioactivity of human milk.

An experimental pasteurizer was used to determine the maximum temperature at which 90% of secretory IgA, lysozyme, and lactoferrin were retained and whether this temperature was capable of inactivating five common bacterial contaminants. The retention of these proteins was also compared using a commercially available bottle immersion or holding chamber system.
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