Generally, breastmilk is the perfect first food for the infant, due not only to its optimal nutritional profile including probiotic bacteria, but also to naturally occurring immunological components – which together support healthy growth and development, and support for a healthy immune system. In fact, human milk is well known to contain immune promoting compounds, including immunoglobulins, growth factors that promote gastrointestinal and immune system maturation, and other components that have antimicrobial activity.
Due to the overwhelming evidence supporting health benefits associated with breastfeeding, encouraging the initiation and continuation of breastfeeding should be a fundamental objective of healthcare professionals.
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Generally, breastmilk is ideal for infants, and the composition changes to meet the infant’s growing nutritional demands. The first milk, called
colostrum, is present in small amounts for approximately the first 3 days after birth to match the small size of the infant’s gut. Mothers should be encouraged to breastfeed at least 8 to 12 times per 24 hours so baby receives this valuable milk. Colostrum is designed to meet a newborn’s special needs – and is high in protein and low in fat and sugars. In fact, the protein content is 3 times higher than mature milk, because it is rich in the mother’s immunological components – helping to support the infant’s developing immune system.
Transitional milk comes in approximately two to five days after birth. Transitional milk has high levels of fat, lactose and water-soluble vitamins, and contains more calories than colostrum. Transitional milk gradually changes to
mature milk by about two weeks after birth. Mature milk is produced in the same volume as transitional milk but is thinner and more watery. Mature milk has further changes in nutrient composition to meet the infant’s needs.
Breastfeeding is a continuous biological process. With every breastfeeding, the first milk delivered is called
foremilk. Foremilk is characterized by a more watery appearance and lower fat and higher carbohydrate content relative to the creamier milk that follows. After several minutes of nursing, the creamier
hindmilk is released. Hindmilk has the highest concentration of fat and is higher in protein and calories – helping baby feel satisfied and gain weight.
While the protective effects of breastfeeding against allergic disease in general are not yet completely confirmed, evidence supports the role of breastfeeding in protection against some food allergies as well as atopic conditions including atopic dermatitis. Breastfeeding is universally recommended by pediatric medical societies for all infants regardless of atopic heredity. In their 2008 Clinical Report, the American Academy of Pediatrics states, “There is evidence that breastfeeding for at least 4 months, compared with feeding formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood.”
Breastfeeding confers immunity, in part, by passing on microbes in breastmilk to the baby for immune protection. We know the intestinal microbiota (also known as microflora) play a critical role in the development and maturation of the infant’s immature immune system. Health-promoting bifidobacteria make up 80–90% of the intestinal microbiota of breastfed infants, derived from bifidus-promoting oligosaccharides in breastmilk, and from the naturally occurring bifidobacteria in breastmilk. Immune protective effects of bifidobacteria have been well established.
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Yoshioka H et al. Development and differences of intestinal flora in the neonatal period in breast-fed and bottle-fed infants. Pediatrics 1983;72:317–21.
Fooks LJ, Gibson GR. Probiotics as modulators of the gut flora. Br J Nutr 2002;88(Suppl 1):S39–S49.
Gueimonde M et al. Breast milk: a source of bifidobacteria for infant gut development and maturation? Neonatology 2007;92:64–6. Saavedra JM. Use of probiotics in pediatrics: rationale, mechanisms of action, and practical aspects. Nutr Clin Pract 2007;22:351–65.