INTRODUCTION of over 820000 children under the age of

INTRODUCTION

 

The composition of milk varies according to the mammal it comes from,
providing the correct growth rate and development of a young of a species, thus
for human infant, human milk is obviously more suitable than infant formula.

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 Over the years since the early
1960’s studies have been increasingly published to show components that
provides the infant with excessive nutrition, moreover breast milk also widely
recognised as a biological fluid required for optimum infant development and
growth,  the Colostrum found in breast
milk is the main component that is essential for all the recognised
functionality of breast milk .Published studies in JAMA pedantries show that
the longer the infant consumes breast milk the more intelligent they become when
they grow up.

The colostrum also helps manage infants with chronic diarrhoea, In 8/10
of children with chronic diarrhoea ranging from 9 to 3 years of age E COLI was
present in all 8 cases  , ASCARTIS
LAMBRICOIDIS in 4 cases and GIADIA LAMBIA in one ,

Health Organisation also published that optimum breastfeeding can save
the lives of over 820000 children under the age of 5 years. Breast feeding is
also a source of energy and nutrition 
for children aged 6 to 23 months during illness of infants it also reduces
mortality among children who are malnourished, thus babies whom are fed breast
milk are less likely to be overweight or obese.

Globally,
only 38% of infants are exclusively breastfed and Botswana’s extensive
breastfeeding rates stands at 20%.Decision to breastfeeding is widely influenced
by many factors, they can be of maternal factors e.g., stress anxiety may
decrease production and milk ejection reflex, separation of mother and child
(e.g. return to work or school), hormonal imbalance (thyroid gland, polycystic
ovary and diabetes type one and two). Other factors can be the infant factors
e.g. baby refusing the nipple due to it being large (flat nipple), baby
sleeping for long periods or does not wake up (prematurity, certain
medication). But mostly healthy mothers tend to breast feed their babies breast
milk because it is cheap, and helps the child and the mother to connect.

Infant
formula was created by a scientist called Justus von Liebig in the 1800’s, it
was made as a substitute or supplement for human milk for mothers who chose not
to breast feed or cannot do so exclusively. It was also created for infants
whom breastfeeding is medically unfit or those with born error of metabolism
Infant formulas manufactured to mimic the nutritional composition of human milk
for the growth and development of infants.

These
formulas are made from cow’s milk and soy milk. Soy milk based formulas are
made from soy proteins with added vegetable oil corn syrup and sucrose(for
carbohydrates) which are made for infants who are lactose intolerant to
allergic to the whole protein in cow’s milk and milk based formulas.

 

2. HUMAN MILK

Human milk
consists of proteins, fats, carbohydrates and other nutrients with many more
bioactive molecules. Babies who are fed breast milk tend to grow faster more
intelligent than those who are fed instant formula. Human
milk oligosaccharides (HMOs) possess anti-infective properties against
pathogens in the infant gastrointestinal tract, such as Salmonella, Listeria,
and Campylobacter, by flooding the infant gastrointestinal tract with decoys
that bind the pathogens and keep them off the intestinal wall.

2.1 COMPOSITION OF HUMAN MILK (PROTEINS,
CARBOHYDRATES AND FATTY ACIDS)

Human milk is made up of 3.8% of fats, 1.0%of proteins and
7% carbohydrates. As the infant grows their needs change and the makeup of the
human milk adapt to these needs. For example the milk is thinner with a high
content of lactose during nursing season there after the milk gets thicker and
creamier with high fats content as the baby needs for proper growth of infants.
During early lactation, the protein content in human milk ranges from 1.4–1.6
g/100 mL, to 0.8–1.0 g/100 mL after three to four months of lactation, to
0.7–0.8 g/100 mL after six months.

Proteins in breast milk are divided in to two the casein
and the whey proteins these are in the ratio of 40:60 respectively. Whey is
domain over the casein proteins that is because they are much easier to digest
over the casein proteins, during the early stages of lactation. Moving forward
to the hind-milk, the ratio changes to 50:50. Fats content change depending on
the maternal diet and to weight gain during pregnancy, so the more the mother
gains weight during pregnancy the more the fat content she will have in her breast
milk.

In distinction protein and fats, lactose is almost always
constant throughout the lactation period. It is important to keep levels of
lactose constant in breast milk because many carbohydrate-based bioactive
compounds such oligosaccharides, are attached to lactose. If the
small intestine does not produce enough of an enzyme (lactase) to digest these
sugar complexes, lactose malabsorption and intolerance syndromes can be
observed. Lactase deficiency malabsorption and disease are extremely rare in the
exclusively breastfed infant.

 

Table
1.1

Gross composition, protein profile, and fatty acids in human and bovine
milk

Human
milk

Bovine
milk

Gross
composition (%)

 Protein

1.00

3.40

 Caseins

0.3

2.6

 Whey
protein

0.7

0.8

 Casein:
Whey protein

30:70

80:20

 Fat

3.80

3.50

 Lactose

7.00

5.00

3. BIOACTIVITY OF (PROTEINS,
CARBOHYDRATES AND FATTY ACIDS) IN

HUMAN MILK

  Bioactivity
is the effect of a given agent on a living organism or on a living tissue.

PROTEINS

The difference
in the proteins of breast milk result in the different amino acids profile
depending on the lactation stages. The amino acid glutamine is nearly 20 times
higher in mature milk than its lowest value in colostrum and is also
responsible for providing hetoglutaric acid for citric acid cycle, possibly
acting as a neurotransmitter in the brain ,it also serve as an energy surface
for intestinal cells. Whey is mainly composed of alpha – lactalbumin, lactaferrin
and secretory 1gA, some include lysozyme, folate-binding protein, bifidus factor,
casein, lipase and amylase, alpha1-antitrypsin and antichymotrypsin,
and haptocorrin .These proteins are broken down by ingestion to release amino
acids to be easily absorbed and used by the body, as an example
alpha-lactalbumin is important for the synthesis of lactose and binding of Ca
and Zn.

 

Figure
1.1 showing production of major bioactive peptides from milk proteins

 

 

FATTY ACIDS

Fats are indispensable as they provide energy
and also help develop the central nervous system. Milk contains 3% – 5 %of fats
it also entails two highly important fatty acids, linoleic acid
(C18:2w6) at a percentage of 15 and alpha-linolenic acid (C18:3w3) at 0.35%.
These two fatty acids are, respectively, converted to arachidonic acid (AA,
C20:4w6) and eicosapentaenoic acid (EPA, C20:5w3), the last of which is further
converted to docosahexaenoic acid (DHA, 22:6w3). AA, EPA and DHA are vital for
regulating growth, inflammatory responses, immune function, vision, cognitive
development and motor systems in neonates. Long chain polyunsaturated fatty
acids are transferred from mother to foetus in the third trimester through the
placenta, and to infants through breast milk after birth and during this stage
maximum synthesis of brain tissue takes place.

CARBOHYDRATES

Human milk oligosaccharides (HMOs) retain anti-infective chattels
against pathogens in the infant gastrointestinal tract, such as Salmonella,
Listeria, and Campylobacter, by flooding the infant gastrointestinal tract with
inducements that bind the pathogens and keep them off the intestinal wall.
Oligosaccharides also play a vigorous role in the development of a diverse and
balanced microbiota, crucial for appropriate innate and adaptive immune
responses, and help colonize up to 90% of the infant biome.

 

COMPARISON
OF HUMAN MILK AND INFANT FORMULA

Popular studies by health care professionals is that
ordinary infant formula made from cows milk, goat milk condensed milk, dried
milk and evaporated milk or any other milk beverage should not be given to
infants or children under the age of one. This is because of difference in
composition of milk that have been revealed by research over a decade ago. Both
infant formulas and breast milk differ on a wide range of aspects.

 

 

 

 

 

 

 

 

 

 

TABLE 1.2  SHOWING A
COMPARISON OF PROTEINS, CARBPHYDRATES AND FATTY ACIDS OF WHOLE INFANT AND
BREAST MILK (PER 100G)

 

Table 1.2

 

PROTEINS

Table 1.2 shows that proteins content In 100g
of infant formula made from cows milk (5.6%) is more than that of human milk,
this is linked to the amount of proteins in the milk is linked to how long a
particular species of animal to grow in size. Growing calves need more proteins
to enable them to grow quickly. Human infants on the other hand needs less of
proteins more fats as their energies are expected primarily in the development
of brain, spinal cord and nerves.

FATTY ACIDS

Instant formula that include cow’s milk lipids
and milk fat membrane entrants were found to be more similar to the structure
and composition of human milk. However many infant formulas use vegetable
lipids as they are cheaper then cows lipids. SIMILAC, S-26 GOLD and hiptomil
have vegetable oil as sole source of fats. Furthermore natural milk contains
the correct proportion of lipids which are more suitable for human infants.

 CARBOHYDRATES

Cow’s milk has a lower
lactose content compared to human milk; lactose contains galactose, a kind of
“brain sugar” that is needed in the development of the myelin sheath that
surrounds and sequesters nerves .Neonates naturally have a high percentage of
bifidus flora in their intestines to expedite milk digestion. The beta-lactose
in human milk maintains a healthy culture of bifidus flora, whereas the
alpha-lactose of cow’s milk is unable to properly maintain a
healthy culture of bifidus bacteria. In the absence of bifidus,
harmful bacteria flourish, producing damaging by-products.

 

TABLE1.3
SHOWING DIFFERENCE IN NUTRIENTS OF HUMAN MILK AND INFANT FORMULA

NUTRIENT FACTOR

BREAST MILK CONTAINS

FORMULA
CONTAINS

COMMENT

Fats

Rich in brain-building
omega 3s, namely DHA and AA
Automatically adjusts to
infant’s needs; levels decline as baby gets older
Rich in cholesterol
Nearly completely absorbed
Contains fat-digesting
enzyme, lipase

No DHA
Doesn’t adjust to infant’s
needs
No cholesterol
Not completely absorbed
No lipase

Fat is
the most important nutrient in breastmilk; the absence of cholesterol and
DHA, vital nutrients for growing brains and bodies, may predispose a child to
adult heart and central nervous system diseases. Leftover, unabsorbed fat
accounts for unpleasant smelling stools in formula-fed babies.

Protein

Soft, easily-digestible
whey
More completely absorbed;
higher in the milk of mothers who deliver preterm
Lactoferrin for intestinal
health
Lysozyme, an antimicrobial
Rich in brain and body building
protein components
Rich in growth factors
Contains sleep-inducing
proteins

Harder-to-digest casein
curds
Not completely absorbed,
more waste, harder on kidneys
No lactoferrin, or only a
trace
No lysozyme
Deficient or low in some
brain-and body-building proteins
Deficient in growth
factors
Does not contain as many
sleep-inducing proteins.

Infants
aren’t allergic to human milk protein.

Carbohydrates

Rich in lactose
Rich in oligosaccharides,
which promote intestinal health

No lactose in some formulas
Deficient in
oligosaccharides

Lactose
is considered an important carbohydrate for brain development. Studies show
the level of lactose in the milk of a species correlates with the size of the
brain of that species.

 

CONCLUSION

Breast
milk is the best when it comes to infant development and growth as it has
proteins essential for proper growth and they are easier for digestion .For new-borns
are unable to get adequate breast milk from the mother, infant formula is used
as a substitute.

Therefore
we strongly disagree with the use of instant formula as it has no antibodies
thus it does not add any protection against infection and illnesses that breast
milk does.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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·        
Department of Surgery, Feihe Nutrition Laboratory, Beth Israel Deaconess
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·        
Department of Surgery, Feihe Nutrition Laboratory, Beth Israel Deaconess
Medical Centre, Harvard Medical School, Boston, MA 02215, USA.
[email protected]

 

 

 

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