Human and Cow milk

• Less than six noticeably wet diapers per 24 h by day 3–4
• Less than four stools per day by day 3–4
• Nursing less than eight times per 24 h

Breast milk is especially rich in secretory IgA, that prevents microorganisms from adhering to intestinal mucosa.

Immunoglobulin A (IgA) ingested in colostrum provides mucosal protection against enteric infections.

This may also explain the small amount of fetal secretory IgA found in amnionic fluid.

Colostrum is very rich in proteins, vitamin A and sodium chloride, but contains lower amounts of carbohydrates, lipids, and potassium than normal milk.

Colostrum contains immunoglobulins such as IgA, IgG, and IgM.

Under normal conditions breast milk production reaches a maximum when the baby is around 4 – 6 months.

Ans. is a i.e. IgA

“Breast milk has a high concentration of secretory IgA, 1gM”. ‘Colostrum –Contains antibody (1gA) produce locally”.

Therefore, IgA is the option of choice.

D i.e. Docosahexanoic Acid

Most of the naturally occurring unsaturated fatty acids are cis-isomers. Trans-FA do not occur naturally in plants and occurs only in small amounts in animals as ruminant fat (eg butter fat) arising from the action of micro organisms in rumen. Cis isomers are less stable than trans FA.

– Trans fatty acids formed during partial hydrogenation or hardening (saturation /deep frying)Q of vegetable oils – a procedure to improve stability or shelf life. Trans – FA increase incidence of coronary heart disease by increasing LDL and decreasing HDLQ.

– Linoelic acid is the most important essential fatty acid because it serves as the basis for production of other EFAs like arachidonic acid & docosahexanoic acid. Arachidonic acid, a w-6 PUFA is essential as it is a precursor of prostaglandins & leukotrienes.

Linoleic acid is the most important essential fatty acid, maximally found in Safflower oilQ>Corn oilQ> Sunflower oilQ

–  Docosahexanoic Acid (DHA; tai, 22:6) which is synthesized from a-linolenic acid or obtained directly from fish oils, is present in high concentrations in retina, cerebral cortex, testis & sperm. DHA is particularly needed for development of brain & retina and is supplied via the placenta and milk. Milk is the constant and continuous source of DHA as placenta is not present at all time. Patients with Retinitis pigmentosa are reported to have low levels of DHA.

Plasma membrane contains both saturated & mono or poly unsaturated FA.

Ans. is ‘a’ i.e., Better nutrition; ‘b’ i.e., Less infection

Breast feeding

o Breast feeding is feeding an infant or young child with breast milk directly from breast and not from a baby bottle or other container.

o Under any circumstances, breast milk is the ideal food for the infant —> Human breast milk is the best source of nourishment for human infants.

o No other food is required by the baby until the age of 6 months after birth.

o So, exclusive breast feeding should be given to infant for first 6 months of life.

Benefits of breast feeding

o Among the benefits of breast feeding are the following ‑

1. Superior nutrition

A. Carbohydrates

• Lactose is in a high concentration in breast milk which helps in the absorption of calcium and enhances the growth of lactobacilli in the intestine.

B. Proteins

• The protein content of breast milk is low which causes lower solute load on the kidney.
• Most of the protein is whey proteins (lactalbumin and lactoglobulin), which can be digested easily (In contrast cow milk contains more casein).
• Breast milk contains the ideal ratio of the amino acids cystine, taurine and methionine to support development of central and peripheral nervous system.

C. Fats

• Breast milk is rich in polyunsaturated fatty acids, necessary for the myelination of the nervous system and brain growth.
• Active lipase in the breast milk promotes digestion of fats and provides FFA.
• The pattern of fats facilitates absorption of calcium.

D. Minerals

• Breast milk protects against neonatal hypocalcemia and tetany due to ideal calcium phosphorus ratio (2:1) and better calcium absorption.
• Iron of breast milk is very well absorbed —> breast feeding prevents against iron deficiency anemia.
• Breast milk also prevents deficiencies of vitamin A, C, D, E and zinc.
• Breast milk has a water content of 88% and hence a breastfed baby does not require additional water in the first 6 months of life even in summer months.
• Breast milk has a low mineral and sodium content —> low osmolality presents a low solute load to the kidney.

2. Lower risk of infection

• The breast milk is clean and uncontaminated with several anti-infective factors protect the baby from infection and diarrhea.

3. Protection from allergy (atopy)

• Low protein contents of breast milk along with a higher concentration of secretory IgA decreases the absorption of protein macromolecules                                                       less chances of allergy and asthma.

4. Emotional bonding

• Breast feeding promotes close physical and emotional bonds between the mother and the baby.

5. Others

•   Breast feeding lowers the risk of ovarian and breast cancer in mother.
•  Breastfed babies have a higher IQ and have less chances of developing hypertension, obesity, coronary artery disease and diabetes in their adulthood.
•  The other diseases which are less common in breastfed babies include inflammatory bowel disease, Hodgkin’s lymphoma, necrotizing enterocolitis and sudden infant death syndrome.

Ans. is ‘a’ i.e., Cow’s milk contain 80% whey protein not casein

o Whey protein constitutes 80% of the protein in human milk, while the main protein in cow’s milk is casein.

Ans. is ‘a’ i.e., 7.2%

o It is not exactly 7.2% but it is the closest choice.

Nutrient                                             Content / 100 ml

Macronutrients

o Calories                                                    67 kcal

o Proteins                                                   1.1 g

o Fat                                                          3.5 g

o Lactose                                                   7.0 g Minerals / Micronutrients

o Sodium                                                    0.9 mEq

o Potassium                                                1.4 mEq

o Calcium                                                  35 mg

o Phosphorus                                             15 mg

o Iron                                                       30-50 g

o Zinc                                                       120 g Vitamins

o Vitamin A                                                60 g

o ‘Vitamin C                                               5.2 mg

Ans. is ‘a’ i.e., Lactose

Ans. is ‘c’ i.e., Fat

o The composition of breastmilk varies at different stages after birth to suit the needs of the baby.

o According to the postnatal period the breast milk is divided into –

1. Clostrum

          Is the milk secreted during the first three days after delivery.

          It is yellow and thick.

          It contains more antibodies and cells and high amounts of vitamins A,D,E and K.

2. Transitional milk

          Is secreted during the following two weeks (after clostrum).

          The immunoglobulin and protein content decreases while the fat and sugar content increases.

3. Mature milk

          Follows transitional milk.

          It is thin and watery but contains all the nutrients essential for optimal growth of the body.

o According to feed the breast milk is divided into ‑

1. Fore milk

           It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby’s thirst.

2. Hind milk

         Comes towards the end of feed

           Rich in fat content and provides more energy, and satisfies the baby’s hunger.

o The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term –

Preterm milk

Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby.

Ans. is ‘a’ i.e., Lactose

o Sugar is less in clostrum.

Ans. is ‘d’ i.e., 24 hrs

Breast milk

o Can be stored at room temperature     —>        For 8-10 hours

o In a refrigerator                             —>        For 24 hours

o In a freezer                                  —>       -20°c for 3 months

Ans. is ‘b’ i.e., 8 hrs

Ans. is ‘a’ i.e., Plasmodium vivax

Ans. is ‘c’ i.e., 5-6 months

o Breast milk is maximum at 5-6 months of lactation —> 730 ml/day.

o It is minimum at 37-38 months of lactation  —> 345 ml/day.

Ans.is ‘a’ i.e., Lactose

Premature milk contains less lactose in comparison to term milk

Ans is ‘d’ i.e., 7 gm

Ans. is ‘d’ i.e., Docosahexaenoic acid 

o Up to 5-10% of fatty acids in human milk are polyunsaturated. Most of these are linoleic acid with smaller amounts of linolenic acid.

o Linoleic acid —> gives rise to Arachidonic acid

o Linolenic acid —> gives rise to Docosahexaenoic acid

o Docosahexaenoic acid is found in human milk and brain lipids and is required for the development of our nervous system and visual abilities during the first six months of life.

o Lack of sufficient Docosahexaenoic acid may be associated with impaired mental and visual functioning as well as attention deficit hyperactivity disorder.

Ans. is ‘a’ i.e., The maximum milk output is seen at 12 months 

o Under normal conditions, Indian mothers secrete 450 – 600 ml of milk daily

Maximum output of milk is at 5 – 6 months (730 ml/ day) after which the output constantly declines. At 12 months the output is 525 ml/day -Park p. 455

o Iron was supposed to be deficient in breast milk, but recent work has shown that iron contained in human milk has a high level of bioavailiability thanks to complex phenomena.

The coefficient of uptake of iron in breast milk may be as high as 70% where as it is only 30 percent for cow’s milk and infant formulas’ Park p. 463

• The calcium phosphorus ratio is high so that uptake of calcium is better than cow’s milk’ – Park p. 374
• Energy value of human milk is 64 to 72 kcal per 100 ml. -Park 463

Ans. is ‘c’ i.e., 35 mg/di 

Ans. is ‘a’ i.e., Lactose 

Ans. is ‘a’ i.e., Less fat; `b’ Less protein

Human milk has less fat, less protein, more carbohydrates and less calcium, in comparison to cow milk.

Human milk has less sodium, potassium and chloride. However, these substances are in correct amount (though less) in human milk.

Ans. is ‘a’ i.e., Vitamin K 

o Milks from the mother whose diet is sufficient and properly balanced will supply all the necessary nutrients except fluoride and Vitamin D.

o The iron content of human milk is low, but most normal term infants have sufficient iron stores for the first 4-6 months. Human milk iron is well absorbed. Nonetheless, by 6 months the breast-fed infant’s diet should be supplemented with iron fortified complementary foods.

o The Vitamin K content of human milk is low and may cause hemorrhagic disease of newborn.

Ans. is ‘b’ i.e., Protein 

o The composition of breastmilk varies at different stages after birth to suit the needs of the baby. o According to the postnatal period the breast milk is divided into ‑

1. Clostrum

          Is the milk secreted during the first three days after delivery.

          It is yellow and thick.

          It contains more antibodies and cells and high amounts of vitamins A, D, E, K, & “Protein”.

2. Transitional milk

          Is secreted during the following two weeks (after clostrum).

          The immunoglobulin and protein content decreases while the fat and sugar content increases.

3. Mature milk

          Follows transitional milk.

      It is thin and watery but contains all the nutrients essential for optimal growth of the body. o According to feed the breast milk is divided into –

4. Fore milk

       It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby’s thirst. 2. Hind milk

       Comes towards the end of feed

       Rich in fat content and provides more energy, and satisfies the baby’s hunger.

o The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term – Preterm milk

Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby.

Ans. is ‘a’ i.e., 6 months 

Exclusive breast feeding :The baby should be given only breast milk and nothing else (not even water) for first 6 months of life. Weaning should be started by 6 months of age with semisolid food, in addition to continuing breast feeding.

o The WHO recommends exclusive breast feeding for the first six months of life and then breast feeding up to two years or more.                                                                   

Internet Complementary feeding means giving the child other nutritious foods in addition to breast milk. Breast feeding

is sufficient food for first 6 months. Thereafter, concentrated energy dense complementary foods are essential in order to maintain an adequate velocity of growth for the infant.

Ans. is ‘a’ i.e., Human 

Nutritive value of milks compared (value per 100 grams)

Ans. is ‘c’ i.e., Carbohydrate and iron

• Human milk contains 1.1% protein, 3.4% fat, 7.4% carbohydrates, and 0.1% ash (minerals).

• Carbohydrates are mainly lactose.

• The fat fraction contains specific triglycerides of palmitic and oleic acid (0-P-0 triglycerides), and also quite a large quantity of lipids with trans bonds.

• They are vaccenic acid, and Conjugated linoleic acid (CLA) accounting for up to 6% of the human milk fat.

• The principal proteins are casein (homologous to bovine beta-casein), alpha-lactalbumin, lactoferrin, IgA, lysozyme, and serum albumin.

Ans. is ‘b’ i.e., Buffalo, Goat, Cow, Human 

o Fat content of milk: Buffalo > Goat > Cow > Human

o Protein content of milk: Buffalo > Goat > Cow > Human

o Lactose content of milk: Human > Buffalo > Goat > Cow

o Energy content of milk: Buffalo > Goat > Cow > Human

Ans. is ‘c’ i.e., Vitamin C 

Ans: D i.e. Human milk has comparatively less of lactose

Comparison of human and cow link

• Protein in human milk is 1.1 g, whereas in cow milk it is 3.2
• Calcium in human milk is 28 mg, whereas in cow milk it is 120 mg
• Minerals in human milk is 0.1 g, whereas in cow milk it is 0.8 g
• Lactose in human milk is 7.4 g, whereas in cow milk it is 4.4 g

Ans. B: 24 hours

Expressed breast milk can be stored at room temperature for 6-8 hours, in a refrigerator for 24 hours and a freezer at -20 degree C for 3 months

Ans. D i.e. Rubella

Ans. is ‘b’ i.e., 0^.9 gm per 100 ml

Ans. is ‘d’ i.e., 500-600 ml

Under normal conditions, Indian mothers secrete 450 – 600 ml of milk daily

Maximum output of milk is at 5 – 6 months (730 ml/ day) after which the output constantly declines.

At 12 months the output is 525 ml/day -Park p. 455