**Author details**

René Mauricio Barría P

Address all correspondence to: rbarria@uach.cl

Faculty of Medicine, Institute of Nursing, Universidad Austral de Chile, Valdivia, Chile

#### **References**


[8] Cattaneo A, Quintero-Romero S. Protection, promotion and support of breastfeeding in low-income countries. Seminars in Fetal & Neonatal Medicine. 2006;**11**:48-53. DOI: 10.1016/j.siny.2005.10.007

[21] Ichisato SM, Shimo AK. Aleitamento materno e as crenças alimentares. Revista Latino-Americana de Enfermagem. 2001;**9**:70-76. DOI: 10.1590/S0104-11692001000500011 [22] Ishak S, Adzan NA, Quan LK, Shafie MH, Rani NA, Ramli KG. Knowledge and beliefs about breastfeeding are not determinants for successful breastfeeding. Breastfeeding

Introductory Chapter: A Comprehensive Approach to the Process of Breastfeeding

http://dx.doi.org/10.5772/intechopen.82177

9

[23] Reinsma K, Bolima N, Fonteh F, Okwen P, Yota D, Montgomery S. Incorporating cultural beliefs in promoting exclusive breastfeeding. African Journal of Midwifery and

[24] Trejo Hernandez P, Callahan S. Attributions of breastfeeding determinants in a French

[25] Barría RM. La necesidad de una mirada integral del proceso de la Lactancia Materna en el contexto de la Atención Primaria de Salud: Desafío para la formación y práctica. Enfermería Universitaria. 2018;**15**:223-225. DOI: 10.22201/eneo.23958421e.2018.3.67213

population. Birth. 2008;**35**:303-312. DOI: 10.1111/j.1523-536X.2008.00257.x

Medicine. 2014;**9**:308-312. DOI: 10.1089/bfm.2013.0124

Women's Health. 2012;**6**:65-70. DOI: 10.12968/ajmw.2012.6.2.65


[21] Ichisato SM, Shimo AK. Aleitamento materno e as crenças alimentares. Revista Latino-Americana de Enfermagem. 2001;**9**:70-76. DOI: 10.1590/S0104-11692001000500011

[8] Cattaneo A, Quintero-Romero S. Protection, promotion and support of breastfeeding in low-income countries. Seminars in Fetal & Neonatal Medicine. 2006;**11**:48-53. DOI:

[9] Paricio Talayero JM, Lizan-Garcia M, Otero PA, Benlloch Muncharaz MJ, Beseler SB, Sanchez-Palomares M, et al. Full breastfeeding and hospitalization as a result of infections in the first year of life. Pediatrics. 2006;**118**:e92-e99. DOI: 10.1542/peds.2005-1629

[10] Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Systematic Reviews. 2012;(8):CD003517. DOI: 10.1002/14651858.CD003517.pub2

[11] Victora CG, Bahl R, Barros AJ, Franca GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet. 2016;**387**:475-490.

[12] Meedya S, Fahy K, Kable A. Factors that positively influence breastfeeding duration to 6 months: A literature review. Women and Birth. 2010;**23**(4):135-145. DOI: 10.1016/j.wombi.

[13] Cohen SS, Alexander DD, Krebs NF, Young BE, Cabana MD, Erdmann P, et al. Factors associated with breastfeeding initiation and continuation: A meta-analysis. The Journal

[14] Yuzugullu DA, Aytac N, Akbaba M. Investigation of the factors affecting mother's exclusive breastfeeding for six months. Türk Pediatri Arşivi. 2018;**53**:96-104. DOI: 10.5152/

[15] Wambach KA, Cohen SM. Breastfeeding experiences of urban adolescent mothers. Journal of Pediatric Nursing. 2009;**24**:244-254. DOI: 10.1016/j.pedn.2008.03.002

[16] Nesbitt SA, Campbell KA, Jack SM, Robinson H, Piehl K, Bogdan JC. Canadian adolescent mothers' perceptions of influences on breastfeeding decisions: a qualitative descriptive study. BMC Pregnancy and Childbirth. 2012;**12**:149. DOI: 10.1186/1471-2393-12-149

[17] Mossman M, Heaman M, Dennis CL, Morris M. The influence of adolescent mothers' breastfeeding confidence and attitudes on breastfeeding initiation and duration. Journal

[18] Vari P, Vogeltanz-Holm N, Olsen G, Anderson C, Holm J, Peterson H, et al. Community breastfeeding attitudes and beliefs. Health Care for Women International. 2013;**34**:592-606.

[19] Li R, Hsia J, Fridinger F, Hussain A, Benton-Davis S, Grummer-Strawn L. Public beliefs about breastfeeding policies in various settings. Journal of the American Dietetic

[20] Osman H, El ZL, Wick L. Cultural beliefs that may discourage breastfeeding among Lebanese women: A qualitative analysis. International Breastfeeding Journal. 2009;**4**:12.

of Human Lactation. 2008;**24**:268-277. DOI: 10.1177/0890334408316075

Association. 2004;**104**:1162-1168. DOI: 10.1016/j.jada.2004.04.028

of Pediatrics. 2018. DOI: 10.1016/j.jpeds.2018.08.008. In Press

10.1016/j.siny.2005.10.007

8 Selected Topics in Breastfeeding

DOI: 10.1016/S0140-6736(15)01024-7

TurkPediatriArs.2018.6262

DOI: 10.1080/07399332.2012.655391

DOI: 10.1186/1746-4358-4-12

2010.02.002


**Chapter 2**

**Provisional chapter**

**Bioactive Components of Human Milk: Similarities and**

**Differences between Human Milk and Infant Formula**

**Bioactive Components of Human Milk: Similarities and** 

DOI: 10.5772/intechopen.73074

**Differences between Human Milk and Infant Formula**

Nowadays, there is an increasing awareness regarding the relationship between food, nutrition, and health. It is obvious that this relation starts from the birth. In the early stage of life, breastfeeding is considered the preferred choice for infant feeding and human milk is the optimal food for an infant to keep its nutritional and health status. Because it contains a large group of bioactive compounds such as proteins, vitamins, nucleotides, oligosaccharides, immunoglobulins, and some of the bioavailable minerals beyond its content of the essential nutrients, human milk is classified as the first functional food in the infant life. The various bioactive components of human milk play a pivotal role in preventing the gastrointestinal and respiratory infections, anemia, and bone-related problems as well as it enhances the immune function and helps in the maturation of the digestive system. The exclusive breastfeeding pattern during the first 6 months of infant life and introducing complementary foods after this period have a potential role in protecting against certain diseases in the adult stage of life. This chapter is underlying the great potential of breastfeeding for mothers and babies. Moreover, it discusses the functionality of some components of human milk and its similarities and differences between

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Milk and dairy product are considered a main part of the healthy and balanced diet [1]. In this context, human milk is the most appropriate choice for feeding newborns and provides all the energy and nutrients needed to ensure proper growth and development [2]. Furthermore,

**Keywords:** breastfeeding, human milk, bioactive components, lactoferrin,

Esmat Aly, Aliaa Ali Darwish, Ruben Lopez-Nicolas, Carmen Frontela-Saseta and Gaspar Ros-Berruezo

Esmat Aly, Aliaa Ali Darwish, Ruben Lopez-Nicolas, Carmen Frontela-Saseta and Gaspar Ros-Berruezo

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73074

human milk and infant formulas.

oligosaccharides, infant formulas

**Abstract**

**1. Introduction**

**Provisional chapter**

### **Bioactive Components of Human Milk: Similarities and Differences between Human Milk and Infant Formula Differences between Human Milk and Infant Formula**

**Bioactive Components of Human Milk: Similarities and** 

DOI: 10.5772/intechopen.73074

Esmat Aly, Aliaa Ali Darwish, Ruben Lopez-Nicolas, Carmen Frontela-Saseta and Gaspar Ros-Berruezo Carmen Frontela-Saseta and Gaspar Ros-Berruezo Additional information is available at the end of the chapter

Esmat Aly, Aliaa Ali Darwish, Ruben Lopez-Nicolas,

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73074

#### **Abstract**

Nowadays, there is an increasing awareness regarding the relationship between food, nutrition, and health. It is obvious that this relation starts from the birth. In the early stage of life, breastfeeding is considered the preferred choice for infant feeding and human milk is the optimal food for an infant to keep its nutritional and health status. Because it contains a large group of bioactive compounds such as proteins, vitamins, nucleotides, oligosaccharides, immunoglobulins, and some of the bioavailable minerals beyond its content of the essential nutrients, human milk is classified as the first functional food in the infant life. The various bioactive components of human milk play a pivotal role in preventing the gastrointestinal and respiratory infections, anemia, and bone-related problems as well as it enhances the immune function and helps in the maturation of the digestive system. The exclusive breastfeeding pattern during the first 6 months of infant life and introducing complementary foods after this period have a potential role in protecting against certain diseases in the adult stage of life. This chapter is underlying the great potential of breastfeeding for mothers and babies. Moreover, it discusses the functionality of some components of human milk and its similarities and differences between human milk and infant formulas.

**Keywords:** breastfeeding, human milk, bioactive components, lactoferrin, oligosaccharides, infant formulas

#### **1. Introduction**

Milk and dairy product are considered a main part of the healthy and balanced diet [1]. In this context, human milk is the most appropriate choice for feeding newborns and provides all the energy and nutrients needed to ensure proper growth and development [2]. Furthermore,

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

human milk provides a large group of functional components which improve the newborn health, increase the immunity, and protect against the gastrointestinal and respiratory infections [3]. So, it was noted that breastfed infants suffer less gastrointestinal disorders and respiratory infections rather than formula-fed infants [4]. The exclusive breastfeeding pattern during the first 6 months of life was recommended by various health and breastfeeding organizations such as the American Academy of Pediatricians (AAP) and the American Academy of Family Physicians (AAFP) [5].

On the other hand, breastfeeding pattern provides the protection against childhood-related diseases. In this regard, breastfed infants showed higher resistance to infectious disease and stronger immune systems, leading to lower rates of chronic diseases as compared to formula-fed infants. The ideal composition of human milk provides nutritional, growth, and developmental advantages to the child [13]. By the way, lower risk of gastrointestinal infection, otitis media, asthma, allergies, respiratory tract infection, type 1 diabetes, and sudden infant death syndrome are observed in breastfed infants. Other benefits include evidence of protection against childhood obesity, which may persist into adulthood, and less cognitive development and behavioral problems in breastfed children compared with children not breastfed [14]. Based on the abovementioned, breastfeeding should be actively recommended and supported as the most preferred method of infant feeding at both nutri-

Bioactive Components of Human Milk: Similarities and Differences between Human Milk and…

http://dx.doi.org/10.5772/intechopen.73074

13

It is well established that infancy is the most important stage of human life where newborns are growing with high rate allowing to duplicate the infant weight in only 4–5 months. So, an adequate supply of nutrients represents paramount importance in this early stage of infant life. The breastfeeding of infants is obviously important to provide the needed nutrients and energy for the synthesis and deposition of new tissues from birth until 4–6 months of infant life.

The high metabolic requirements contrast with the limited ability of young infants to compensate for an inadequate supply of nutrients due to the diminished body reserves of nutrients and the immature homeostatic mechanisms. For example, the activity of some metabolic pathways and the kidney's ability to concentrate the urine are still low during the first 3–4 months of life. Young children may not be able to synthesize sufficient amounts of certain substrates considered as nonessential or dispensable since the limited capacity of the specific metabolic synthesis is not always sufficient to achieve the high requirements. Some nutrients considered nonessential in adults and older children can become indispensable for young infants that

In addition to the immediate consequences of infant feeding on growth, body composition, health, and wellness, a number of recent studies have also provided indications that the quantity and quality in the supply of nutrients during childhood has important long-term consequences in the development and function of the organs, health, and risk of disease as well as in the cognitive ability [16]. Human milk is nowadays universally recognized as the optimal feeding choice for every infant [17] where it contains many nutritional components that are

The nutritional components of human milk are classified into two categories: macronutrients and micronutrients [18]. Macronutrients of human milk include protein, fat, and sugar. The concentration of human milk macronutrients differed during the course of lactation and between the mothers as well as differed between term and preterm milk. The latter has a higher content of protein and fat. Generally, the mean macronutrient composition of term

tionally and healthy states.

would be supplied in the diet [15].

able to conserve his development.

**3. Nutritional significance of breastfeeding**

It is scientifically accepted that using the nutritional factors may decrease or prevent the extension of these diseases and its implications to the adult life. Nowadays, researchers and health and breastfeeding organizations are trying to discover the precise substances in human milk that seem to supply physiological benefits beyond its normal nutritional value which contribute earlier in delay, treatment or prevent some diseases [6]. Thus, these functional ingredients hold a great promise for future trends in human nutrition. Additionally, the relationship between milk consumption and human health requires a deeper understanding to uncover the protective role of some bioactive compounds, which naturally present in human milk.

Although human milk is considered the optimal food and supplies all the nutrient and some bioactive components, it is no longer sufficient to meet all the necessary nutritional requirements after 4–6 months of infant life [7]. In this case, infant formulas play an indispensable role in infant feeding. The formulas should be similar to mature human milk regarding its micronutrient and macronutrient contents. During the evolution of infant formulas, the manufacturers should take into account the necessary nutritional requirements of the newborns and infants and enrich the formulas with the functional ingredients which are naturally present in human milk [8]. The aim of this review is to present current knowledge regarding evidence on the importance of breastfeeding, the functionality of selected human milk ingredients, infant formulas as a human milk alternative, and the similarities and differences between human milk and infant formulas.
