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Excessive maternal fat mass may impair lactogenesis and lead to lower breastmilk volume. We investigated this relationship in rural Indonesian exclusively breastfeeding mother-infant (2-5.3 months) dyads (n = 112) by measuring breastmilk intake by deuterium oxide dose-to-mother technique (DDMT) and maternal fat mass by DDMT, bioelectrical impedance analysis (BIA), and body mass index (BMI). We also compared fat mass assessed by DDMT and BIA. In this population, we found a significant negative relationship between breastmilk intake and maternal fat mass measured by DDMT ([beta] = -5.04 mL, 95% CI: -9.36, -0.72, P = 0.023), and similar but slightly weaker negative trend with BIA and BMI, after adjusting for social-economic status, maternal age, infant age and sex. Maternal fat mass estimates by BIA and DDMT showed good agreement. In light of the trend for overweight and obesity worldwide, further research is needed into the underlying mechanisms of this negative relationship., Author(s): Aly Diana [sup.1] [sup.2] , Jillian J. Haszard [sup.1] , Lisa A. Houghton [sup.1] , Rosalind S. Gibson [sup.1] Author Affiliations: (1) Department of Human Nutrition, University of Otago, [...]

Zika virus belongs to the family Flaviviridae and was first described in 1947. The first outbreak of infection with this virus was on Yap Island, Micronesia, in 2007 (1). The [...]

Background/objectives This study was aimed to investigate the association of maternal serum and breast-milk levels of macronutrients, hormones, growth factors, and maternal body composition with infant's body weight. Subjects/methods Eighty mother-infant pairs comprised 40 with overweight or obese infant and 40 with normal-weight infant were enrolled in this study. The level of ghrelin, Leptin, adiponectin, EGF, and IGF1 in plasma and breast milk were assessed. Daily breast milk intake and macronutrient concentration along with anthropometric indices of mother-infant pairs were also assessed. Results No significant differences were observed in concentrations of serum hormones between two groups (p > 0.05). However, hormones levels in maternal serum were higher than those in breast milk. A significant positive correlation was found between serum EGF and ghrelin (r = 0.57, p = 0 < 0001). Higher IGF1 in serum showed a significant association with its milk counterpart (r = 0.37). Current mother's weight was associated with infant's weight at the 2nd and 6th month (B = 0.023 p = 0.04, B = 0.055 p = 0.005). The breast-milk macronutrient content was not comparable between two groups. However, the average daily breast milk consumption in obese infants was higher than normals (p = 0.001). Milk EGF and leptin were related to a decrease of 59% and 46% the odds of obese infant development, respectively. There was a significant association of milk EGF and ghrelin with birth weight (B = -0.19, p = 0.04 and B = -0.2, p = 0.04, respectively), and also serum leptin with infant's body weight at the 6th month. Conclusions Our findings provide a positive association of maternal weight, daily breast milk intake, EGF, and ghrelin with infant's body weight., Author(s): Adeleh Khodabakhshi [sup.1] [sup.2] , Hassan Mehrad-Majd [sup.3] , Farhad Vahid [sup.2] [sup.4] , Mohammad Safarian [sup.5] Author Affiliations: (1) Student Research committee, Faculty of Nutrition and Food Technology, [...]

BACKGROUND: Phthalates are ubiquitous in the environment, but concentrations in multiple media from breast-feeding U.S. women have not been evaluated. OBJECTIVES: The objective of this study was to accurately measure [...]

BACKGROUND: One of the most serious human health concerns related to environmental contamination with polychlorinated biphenyls (PCBs) is the presence of these chemicals in breast milk. OBJECTIVES: We developed a [...]

When it comes to feeding the newborn, human milk is, from an evolutionary perspective, the biological norm, the time-tested standard of care. The health benefits to the infant of breastfeeding [...]

BACKGROUND: Phthalates may pose a risk for perinatal developmental effects. An important question relates to the choice of suitable biological matrices for assessing exposure during this period. OBJECTIVES: This study [...]

Allergic asthma is a chronic disease characterized by airway obstruction in response to allergen exposure. It results from an inappropriate T helper type 2 response to environmental airborne antigens and affects 300 million individuals (1). Its prevalence has increased markedly in recent decades, most probably as a result of changes in environmental factors (2). Exposure to environmental antigens during infancy is crucial to the development of asthma (3). Epidemiological studies on the relationship between breastfeeding and allergic diseases have reached conflicting results (4-8). Here, we have investigated whether the exposure of lactating mice to an airborne allergen affects asthma development in progeny. We found that airborne antigens were efficiently transferred from the mother to the neonate through milk and that tolerance induction did not require the transfer of immunoglobulins. Breastfeeding-induced tolerance relied on the presence of transforming growth factor (TGF)-[beta] during lactation, was mediated by regulatory [CD4.sup.+] T lymphocytes and depended on TGF-[beta] signaling in T cells. In conclusion, breast milk-mediated transfer of an antigen to the neonate resulted in oral tolerance induction leading to antigen-specific protection from allergic airway disease. This study may pave the way for the design of new strategies to prevent the development of allergic diseases., We assessed the impact of airborne antigen exposure of lactating mice on the development of allergic asthma in their progeny (Fig. 1a). When they reached adulthood, the offspring were sensitized, [...]

BACKGROUND: Little is known about the rates of loss (depuration) of polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) from mothers during lactation. Depuration rates affect infant exposure to chemicals during breast-feeding, and fetal and lactational transfers during subsequent pregnancies. OBJECTIVE: Our objective in this study was to estimate depuration rates of PBDEs and PCBs using serial samples of breast milk. METHOD: Nine first-time mothers (primiparae) each collected samples at 4, 6, 8, 12, 16, 20, and 24 weeks after birth. Nine additional primiparae each collected two samples at varying time intervals (18 to > 85 weeks after birth). Analytical precision was assessed to evaluate the accuracy of measured monthly percentage declines in PBDEs and PCBs. RESULTS: The four major PBDE congeners decreased 2 or 3% [+ or -] 1% per month over the 6-month period. These decreases were consistent over a 50-fold range (21-1,330 ng/g lipid weight) of initial PBDE concentrations in breast milk. The change in PCB-153 ranged from + 0.3% to -0.6% per month, with heterogeneous slopes and greater intraindividual variability. PBDE and PCB concentrations declined 1% per month over longer periods (up to 136 weeks). CONCLUSIONS: Our data indicate that PBDEs and PCBs are not substantially (4-18%) reduced in primiparae after 6 months of breast-feeding. Consequently, the fetal and lactational exposures for a second child may not be markedly lower than those for the first. Participants were volunteers from a larger study population (n = 82), and were typical in their PBDE/PCB levels and in many demographic and lifestyle factors. These similarities suggest that our results may have broader applicability. KEY WORDS: breast-feeding, breast milk, brominated flame retardants, depuration, exposure assessment, lactation, PBDEs, PCBs. Environ Health Perspect 115:1271-1275 (2007). doi:10.1289/ehp.10166 available via http://dx.doi.org/ [Online 28 June 2007], Polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) are persistent, lipophilic chemicals with different sources, pathways, and patterns of human exposure. Mixtures of PBDEs are present as noncovalently bound flame-retardant [...]

A simple method of flash-heat to inactivate HIV in naturally infected breast milk from HIV-positive mothers is investigated. It is indicated that flash-heat is capable of inactivating cell-free HIV-1 in naturally infected breast milk from HIV-positive women.

Increasing calcium absorption and bone calcium accretion to levels above those achieved by human milk-fed, full-term infants is possible with infant formulas. However, no data support such a goal or suggest that it is beneficial to short- or long-term bone health. Small differences in the bioavailability of calcium between infant formulas are unlikely to have long-term consequences. Long-term studies of the effects of infant feeding type on ultimate bone mass are needed. For now, the vitamin-replete breast-fed infant's rate of calcium accretion during the first year of life should be the standard targeted for infant formulas. Key words: bone mineral content, calcium absorption, human milk, minerals

Currently limited information exists on how maternal supplementation with provitamin A carotenoids might influence the carotenoid pattern in breast milk during lactation. This study was designed to investigate the effect of maternal red palm oil supplementation (~12 g/d) throughout the 3rd trimester of pregnancy and the first 3 mo postpartum on carotenoid pattern in both plasma and breast milk. Plasma and breast milk [alpha]- and [beta]-carotene concentrations increased in response to red palm oil supplementation and were different (P < 0.001) from the control group at both 1 and 3 mo postpartum. Plasma lutein and zeaxanthin concentrations were reduced (P < 0.001) from pregnancy to 1 mo postpartum and remained stable until 3 mo postpartum. However, breast milk lutein concentrations, expressed per gram of milk fat, increased (P < 0.05) in both groups from 1 to 3 mo postpartum. The results of this study show that there are proportionally more hydrocarbon carotenoids such as [alpha]- and [beta]-carotene in plasma than in breast milk, whereas xanthophylls, such as lutein and zeaxanthin, are proportionally more prevalent in breast milk. More importantly, red palm oil supplementation increases the milk concentrations of provitamin A carotenes without decreasing the milk concentrations of xanthophylls. In summary, this study demonstrates that a regulated uptake of polar carotenoids into breast milk exists and that supplementation with [alpha]- and [beta]-carotene does not negatively affect this transfer. The mechanisms behind this transport are not fully understood and merit further study. KEYWORDS: * [beta]-carotene * lutein * lactation * breast milk * red palm oil

Objective To evaluate the growth of resident aerobic mesophilic flora and added Enterobacter sakazakii in fresh, unfortified human milk; fresh human milk fortified with two commercial powdered fortifiers differing in iron content; and infant formula prepared from powder. Subjects Eight mothers provided preterm breast milk samples. Methods Breast milk samples were divided into three aliquots: unfortified, fortified with fortifier containing 1.44 mg iron/14 kcal, and fortified with fortifier containing 0.4 mg iron/14 kcal. Aliquots of formula were prepared. Breast milk and formula aliquots were divided into two test samples. Half were inoculated with low amounts of E sakazakii; half were not. All test samples were maintained at room temperature (22[degrees]C), serially diluted, and plated onto agars after 0, 2, 4, and 6 hours. Plates were incubated at 35[degrees]C and enumerated. Statistical analyses Data were analyzed using repeated measures analysis of variance. P<.05 was considered significant. Results There were no differences in colony counts of aerobic bacteria among uninoculated or among inoculated human milk samples at any time; counts did not increase significantly over 6 hours. There were no differences in colony counts of E sakazakii among inoculated human milk samples at any time; counts did not increase significantly over 6 hours. Aerobic bacteria and E sakazakii colony counts from infant formula did not increase significantly over 6 hours. Conclusions During 6 hours at 22[degrees]C, fresh human milk and formula had negligible bacterial growth; fortifying human milk with powdered fortifiers did not affect bacterial growth. J Am Diet Assoc. 2005;105:1567-1572.

Milk oligosaccharides have been shown to interfere with adhesion of many pathogens to host mucosal surfaces. Characterization of the adhesion mechanisms of the bacteria to host cell surface is needed to develop novel functional food, infant formulas, and anti-infective drugs. Adhesion of Neisseria meningitidis, a human specific pathogen causing meningitis and septicemia, is not completely understood but is mediated by type IV pili. Here, we developed a microtiter well pili binding assay to investigate the binding activities of N. meningitidis isolated type IV pili to different glycoproteins. Pili binding activities to bovine thyroglobulin and human salivary agglutinin but not to chicken ovalbumin were present. Inhibition of these binding activities was demonstrated by fractionated human or bovine milk oligosaccharides. The binding of neisserial pili to bovine thyroglobulin was most effective and was clearly inhibited by human milk neutral or bovine milk acidic oligosaccharides. KEY WORDS: * Neisseria meningitidis * oligosaccharide * human milk * bovine milk * bacterial adhesion

Objective. Compared with preterm formula (PF), mother&apos;s milk (MM) is associated with lower rates of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) among premature infants. Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization, we reasoned that pasteurized donor human milk (DM) would be a suitable alternative. Methods. Extremely premature infants ( Results. Of 243 infants, 70 (29%) received only MM; group DM included 81 infants and group PF included 92 infants. Because of poor weight gain, 17 infants (21%), all in group DM, were switched to PF. There were no differences in birth weight, gestational age, multiple births, and age at attainment of feeding of 50 mL/kg among groups. There were no differences between group DM and group PF in LOS and/or NEC, other infection-related events, hospital stay, or number of deaths. Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain, compared with group PF. Compared with groups DM and PF, group MM had fewer episodes of LOS and/or NEC and total infection-related events and a shorter duration of hospital stay. Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups. Conclusions. In this randomized, blinded trial of feeding of extremely premature infants, we found that, as a substitute for MM, DM offered little observed short-term advantage over PF for feeding extremely premature infants. Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays. Pediatrics 2005;116:400-406; human milk, pasteurized human donor milk, premature infant feeding. ABBREVIATIONS. DM, donor human milk; PF, preterm formula; MM, mother&apos;s milk; LOS, late-onset sepsis; NEC, necrotizing enterocolitis; ROP, retinopathy of prematurity; OR, odds ratio; CI, confidence interval., In a previous study of the time of initiation and method of feeding for premature infants, the benefits observed were overshadowed by the type of milk fed (mother's milk [MM] [...]

Breast-feeding is a highly effective strategy for preventing morbidity and mortality in infancy. The human-milk glycans, which include oligosaccharides in their free and conjugated forms, constitute a major and an innate immunologic mechanism by which human milk protects breast-fed infants against infections. The glycans found in human milk function as soluble receptors that inhibit pathogens from adhering to their target receptors on the mucosal surface of the host gastrointestinal tract. The [alpha]1,2-linked fucosylated glycans, which require the secretor gene for expression in human milk, are the dominant glycan structure found in the milk of secretor mothers, who constitute the majority (~80%) of mothers worldwide. In vitro and in vivo binding studies have demonstrated that [alpha]1,2-linked fucosylated glycans inhibit binding by campylobacter, stable toxin of enterotoxigenic Escherichia coil, and major strains of caliciviruses to their target host cell receptors. Consistent with these findings, recently published epidemiologic data demonstrate that higher relative concentrations of [alpha]1,2-linked fucosylated glycans in human milk are associated with protection of breast-fed infants against diarrhea caused by campylobacter, caliciviruses, and stable toxin of enterotoxigenic E. coil, and moderate-to-severe diarrhea of all causes. These novel data open the potential for translational research to develop the human-milk glycans as a new class of antimicrobial agents that prevent infection by acting as pathogen anti-adhesion agents. KEY WORDS: * oligosaccharide * anti-adhesion agents * innate immunity * receptor analogs * histo-blood groups

Human neonates are born with an immature and naive acquired immune system, and many of the innate components of mucosal immunity are not fully developed. Thus, the innate immune system of human milk is an important complement to the mucosal barrier of the developing gut. The nursing mother provides her infant many protective agents through milk, a growing number of which have been identified as isolates of milk in laboratory models of infection. The number, the potency, and the importance of these protective agents are probably greater than previously thought. For example, many potent protective agents are not found in milk until digestion releases antimicrobial agents such as fatty acids and peptides. An alternate conformer of [alpha]-lactalbumin forms from milk in the stomach and inhibits cancer cells. Many of the protective constituents of human milk inhibit different aspects of a pathogenic process, creating a synergy, where much lower concentrations of each component become protective. Some components have a temporal and a spatial specificity that would cause their protective role to go unrecognized by most laboratory models of infection. Some protective components had remained underappreciated because of technical challenges in their isolation and testing. Recent reports suggest that human milk contains a highly potent mixture of protective agents that constitute an innate immune system, whereby the mother protects her infant from enteric and other diseases. These human-milk components may represent a rich source of novel classes of therapeutic agents against human pathogens. KEY WORDS: * innate immunity * disease * human milk * neonates * protection

Infants are exposed to variable copper (Cu) intake; Cu in breast milk is low, whereas infant formulas vary in Cu content as well as the water used for their preparation. Little is known about the regulation of Cu absorption during infancy. The objectives of this study were to determine effects of Cu supplementation on Cu absorption and tissue distribution and the expression of Cu transporters in an infant rat model. Suckling rat pups were orally dosed with 0, 10, or 25 [micro]g Cu/day. Intestine and liver were collected at days 10 and 20, and Cu concentration, Cu transporter-1 (Ctr1), Atp7A, AtpTB, and metallothionein (MT) mRNA and protein levels were measured. [sup.67]Cu absorption was measured at days 10 and 20. Total [sup.67]Cu absorption decreased, and intestinal [sup.67]Cu retention increased with increased Cu intake. At day 10, intestine Cu concentration, MT mRNA, and Ctr1 protein levels increased with supplementation, but no changes in Atp7A or Atp7B levels were observed. At day 20, intestine Cu concentration was unaffected by Cu supplementation, but Ctr1 protein and Atp7A mRNA and protein levels were higher than in controls. In liver, Cu level reflected Cu intake at days 10 and 20. There was a significant increase in Ctr1. Atp7B, and MT mRNA expression in liver at both ages with Cu supplementation. In conclusion, the ability of suckling rat pups to tolerate varying amounts of dietary Cu may be due to changes in Cu transporters, facilitated by transcriptional and posttranslational mechanisms. Despite these adaptive changes, Cu supplementation resulted in elevated alanine aminotransferase levels, suggesting a risk of Cu toxicity with supplementation during infancy. copper transport; infancy; intestine; liver; copper transporter-1; Atp7A; Atp7B

Trans fatty acids (TFA) are found naturally in some foods (e.g., dairy products) as well as many processed foods made with partially hydrogenated vegetable oils (PHVO). Data from a growing literature suggest that some TFA decrease milk fat in lactating animals. Because the physiologic effects of TFA in lactating women are unknown, this study was designed to investigate the effects of TFA consumption on human milk fat. A randomized, crossover design (n = 12) was used to study the effect of 3 dietary treatments: high PHVO (regular margarine), low PHVO (low TFA margarine), or low PHVO but high in naturally occurring TFA (butter) on milk fat. Treatments were administered for 5 d, with 7-d washout periods. Maternal adiposity was estimated by dual-energy X-ray absorptiometry. Milk and blood were collected on d 5 of each intervention period. In general, milk and serum fatty acid concentrations mirrored those of the dietary treatments. There were significant interactions between treatment and maternal adiposity on milk fat and infant milk consumption, as well as on serum glucose and nonesterified fatty acid (NEFA) concentrations. Consumption of regular margarine, compared with low TFA margarine, resulted in lower milk fat in leaner, but not in more obese women. Consumption of either regular or low TFA margarine, compared with butter, elevated serum NEFA concentrations in the more obese women. In summary, consumption of regular margarine, compared with low TFA margarine, decreased milk fat in lean women. Further studies are required to determine whether infant milk consumption might compensate for this potentially important change in milk composition. KEY WORDS: * human milk * milk fat * lactation * breast-feeding * trans fatty acid

In adults, psychological stress regulates immune responsiveness in part via the increased levels of corticosterone that are produced as a result of hypothalamic-pituitary-adrenal (HPA) axis activation. However, there is a lack of knowledge as to the role such regulation may play in the neonate. Neonates are severely compromised in their ability to generate an immune response to pathogens encountered after birth and therefore rely heavily on maternally derived antibody acquired postnatally through the milk. This passive transfer of antibody is critical for protection of the neonate from severe herpes simplex virus (HSV) infection and mortality. Using a well-established postnatal restraint/light stress model, we determined whether maternal stress and the associated increases in corticosterone would affect the transmammary transfer of antibody and subsequent neonate susceptibility to HSV-associated mortality. Serum corticosterone levels were markedly increased in lactating mice subjected to the restraint/light stress, and increased levels of corticosterone were transferred through the milk of these stressed mothers to their neonates. Despite these increases in corticosterone, the transmammary transfer and accumulation of total and HSV-specific IgG in neonate serum remained intact. This milk-derived, HSV-specific antibody alone protected the neonate from systemic viral spread. Interestingly, postnatal maternal stress significantly increased neonate survival after HSV-2 infection despite no apparent alteration in viral spread. These studies demonstrate that although the transmammary transfer of antibody is unaffected by maternal stress, stress may be enhancing components of antiviral immunity that are effective in protecting neonates from HSV-associated mortality. postnatal stress; milk; antibody; viral infection

Human breast milk suppresses the transcriptional regulation of IL-1[beta]-induced NF-[kappa]B signaling in human intestinal cells. Am J Physiol Cell Physiol 287:C1404-C1411, 2004. First published June 30, 2004; doi:10.1152/ajpcell.00471.2003.--Neonatal necrotizing enterocolitis (NEC), which is a disease with a poor prognosis, is considered to be caused by the coincidence of intestinal ischemia-reperfusion injury and systemic inflammation due to the colonization of pathogenic bacteria. Interleukin (IL)-8, a proinflammatory cytokine, plays an important role in the pathophysiology of NEC. It was recently reported that IL-1[beta] activates the IL-8 gene by regulating the transcriptional nuclear factor [kappa]B (NF-[kappa]B) signaling pathways in intestinal cells. The protective role of maternal milk in NEC pathogenesis has been reported in both human and animal studies. In this study, we show that human breast milk dramatically suppressed the IL-1[beta]-induced activation of the IL-8 gene promoter by inhibiting the activation pathway of NF-[kappa]B. Moreover, we also show that human breast milk induced the production of I[kappa]B[alpha]. These results suggest that human breast milk could be protective and therapeutic in neonates with NEC by inhibiting the activation pathway of NF-[kappa]B. interleukin-8

An overlap of breast-feeding and late pregnancy is associated with decreased intake of human milk and reduced infant growth. We evaluated the association of an overlap with macronutrient and immunological components of milk, infant urinary IgA, and infant and maternal morbidity. On d 2 and 1 mo postpartum, staff measured 24-h intake of breast milk and collected samples from 133 Peruvian women; 68 had breast-fed during the last trimester of pregnancy (BFP) and 65 had not breast-fed during pregnancy (NBFP). Data on maternal and infant anthropometry and health were collected for 1 mo. On d 2, lactose and lysozyme concentrations were higher, total lysozyme intake was higher and concentration and total intake of lactoferrin were lower in the BFP than the NBFP group (P < 0.05). The total 1-mo IgA intake was lower among BFP than NBFP infants (P = 0.01). Urinary IgA concentration was correlated with breast milk IgA concentration (r = 0.29; P = 0.01) but not with breast-feeding during pregnancy. An overlap was not associated with diarrhea but BFP infants were 5 times as likely to have a cough for at least 7 d than NBFP infants (P < 0.05). Reported mastitis was rare and occurred only in the NBFP group (P = 0.05). An overlap of breast-feeding and late pregnancy was associated with changes in milk composition, an increased frequency in symptoms of infant respiratory illness but decreased reported mastitis. Further in-depth studies are warranted to determine the cumulative effects associated with a breast-feeding/ pregnancy overlap on infant and maternal outcomes. KEY WORDS: * breast-feeding * pregnancy * breast milk composition * immunology * respiratory illness

Research has been conducted on the (super) 1 H - (super)13 C one-bond dipolar coupling values. The natural abundance samples of human milk oligosaccharides have been investigated.

The retinol concentration in breast milk declines with the duration of lactation, according to research undertaken among 91 mothers and their infants from a middle-income area in East-Jakarta, Indonesia. There was also found to be a connection between the retinol concentration in blood and milk. This highlights the importance of the vitamin A status of the mother in providing an adequate vitamin A uptake by the infant. The zinc status of the women surveyed was not as adequate as their vitamin A status, taking into account the fact that around 29% had low plasma zinc levels.

Haemophilus influenzae is a major cause of otitis media and other respiratory tract disease in children. The pathogenesis of disease begins with colonization of the upper respiratory mucosa, a process that involves evasion of local immune mechanisms and adherence to epithelial cells. Several studies have demonstrated that human milk is protective against H. influenzae colonization and disease. In the present study, we examined the effect of human milk on the H. influenzae IgA1 protease and Hap adhesin, two autotransported proteins that are presumed to facilitate colonization. Our results demonstrated that human milk lactoferrin efficiently extracted the IgA1 protease preprotein from the bacterial outer membrane. In addition, lactoferrin specifically degraded the Hap adhesin and abolished Hap-mediated adherence. Extraction of IgA1 protease and degradation of Hap were localized to the N-lobe of the bilobed lactoferrin molecule and were inhibited by serine protease inhibitors, suggesting that the lactoferrin N-lobe may contain serine protease activity. Additional experiments revealed no effect of lactoferrin on the H. influenzae P2, P5, and P6 outer-membrane proteins, which are distinguished from IgA1 protease and Hap by the lack of an N-terminal passenger domain or an extracellular linker region. These results suggest that human milk lactoferrin may attenuate the pathogenic potential of H. influenzae by selectively inactivating IgA1 protease and Hap, thereby interfering with colonization. Future studies should examine the therapeutic potential of lactoferrin, perhaps as a supplement in infant formulas.

To evaluate whether milk production can be improved by increasing food intake, a randomized, double-blind, supplementation trial was completed among 102 lactating Guatemalan women. The subjects were undernourished, as indicated by their low values for calf circumference (CC) and the small size of their infants at birth. A high-energy (2.14 MJ/d, HES) and a low-energy (0.50 MJ/d, LES) supplement were distributed 6 d/wk from wk 5 to 25 of lactation. Data were evaluated using repeated-measures analysis of variance on the increments from initial values for each outcome variable with one-tailed tests of statistical significance. The maternal energy intake increased 1.18 MJ/d (P < 0.01) more among the HES than the LES women. Benefit from supplementation was more evident among the more undernourished (CC [less than or equal to] median value, 29.5 cm) women. Among these 53 lower-CC women, infant milk and milk energy intakes were 10% higher (64 g/d and 14 MJ/d, respectively, at wk 25) in the HES than the LES group. After controlling for other determinants of infant milk and energy intakes in regression analyses, the significance of these differences increased to P < 0.04. However, there was no detectable effect on infant growth. Logistic regression analysis was used to show that HES women were significantly (P < 0.05) more likely than LES women to be exclusively breast-feeding their infants at wk 20, the time when the effect of supplementation was most evident. These findings establish that milk production and the duration of exclusive breast-feeding of undernourished women can be improved with the provision of supplemental food. KEY WORDS: * lactation * malnutrition * food supplementation * breast-feeding human milk

A dose dependent saturable rise in infant plasma and erythrocyte phospholipid docosahexaenoic acid (DHA) results from boosting breast milk DHA levels. It was established that there is no connection between visual evoked potential (VEP) acuity and dietary grouping or the level of DHA in breast milk. It is possible that increasing DHA in breast milk during the first three months of life may have a small impact on MDI scores at one year.

Postpartum megadose vitamin A supplementation to malnourished mothers resulted in a sustained retinol concentration in breastmilk for up to six months. Vitamin A supplementation provides substantial benefits to breastfed infants. The duration of Acute Respiratory Infection was shorter and incidence of febrile illness was less in infants of supplemented mothers compared to infants of unsupplemented mothers.

The purpose of this investigation was to determine if feeding diets containing human milk resulted in increased numbers of microorganisms implicated in increased folate production and the effect on folate availability. Following a folate-depletion period (5 wk), 30 rats were fed folate-repletion diets (4 wk) with or without 20% milk solids (human, cow or goat) and containing either 906 or 4530 nmol folic acid/kg. At the end of the test period, the cecum and colon were removed in an anaerobic chamber, homogenized, diluted ([10.sup.-2]-[10.sup.-8]), and the contents of each plated on selective and nonselective media. In addition to enumeration of the total anaerobic load, five genera of bacteria were counted (Bacteroides, Bifidobacterium, Clostridium, Escherichia and Streptococcus). Rats fed human milk solids had at least a seven- and onefold mean increase in the Bifidobacterium concentration in the cecum (P < 0.006) and colon (P < 0.04), respectively, compared with rats fed other diets. The total anaerobic bacterial concentration in the cecum and the colon of rats fed human milk solids was also greater than that of rats fed the other diets (P < 0.05). The single exception was the total anaerobic count in the cecum of rats consuming goat milk solids, which did not differ from that of rats consuming human milk solids. Further, rats fed human milk solids had at least a 42 and 48% higher mean plasma folate concentration and total cecal material folate content, respectively, than rats in other dietary treatments containing 906 nmol/kg folic acid. Therefore, the improved folate status of rats fed human milk - containing diets appears to be due, at least in part, to increased folate synthesis by Bifidobacteria and other folate-synthesizing microbes in the cecum and colon. J. Nutr. 126: 1505-1511, 1996. INDEXING KEY WORDS: * folate * milk * microflora * Bifidobacterium * rats

Human milk samples were obtained from 146 lactating women living in five distinct geographic regions of the People's Republic of China. The regions were characterized as follows: pastoral, rural, urban 1, urban 2, and marine. Dietary information obtained on a subsample of women providing milk suggested distinct differences in the food availability in the five regions and the habitual diets of the lactating women studied. The milk concentration of docosahexaenoic acid (DHA) varied greatly (g/100 g total fatty acids): 0.44 [+ or -] 0.29 (pastoral), 0.68 [+ or -] 0.29 (rural), 0.88 [+ or -] 0.34 (urban 1), 0.82 [+ or -] 0.35 (urban 2), and 2.78 [+ or -] 1.20 (marine region). Docosahexaenoic acid is critical for brain and retina development in the infant. Milk arachidonic acid (AA) ranged from 0.80 [+ or -] 0.14 (rural) to 1.17 [+ or -] 0.33 and 1.22 [+ or -] 0.32 g/100 g fatty acids from the marine and pastoral regions. Arachidonic acid is associated with infant growth. The AA to DHA ratio (g/g) was highly variable also: 2.77 (pastoral), 1.18 (rural), 1.01 (urban 1), 1.23 (urban 2), and 0.42 (marine). The DHA concentration found in the milk of women from the marine region was twice as high as any reported previously, but was in a range similar to the amounts found in the milk of women fed fish oil. Seafood consumption by the women residing in the marine region is a likely contributor to the DHA concentration in their milk. These data illustrate the heterogeneity of the fatty acid composition of human milk and suggest a great influence of geography and the maternal diet on concentrations of DHA and AA in human milk. INDEXING KEY WORDS: milk; humans; docosahexaenoic acid; arachidonic acid; (n-3) fatty acids