Today, I was stunned to see a press release for a new breastfeeding measurement tool, the MilkSense. From a research standpoint, I will admit that any handheld device that allows me to accurately measure milk transfer and is small enough to fit in my backpack makes me excited. Those highly accurate baby scales are heavy when they have to be moved by hand at altitudes greater than >10,000 feet. But, when I see devices like this, I, the researcher, want to be the product’s intended audience. Sadly, I, and other researchers, am never the target audience. It is always mothers. And that is a huge problem. Why? Because what devices like the MilkSense and the recently discontinued Milk Screen test strips actually serve to do is not to increase maternal confidence in the capacity to produce milk, but to call into question the ability of breastfeeding to meet an infant’s needs. Human milk and human babies evolved together, and hands
Compared to most other, non-aquatic animals, we give birth to infants with relatively amounts of body fat. This has been hypothesized to explain why our infants can sustain a weight loss of 8-10% after birth while receiving immune factor rich colostrum. Infant body fat frequently increases across the first few months of life, and it is generally thought that this is in anticipation of nutritional stresses that may be associated with weaning and independent motor development (crawling, walking). However, baby fat is not all the same – babies actually have multiple different types of fat (also called adipose tissue). When it comes to BAT, BeAT, and babies, we actually know very little about the production and maintenance of BAT and BeAT (this is actually true for all ages). What can explain the differences seen in rates of BAT and BeAT decline in different infants based on the handful of studies? The answer may be BREAST MILK.
In the neonatal intensive care unit, human milk is preferred food for preterm and very preterm infants. For very premature infants (less than 30 weeks), it is well established that human milk reduces the risk of necrotizing enterocolitis (NEC), a bacterial infection of the intestines with devasting consequences, and is associated with improved growth, cognitive development, and survival compared to infants receiving formula. There’s just one problem: donor milk, used when an premature infant’s mother’s own milk (MOM) is not available, generally consists of pooled and pasteurized milk from several donors. Donor milk – the second best food for premature infants after milk from the infant’s own mother – is suddenly missing one OR MORE of the factors in human milk that is thought to protect against NEC and other gastrointestinal infections. But, what would happen if you incubated donor milk with unpasteurized milk, from the infant’s own mother?
and so I bring you “who manages the mammaries: physiology edition”, specially looking at how milk synthesis starts and milk supply is maintained. I think this will be useful for the overall trajectory of the multipart series emerging here. The onset of milk production occurs with lactogenesis. In humans, this is split into two general stages, the first occurring during the transition from pregnancy to lactation and the second characterized by secretory activation of the mammary gland. More than simply the onset of milk production, each discrete physiological phase hallmarks a number of important cellular changes within the mammary epithelium and the mammary ducts. The first phase, secretory differentiation, previously called lactogenesis I is followed by secretory activation, formerly known as lactogenesis 2, is characterized by a shift to full milk production and further cellular level changes (Neville et al., 2012). Secretory activation is usually complete within 72 hours following birth, however there is an increased incidence in delayed activation
It is well established that with very few exceptions, human milk is the preferred first food for infants. While the benefits of breastfeeding/receiving human milk are considerable and influence the development of multiple systems in the infant, perhaps the best known benefits of human milk are its immunoprotective properties. Worldwide, breastfeeding is associated with reduced risk of infectious diseases in infants, and these protections persist even in highly hygienic conditions such as the United States (Bartick & Reinhold 2010). Many immune factors are found in human milk, including immune cells, cytokines that regulate immune responses, and secretory Immunoglobulin-A (sIgA), perhaps the most common immunoprotein in human milk. It is well established that there is considerable variation in the immune factors in milk between individual mothers and between populations. It is also known that many of the immune factors in milk are highly responsive, changing in response to active infection of either the mother or infant (blog post on this topic
Perhaps one of the most widespread pieces of advice women expressing milk will hear is about the best way to
Breastfeeding belongs in our modern understanding of what public health is.