Academy of Breastfeeding Medicine founder's lecture 2008: breastfeeding--an extrauterine link between mother and child

Abstract

In addition to a near-optimal combination of nutrients for the growing infant, breastmilk contains a wide array of bioactive molecules that are known to protect the infant against infectious disease and modulate the composition of the indigenous intestinal microbiota. A growing number of factors that modulate the infant's immunophysiology have also been identified in breastmilk. We suggest that this early immunomodulation via breastmilk is vital for infant health and may explain the epidemiological data indicating that breastmilk reduces the risk of immunoinflammatory conditions in infancy and also later in life. The body of scientific data regarding the role of transforming growth factor-beta in breastmilk in enhancing healthy immune maturation and reducing the risk of disease is reviewed in this article.

FIG. 1.

Meta-analysis of four clinical studies examining the effect of breastfeeding on the incidence and severity of NEC. Reproduced with permission from McGuire and Anthony.

FIG. 2.

Meta-analysis of four clinical studies examining the effect of breastfeeding on the incidence of celiac disease. Reproduced with permission from Akobeng et al.

FIG. 3.

Cartoon suggesting the role of breastfeeding in the expression of asthma in an animal model for asthma when the mother has the inhaled allergen in the breastmilk along with TGF-β. The combination of small quantities of allergen in the presence of TGF-β in breastmilk renders the suckling offspring permanently tolerant to the allergen, thus preventing the expression of asthma. Reproduced with permission from Puddington and Matson.