Impact of breast milk on IQ, brain size and white matter development

Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesised that breast milk mediates cognitive effects by affecting brain growth.

We used detailed data from a randomized feeding trial to calculate percentage of breast milk (%EBM) in the infant diet of 50 adolescents. MRI scans were obtained (mean age=15y9m), allowing volumes of total brain (TBV), white and grey matter (WMV, GMV) to be calculated. In the total group %EBM correlated significantly with Verbal IQ (VIQ); in boys, with all IQ scores, TBV and WMV. VIQ was, in turn, correlated with WMV and, in boys only, additionally with TBV. No significant relationships were seen in girls or with grey matter.

These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. The selective effect in males accords with animal and human evidence regarding gender effects of early diet. Our data have important neurobiological and public health implications and identify areas for future mechanistic study.

Infant sex predicts breast milk energy content

Camille E. Powe 1 *, Cheryl D. Knott 2, Nancy Conklin-Brittain 1


Abstract
During human evolutionary history, and for many around the world, breast milk is the primary source of nutritional energy for infants. Variation in breast milk quality might logically have important effects on infant health, growth, and development, yet the sources of this variation remain largely unelucidated. We quantified nutrient and energy content of breast milk from 25 healthy, well-nourished Massachusetts mothers with infants aged 2-5 months. We examined several potential sources of variation in milk quality, particularly feeding patterns, infant sex, and maternal breast growth during pregnancy.

After controlling for time since last feeding, a known correlate of milk composition, we found that mothers of male infants produced milk that had 25% greater energy content than mothers of female infants (P < 0.001). Change in maternal bra cup size during pregnancy was associated with 16.17 kcal/100 ml greater energy content of milk (P = 0.009), but was not significant after taking infant sex into account. Greater nutritional investment in sons may account for the greater observed growth rates in male compared to female infants.

Funded by:
Harvard College Research Program, Cambridge, Massachusetts
Camille E. Powe 1 *, Cheryl D. Knott 2, Nancy Conklin-Brittain 1
1Department of Anthropology, Harvard University, Cambridge, Massachusetts 02138
2Department of Anthropology, Boston University, Boston, Massachusetts 02115

Protein Content and Fortification of Human Milk Influence Gastroesophageal Reflux in Preterm Infants

Aceti A, Corvaglia L, Paoletti V, Mariani E, Ancora G, Galletti S, Faldella G.
*Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Italy dagger"Centro Interdipartimentale di Ricerca sull'Alimentazione Umana, CIRAU," University of Bologna, Italy.

OBJECTIVES:: Preterm human milk (HM) may provide insufficient energy and nutrients and thus may need to be fortified. Our aim was to determine whether fat content, protein content, and osmolality of HM before and after fortification may affect gastroesophageal reflux (GER) in symptomatic preterm infants. METHODS:: Gastroesophageal reflux was evaluated in 17 symptomatic preterm newborns fed naïve and fortified HM by combined pH/intraluminal-impedance monitoring (pH-MII). Human milk fat and protein content was analysed by a near-infrared reflectance analysis. Human milk osmolality was tested before and after fortification. Gastroesophageal reflux indexes measured before and after fortification were compared and were also related to HM fat and protein content and osmolality before and after fortification. RESULTS:: An inverse correlation was found between naïve HM protein content and acid reflux index (RIpH: P = 0.041, rho =-0.501). After fortification, osmolality often exceeded the values recommended for infant feeds; furthermore, a statistically significant (P < 0.05) increase in nonacid reflux indexes was observed. CONCLUSIONS:: Protein content of naïve HM may influence acid GER in preterm infants. A standard fortification of HM may worsen nonacid GER indexes and, due to the extreme variability in HM composition, may overcome both recommended protein intake and HM osmolality. Thus, an individualized fortification, based on the analysis of the composition of naïve HM, could optimize both nutrient intake and feeding tolerance

Nutrient-gene interactions in early life programming: leptin in breast milk prevents obesity later on in life

Palou A, Sánchez J, Picó C.
Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics), University of the Balearic Islands (UIB) and CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Palma de Mallorca, 07122, Spain, andreu.palou@uib.es.

Breast milk is practically the only food eaten during the first months of life in fully breastfed infants and it is assumed to match the nutritional needs during these first months of postnatal life. Breastfeeding compared with infant formula feeding confers protection against several metabolic and physiological changes later on in life and, particularly, against obesity and related medical complications. Recent data from our laboratory, identifying leptin as the first specific compound responsible for these beneficial effects, are reviewed and discussed.

Innate Factors in Human Breast Milk Inhibit Cell-Free HIV-1 but Not Cell-Associated HIV-1 Infection of CD4+ Cells

From the Departments of *Physiology and daggerMicrobiology and Immunology, Dartmouth Medical School, Lebanon, NH; and double daggerVA Medical Center, White River Junction, VT.

BACKGROUND:: Transmission of HIV from mother to child through breast-feeding remains a global health challenge, particularly in developing countries. Breast milk from an HIV-infected women may contain both cell-free HIV-1 and cell-associated virus; however, the impact of human Breast Milk on HIV infection and replication in CD4 cells remain poorly understood. OBJECTIVES:: In the present study, we evaluated the effects of breast milk in vitro on infection of CD4 cells with cell-free HIV-1, including effects on HIV-1 receptor expression, reverse transcription, integration, and viral transcription. Additionally, we evaluated the ability of breast milk to inhibit cell-associated transmission of HIV-1 from infected CD4 T lymphocytes.

RESULTS:: Our results demonstrate that breast milk potently inhibits infection with cell-free HIV-1 in vitro independently of viral tropism and significantly decreases HIV-1 reverse transcription and integration in CD4 cells. However, the inhibitory effect of breast milk on HIV-1 infection of CD4 cells was lost during extended culture, and direct coculture of HIV-infected CD4 T lymphocytes with susceptible target cells revealed that breast milk was ineffective at blocking cell-associated HIV-1 infection.

CONCLUSIONS:: Our findings suggest that breast milk may provide a protective function against cell-free HIV-1 but may be less effective at blocking infection by cell-associated virus.
J Acquir Immune Defic Syndr. 2009 Apr 2

Automated on-line column-switching HPLC-MS/MS method with peak focusing for measuring parabens, triclosan, and other environmental phenols in human mi

Parabens (esters of p-hydroxybenzoic acid) and triclosan are widely used as preservatives and antimicrobial agents, respectively, in personal care products, pharmaceuticals, and food processing. Because of their widespread use and potential risk to human health, assessing human exposure to these compounds in breastfed infants is of interest. We developed a sensitive method, using a unique on-line solid-phase extraction-high performance liquid chromatography-tandem mass spectrometry system with peak focusing feature, to measure in human milk the concentrations of five parabens (methyl-, ethyl-, propyl-, butyl-, and benzyl parabens), triclosan, and six other environmental phenols: bisphenol A (BPA); ortho-phenylphenol (OPP); 2,4-dichlorophenol; 2,5-dichlorophenol; 2,4,5-trichlorophenol; and 2-hydroxy-4-methoxybenzophenone (BP-3). The method, validated by use of human breast milk pooled samples, shows good reproducibility (inter-day coefficient of variations ranging from 3.5% to 16.3%) and accuracy (spiked recoveries ranging from 84% to 119% at four spiking levels). The detection limits for most of the analytes are below 1 ng mL−1 in 100 μL of milk. We tested the usefulness of the method by measuring the concentrations of these twelve compounds in four human milk samples. We detected methyl paraben, propyl paraben, triclosan, BPA, OPP, and BP-3 in some of the samples tested. The free species of these compounds appear to be the most prevalent in milk. Nevertheless, to demonstrate the utility of these measures for exposure and risk assessment purposes, additional data about sampling and storage of the milk, and on the stability of the analytes in milk, are needed.


ARTICLE

Distribution of polychlorinated biphenyls and organochlorine pesticides in human breast milk from various locations in Tunisia: Levels of contaminatio

The concentrations of dichlorodiphenytrichloroethane and its metabolites (DDTs), hexachlorobenzene (HCB), hexachlorocyclohexane isomers (HCHs), dieldrin, and 20 polychlorinated biphenyls (PCBs) were determined in 237 human breast milk samples collected from 12 locations in Tunisia. Gas chromatography with electron capture detector (GC-ECD) was used to identify and quantify residue levels on a lipid basis of organochlorine compounds (OCs). The predominant OCs in human breast milk were PCBs, p,p′-DDE, p,p′-DDT, HCHs, and HCB. Concentrations of DDTs in human breast milk from rural areas were significantly higher than those from urban locations (p<0.05). With regard to PCBs, we observed the predominance of mid-chlorinated congeners due to the presence of PCBs with high Kow such as PCB 153, 138, and 180. Positive correlations were found between concentrations of OCs in human breast milk and age of mothers and number of parities, suggesting the influence of such factors on OC burdens in lactating mothers. The comparison of daily intakes of PCBs, DDTs, HCHs, and HCB to infants through human breast milk with guidelines proposed by WHO and Health Canada shows that some individuals accumulated OCs in breast milk close to or higher than these guidelines.

ARTICLE