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| Breast Milk, Infections, Iron, GLA, EPA, and Asthma |
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Breast Feeding and Prevention of Asthma
Asthma is the leading cause of
hospitalization in American and Australian children, and the prevalence of asthma is
increasing in both countries. About one-third to one-half of all patients with asthma are
under the age of 10.
It has been recently shown that children who are breast-fed exclusively for the first four months of their lives have a reduced risk of asthma. To date, the mechanisms behind this are unexplained.
However, if we examine the roles
breast milk vs alternatives, a hypothesis begins to form, one that follows the existing
medical literature.
Oddy and associates followed 2187 children from birth, to evaluate the association between the duration of breast feeding and the development of asthma related outcomes in the children at age 6 years.
After adjustment for confounders, the
introduction of milk other that breast milk before 4 months of age was a significant risk
factor for all asthma and atopy related outcomes in children aged 6 years, including:
asthma diagnosed by a doctor, 74% were more likely to have sleep disturbance due to wheeze
within the last 12 months, wheezed three or more times since 1 year of age, 41% more
likely to have wheezed in the past year, 27% more likely to be diagnosed with asthma by
age six, age at first wheeze, and positive skin prick test reaction to at least one common
aeroallergen.
The researchers concluded that a significant reduction in the risk of childhood asthma at age 6 years occurs if exclusive breast feeding is continued for at least the 4 months after birth.
“The findings of this study are important for the prevention of asthma in children,” Oddy said.
There are several possible reasons for the findings, she noted. “In the past year or two, breast milk has been shown to be a bioactive, live fluid filled with proteins and lipids so essential for developing infants,” she said.
“Babies need as much help as they can get in developing their immune system and organs. Their mother’s milk gives them the very best protective immunological factors, which are difficult (ed. note: or impossible) to include in formula,” she added.
Breast milk transmits immunity from
the mother to baby, and can lead to enhanced tolerance to infection, which increases
chances of an infant’s survival.
“Because asthma is a disease of inflammation, these processes occurring very early in life may affect an individual’s health well into childhood and beyond,” she said. “My research has shown that this is occurring, with protection against asthma and allergy from exclusive breastfeeding (and no introduction of other formula or milk) extending into childhood.” 21
A connection betweeen breast feeding and the reduced risk of asthma can be found in the fact that gamma-linolenic acid (GLA) and one of richest sources of preformed di-hommo-gamma linolenic acid (DGLA) are found in human breast milk.
As noted previously, GLA and DGLA are
essential in the production of PGE1 prostaglandins.
The importance of dietary GLA in human health and nutrition was noted by YY Fan and RS Chapkin, of the Faculty of Nutrition, Molecular and Cell Biology Group, Texas A&M University.
Their report examined the strategy of using GLA as a prophylactic in treating various chronic diseases. The strategy is based on the ability of the diet to modify cellular lipid composition and eicosanoid (cyclooxygenase and lipoxygenase) biosynthesis.
Recent studies demonstrate that dietary GLA increases the content of its elongase product DGLA, within cell membranes without concommitant changes in arachidonic acid (AA).
Subsequently, upon stimulation, DGLA can be converted by inflammatory cells to 15-(S)-hydroxy-8,11,13-eicosatrienoic acid and prostaglandin E1.
This is noteworthy because these
compounds possess both anti-inflammatory and antiproliferative properties. 22
GLA Compromised Twice in Lifetime
Twice in a lifetime, the body’s ability to produce GLA is compromised.
The first is in the first six months after birth before the delta 6 desaturase enzyme reaches full activity. During this period the essential supplies of GLA (which the infant still can’t make effectively) comes only from mother’s breast milk.
Cow’s milk or soy milk used in infant formulas contain virtually no GLA.
Six months after birth, the delta 6
desaturase enzyme comes to full activity which allows children to use dietary linoleic
acid to make adequate levels of GLA on their own
In a placebo-controlled study a variety of evening primrose oil (Efamol) rich in linoleic and gamma-linolenic acids, or a matching placebo were given to 39 women for a period of 8 months starting between the 2nd and 6th months of lactation.
Total fat and EFA contents of the milk declined in the placebo group but rose in the primrose oil supplemented group.
A surprisingly high proportion of the supplemented dietary fatty acids could be accounted for by appearance in the milk.
The milk composition can be readily
manipulated by changing the fatty acid composition of the maternal diet. 23
The second time the body’s ability to make GLA is compromised is after the age of thirty. As people age, the activity of the delta-6-desaturase enzyme slows down.
Studies have indicated that the ability to make eicosanoids at age sixty-five is one-third what it was at age twenty-five. This is of note, as asthma increases with age in some groups.
Other inhibitors of GLA include:
high levels of carbohydrates in the bloodstream, which slow down delta-6-desaturase activity and decrease GLA production;
trans fatty acids which inhibit delta-6-desaturase;
viral disease;
elevated adrenaline (decreases
delta-6-desaturase) and cortisol (due to stress) levels which increase insulin levels and
lead to excess arachidonic acid production via activation of delta-5-desaturase enzyme.
Since activation of delta-5-desaturase depends on insulin, and insulin is balanced by
glucogon (which inhibits delta-5-desaturase), it is critical that insulin/glucogon levels
are kept in balance. 24
High carbohydrate intake, high trans fatty acid intake, stress, and viral diseases are common in Westernized societies.
It is suggested that some, or all, of
these factors inherent in eicosanoid metabolism, may play associated roles in asthma, as
outlined in the above studies.
Iron, Bacterial Infections and Breast
Milk
A number of other factors in connecting breast-fed babies with decreased rates of asthma arise from a report by M. Colgan.
He reports that substances in breast-milk include at least twenty enzymes such as lysozyme that attaches to susceptible bacteria, secretory IgA antibodies that neutralize many enteric pathogens and toxins, fibronectin that promotes uptake of microbial pathogens and other substances by phagocytic cells.
Human milk also contains enormous
numbers of highly active macrophages and lymphocytes that secrete certain lymphokines that
may serve to protect host defense.
25-27
One of the most important substances in human milk is glycoprotein lactoferrin that competes for the iron necessary for pathogenic microorganisms to replicate.
When a human baby is born, its gastrointestinal tract is sterile, that is, it contains zero bacteria. It also contains zero iron.
So, the only bacteria that can grow in it are the lactic acid bacteria - the only bacteria that can live in the absence of iron.
These bacteria start infiltrating the gut within minutes of birth. It’s a nice evolutionary trick, as lactic acid bacteria are essential to digest breast milk.
This lactic acid bacteria combined
with glycoprotein lactoferrin from breast milk helps to protect the baby from harmful
bacteria that grow greedily in the presence of iron. Breast milk also contains virtually
no iron.
28
We Are Born With a Reserve of Iron
The human baby is born with a reserve supply of iron in its tissues of approximately 75 mg per kilogram bodyweight.
That’s about twice the iron level found in the tissue of healthy athletes.
Your baby can grow healthy and normal
for at least a year without requiring any external iron. Nature designed it that way to
allow the immune system to develop before the onslaught of bacterial infections that
occurs once the baby is weaned onto solid foods.
Infant formulas that contain iron, increase infections and death rates in infants. There is now a lot of research that shows iron supplementation is detrimental to babies.
A whole new medical text, Iron and Infection, cites hundreds of recent
studies showing that excess iron in the body enables infections to flourish. 29-31
A good example of this occurred in California in 1979. There was an outbreak of 60 cases of infant botulism. Researchers compared breast-fed babies (receiving no supplemental iron) with babies fed iron-supplemented infant formula.
The breast-fed babies all had milder
cases of the disease and none died. The formula-fed babies all had severe cases of the
disease and ten died. 160
So why do physicians still recommend iron for infants and why do baby food manufacturers fortify baby formulas with iron?
It appears in this case, that medical science is years ahead of medical practice and modern baby-food marketing.
Old medical texts, ignorant of the intricacies of nutrition, taught physicians only that iron is an important nutrient needed for making red blood cells and that pregnant women often become near anemic as blood is taken by the growing fetus.
So they still feed pregnant women huge amounts of iron, 300 mg a day is commonplace, to try to boost their hemoglobin levels. Doesn’t work, never has. And it doesn’t put iron into the mother’s milk either.
The illogical extension of this nonsense in then to feed the newborn with iron-supplemented formula, presumably to continue the iron the mother was getting.
What it amounts to is that some
academic physicians decided that they were smarter than Nature and could design a better
formula than mother’s milk, putting in iron (and other nutrients) in amounts that
devastate the infant’s gut.
It is of note then that early
infections have been related to higher risks of asthma in children. The existing research
bears out the hypothesis that iron supplementation in formulas, and even children's
nutritional supplements, may be indirect risk factors for asthma in children.
Respiratory Tract Infections and Asthma
UK Researchers report an association between respiratory tract infection during gestation and childhood asthma.
Dr. CH Hughes and colleagues from the University of Plymouth, conducted a retrospective case-control study of 200 asthmatic children aged 5 to 16 years.
Examination of data from primary care records indicated that respiratory tract infection during pregnancy was significantly associated with childhood asthma (odds ratio 1.69).
This relationship remained significant after allowing for factors such as maternal smoking, wheeze and asthma treatment.
In addition, there was a
"dose-dependent" association between the number of presentations with
respiratory infection and childhood asthma. The researchers, who speculate that
"...respiratory viral particles or antigens" might cross the placenta, conclude
that the findings "...support the theory that respiratory viruses may be implicated
in the aetiology of asthma." 32