Breast milk, microbiota, and intestinal immune homeostasis

Walker, W. Allan; Iyengar, Rajashri Shuba

doi:10.1038/pr.2014.160

Cited by 258 publications

(194 citation statements)

References 83 publications

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“…Breast-fed infants experience fewer and shorter infections, exhibit different growth patterns, have different gut microflora, show better cognitive development and even face differences in the risk of chronic diseases, such as obesity, type 1 and type 2 diabetes and cardiovascular disease. Breastfeeding also appears to be protective against sudden infant death syndrome, the risk of diarrhea, respiratory infections, and malocclusion, but does not seem to provide a protection towards either eczema or food allergy [94,95]. Breastfeeding outcomes are also related to mother genotype, phenotype, diet, disease, and lifestyle [90].…”

Section: Breastfeeding and Associated Outcomesmentioning

confidence: 99%

Physiology of milk secretion

Truchet

Honvo-Houeto

2017

Best Practice & Research Clinical Endocrinology & Metab

100

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Section: Breastfeeding and Associated Outcomesmentioning

confidence: 99%

Physiology of milk secretion

Truchet

Honvo-Houeto

2017

Best Practice & Research Clinical Endocrinology & Metab

100

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“…It has been very well documented in the literature that breast milk for newborn's nutrition is the best source, in terms of nutritional characteristics and health beneficial properties [1][2][3][4]. It has balanced nutrients such as fats, carbohydrates, proteins, and other important dietary components and therefore it contributes to infant growth, immunity, and development [5].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Aflatoxin M1 and Heavy Metal Levels in Mothers Breast Milk in Famagusta, Cyprus

Kunter

Hürer

Gülcan

et al. 2016

Biol Trace Elem Res

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Breast milk contributes towards optimal nutrition for infants. However, studies showed that it can also contain different toxins and heavy metals, which reduce its health benefits. The aim of this study is to determine the level of contaminants such as aflatoxin M1 (AFM1), Pb, Cd, As, and Hg in breast milk samples from Famagusta, Cyprus. Correlations between moldy food consumption, smoking habits of the mothers, and contaminant levels in breast milk were also investigated. Breast milk samples from 50 lactating mothers in rural and urban areas of Famagusta District were analyzed for AFM1 by ELISA. Eighty percent of them were found to be contaminated with AFM1 with the mean measurement of 7.84 ± 1.72 ng/l. Socio-demographic status, moldy food consumption habits, and smoking status do not have any effect on the AFM1 levels observed in breast milk. Heavy metal levels in breast milk were examined by inductively coupled plasma mass spectrometry, and the mean measurements were1.19 ± 1.53 ppm for Pb, 0.73 ± 0.58 ppm for As, 0 ± 0.20 ppm for Hg, and 0.45 ± 0.23 ppm for Cd. This study indicates that the levels of these contaminants in breast milk samples obtained in Famagusta District are well within the acceptable levels. However, the presence of AFM1 and heavy metals still may pose risks for infant health.

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“…Breastmilk is known to confer immunological benefits to infants that are especially important for preterm infants, 23 and breastmilk intake is likely to have been lower among infants in the 4 month group, as discussed earlier. Besides, the role of dietary exposures in shaping both short and long term immune function in infants might also be a factor 24, 25. Little difference in growth patterns between the two groups with little catch up growth in either group might explain similar body composition and similar markers of metabolic syndrome between the groups.…”

Section: Discussionmentioning

confidence: 99%

Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial

Gupta

Agarwal

Aggarwal

et al. 2017

The Lancet Global Health

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SummaryBackgroundEvidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation.MethodsIn this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India. Eligible infants were tracked from birth and randomly assigned (1:1) at 4 months corrected age to receive complementary feeding at 4 months corrected age (4 month group), or continuation of milk feeding and initiation of complementary feeding at 6 months corrected age (6 month group), using computer generated randomisation schedule of variable block size, stratified by gestation (30 weeks or less, and 31–33 weeks). Iron supplementation was provided as standard. Participants and the implementation team could not be masked to group assignment, but outcome assessors were masked. Primary outcome was weight for age Z-score at 12 months corrected age (WAZ12) based on WHO Multicentre Growth Reference Study growth standards. Analyses were by intention to treat. The trial is registered with Clinical Trials Registry of India, number CTRI/2012/11/003149.FindingsBetween March 20, 2013, and April 24, 2015, 403 infants were randomly assigned: 206 to receive complementary feeding from 4 months and 197 to receive complementary feeding from 6 months. 22 infants in the 4 month group (four deaths, two withdrawals, 16 lost to follow-up) and eight infants in the 6 month group (two deaths, six lost to follow-up) were excluded from analysis of primary outcome. There was no difference in WAZ12 between two groups: −1·6 (SD 1·2) in the 4 month group versus −1·6 (SD 1·3) in the 6 month group (mean difference 0·005, 95% CI −0·24 to 0·25; p=0·965). There were more hospital admissions in the 4 month group compared with the 6 month group: 2·5 episodes per 100 infant-months in the 4 month group versus 1·4 episodes per 100 infant-months in the 6 month group (incidence rate ratio 1·8, 95% CI 1·0–3·1, p=0·03). 34 (18%) of 188 infants in the 4 month group required hospital admission, compared with 18 (9%) of 192 infants in the 6 month group.InterpretationAlthough there was no evidence of effect for the primary endpoint of WAZ12, the higher rate of hospital admission in the 4 month group suggests a recommendation to initiate complementary feeding at 6 months over 4 months of corrected age in infants less than 34 weeks of gestation.FundingIndian Council of Medical Research supported the study until Nov 14, 2015. Subsequently, Shuchita Gupta's salary was supported for 2 months by an institute fellowship from All India Institute Of Medical Sciences, and a grant by Wellcome Trust thereafter.

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Breast milk, microbiota, and intestinal immune homeostasis

Cited by 258 publications

References 83 publications

Physiology of milk secretion

Physiology of milk secretion

Assessment of Aflatoxin M1 and Heavy Metal Levels in Mothers Breast Milk in Famagusta, Cyprus

Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial

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