Human milk infants

Isaacs, C. E., Litov, R. E., and Thormar, H. (1995). Antimicrobial activity of lipids added to human milk, infant formula, and bovine milk. /. Nutr. Biochem. 6, 362-366. 

Manganese is found in much higher concentrations in infant formulas than in breast milk. In fact, soy-based formulas were shown to contain about 80 times more Mn than breast milk [11]. Also, animal protein-based formulas contained also about 30 times more Mn than human milk. Infants are not able to absorb and excrete excess Mn during their first year of life, a period of rapid development. As Mn is neurotoxic and impairs intestinal Fe absorption, it would be desirable to reduce Mn levels in infant formulas down to those found in human milk (4-8 p,g l-1). Coni et al. [12] reported that in formulas more than 25 percent of total Mn is bound to caseins. On the other hand, Mn present in soy- and in cow s milk-based formula whey is mainly associated with LMW components (< 10 kDa), as is the case with human milk whey [15, 18, 34, 72],... 

Fatty Acid Human milk (%) Infant formula... 

Iron supplementation to meet nutritional requirements can seriously limit the shelf life of milk products especially infant formulas. lipid oxidation can be controlled in iron-supplemented milk by using lactoferrin, a non-heme ironbinding glycoprotein found in human (1.4 mg/ml) and bovine milk (0.1 mg/ ml). Lactoferrin in bovine milk is 22% saturated with iron compared to 4% in mature human milk. Compared to human milk, infant formulas are more susceptible to lipid oxidation because they are supplemented with greater amounts of iron and do not contain lactoferrin. This antioxidant protein in milk has an important activity by binding prooxidant iron ions. Commercially available bovine lactoferrin, isolated from cheese whey, inhibited lipid... 

Infant formulas are liquids or reconstituted powders fed to infants and young children to serve as substitutes for human milk. Infant formulas have a special role in the diet because they are the only source of nutrients for some infants. In the United States and other industrialized countries, the vast majority of infants receive infant formula at some time during their first year of life (Hediger et al., 2000 Ryan et al., 2002) as the number of infants breastfed after birth rapidly decreases (Figure 1-1). Many infants receive formula in combination with breastfeeding. During these mixed feeding routines there are potential interactions between the components of human milk and those contained in formulas. 

Dietary recommendations for infants are based on the iron content and bioavailability of human milk. The iron in infant formula is much less bioavailable (10%) than that of human milk and is thus present in greater concentrations than that of human milk. Infants who are not breast-fed should consume iron-fortified formula. Complementary foods offered after 6 months of age can potentially meet iron needs if they have a high content of meat and ascorbic acid. This is rarely the case in developing or developed countries, and fortified infant cereals and iron drops are often introduced at this time in developed countries. In developing countries where diets are poor in bioavailable iron, iron-fortified weaning foods are not commonly consumed, and iron supplements are rarely given to infants and children. 

Donovan, S.M., Atkinson, S.A and Lonnerdal, B. 1986 Total nitrogen and non-protein nitrogen balance in preterm infants fed preterm human milk. In Jensen, R.G. and Neville, M.C., eds.. Human Lactation 2. Maternal and environmental factors. New York, Plenum Press 603-610. 

Vitamin K is a fat-soluble vitamin cofactor for the activation of factors II, VII, IX, and X in the liver. Almost all neonates are vitamin K-deficient at as a result of (1) insignificant transplacental vitamin K crossover, (2) lack of colonization of the colon by vitamin K-producing bacteria, and (3) inadequate dietary vitamin K intake (especially in breast-fed infants because human milk contains less vitamin K than infant formula or cow s milk). Vitamin K-deficiency bleeding (VKDB) refers to bleeding attributable to vitamin K deficiency within first 6 months of life. It occurs in three general time frames early (0-24 hours), classic (1-7 days), and late (2-12 weeks). Early onset occurs rarely and usually is associated with maternal ingestion of anticonvulsants, rifampin, isoniazid, and warfarin. Classic vitamin K-dependent bleeding usually results from the lack of prophylactic vitamin K administration in... 

Chan GM, Rau C, Gellermann W, and Ermakova M (2006), Retinopathy of prematurity and carotenoids in human milk fed infants, Abstract, Meeting of the American Academy of Pediatrics, Washington, D.C. 

Chao HR, Wang SL, Lee CC, Yu HY, Lu YK, Pake O (2004) Level of polychlorinated dibenzo-p-dioxins, dibenzofurans and biphenyls (PCDD/Fs, PCBs) in human milk and the input to infant body burden. Food Chem Toxicol 42(8) 1299-1308. doi 10.1016/j. fct.2004.03.008... 

AG secretion increased inspiratory amplitude in the infants more than all stimuli, but human milk. Thus, AG cues appear to carry the same general behavioural impact as milk, indicated by the intensification of respiration, but they have distinctively higher appetitive impact than milk and sebum, as attested by oro-facial responses. Interestingly, the mode of feeding, and hence the rate of previous exposure to breast-related stimuli, did not affect the infant responses to the odour of AG secretion. 

A model describing transfer of -hexane via lactation from a mother to a nursing infant is also available (Fisher et al. 1997). Human milk/blood partition coefficients for 19 volatile organic chemicals including u-hexane were experimentally determined using samples from volunteers. These parameters were used to estimate the amount of w-hcxanc an infant would ingest from milk if the mother was occupationally exposed to w-hcxanc at the Threshold Limit Value (TLV) throughout a workday. 

Several studies have been conducted on calcium-fat interactions in human infants (64-70). Low synthesis of bile salts and low pancreatic lipase activity may be responsible for poorer fat utilization in infants than in adults (63,71). Fat from infant formulas may be lower than that from human milk because of the lack of a bile-stimulated lipase in the former (72). In infants, fat absorption tends to decrease with increase in fatty acid length, with lower degree of saturation, and with increase of total fat (3). Triglyceride structure may also influence fat absorption in the infant and, thus, indirectly, might also affect calcium absorption in the infant. 

Kanja LW, Skaare JU, Ojwang SBO, et al. 1992. A comparison of organochlorine pesticide residues in maternal adipose tissue, maternal blood, cord blood, and human milk from mother/infant pairs. Arch Environ Contain Toxicol 22 21-24. 

Morrow, A. L., Ruiz-Palados, G. M., Jiang, X., and Newburg, D. S. (2005). Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. /. Nutr. 135,1304—1307. 

In the human studies described below, levels of organochlorine pesticides were measured in various tissues of adults at autopsy in stillborn infants and newborns at autopsy and in body fat, human milk, and serum. With the exception of one study (Stehr-Green et al. 1986), all of the studies are limited by the unknown exposure history of the individuals. 

Human milk is rich in essential fatty acids of both the omega-3 and omega-6 families. This suggests that the activity of the A -desaturase may be too low in the infant to provide a sufficient amount of these fatty acids for development of tissues, particularly the brain and retina. It has been shown that development of visual acuity in infants is dependent upon the presence of docosahexaenoic acid in mother s milk. Hence, it is recommended that breastfeeding should be carried out for as long as 12 months after birth. These fatty acids are now added to commercial infant feeds (Chapter 15, Table 15.8). 

Shi ZX, Wu YN, Li JG, Zhao YE, Eeng JE (2009) Dietary exposure assessment of Chinese adults and nursing infants to tetrabromobisphenol-A and hexabromocyclododecanes occurrence measurements in foods and human milk. Environ Sci Technol 43 4314 319... 

There is no information on in utero developmental effects in humans exposed to HCB, but oral exposure of young children has caused small or atrophied hands, short stature, pinched facies, osteoporosis of the carpal, metacarpal, and phalangeal bones, and painless arthritic changes. HCB has been demonstrated to cross the placenta in humans and in rodents. HCB residues have been detected in human milk and adipose tissue and in the blood of the umbilical cord of newborn infants and their mothers. Teratogenic effects were not... 

Lactation It is not known whether ganciclovir or valganciclovir is excreted in human milk. Because of potential for serious adverse events in nursing infants, mothers should be instructed not to breastfeed if they are receiving valganciclovir tablets. In addition, the Centers for Disease Control and Prevention recommend that HIV-infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV. 

Capsules/Tablets/Oral solution - It is not known whether ribavirin is excreted in human milk. Because of the potential for serious adverse reactions from the drug in nursing infants, a decision should be made whether to discontinue nursing or to delay or discontinue ribavirin. 

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