Breastfeeding is awesome – find out why

The Breastfed Baby

  • Immune system – Breast milk helps to mature the immune system. Responds better to vaccinations. Decreased risk of childhood cancer
  • Skin – Less allergic eczema in breastfed infants
  • Joints and muscles – Juvenile rheumatoid arthritis is less common in children who were breastfed
  • Bowels – Less constipation
  • Urinary tract – fewer infections in breastfed infants
  • Digestive system – Less diarrhoea, fewer gastrointestinal infections in babies who are breastfeeding. Six months of exclusive breastfeeding reduces risk of food allergies. Also, less risk of Crohn’s disease and ulcerative colitis in adulthood
  • Heart and circulation – Breastfed children have lower cholesterol
  • Respiratory system – Breastfed babies have fewer and less severe upper respiratory tract infections, less pneumonia and less influenza
  • Mouth – less need for orthodontics in children breastfed more than a year. Improved muscle development of face from suckling at the breast. Subtle changes in the taste of breast milk from one feed to the next prepares baby to accept a wide variety of solid foods
  • Endocrine system – reduced risk of developing diabetes
  • Higher IQ – Breast milk supports the growth of brain tissue
  • Eyes – Visual acuity is higher in breastfed babies
  • Ears – Breastfed babies get fewer ear infections

So, we see breast milk is awesome so let’s understand why it is so great!

It is due to something in breast milk called HMO’s – Human Milk Oligosaccharides.

Carbohydrates are classified based on their amount of monosaccharides.

Monosaccharides (one sugar) are the smallest building block of carbohydrates eg glucose

Two monosaccharides joined together = disaccharide (two sugars) eg lactose

3-10 monosaccharides linked together = oligosaccharide (many sugars) eg HMO

History of HMO’s

In the 1900’s –

  • It was known that breastfed infants had a survival advantage
  • It was discovered that there were differences in the stool bacterial composition of breastfed and formula-fed infants
  • Mothers milk was discovered to have an unidentified carbohydrate fraction

In the 1930’s –

  • Bifidogenic factor in human breast milk consists of oligosaccharides
  • First individual HMOs characterised

In the 1950’s –

  • Discovery and characterisation of the most abundant oligosaccharides in human breast milk
  • Ongoing research on metabolic and health benefits of HMOs for infants and their mothers

HMOs are the third largest solid component in Human Breast Milk


Jantscher-Krenn and Bode, Minerva Pediatr. 2012. Bode. Glycobiology, 2012. Zivkovic et al., Proc Natl Acad Sci, 2011. Austin et al., Nutrients, 2016.

The HMO fraction is considered to be a key component of human breast milk, after lactose and lipids.

  • HMO levels range between 20 and 25 g/L for colostrum and 5 and 15 g/L for mature milk
  • 2‘FL and LNnT are among the most abundant HMOs

More than 150 HMO’s have been isolated in breast milk. The two most common HMO’s are 2FL and LNnT.

The factors influencing the concentration of HMOs in breast milk are

  • Mothers genetic profile – whether she is Lewis gene + or – and secretor status + or –
  • Whether it is early in lactation or late – ie the concentration of HMOs are increased in colostrum – the first type of breast milk
  • Whether it is full term pregnancy or a preterm pregnancy
  • Whether it is a vaginal birth or a caesarean.

The factors influencing the neonatal microbiome

  • Whether it is a vaginal birth or a caesarean
  • Breast fed or formula fed
  • Home birth or hospital birth
  • Mothers health
  • Use of antibiotics either by mom in labour or baby as a newborn.

Gut microbiota development during early life

Gut microbiota plays an important role in the maturation of gut barrier function and stimulation of immune development.

The development of a normal commensal gut microbiota is one of the key drivers for the maturation of the intestinal immune system. At birth the baby’s immature gut and immune functions have to move from the protected intra-uterine environment… ie passive immune protection to the mature gut and immune functions of the outside world ie active immune protection.

The initial colonisation of the baby’s gut comes from the mother’s vaginal fluid, the mothers gut microorganisms, the mother’s skin organisms while doing skin to skin and then from the breast milk as the baby suckles on the breast and receives colostrum. Breastfed infants have an abundance of bifidobacteria in the gut, crucial for appropriate development and maturation of the gut immune system.

Breastfeeding causes early colonisation of beneficial bifidobacterial and bifidobacterial abundance. HMOs promote the growth of beneficial bacteria. Most HMOs pass unabsorbed into the gut, where they promote the growth of beneficial gut bacteria. HMOs serve as metabolic substrates for specific beneficial bifidobacteria and provide them with a growth advantage over potential pathogens. HMOs are generally non-digestible, and merely 1% – 2% reach the systemic circulation. The message is one of interrelationship between HMO’s, mother’s gut microbiota and infant health.

HMOs play an important role in preventing pathogens (bad microorganisms) from adhering to the gut epithelial cells and so preventing disease. In the large intestine, HMOs play a fundamental role as prebiotics, specifically enhancing and nourishing bifidobacteria.

Select Bifidobacterium have been shown to consume HMOs. Infants with bifidobacteria-dominated gastrointestinal tracts have higher resistance to colonization by some pathogens and enhanced gut barrier function. Bifidobacteria aid the development of the infant’s innate and acquired immune systems, enhancing surveillance and reducing inflammation.

  • Ear – Breastfed infants have a lower risk of developing otitis media than formula fed infants. Common pathogens of otitis media are inhibited by HMOs.
  • Stomach – HMOs inhibit Helicobacter pylori binding to gastric mucosal receptors.
  • Kidney, ureter, bladder – Breastfed infants have a lower risk of developing urinary tract infections. HMOs inhibit adhesion of uropathogenic E.Coli to bladder epithelium.
  • Lungs – Breastfed infants have a lower risk of developing respiratory infections than formula fed infants.
  • Small intestine – Breastfed infants have a lower risk of developing enteric infections and auto-immunity than formula fed infants. HMOs and HMGs inhibit binding of enteropathogens to mucosal receptors. HMOs suppress mucosal inflammation.
  • Large intestine – Breastfed infants have a lower risk of developing severe enteric infections and automimmune disease than formula fed infants. The microbiota of breastfed infants contains abundant beneficial bifidobacterial. HMOs support the growth of bifidobacterial and their production of organic acids. HMOs inhibit the binding of enteropathogens to mucosal receptors. HMOs suppress mucosal inflammation.

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