The Dynamic Effects of Breastfeeding on Intestinal Development and Host Defense
In this review, evidence is provided to support the hypothesis that human milk provides a link between the mother and her newborn infant in the extrauterine environment in a manner similar to the placental link between mother and fetus in utero. In addition, breastfeeding helps prevent age-related diseases affecting the gastrointestinal tract during the newborn period. To provide evidence to support this hypothesis, anecdotal clinical studies are sited to suggest that human milk contains factors that may be missing in inherited diseases of inborn errors in metabolism and provide passive protective factors that lessen the expression of neonatal allergic and infectious diseases. In some instances, by providing the missing factor in an inherited disease, the newborn may be protected from serious damage to its developing brain. A second line of evidence to support this hypothesis is the observation that the composition of human milk varies with the infant’s needs. To illustrate this principal, the composition of milk from mothers delivering prematurely and milk of mothers of full-term infants were compared, and the differences in trophic and protective factors in colostrum versus mature milk from mothers delivering full-term are cited. Finally, using observations from, the laboratory that define the immaturities in neonatal and premature human intestinal defenses as the neonate’s host defense deficiency, the specific effect that anti-inflammatory and maturational factors in human milk has on these immaturities is discussed. The active stimulus of maternal milk on the rapid development of host defenses is underscored. These cited examples of human milk effects in the newborn help support the stated hypothesis. Additional studies of human immature gut function along with translational and clinical studies are necessary to provide further objective evidence in support of breastfeeding for all neonates, particularly premature neonates.
KeywordsHuman Milk Newborn Infant Cholera Toxin Congenital Hypothyroidism Mature Milk
Unable to display preview. Download preview PDF.
- Adlerberth I, Hanson LA, Wold AE. The ontogeny of the intestinal flora. In: Sanderson IR, Walker WA, editors. Development of the Gastrointestinal Tract. Hamilton, Ontario: BC Decker, 1999.Google Scholar
- Bernt KM, Walker WA. Human milk as a carrier of biochemical messages. Acta Paediatr 1999;430(Suppl):27–41.Google Scholar
- Groer M, Walker WA. What is the role of preterm human milk supplement in the host defenses of the preterm infant? Science vs. Fiction. Adv Pediatr 1996;43:335–358.Google Scholar
- McClelland DBL, McGrath J, Samson RR. Antimicrobial factors in human milk. Studies of concentration and transfer to the infant during the early stages of lactation. Acta Paediatr Scand 1978;271(Suppl):l–20.Google Scholar
- Nanthakumar NN, Dai D, Newburg DS, Walker AW. The role of indigenous microflora in the development of murine intestinal fucosyl- and sialyltransferases. FASEB J Express 10.1096/fj.02–0031fje, November 15, 2002.Google Scholar
- Seo JK, Chu SW, Walker WA. Development of intestinal host defense: An increased sensitivity in the adenylate cyclase response to cholera toxin in suckling rats. Pediatr Res 189;25:225–227.Google Scholar
- Shaw JCL. Trace elements in the fetus and young infant. I. Zinc. Am J Dis Child 1979;133:1260–1268.Google Scholar
- Wold AE, Adlerberth I. Breast feeding and the intestinal microflora of the infant—implications for protection against infectious diseases. In: Koletzko B, Michaelsen K, Hernell O, editors. Short and Long Term Effects of Breast Feeding on Child Health. New York: Kluwer Academic/Plenum Publishers. Adv Exp Med Biol. 2000;478:77–93.Google Scholar
- Xanthou M, Bines J, Walker WA. Human milk and intestinal host defense in newborns. Adv Pediatr 1995;42:171–208.Google Scholar