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      Innate Immunity and Breast Milk

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          Abstract

          Human milk is a dynamic source of nutrients and bioactive factors; unique in providing for the human infant’s optimal growth and development. The growing infant’s immune system has a number of developmental immune deficiencies placing the infant at increased risk of infection. This review focuses on how human milk directly contributes to the infant’s innate immunity. Remarkable new findings clarify the multifunctional nature of human milk bioactive components. New research techniques have expanded our understanding of the potential for human milk’s effect on the infant that will never be possible with milk formulas. Human milk microbiome directly shapes the infant’s intestinal microbiome, while the human milk oligosaccharides drive the growth of these microbes within the gut. New techniques such as genomics, metabolomics, proteomics, and glycomics are being used to describe this symbiotic relationship. An expanded role for antimicrobial proteins/peptides within human milk in innate immune protection is described. The unique milieu of enhanced immune protection with diminished inflammation results from a complex interaction of anti-inflammatory and antioxidative factors provided by human milk to the intestine. New data support the concept of mucosal-associated lymphoid tissue and its contribution to the cellular content of human milk. Human milk stem cells (hMSCs) have recently been discovered. Their direct role in the infant for repair and regeneration is being investigated. The existence of these hMSCs could prove to be an easily harvested source of multilineage stem cells for the study of cancer and tissue regeneration. As the infant’s gastrointestinal tract and immune system develop, there is a comparable transition in human milk over time to provide fewer immune factors and more calories and nutrients for growth. Each of these new findings opens the door to future studies of human milk and its effect on the innate immune system and the developing infant.

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          Innate immunity.

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            Delayed breastfeeding initiation increases risk of neonatal mortality.

            Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal mortality. We sought to assess the contribution of the timing of initiation of breastfeeding to any impact. This study took advantage of the 4-weekly surveillance system from a large ongoing maternal vitamin A supplementation trial in rural Ghana involving all women of childbearing age and their infants. It was designed to evaluate whether timing of initiation of breastfeeding and type (exclusive, predominant, or partial) are associated with risk of neonatal mortality. The analysis is based on 10,947 breastfed singleton infants born between July 2003 and June 2004 who survived to day 2 and whose mothers were visited in the neonatal period. Breastfeeding was initiated within the first day of birth in 71% of infants and by the end of day 3 in all but 1.3% of them; 70% were exclusively breastfed during the neonatal period. The risk of neonatal death was fourfold higher in children given milk-based fluids or solids in addition to breast milk. There was a marked dose response of increasing risk of neonatal mortality with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.4-fold increase in risk. The size of this effect was similar when the model was refitted excluding infants at high risk of death (unwell on the day of birth, congenital abnormalities, premature, unwell at the time of interview) or when deaths during the first week (days 2-7) were excluded. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour. Breastfeeding-promotion programs should emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.
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              Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life.

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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/403372
                URI : http://frontiersin.org/people/u/421887
                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                29 May 2017
                2017
                : 8
                : 584
                Affiliations
                [1] 1Division of Neonatology, Department of Pediatrics, University of Florida , Gainesville, FL, United States
                [2] 2Division of Pediatric Infectious Disease, Department of Pediatrics, University of Florida , Gainesville, FL, United States
                Author notes

                Edited by: Joseph M. Bliss, Women & Infants Hospital of Rhode Island, United States

                Reviewed by: Dina Weilhammer, Lawrence Livermore National Laboratory (DOE), United States; Leonardo H. Travassos, Federal University of Rio de Janeiro, Brazil

                *Correspondence: Nicole Theresa Cacho, nicole.cacho@ 123456peds.ufl.edu

                Specialty section: This article was submitted to Microbial Immunology, a section of the journal Frontiers in Immunology

                Article
                10.3389/fimmu.2017.00584
                5447027
                28611768
                22ef4863-891f-46f6-b50e-eb3aeb6a16c5
                Copyright © 2017 Cacho and Lawrence.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 January 2017
                : 01 May 2017
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 103, Pages: 10, Words: 8359
                Categories
                Immunology
                Review

                Immunology
                human milk,breast milk,innate immunity,colostrum,preterm
                Immunology
                human milk, breast milk, innate immunity, colostrum, preterm

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