The Benefits of Breastfeeding
30/05/2022 | Catarina Vilela - Mipmed
Worldwide, there is unanimous consensus on the importance of breastfeeding. This is reflected in the World Health Organization's recommendation that mothers exclusively breastfeed for the first six months of the baby's life, continuing to breastfeed in addition to solid foods for at least the first two years. However, breastfeeding has other advantages in addition to its nutritional benefits; protects the baby against infections, regulates and strengthens the mother's and baby's physiological systems, and promotes bonding between the two.
Benefits for mothers
Physical contact between mother and baby during the early postpartum period helps to prolong the period of breastfeeding and can help the mother's gastrointestinal tract adapt to the increased energy needs during breastfeeding. Breastfeeding increases the mother's attention to the baby's needs, speeds up uterine contraction after delivery, and reduces the risk of bleeding. It also helps the mother regain pre-pregnancy weight and lowers the risk of ovarian and breast cancer, cardiovascular disease, and type 2 diabetes.
Breastfeeding provides long-term anti-stress effects; with each breastfeeding session, mothers experience a reduction in blood pressure and cortisol levels, and the increases in their cortisol levels in response to physical stress are smaller compared to bottle-feeding mothers. Breastfeeding mothers are also more likely to be calmer and more social than other women of the same age who are neither breastfeeding nor pregnant. In fact, mothers who have skin-to-skin contact with newborns immediately after birth spend more time with their babies, interact more with them during breastfeeding, and breastfeed longer.
Benefits for babies
Breast milk provides optimal nutrition (fat, lactose, protein, and macronutrients) to support your baby's growth and development, as well as complete protection (with biochemical and cellular components) against infections. Term babies who receive human milk show significant improvements in nutritional status, gastrointestinal maturation, and neurological development, as well as in the control of infectious and chronic diseases, when compared to babies fed with replacement milk. Premature babies who receive human milk have additional benefits, including a lower risk of necrotizing enterocolitis (NEC), enteral nutrition intolerance, chronic lung disease, retinopathy of prematurity, neurodevelopmental delays, and hospital readmission.
Developmentally, babies who are breastfed benefit in other ways, including improved neurodevelopmental and behavioral indices and a reduced risk of developing obesity and type 2 diabetes in adulthood. In addition, breastfeeding promotes normal orofacial development in babies, including better teething, perioral and masseter muscle activity, and palate growth. It also decreases the risk of otitis media.
The act of breastfeeding also facilitates the creation of bonds between mother and baby. Skin-to-skin contact and tactile stimulation of the nipple, including sucking, result in the release of oxytocin, an essential component of the milk ejection reflex that creates a bond between mother and baby. The release of oxytocin increases blood flow to the mother's breast and nipple area, increasing skin temperature and creating a warm and welcoming environment for the baby.
Benefits of breast milk
Breast milk provides all the essential components for the baby's growth and development. This includes macronutrients (fats, carbohydrates and proteins), micronutrients (vitamins and minerals) and development factors (long-chain polyunsaturated fatty acids known as PUFAs, growth factors, and cytokines). Breast milk also provides vital protection, reducing infections through immunoglobulins and anti-infective proteins. Therefore, it is recommended as the only source of nutrition for all babies during the first six months of life, with continued breastfeeding in addition to solid foods for at least the first few years.
Human milk fat provides 50-60 percent of a full-term baby's caloric intake. Fat also plays a vital role in providing your baby with free fatty acids and fat-soluble vitamins. Triacylglycerols, composed of saturated and unsaturated fatty acids, are the most abundant type of fat in human milk, accounting for more than 98 percent of the total fat content. Long-chain polyunsaturated fatty acids (cl-PUFAs), including docosahexaenoic acid (DHA) and arachidonic acid (AA), are especially important as they accumulate in lipids in brain and retinal membranes, where they perform relevant visual and neural functions. In fact, babies who are fed higher amounts of human milk show higher levels of concentration of DHA and AA in the plasma of the cerebral cortex and the gray and white matter of the brain, as well as higher IQ values up to 15 years of age. age, compared to babies who are fed replacement milk that does not contain cl-PUFA.
Lactose is the main carbohydrate in milk, providing 30-40 percent of the baby's energy. It becomes the biggest source of energy for the baby as it is broken down into glucose and galactose. Glucose mostly passes into the peripheral circulation and is used as a substrate for energy production, while galactose is absorbed through the liver and converted to glucose-1-phosphate, which is further converted to glucose or used to replenish body cells. liver glycogen stores. Both galactose and glucose can also be used by the brain for energy; galactose in particular is vital for the production of galactolipids (cerebroside), which are essential for the development of the baby's central nervous system.
Human milk oligosaccharides (HLO) are complex carbohydrates ranging in length from 3 to 10 monosaccharides. OLHs are the third largest component of human milk, after lactose and triacylglycerols. OLH are not a great source of energy for the baby as they are not digested in the small intestine. Instead, OLH have an important immune function, acting as prebiotics and promoting the growth of commensal bacteria in the gut, in particular B.bifidum subspecies infantile and Bifidobacterium longum. They also act as receptor decoys or analogues to inhibit the binding of pathogens – including rotavirus – to the surface of the intestine. Specific OLHs have also been associated with greater gastrointestinal protection against necrotizing enterocolitis, which is probably even more important in preterm infants (gestational age <36 weeks) because of their increased vulnerability to necrotizing enterocolitis (NEC).
Proteins provide approximately 8 percent of the baby's energy. More than 415 have been identified in human milk, many of which are active and play a role in protecting the baby. Although protein levels vary greatly between mothers, the protein level is highest in colostrum (30-70 g/l) and then decreases until it reaches a stable level in mature milk (7-14 g/l). The proteins present in human milk can be divided into three groups: caseins, whey proteins and proteins associated with the globular membrane of milk fat. Whey proteins make up the majority of the protein content in colostrum, decreasing to about 60 percent in mature milk.
Proteins such as β-casein play important antiseptic and anti-infective functions by inhibiting bacterial and viral protease. Furthermore, the peptides generated in the digestion of α-lactoalbumin show powerful antibacterial activity against gram-positive and gram-negative bacteria. Although they are multifunctional, other proteins present in human milk, including sIgA, lactoferrin and lysozyme – and macrophages and free fatty acids – act as anti-infective agents, which are essential for the premature baby. These agents work together to inactivate, destroy or bind to specific microbes, preventing them from becoming lodged on mucosal surfaces.
Human milk simultaneously contains protective commensal bacteria that integrate the intestinal microflora and influence inflammatory and immunomodulatory processes. Commensal bacteria not only prevent the excessive proliferation of pathogenic bacteria but also acidify the intestine, ferment lactose, break down lipids and proteins and produce vitamin K and biotin.
Human milk provides the baby with micronutrients, including fat-soluble vitamins, water-soluble vitamins, minerals and trace elements, all of which depend on the mother's diet. Calcium and phosphate, although independent of maternal nutrition, are essential components of casein micelles and necessary for bone mineralization. Trace elements present in breast milk include copper, zinc, barium, cadmium, cesium, cobalt, cerium, lanthanum, manganese, molybdenum, nickel, lead, rubidium, tin, and strontium, and their bioavailability is high only in breast milk.
Human milk contains live maternal cells, including blood-derived leukocytes, breast epithelial cells, and cell fragments. Leukocytes protect the mother and also have an immunoprotective function in the baby. Stem cells have also been identified in human milk, which have the ability to differentiate into mammary epithelial strains when subjected to in vitro mammary differentiation conditions, as well as into other cell types in corresponding microenvironments, including bone cells, brain cells, liver cells, pancreatic beta cells and heart cells. The function of stem cells in the baby is still not well understood and more research is needed to understand their potential.
The components of human milk, especially the living cells of the baby's mother, cannot be replaced by others from artificial sources. A diet exclusively based on breast milk meets the nutritional needs of full-term babies during the first six months, and breastfeeding should continue for the first two years, in association with the intake of solid foods.
Catarina Vilela - Nurse