Amazing Breastmilk

A friend sent this to me from a LLL conference. I thought it was crazy interesting.

Lactogenesis II is triggered by the sudden drop in progesterone. Prolactin levels in Lactogenesis I are high and maintain those levels after Lactogenesis II has been triggered. Even though prolactin has to be high in Lactogenesis I, at about 6 months prolactin levels drop off and they are less important in later lactation. Instead the removal of milk is what is most important to maintain lactation.

They have found that half of lactating moms have 3 or more letdowns in a feeding. Also that is takes double the time to get the same amount pumping as it would to breastfeed. Breast anatomy has been redefined by ultrasound technology. There are no lactiferous sinuses unlike had been previously thought. The old model of breast anatomy was formed by pouring hot wax into the breast of cadavers. The hot wax had expanded the tissue at the entry, instead the alveoli is spread out everywhere even under the areola. Milk ducts are a complicated network that intertwine with each other.

Even women who experience no visible breast changes during pregnancy can breastfeed because what happens is that instead of building tissue that is added to breast volume, their tissues are replaced. For example, fatty tissue is turned into mammary tissue.

They have found that they can look at four key aspects of breast milk in mothers of preterm infants to calculate how much difficulty she will have in lactating. The four are levels of protein, lactose, sodium, and citrate. They used those four because they have the most significant differences in levels between colostrum and mature milk. They found in there study that 86% of women had compromised initiation of lactation. The more markers that came up(up to 4 for protein, lactose, sodium and citrate) the more abnormal lactation was and there was less milk.

They have also found that steriod shots used to mature the infant lungs may compromise lactation. In their study they found that women who gave birth within 3 days of receiving the shots had longterm difficulty with lactation. Women who gave birth 10 or more days after receiving them saw a boost in production. Women who gave birth within 4-9 days had problems until day 10 and then returned to normal lactation. Another cause may be that moms who deliver early haven't completed mammogenesis and therefore their breasts aren't completely prepared to lactate.

Funny factoid mentioned: 2/3 of babies are right breasted and 1/3 are left breasted. (kent j.c. et. al. pediatrics 2006)

It was shown that to drain the breast takes all day, this explains why milk volume is at its lowest in the evening and highest in the morning. The evening milk is higher in fats and living cells. Breast refill on average 25-30 ml per hour. Keep in mind this is just an average and differs from person to person.

This is how stress kills supply in technical terms. Cortisol(the stress hormone) kills oxytocin. Oxytocin aids in milk removal by triggering the milk ejection reflex(letdown). Removal of milk is directly related to supply. Therefore stress can kill supply.

The immune cells in breast milk, unlike the immune cells in our bodies, come activated so that they are ready to protect the baby from any bacteria/pathogens that may already be there. There are four: macrophages, neutrophils, lymphocytes, and lactocytes. Foremilk has less living cells and more dying cells, hindmilk is more fresh and higher in cells contents and more living cells. Leukocytes in breast milk can survive digestion by the infant and can be found in their feces. This is possible only until the infants gut matures somewhere around 6 months of age and this is how the infant has added protection from illness.

Women and baby pairs who breastfeed and have mothers organs used in a transplant with baby are found to be more compatible. They have a lower risk of organ rejection because their immune systems have a higher compatibility.

Of the stem cells in breast milk only 2% have taken on the lineage of mammary stem cells. They have found that breast milk has 200% more stem cells than bone marrow. In one drop of breast milk there are 800 uncommitted stem cells.

They said even though the evidence shown in the protection from breast milk seems marginal when collected together it is significant. The risk of obesity is 2% higher. This means that 2 in 100 formula fed infants will end up obese. When looking at necrotizing enterocolitis 3 in 253 of breastfed infants and 17 in 236 formula fed infants. Formula fed infants are 3x more at risk for respiratory illness, 3-7x for SIDS, and 6x more likely to develop lymphoma.

He also disclosed that the studies done trying to discount the effects of breast milk on IQ(7-8 points higher in b/f children) allowed up to 25% formula. Studies also show the longer you breastfeed the more significant the point improval.

Breast milk is best kept in the fridge to stop the growth of bacteria and also preserve as many live cells as possible. Freezing breast milk kills almost all the cells, even so this doesn't take away the benefits of the breast milk over formula. Of course the fresher the milk the better.

Studies have also shown the higher socioeconomic status of children's parents the higher the level of auto immune disease. This suggests that infants need exposure to pathogens to build a healthy immune system. Obviously, with the preterm infants there is a need to be more careful.

Dr. Mark Cregan said that there is no need to throw out the milk left in a bottle if not finished. Just make sure to clean/rinse off the nipple of the bottle or replace the nipple at the next feeding. After thawing the milk it needs to be used within 24 hours.