Breastmilk is a biologically active living fluid. It contains easily digestible nutrients for health and growth and has the ability to adapt as the infant grows. Human milk contains hundreds to thousands of distinct bioactive molecules, the role of which is to protect against infection and inflammation, contribute to immune maturation, contribute to organ development and ensure healthy microbial colonisation. The longer-term benefits of breastfeeding include reduced incidence of: insulin dependent diabetes mellitus, lymphoma, chrons disease, obesity, necrotising enterocolitis, gastrointestinal and respiratory infections and otitis media (middle ear infection), and most recently has been shown to positively impact the development of the infants gut microbiome.
Breastmilk & Nutritional Composition
Breastmilk is composed of 80% water. It contains ~6-7g/100ml of carbohydrates, predominately lactose & oligosaccharides. Breastmilk contains 0.9g/100ml of protein, whereby 40% is casein and 60% is whey protein. Roughly 30-55% of energy in breastmilk comes from fat – important for brain and eye development and essential for baby’s growth.
The hind milk contains a greater amount of fat (compared to the fore milk) and this is influenced by the mother’s diet. Breastmilk also contains anti-inflammatory agents, including antioxidants and enzymes, lysozyme; an enzyme which has a non-specific antimicrobial factor and cellular components, which includes macrophages, leukocytes and lymphocytes – all which play a role in immune defence.
Colostrum & Nutritional Composition
Colostrum is the milk secreted in the early days after birth. Colostrum is low in volume and energy but higher in protein. It contains concentrated anti-infective properties and is strongly encouraged in the early days after birth due to the IgA levels- an important antibody for immune function. Specifically, colostrum contains 365mg/100ml of IgA, compared to 140mg in mature milk.
How is milk produced?
Milk is produced by the release of prolactin in response to the baby sucking and also by oxytocin, in response to visual, auditory and olfactory stimuli. Milk production is influenced by the frequency, intensity and duration of suckling in the early post-partum period. When the infant is born, it has certain reflexes, such as rooting, sucking and swallowing to also assist milk production.
Lactation Nutritional Requirements
Except for a few components, the maternal diet does not influence the composition of breastmilk. Below is a breakdown of the nutritional needs for a lactating mother:
- Breastfeeding mothers require an additional 2,000–2,100 kJ/day
- 2,000kJ = a sandwich and a glass of milk
- An extra ~20g/day of protein is required for lactation
- 16g = 2 eggs and 2tbsp of Greek yoghurt
- Essential fatty acid, Alpha-linolenic acid (ALA) & Linoleic acid needs increase during lactation.
- Diets containing <20% of energy from fat are not recommended for lactating mothers as it is likely to affect the fat content of breast milk
Fibre – the adequate intake for fibre increases from 25g/day to 30g/day. This is based on the estimated increased in additional energy needs of ~20% when lactating
Water – increases to ~3.5L/day based on the fact that fluids are lost in breastmilk production and therefore fluid needs to be replaced
Other micronutrient needs that increase due to the additional cost of energy production of breastmilk include Zinc, Iodine, Iron, Thiamine, Niacin, B12, Folate, B6, Vitamin E, Vitamin C and Vitamin A.
Support services for breastfeeding mothers:
1. Australian Breastfeeding Association https://www.breastfeeding.asn….
2. Lactation consultants https://www.lcanz.org/find-a-l…
3. Breastfeeding helpline 1800 mum2mum (1800 686 2 686)
4. Dietitian’s Association of Australia www.daa.asn.au
Accredited Practicing Dietitian
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