Composition of Human Milk vs. Cow’s Milk
Key Differences:
- Human milk has a higher whey: casein ratio (60:40), making it easily digestible.
- Cow’s milk is richer in protein but has a higher casein content, making digestion harder for infants.
- Human milk has higher lactose content, which aids brain development.
- Cow’s milk contains excessive sodium and lower bioavailable iron, increasing the risk of anemia.
Differences in Human Milk Composition in Term vs. Preterm Mothers
Significance:
- Preterm milk is specifically designed to meet the nutritional needs of premature infants, offering more protein, immunological protection, and energy-dense fats.
Bioactive & Anti-infective Properties of Human Milk
Human milk contains several bioactive factors that protect against infections and support immune development:
- Immunoglobulin A (IgA): Prevents pathogen adherence to mucosal surfaces.
- Lactoferrin: Binds iron, preventing bacterial growth (e.g., E. coli).
- Lysozyme: Destroys bacterial cell walls.
- Oligosaccharides: Act as prebiotics and prevent pathogen adhesion.
- Cytokines and Growth Factors: Aid gut maturation and immune modulation.
Role in Hypoglycemia & Iron Deficiency Anemia Prevention:
- Hypoglycemia: Human milk provides lactose, which supports continuous glucose supply and hepatic glycogen storage.
- Iron Deficiency Anemia: Despite low iron content, human milk offers higher bioavailability (~50% absorption) compared to cow’s milk (~10%).
Physiology of Breast Milk Secretion
Hormonal Regulation:
- Prolactin: Stimulates milk production (synthesized in response to suckling).
- Oxytocin: Triggers milk ejection (let-down reflex).
- Feedback Inhibitor of Lactation (FIL): Regulates milk synthesis based on demand.
Milk Ejection Reflex:
- Suckling → Hypothalamus stimulation → Oxytocin release → Myoepithelial cell contraction → Milk ejection.
Advantages of Breastfeeding (Metabolic Aspects)
- Nutritional Benefits: Optimal protein, fat, and lactose for infant metabolism.
- Immunological Protection: Reduces infections, allergies, and chronic diseases.
- Prevents Hypoglycemia: Maintains steady blood glucose levels.
- Gut Maturation: Promotes beneficial gut microbiota.
- Long-term Health Benefits: Lowers risk of obesity, diabetes, and metabolic syndrome.
Causes of Lactation Failure
- Maternal Factors:
- Insufficient glandular tissue
- Hormonal imbalances (e.g., Sheehan’s syndrome)
- Postpartum stress and fatigue
- Inverted or flat nipples
- Infant Factors:
- Poor latch or ineffective suckling
- Prematurity or congenital issues (e.g., cleft palate)
- Other Factors:
- Early introduction of formula → Decreased milk production
- Incorrect breastfeeding techniques
Common Breastfeeding Problems & Management
- Poor Latch: Correct positioning and attachment.
- Engorgement: Frequent feeding, warm compress, and expressing milk.
- Sore Nipples: Ensure proper latch, nipple care, and avoid artificial nipples.
- Blocked Ducts/Mastitis: Massage, continued breastfeeding, and antibiotics if infected.
Assessing Adequacy of Breast Milk for a 2-Month-Old Infant
Signs of Adequate Breastfeeding:
- Baby appears satisfied after feeding.
- 6-8 wet diapers/day with pale urine.
- Normal weight gain (~20-30 g/day).
- Regular stooling pattern (soft yellow stools).
Good Attachment Features:
- Mouth wide open.
- Lower lip turned outward.
- More areola visible above the upper lip.
- Chin touching the breast.
Problems with Poor Attachment:
- Inefficient milk transfer → Poor weight gain.
- Nipple pain & damage → Increased risk of mastitis.
- Reduced milk supply due to ineffective suckling.
Conclusion
Breastfeeding provides optimal nutrition, immune protection, and metabolic stability for infants. Understanding the differences in milk composition, bioactive factors, and potential problems is crucial for ensuring successful lactation and infant well-being. Encouraging proper breastfeeding techniques and addressing lactation challenges can significantly improve infant health outcomes.
