cells of the adaptive immune system, antibodies, come in several
flavors: Immunoglobulin M (IgM), which is the first type of antibody produced
and isn't very specific; IgG which is transferred across the placenta and is the
only immunoglobulin that the baby gets from mom and has at birth (the newborn,
with only IgG is essentially immuno-compromised); IgE which isn't too relevant
here; and IgA which rocks. IgA is a "sticky" immunoglobulin that protects
surface areas from infection. A special type of IgA, secretory IgA, is
found in huge numbers in human milk and protects the airway, gut and other
mucous membranes from infection. Secretory IgA is special because the
"secretory" part is an addition to the IgA and importantly, is
resistant to being broken down by the baby' stomach and GI tract.
we have a new baby, exposed immediately to bacteria...why no inflammation?
Well, the activity of the T-cells is delayed for about 10 days (remember,
T-cells cause inflammation and tissue damage.) Well... secretory IgA helps.
It's made by mom in response to infections in her environment and passed to the
baby through breastfeeding. Moms and babies should stay together.
This is one good reason: mom can't make antibodies to things that the baby is
exposed to if the baby isn't with her.
Human milk also contains special sugars, oligosaccharides, which help feed good
bacteria. In fact, they are necessary for that good bacteria to grow.
Plus, they are a type of prebiotic-
something can block bad bacteria before they ever get to the surface of the gut.
They let the probiotics, the
good bacteria, stay in the gut. And because they never let the bad
bacteria get to the gut surface, no innate immune system is needed, and we get
no inflammation or tissue damage. Oligosaccharides also work with certain
receptors (called Toll Like Receptors). These receptors work in the first
5 days (when are our kids getting supplemented?) and are controlled tightly,
like hour by hour.
the time that the immune system is delayed, oligosaccharides, toll like
receptors and good bacteria protect against bad bacteria and avoid the need for
an inflammatory response. Any alteration
in human milk or addition of formula interferes with toll like receptor
function, changes the bacteria that the baby's gut gets exposed to and can then
lead to inflammation and tissue
damage, the result we were trying so hard to avoid.
Just one bottle.
lesson? Let's make sure we know why we are supplementing.
that's another soap box- check out the "3b's" birth
weight, blood sugar and
Jenny Thomas, MD, IBCLC, FAAP, FABM
More info? A very nice book from Dr. Lars Hanson on Breastfeeding and