La leche materna es un tejido vivo y es específico para la especie, con componentes únicos, agentes inmunológicos particulares y recientemente se han identificando células madres. Sus componentes varían según la necesidad, hora del día, si es principio de la mamada o el final de la misma, edad del niño, alimentación materna, condición de salud del bebé, si es prematuro o nacido a término, edad infantil, si el pecho está lleno o menos lleno, el estado de ánimo de la madre, entre otros.
La madre empieza a proteger su hijo con anticuerpos a través de la placenta y por ingerir líquido amniótico que contiene una cantidad de proteína y lo continúa haciendo una vez que nace a través de su leche.
Protección inmunológica
La salud empieza en los intestinos, el mayor órgano en el cuerpo, inmaduro en el recién nacido y con una gran permeabilidad intestinal que permite a los patógenos y proteínas extrañas penetrar fácilmente a través de las vellocidades intestinales, El cierre de las uniones estrechas ocurre prontamente en los bebés amamantados. (Catasis, 1995)
- Elementos humorales y celulares
- linfocitos, leucocitos polimorfonucleares PMN, macrófagos
- Inmunoglobulinas y factores anti-infecciosos
- IgA, IgA secretora, oligosacáridos, glicoproteínas y citocinas.
- La leche materna se asocia con la protección de infecciones o condiciones relacionadas: gastroenteritis, infección respiratoria, otitis media, infección del tracto urinario, septicemia neonatal y enterocolitis necrotizante. Algunos de los efectos protectores pueden derivar del patrón de colonización de la mucosa en el lactante alimentado con leche materna.
- Lactoferrina, Lisozima, Caseína, Mucina
- Xantina oxidasa: Su capacidad endógena en la leche materna genera óxido nítrico radical antimicrobiano e inhibe el crecimiento de Escherichia coli y Salmonella.
- Factor bífido: Permite el crecimiento de bacterias beneficiosas a la vez que impide el crecimiento de bacterias no-amigables como E. Coli y Shigella Mantiene el PH en el intestino grueso.
- Lactoperoxidasa: Muestra actividad anti-microbio.
- Oligosacáridos: influyen en la composición de la microbiota intestinal en los lactantes alimentados con leche materna
- Propiedades anti-inflamatorias
- Complemento: Protege de inflamación el tracto gastro-intestinal del bebé y la glándula mamaria.
- El calostro humano ayuda con la profilaxis de ojos pegajosos y conjuntivitis en el recién nacido.
- La leche materna es anti-inflamatoria. Estos factores son esenciales para la protección de la glándula mamaria. La leche materna facilita el establecimiento de la flora intestinal que inhibe la colonización por muchos agentes patógenos y estimula el crecimiento de microorganismos beneficiosos. Contiene hormonas y factores que contrarrestan la diarrea. Por lo tanto, los bebés lactantes pueden ser colonizados por reconocidos patógenos diarréicos y estar sanos. La microflora intestinal es más virulenta en los alimentados artificialmente que en los alimentos con leche materna.
- Glutationa peroxidasa: antioxidante importante que transporta selenio.
- Catalase
- Vitamina A, C, E
- Inmunomoduladores:
- Prolactina
- Citocinas
- Cortisol
- Tiroxina
- Insulina
- Factores de crecimiento: estimulan el crecimiento y el desarrollo del tracto gastrointestinal
- Interleucina
- Interferón
- factor de necrosis tumoral (TNF)
- factor de crecimiento transformante (TGF)
- Recientemente se ha empezado a encontrar explicación de como la leche materna y el calostro protegen contra el cáncer. No solo el bebé se protege del cáncer, también la madre.
Enzimas
- Amilasa. contribuye a la digestión de hidratos de carbono. El niño por si mismo es deficiente de amilasa hasta los dos años.
- Lipasa, que es una enzima digestiva que transporta y procesa los lípidos. Se encuentra en la leche materna y en los intestinos. Está disponible a través de la leche materna previo a la digestión.
- Diastasa: Descompone los hidratos de carbono y los convierte en azúcar para su fácil digestión.
- Peptidasa: Descompone los péptidos en aminoácidos
- Lactosa-sintasa: Proteína en la leche humana que acelera la formación de lactosa de la glucosa y galactosa.
«La lactancia materna es una relación físicamente íntima, amorosa entre dos personas que se aman, confían el uno en el otro y se respetan mútuamente. Se trata del calor de los brazos de mamá, de la adoración en los ojos de un niño, del olor de la cabecita del bebé, del confort de la voz de tu madre. No existe sustituto para la lactancia». Katherine Dettwyler
Referencias:
¿Alguna vez te has preguntado que hay en la leche?
Dettwyler, Katherine: Por qué soy fervierte activista de la lactancia materna. Amor maternal. 2012
Organización Mundial de la Salud Estrategia Mundial para la Alimentación del Lactante y del Niño Pequeño 2003
En inglés:
AAP Breastfeeding and the Use of Human Milk, Section on Breastfeeding, February 27, 2012.
Azad MB, Konya T, Maughan H, Guttman DS, Field CJ, Chari RS, Sears MR, Becker AB, Scott JA, Kozyrskyj AL; CHILD Study Investigators. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months CMAJ. 2013 Mar 19;185(5):385-94
Azizi F, Smyth P. Breastfeeding and maternal and infant iodine nutrition. Clin Endocrinol (Oxf). 2009 May;70(5):803-9. Epub 2008 Oct 6.
Belfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, Gillman MW, Oken E. Infant feeding and childhood cognition at ages 3 and 7 years: Effects of breastfeeding duration and exclusivity. JAMA Pediatr. 2013 Sep;167(9):836-44.
Ballard B., Morrow A. Human Milk Composition: Nutrients and Bioactive Factors Pediatr Clin North Am. 2013 Feb; 60(1): 49–74.
Beral V., Bull D., Doll R., Peto R., Reeves G. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease (2002) Lancet, 360 (9328), pp. 187-195.
Biochem J. 1969 February; 111(3): 14P–15P. Lactose synthetase A protein from human milk. P Andrews
Bonyata, K Do mom’s vaccines protect her breastfed baby?, 2005
Brandtzaeg P. The mucosal immune system and its integration with the mammary glands. J Pediatr. 2010 Feb;156(2 Suppl):S8-15.
Buescher ES. Anti-inflammatory characteristics of human milk: how, where, why. Adv Exp Med Biol. 2001;501:207-22.
Butler JE. Immunologic aspects of breast feeding, antiinfectious activity of breast milk. Semin Perinatol. 1979 Jul;3(3):255-70.
Butte N, Lopez-Alarcon M, Garza C Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life World Health Organization 2002
Catasis 1995
Chirico G, Gasparoni A. Immunologic components of human milk, haematologica reports 2006;2(10):27-30
Chirico G, Marzollo R, Cortinovis S, Fonte C, Gasparoni A. Antiinfective properties of human milk. J Nutr. 2008 Sep;138(9):1801S-1806S.
Cuervo M1, Sayon-Orea C2, Santiago S3, Martínez JA4. Dietary and health profiles of Spanish women in preconception, pregnancy and lactation. Nutrients. 2014 Oct 20;6(10):4434-51.
Colson S White blood: dose benefits of human milk, The Practising Midwife, Volume 6 Number 9, 2003
Cregan MD, Fan Y, Appelbee A, Brown ML, Klopcic B, Koppen J, Mitoulas LR, Piper KM, Choolani MA, Chong YS, Hartmann PE. Identification of nestin-positive putative mammary stem cells in human breastmilk. Cell Tissue Res. 2007 Jul;329(1):129-36. Epub 2007 Apr 18.
Cregan MD, Mitoulas LR, Hartmann PE. Milk prolactin, feed volume and duration between feeds in women breastfeeding their full-term infants over a 24 h period. Exp Physiol. 2002 Mar;87(2):207-14.
Cunningham AS, Jelliffe DB, Jelliffe EF. Breast-feeding and health in the 1980s: a global epidemiologic review. J Pediatr. 1991 May;118(5):659-66.
Dai D, Walker WA. Protective nutrients and bacterial colonization in the immature human gut. Adv Pediatr. 1999;46:353-82.
Davanzo R, Zauli G, Monasta L, Brumatti LV, Abate, MV, Ventura G, Rimondi E, Secchiero P, Demarini S. Human Colostrum and Breast Milk Contain High Levels of TNF-related Apoptosis-Inducing Ligand (TRAIL) Journal of Human Lactation 23 apr 2012
Denis W, Talbot F, Minot A Non-protein Nitrogenous Constituents of Human Milk , 1919
Dewit O, Dibba B, Prentice A. Breast-milk amylase activity in English and Gambian mothers: effects of prolonged lactation, maternal parity, and individual variations. Pediatr Res. 1990 Nov;28(5):502-6.
Dvorak B. Milk epidermal growth factor and gut protection. J Pediatr. 2010 Feb;156(2 Suppl):S31-5.
Ellis LA, Mastro AM, Picciano MF. Do milk-borne cytokines and hormones influence neonatal immune cell function? J Nutr. 1997 May;127(5 Suppl):985S-988S.
Fan Y, Chong YS, Choolani MA, Cregan MD, Chan JK. Unravelling the mystery of stem/progenitor cells in human breast milk. PLoS One. 2010 Dec 28;5(12):e14421.
Field C The Immunological Components of Human Milk and Their Effect on Immune Development in Infants. The American Society for Nutritional Sciences J. Nutr. 135:1-4, January 2005
Focchi GR, Piotto HM, Carneiro-Sampaio MM. Human colostrum and milk cells Rev Paul Med. 1991 Sep-Oct;109(5):225-31.
Goldman AS, Chheda S, Garofalo R, Schmalstieg FC. Cytokines in human milk: properties and potential effects upon the mammary gland and the neonate. J Mammary Gland Biol Neoplasia. 1996 Jul;1(3):251-8.
Goldman AS. The immune system in human milk and the developing infant. Breastfeed Med. 2007 Dec;2(4):195-204.
Groer M, Davis M, Steele K Associations between Human Milk SIgA and Maternal Immune, Infectious, Endocrine, and Stress Variables J Hum LactMay 2004 vol. 20 no. 2 153-158
Hamosh M. Breastfeeding: Unraveling the Mysteries of Mother’s Milk Medscape Women’s Health eJournal 1(5), 1996.
Hanson LA. How Breastfeeding Protects Babies. Pharmasoft Publishing, 2004
Hanson LA. Session 1: Feeding and infant development breast-feeding and immune function. Proc Nutr Soc. 2007 Aug;66(3):384-96.
Hanson LA, Ahlstedt S, Andersson B, Cruz JR, Dahlgren U, Fällström SP, Porras O, Svanborg Edén C, Söderström T, Wettergren B. The immune response of the mammary gland and its significance for the neonate. Ann Allergy. 1984 Dec;53(6 Pt 2):576-82.
Hanson LA, Söderström T. Human milk: Defense against infection. Prog Clin Biol Res. 1981;61:147-59.
Harta S, Boylanb LM, Borderc B, Carrolld S, McGuneglee D, Lampe R Breast milk levels of cortisol and Secretory Immunoglobulin A (SIgA) differ with maternal mood and infant neuro-behavioral functioning Infant Behavior and Development Volume 27, Issue 1, February 2004, Pages 101–106
Hassiotou F, Beltran A, Chetwynd E, Stuebe AM, Twigger AJ, Metzger P, Trengove N, Lai CT, Filgueira L, Blancafort P, Hartmann PE. Breastmilk is a novel source of stem cells with multilineage differentiation potential. Stem Cells. 2012 Oct;30(10):2164-74. doi: 10.1002/stem.1188.
Hosseini S, Inserra P, Araghi-Niknam M, Watson RR. Colostrum and milk in the treatment of disease. Adv Nutr Res. 2001;10:201-12.
Human Milk CIC, 2020
Jakaitis et al Human Breast Milk and the Gastrointestinal Innate Immune System Clin Perinatol. 2014 Jun; 41(2): 423–435.
Jenness R. The composition of human milk. Semin Perinatol. 1979 Jul;3(3):225-39.
Johnson D, France G, Marmer D, Steele R. Bactericidal Mechanisms of Human Breast Milk Leukocytes. Infection and Immunity, May 1980, p. 314-318
Juto P. Human milk stimulates B cell function Archives of Disease in Childhood, 1985, 60, 610-613
Kelleher SL, Lönnerdal B. Immunological activities associated with milk. Adv Nutr Res. 2001;10:39-65
Kim ES, Cho KH, Park MA, Lee KH, Moon J, Lee YN, Ro HK. Taurine intake of Korean breast-fed infants during lactation. Adv Exp Med Biol.1996;403:571-7.
Kunz C, Rudloff S. Potential anti-inflammatory and anti-infectious effects of human milk oligosaccharides. Adv Exp Med Biol. 2008;606:455-65.
Laffan AM, McKenzie R, Forti J, Conklin D, Marcinko R, Shrestha R, Bellantoni M, Greenough WB 3rd. Lactoferrin for the prevention of post-antibiotic diarrhoea. J Health Popul Nutr. 2011 Dec;29(6):547-51.
Lawrence R Storage of human milk and the influence of procedures on immunological components of human milk Acta Pediatr 88: 14-8. 1999
Lawrence R, Pane C Human Breast Milk: Current Concepts of Immunology and Infectious Diseases Curr Probl Pediatr Adolesc Health Care, January 2007
La Leche League International. Can Breastfeeding Prevent Illnesses?, 2006
Mannel R, Martens P, Walker M Core Curriculum for Lactation Consultant Practice ILCA, 2nd ed 2007
Marek A, Szlagatys-Sidorkiewicz A, Liberek A, Gora-Gebka M, Sikorska-Wisniewska G, Marek K, Raczkowska-Kozak J, Jankowska A, Bako W. Immune components of human milk Med Wieku Rozwoj. 2006 Apr-Jun;10(2):545-56.
Martin NW, Benyamin B, Hansell NK, Montgomery GW, Martin NG, Wright MJ, Bates TC. Cognitive function in adolescence: testing for interactions between breast-feeding and FADS2 polymorphisms. J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):55-62.e4. Epub 2010 Dec 3.
May J. Human milk – Tables of the antimicrobial factors and microbiological contaminants relevant to human milk banking, 2005
Mehta R Petrova A Biologically active breast milk proteins in association with very preterm delivery and stage of lactation Journal of Perinatology(2011) 31, 58–62;
Nazrul Islam, Ahmed L, Nazrul Islam Khan, Huque S, Begum A, Mohammed Yunus AB Immune components (IgA, IgM, IgG, immune cells) of colostrum of Bangladeshi mothers Pediatrics International Volume 48, Issue 6, pages 543–548, December 2006.
O’Connor M, Schmidt W, Carroll-Pankhurst C, Olness K Relaxation Training and Breast Milk Secretory IgA Arch Pediatr Adolesc Med.1998;152:1065-1070
Oguchi S, Shinohara K, Yamashiro Y, Walker WA, Sanderson IR. Growth factors in breast milk and their effect on gastrointestinal development. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1997 Sep-Oct;38(5):332-7.
Ogundele MO. Anti-complement activities of human breast-milk. Inflamm Res. 1999 Aug;48(8):437-45.
Orlando S.The immunologic significance of breast milk. J Obstet Gynecol Neonatal Nurs. 1995 Sep;24(7):678-83.
Östlund Å, Nordström M, Dykes F, Flacking R Breastfeeding in Preterm and Term Twins—Maternal Factors Associated With Early Cessation: A Population-Based Study J Hum Lact August 2010 vol. 26 no. 3 235-241
Pamblanco M, Portolés M, Paredes C, Ten A, Comín J. Free amino acids in preterm and term milk from mothers delivering appropriate- or small-for-gestational-age infants. Am J Clin Nutr. 1989 Oct;50(4):778-81.
Paramasivam K, Michie C, Opara E, Jewell AP. Human breast milk immunology: a review. Int J Fertil Womens Med. 2006 Sep-Oct;51(5):208-17.
Paricio JM, Lizán-García M, et al Full Breastfeeding and Hospitalization as a Result of Infections in the First Year of Life PEDIATRICS Vol. 118 No. 1 July 1, 2006 pp. e92 -e99
Piper KM, Berry CA, Cregan MD. The bioactive nature of human breastmilk. Breastfeed Rev. 2007 Nov;15(3):5-10.
Breastfeeding and Human Lactation, Fourth Edition (Riordan, Breastfeeding and Human Lactation)
Jan Riordan, Karen Wambach
Prentice A, Prentice AM, Cole TJ, Paul AA, Whitehead RG. Breast-milk antimicrobial factors of rural Gambian mothers. I. Influence of stage of lactation and maternal plane of nutrition. Acta Paediatr Scand. 1984 Nov;73(6):796-802.
Riskin A, Almog M, Peri R, Halasz K, Srugo I, Kessel A. Changes in immunomodulatory constituents of human milk in response to active infection in the nursing infant. Pediatr Res. 2012 Feb;71(2):220-5. doi: 10.1038/pr.2011.34. Epub 2011 Dec 21.
Rocky Mountain Children’s Health Foundation Value of Human Milk
Ruiz-Moyano S, Totten SM, Garrido D, Smilowitz JT, German JB, Lebrilla CB, Mills DA. Variation in consumption of human milk oligosaccharides by infant-gut associated strains of Bifidobacterium breve. Appl Environ Microbiol. 2013 Jul 26.
Schlimme E, Martin D, Meisel H. Nucleosides and nucleotides: natural bioactive substances in milk and colostrum. Br J Nutr. 2000 Nov;84 Suppl 1:S59-68.
Sheppard, J The Amazing Immunology of Breastmilk Super Healthy Kids:Strengthening Your Child’s Resistance to Disease Pages 26-36
Shin K, Hayasawa H, Lönnerdal B. Purification and quantification of lactoperoxidase in human milk with use of immunoadsorbents with antibodies against recombinant human lactoperoxidase. Am J Clin Nutr. 2001 May;73(5):984-9.
Singh M, Sugathan PS, Bhujwala RA. Human colostrum for prophylaxis against sticky eyes and conjunctivitis in the newborn. J Trop Pediatr. 1982 Feb;28(1):35-7.
Slade HB, Schwartz SA. Mucosal immunity: the immunology of breast milk. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 1):348-58.
Stevens CR, Millar TM, Clinch JG, Kanczler JM, Bodamyali T, Blake DR. Antibacterial properties of xanthine oxidase in human milk. Lancet. 2000 Sep 2;356(9232):829-30.
Stuebe A The Risks of Not Breastfeeding for Mothers and Infants Obstet Gynecol. 2009 Fall; 2(4): 222–231.
Takahashi T, Yoshida Y, Hatano S, Sugita-Konishi Y, Igimi S, Yajima M, Kojima T, Kanno T, Yonekubo A, Yajima T, Kuwata T. Reactivity of secretory IgA antibodies in breast milk from 107 Japanese mothers to 20 environmental antigens. Biol Neonate. 2002;82(4):238-42.
Thomas E, Zeps N, Cregan M, Hartmann P, Martin T. 14-3-3σ (sigma) regulates proliferation and differentiation of multipotent p63-positive cells isolated from human breastmilk. Cell Cycle. 2011 Jan 15;10(2):278-84. Epub 2011 Jan 15.
Udall JN, Dixon M, Newman AP, et al: Liver disease in alpha-1-antitrypsin deficiency: A retrospective analysis of the influence of early breast vs. bottle-feeding. JAMA 253:2679, 1985.
Val-Laillet D, Simon M, Nowak R A full belly and colostrum: two major determinants of filial love, Developmental Psychobiology 45 : 163-173, 2004
Van de Perre P. Transfer of antibody via mother’s milk. Vaccine. 2003 Jul 28;21(24):3374-6.
Van Den Driessche M, Peeters K, Marien P, Ghoos Y, Devlieger H, Veereman-Wauters G. Gastric emptying in formula-fed and breast-fed infants measured with the 13C-octanoic acid breath test. J Pediatr Gastroenterol Nutr. 1999 Jul;29(1):46-51.
Wagner C, Anderson D, Pittard W Special Properties of Human Milk Clin Pediatr June 1996 vol. 35 no. 6 283-293
Walker WA, Iyengar R. Breast milk, microbiota, and intestinal immune homeostasis. Pediatr Res. 2015 Jan;77(1-2):220-8.
Wen LM, Simpson JM, Rissel C, Baur LA. Awareness of Breastfeeding Recommendations and Duration of Breastfeeding: Findings from the Healthy Beginnings Trial. Breastfeed Med. 2012 May 8.
Wold AE, Adlerberth I. Breast feeding and the intestinal microflora of the infant–implications for protection against infectious diseases. Adv Exp Med Biol. 2000;478:77-93.
Xanthou M. Immune protection of human milk. Biol Neonate.1998;74(2):121-33.
Zanardo V, Nicolussi S, Carlo G, Marzari F, Faggian D, Favaro F, Plebani M. Beta endorphin concentrations in human milk. J Pediatr Gastroenterol Nutr. 2001 Aug;33(2):160-4.
Zangen S, Di Lorenzo C, Zangen T, Mertz H, Schwankovsky L, Hyman PE. Rapid maturation of gastric relaxation in newborn infants. Pediatr Res.2001 Nov;50(5):629-32.