OBJECTIVE. We aimed to provide information that can be used as a guide to clinicians when advising breastfeeding mothers on normal lactation with regard to the frequency and volume of breastfeedings and the fat content of breast milk.METHODS. Mothers (71) of infants who were 1 to 6 months of age and exclusively breastfeeding on demand test-weighed their infants before and after every breastfeeding from each breast for 24 to 26 hours and collected small milk samples from each breast each time the infant was weighed.RESULTS. Infants breastfed 11 Ϯ 3 times in 24 hours (range: 6 -18), and a breastfeeding was 76.0 Ϯ 12.6 g (range: 0 -240 g), which was 67.3 Ϯ 7.8% (range: 0 -100%) of the volume of milk that was available in the breast at the beginning of the breastfeeding. Left and right breasts rarely produced the same volume of milk. The volume of milk consumed by the infant at each breastfeeding depended on whether the breast that was being suckled was the more or less productive breast, whether the breastfeeding was unpaired, or whether it was the first or second breast of paired breastfeedings; the time of day; and whether the infant breastfed during the night or not. Night breastfeedings were common and made an important contribution to the total milk intake. The fat content of the milk was 41.1 Ϯ 7.8 g/L (range: 22.3-61.6 g/L) and was independent of breastfeeding frequency. There was no relationship between the number of breastfeedings per day and the 24-hour milk production of the mothers.CONCLUSIONS. Breastfed infants should be encouraged to feed on demand, day and night, rather than conform to an average that may not be appropriate for the mother-infant dyad. REASTFEEDING MOTHERS SHOULD be made aware of the variability of milk volumes per breastfeeding, the frequencies of breastfeedings, and the distribution of milk intake by day and by night of healthy breastfed infants. 1 Mothers among the !Kung hunter-gatherers have been observed to breastfeed 4 times every hour during the day and at least once at night. 2 In contrast, Cadogan,3 in his essay to the Governors of the Foundling Hospital (London, United Kingdom) in 1748 recommended that infants be suckled only 4 times a day and not at night, because he considered the night feeding to result in breastfed infants' becoming "over fat and bloated." Relaxation of the concept of scheduled breastfeeding was first strongly promoted by Wickes 4 in 1953 and subsequently advocated by community support groups such as La Leche League and the Australian Breastfeeding Association that were at the vanguard of the movement back to breastfeeding in the early 1970s in Western societies. As a result, infants were breastfed more frequently both by day and by night. It now is recognized that breast milk provides the optimal nutrition for infants, and current recommendations to mothers are that infants be breastfed "on demand" (according to their appetite) exclusively for the first 6 months of life. 5,6 Bangladeshi infants have been found to consume half their daily milk ...

It was concluded that 82% of preterm women had a compromised initiation of lactation, and this was not uniform in all women.

Stem cells in mammary tissue have been well characterised by using the mammary stem cell marker, cytokeratin (CK) 5 and the mature epithelial markers CK14, CK18 and CK19. As these markers have never been reported in cells from breastmilk, the aim of this study has been to determine whether mammary stem cells are present in expressed human breastmilk. Cultured cells from human breastmilk were studied by using immunofluorescent labelling and reverse transcription/polymerase chain reaction (RT-PCR). We found a heterogeneous population of cells with differential expression of CK5, CK14, CK18 and CK19. Further, by using the multipotent stem cell marker, nestin, we identified cells in culture that were positive only for nestin or double-positive for CK5/nestin, whereas no co-staining was observed for CK14, CK18 and CK19 with nestin. When cells isolated from breastmilk were analysed by using RT-PCR prior to culture, only nestin and CK18 were detected, thereby indicating that breastmilk contained differentiated epithelial and putative stem cells. Furthermore, fluorescence-activated cell-sorting analysis demonstrated, in breastmilk, a small side-population of cells that excluded Hoechst 33342 (a key property of multipotent stem cells). When stained for nestin, the cells in the side-population were positive, whereas those not in the side-population were negative. The presence of nestin-positive putative mammary stem cells suggests that human breastmilk is a readily available and non-invasive source of putative mammary stem cells that may be useful for research into both mammary gland biology and more general stem cell biology.

Objective: To determine the effect of the strength of applied vacuum on the flow rate and yield of breastmilk using an electric breast pump. Study Design: Twenty-one breastfeeding mothers and two expressing mothers expressed their breastmilk for 15 minutes using an electric breast pump set at their own maximum comfortable vacuum, and at one to three softer vacuums. Milk yield and flow rate were measured. Results: At the maximum comfortable vacuum (؊190.7 ؎ 8.8 mm Hg) 4.3 ؎ 0.4 milk ejections occurred during 15 minutes of expression and yielded 118.5 ؎ 11.4 mL of milk (65.5 ؎ 4.1% of the available milk). Softer vacuums yielded less milk volume (p Ͻ 0.05) and less of the available milk (p Ͻ 0.01). Milk flow rate was greater during the first milk ejection than the third or subsequent milk ejections (p Ͻ 0.001). Cream content of the milk was highest after expressing for 15 minutes using the mother's maximum comfortable vacuum. Conclusions: Use of the mother's maximum comfortable vacuum enhances milk flow rate and milk yield. The cream content of the milk at the end of the expression period was an indicator of how effectively the breast had been drained.

BackgroundMammary stem cells have been extensively studied as a system to delineate the pathogenesis and treatment of breast cancer. However, research on mammary stem cells requires tissue biopsies which limit the quantity of samples available. We have previously identified putative mammary stem cells in human breast milk, and here, we further characterised the cellular component of human breast milk.Methodology/Principal FindingsWe identified markers associated with haemopoietic, mesenchymal and neuro-epithelial lineages in the cellular component of human breast milk. We found 2.6±0.8% (mean±SEM) and 0.7±0.2% of the whole cell population (WCP) were found to be CD133+ and CD34+ respectively, 27.8±9.1% of the WCP to be positive for Stro-1 through flow-cytometry. Expressions of neuro-ectodermal stem cell markers such as nestin and cytokeratin 5 were found through reverse-transcription polymerase chain reaction (RT-PCR), and in 4.17±0.2% and 0.9±0.2% of the WCP on flow-cytometry. We also established the presence of a side-population (SP) (1.8±0.4% of WCP) as well as CD133+ cells (1.7±0.5% of the WCP). Characterisation of the sorted SP and non-SP, CD133+ and CD133- cells carried out showed enrichment of CD326 (EPCAM) in the SP cells (50.6±8.6 vs 18.1±6.0, P-value  = 0.02). However, culture in a wide range of in vitro conditions revealed the atypical behaviour of stem/progenitor cells in human breast milk; in that if they are present, they do not respond to established culture protocols of stem/progenitor cells.Conclusions/SignificanceThe identification of primitive cell types within human breast milk may provide a non-invasive source of relevant mammary cells for a wide-range of applications; even the possibility of banking one's own stem cell for every breastfeeding woman.