Human Milk: Composition, Clinical Benefits and Future Opportunities

Description

Human milk contains all of the essential nutrients and other functional components thought to have short- and long-term neonatal health benefits, such as positive biological effects on growth, metabolism, cognition, and immunity. This publication brings together the world’s experts who touch on the spectrum of current knowledge, from the history and mechanics of breastfeeding, its physiological and clinical effects, to the new surprises revealed by metabolomics and comparative biology. One of the key points made is that human milk is not only a source of essential nutrients, but also contains a variety of bioactive substances. These include essential microbes, long-chain fatty acids, complex oligosaccharides, nucleotides, and bioactive signaling proteins and hormones. This book provides clinicians and researchers with useful insights from multiple perspectives on the various aspects of human milk and lactation.

Informations

• Publié par: S. Karger AG
• Date de parution: 13 mars 2019
• Nombre de lectures: 0
• EAN13: 9783318063417
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Human Milk: Composition, Clinical Benefits and Future Opportunities
Nestlé Nutrition Institute Workshop Series
Vol. 90
 
Human Milk: Composition, Clinical Benefits and Future Opportunities
Editors
Sharon M. Donovan Urbana, IL
J. Bruce German Davis, CA
Bo Lönnerdal Davis, CA
Alan Lucas London
© 2019 Nestlé Nutrition Institute, Switzerland CH 1814 La Tour-de-Peilz S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com
Library of Congress Cataloging-in-Publication Data
Names: Nestle Nutrition Workshop (90th : 2017 : Lausanne, Switzerland) author. | Donovan, Sharon M., editor. | German, J. Bruce, editor. | Lonnerdal, Bo, 1938- editor. | Lucas, Alan, MD, editor.
Title: Human milk : composition, clinical benefits and future opportunities / editors, Sharon M. Donovan, J. Bruce German, Bo Lonnerdal, Alan Lucas.
Description: Basel (Switzerland) ; New York : Karger ; Switzerland : Nestle Nutrition Institute, [2019] | Series: Nestle Nutrition Institute workshop series, ISSN 1664-2147 ; vol. 90 | Includes bibliographical references and index.
Identifiers: LCCN 2019001860 (print) | LCCN 2019002411 (ebook) | ISBN 9783318063417 (eBook) | ISBN 9783318063400 (hard cover : alk. paper) | ISBN 9783318063417 (e-ISBN)
Subjects: | MESH: Milk, Human | Breast Feeding | Infant Nutritional Physiological Phenomena | Congress
Classification: LCC RJ216 (ebook) | LCC RJ216 (print) | NLM WS 125 | DDC 613.2/69--dc23
LC record available at https://lccn.loc.gov/2019001860
The material contained in this volume was submitted as previously unpublished material, except in the instances in which credit has been given to the source from which some of the illustrative material was derived.
Great care has been taken to maintain the accuracy of the information contained in the volume. However, neither Nestlé Nutrition Institute nor S. Karger AG can be held responsible for errors or for any consequences arising from the use of the information contained herein. © 2019 Nestlé Nutrition Institute (Switzerland) and S. Karger AG, Basel (Switzerland). All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, or recording, or otherwise, without the written permission of the publisher.
Printed on acid-free and non-aging paper (ISO 9706) ISBN 978–3–318–06340–0 e-ISBN 978–3–318–06341–7 ISSN 1664–2147 e-ISSN 1664–2155
 
Contents
Preface
Foreword
Contributors
State of Breastfeeding in the World
Scientific Evidence for Breastfeeding
Lucas, A. (UK)
The Biomechanics of Breastfeeding: Bridging the Gap between Engineering-Based Studies and Clinical Practice
Woolridge, M.W. (UK)
Summary on State of Breastfeeding in the World
Lucas, A. (UK)
Human Milk Composition and Physiological Benefits
Physiological Effects of Feeding Infants and Young Children Formula Supplemented with Milk Fat Globule Membranes
Hernell, O.; Domellöf, M.; Grip, T. (Sweden); Lönnerdal, B. (USA); Timby, N. (Sweden)
Human Milk Oligosaccharides: Factors Affecting Their Composition and Their Physiological Significance
Sprenger, N.; Binia, A.; Austin, S. (Switzerland)
Fatty Acids and Fat-Soluble Vitamins in Breast Milk: Physiological Significance and Factors Affecting Their Concentrations
Morrow, A.L.; Dawodu, A. (USA)
Water-Soluble Vitamins in Human Milk: Factors Affecting Their Concentration and Their Physiological Significance
Allen, L.H.; Hampel D. (USA)
Human Milk MicroRNAs/Exosomes: Composition and Biological Effects
Lönnerdal, B. (USA)
Human Milk Proteins: Composition and Physiological Significance
Donovan, S.M. (USA)
Summary on Human Milk Composition and Physiological Benefits
Lönnerdal, B. (USA)
Clinical Aspects of Human Milk on Infant Health Outcomes
Early-Life Nutrition, Growth Trajectories, and Long-Term Outcome
Haschke, F.; Binder, C.; Huber-Dangl, M.; Haiden, N. (Austria)
Early-Life Nutrition and Cognitive Development: Imaging Approaches
Lin, W.; Baluyot, K.R. (USA); Yao, M.; Yan, J. (Switzerland); Wang, L.; Li, G.; Howell, B.; Elison, J.T.; Shen, D. (USA)
Early-Life Nutrition and Gut Immune Development
van den Elsen, L.W.J.; Rekima, A.; Verhasselt, V. (Australia)
Early-Life Nutrition and Microbiome Development
Isolauri, E.; Rautava, S.; Salminen, S. (Finland); Collado, M.C. (Finland/Spain)
Human Milk and Clinical Outcomes in Preterm Infants
Meier, P.P. (USA)
Summary on Clinical Aspects of Human Milk on Infant Health Outcomes
Donovan, S.M. (USA)
Research Gap and Opportunities
Metabolomics in Human Milk Research
Slupsky, C.M. (USA)
Human Milk Oligosaccharides: Next-Generation Functions and Questions
Bode, L. (USA)
Guiding Development of the Neonate: Lessons from Mammalia
Nicholas, K.R.; Modepalli V.; Watt, A.P.; Hinds, L.A.; Kumar, A.; Lefevre, C.; Sharp, J.A. (Australia)
Milk Lipids: A Complex Nutrient Delivery System
German, J.B. (USA); Argov-Argaman, N. (Israel); Boyd, B.J. (Australia)
Summary on Research Gap and Opportunities
German, J.B. (USA)
Subject Index
For more information on related publications, please consult the NNI website: www.nestlenutrition-institute.org
 
Preface
Human milk is a complex biological fluid that contains all of the essential nutrients as well as other functional components that are thought to contribute to the short- and long-term health outcomes of breast- versus formula-fed infants. The goal of this workshop was to review the current evidence for the composition of human milk and its effects on the developing infant, to identify existing knowledge gaps, and to suggest future opportunities for research in human milk and lactation.
The first session set the stage with speakers providing a historical perspective of the place of breastfeeding in medicine, a biological perspective for the role of breastfeeding in infant health and an overview of the physiological basis and mechanics of breastfeeding. It is a goal of many organizations, governments, and health professionals that babies should be breastfed for at least the first year of life and exclusively for the first 6 months. Thus, breastfeeding may be regarded as major global public health intervention. In general, public health interventions should be rooted in sound scientific evidence. Unfortunately, in the past some of the key scientific pillars that have supported this important field have been based on flawed science and mistaken biological thinking. It was one goal of this session to identify such flaws in order to help pave the way to a new evidence-based “breastfeeding medicine” for the future. A key premise of this session was that a firm scientific evidence base in this rapidly developing field would have practical implications for the care of breastfed babies which in turn would be in the interests of population health. Breastfeeding itself is a mechanical process; therefore, the success of breastfeeding as a public health intervention depends on successful suckling, and for those that assist professionally with breastfeeding management, best practices are underpinned by a scientific understanding of the mechanics of suckling. However, despite the intensity and complexity of a new wave of current research into the mechanics of suckling, this work did not displace the long-standing best practices in breastfeeding management, derived from historical studies. Session 1 as a whole emphasized the importance of getting the science of breastfeeding right, the need for relevant health professionals to understand this science and the great potential that breastfeeding has, as a branch of medical practice, for influencing short- and long-term population health outcomes.
Next session has presented an update on our current understanding of the composition of human milk components and their potential physiological benefits. In the past decade, our understanding of human milk composition has rapidly advanced through the application of sophisticated, high-throughput analytical tools. Infant nutrient requirements are largely based on nutrient intakes of breastfed infants, which are generally assumed to be adequate. Information on nutrient concentrations in human milk and how they may be affected by various factors, such as maternal stores and diet, ethnicity, and length of lactation, is therefore imperative. This is particularly important for micronutrients as they have been difficult to analyze, and micronutrient deficiencies may have short- and long-term physiological implications for infant growth and development. Recent studies performed at multiple geographical locations and with adequate sampling methodology and analytical methods provide essential information for understanding requirements and establishing better recommendations. The composition of human milk proteins, fatty acids, oligosaccharides, and fat- and water-soluble vitamins was presented, along with emerging evidence on human milk microRNAs and exosomes, which may constitute biological messengers affecting infant development. Improvements in dairy technology have enabled the isolation of bioactive proteins from bovine milk for supplementation to infant formula. Findings of a randomized clinical trial with a milk fat globule membrane fraction demonstrate beneficial effects on multiple outcomes ranging from immune and cognitive development to microbiome modulation.
Session 3 extended upon Session 2 by focusing on the clinica