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Caloriesinbreastmilk:Nutritionalinformation

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Caloriesinbreastmilk:Nutritionalinformation

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Nutrientsandcaloriesinbreastmilk:Aguideforthe
scienceminded
2008GwenDewar,Ph.D.,allrightsreserved
Thenutrientsandcaloriesinbreastmilkmayvaryaccordingto

Howmanydaysamotherhasbeenlactating
Thetimeofday
Timeelapsedsincethebeginningofafeed
Themothersdiet
Thefrequencybetweenfeedings
Therearemorethan200constituentsofbreastmilkknowntoscience.Thisarticle
describesjustafewofthem.Aslaboratorymethodsbecomemorerefined,new
constituentsarediscovered.
HereIprovidebasicnutritionalinformation,andoffertipsforassessingandimprovingthe
qualityofyourmilk.
Elsewhere,Idiscusshowthefoodyoueataffectstheflavorofyourmilk.Fordetails,see
thisarticleaboutearlyflavorexperiencesinfluenceyourbaby'sfoodpreferences.

Basicnutritionalinformation
AccordingtoaBritishreport,each100mLof
maturebreastmilk(i.e.,breastmilk
producedafter21daysoflactation)yields
approximately
70calories
89.97gwater
7.4gcarbohydrates(primarilylactose)
4.2gfat
1.3gprotein
Thesearetheaveragesofsamplestaken
repeatedlyovera24hourperiod
(DepartmentofHealthandSocialSecurity1988).
Withineachbreast,milkcompositionfluctuatesduringtheday.Forexample,fatcontent
mayvarybyasmuchas2g/Lover24hours(InstituteofMedicine,NationalAcademyof
Sciences1991,p.118).Thiscausessignificantvariationinthecaloriesinbreastmilk.
Tosomedegree,milkcompositionvariesbydietaswell.Thenumbersabovereflectthe
averagemilkcompositionofBritishwomen.Analysescarriedoutonotherpopulations
consumingdifferentdietsmayyieldslightlydifferentresults.Forinstance,ananalysis
conductedinIndiaproducedanestimateof3.4gfatper100mL(Gopalanetal2000).
Butthegreatestsourceofvariationisfoundbetweenindividualwomen.
Withinagivenpopulation,individualwomenmayrangeinmilkfatcontentfrom
2g/100mLto5g/100mL(InstituteofMedicine,NationalAcademyofSciences1991).
Becausefatconstitutesthemajorityofcaloriesinbreastmilk,thismeansthatsome
womenproducemorecaloriedensemilkthanothers.Momsproducingfewercaloriesin
breastmilkwillneedtonursetheirbabiesmorefrequently.

Colostrum
Milkcompositionalsovariesoverthecourseoflactation.Maturebreastmilklooksvery
differentfromcolostrum,themilkproducedinthefirstfewdaysafterbirth.Accordingto
Guthrie(1989),each100mLofcolostrumyieldsapproximately:
58calories

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Caloriesinbreastmilk:Nutritionalinformation
5.3gcarbohydrates
2.9gfat
3.7gprotein

Colostrumislowinfatandcarbohydrates.Asaresult,therearefewercaloriesinbreast
milkforthefirstfewdaysofababyslife.
Colostrumisyellowbecauseitcontainshighlevelsofbetacarotene(10timesmorethan
isfoundinmaturemilk).
ColostrumalsocontainselevatedlevelsofvitaminEandzinc.
Milkcompositionchangesrapidlyduringthefirstweek,increasinginfatandlactose
concentrationanddecreasinginprotein,vitamin,andmineralcontent.Afterthefirst7
days,changescontinueataslowerrateuntilmilkreachesthemature"stagearoundDay
21(InstituteofMedicine,NationalAcademyofSciences1991).
Untilrecently,peoplebelievedthatthefatcompositionandcaloriesinbreastmilkdidnt
changemuchafteritreachedthematurestage.Butitmight.
A2005studyreportedthatmotherswhohadbeenbreastfeedingforoverayearproduced
significantlyfattierandmorecaloricmilkthandidmotherswhobreastfeedforlessthan
sixmonths(Mandeletal2005).
Theresultsareintriguing,but,becausethestudydidnttrackwomenfromchildbirthon,it
isntknowniftheprolongedbreastfeedershadhigherfatmilktobeginwith.Womenwho
producehigherfatmilkfromthebeginningmighthavemoresuccessbreastfeedingand
persistlonger.

Humanbreastmilkinzoologicalperspective
Whatdoesthisnutritionalinformationmean?
Inpart,itreflectsourstatusasaslowgrowingspeciesdependentonfrequentinfant
feeds.Tounderstandwhy,youneedtocomparehumanmilkwiththemilkofother
mammals.
Zoologicallyspeaking,therearentalotofcaloriesinbreastmilk.Thisisbecausehuman
milkisrelativelylowinfat.Itsalsolowinprotein.
Considerhowhumansstackupagainsttheseanimals(valuesaregiveninpercentage
weightalldatafromJenness1974).
Human:3.8%fat1%protein7%lactose
Cow:3.7%fat3.4%protein4.8%lactose
Rat:10.3%fat8.4%protein2.6%lactose
Dog:12.9%fat7.9%protein3.1%lactose
Rabbit:18.3%fat13.9%protein2.6%lactose
Proteinisadeterminantofgrowthrates,sothelowproteincontentofhumanmilkisone
reasonwhyhumanbabiesdontgrowasfastasbabyrabbitsorpuppies(Bernhart1961).
Thelowfatcontentofbreastmilkreflects,inpart,ourheritageasmammalsthatcarry
theirbabiesaround,ratherthancachetheminnests(BenShaul1962).
Mammalsthatcachetheirbabiesleavethemforlongperiodsduringtheday.Asaresult,
babiesgoforalongtimebetweenfeedings.Theyneedhighcalorie,highfatmilkto
sustainthem.
Whenbabiesstickclosetomotheralldayaswasthecaseforourancestorsbabies
nursefrequently.Insuchfrequentlyfeedingspecies,babiesdontrequirehighfatmilk.
So,comparedwiththemilkofothermammals,humanmilkhasfairlypaltryamountsof
proteinandfat.
Nonetheless,thatfatandproteinisextremelyimportant.

Understandingfat
Byweight,fatmakesuponlyasmallportionofhumanmilk.Butitsresponsibleforthe
majorityofthecaloriesinbreastmilk.
Itsalsooneofthemostvariableconstituentsofbreastmilk.
Thefatcontentofhumanmilkincreasesduringasinglenursingsession.Asa
fullbreastempties,themilkitproducesbecomesmorefatty.

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Caloriesinbreastmilk:Nutritionalinformation

Inaddition,thefatcontentandthereforecaloriesinbreastmilkchangeinresponse
tothefrequencyoffeeds.Morefrequentfeedingsareassociatedwithhigherfatmilk.
Thefatcontentofmilkisimportantforyourbabyshealth.Astheprinciplesourceof
caloriesinbreastmilk,fatdetermineshowmuchmilkyourbabyneedstoconsumeto
meethisneeds.Fatcontentisanimportantdeterminantofgrowthrates.Itisneededto
metabolizemanyvitamins,sotoolittlefatisassociatedwithvitamindeficiencies.
Inaddition,sometypesoffattyacidsfoundinbreastmilkthelongchain
polyunsaturatedfattyacids,orLCPsmayplayimportantrolesinbraindevelopment.The
mostwellknownisdocosahexanoicacid(DHA).
DHAhelpsthebrainmanufacturemyelin,asheaththatinsulatesnervefibers.Thebrains
ofbreastfedbabieshavehigherconcentrationsofDHAthandothebrainsofformulafed
babies(Makridesetal1994).SomehavespeculatedthatDHAispartlyresponsiblefor
theIQgapbetweenbreastfedandformulafedbabies.
However,thisremainscontroversial.Somecarefullycontrolled,longitudinalstudieshave
shownnodifferencesindevelopmentaloutcomesbetweenformulafedbabiesreceiving
supplementalDHAandformulafedcontrols(Auestadetal2001Auestadetal2003).
Possibly,thesestudiesdidntgiveahighenoughdoseofDHAtoinfants.Instudieswhere
formulafedinfantsweregivenhigherlevelsofDHA(greaterthanorequalto0.30%),
supplementationhadabeneficialeffectonneurologicaldevelopmentforthefirst4
monthsoflife(HaddersAlgraetal2007).
Cholesterolisanotherfattycomponentofbreastmilkimportantforbraindevelopment.
LikeDHA,cholesteroliscrucialtotheproductionofmyelin(Pond2003).Atpresent,
infantformulasdonotcontaincholesterol.

Protein
Therearetwoclassesofproteinsinmilkthecaseinsandthewheys.
Caseinsturnintoclotsorcurdsinthestomach.
Thewheysremainliquidandareeasiertodigest.
About60%oftheproteinsinbreastmilkarewhey(Jenness1971).Thatsalotcompared
withothermammals.Inthecow,forinstance,wheyrepresentsonly18%ofmilkprotein
(Jenness1971).Mostbabyformulasarehighincasein.Thismakesthemhardertodigest
thanbreastmilk.
Wethinkofproteinsasthebuildingblocksofmuscleandbone.Butproteinsserveawide
rangeofotherfunctions,includingdefenseagainstpathogens.
Forinstance,immunoglobulinA(IgA)isaproteinthatattacksrespiratoryviruses,
bacteria,andintestinalparasites.Likeotherantimicrobialfactorsinhumanbreastmilk,it
protectstherespiratoryandintestinaltractsofbreastfeedinginfants(Instituteof
Medicine,NationalAcademyofSciences1991).

Otherconstituents
AccordingtostudiescitedbytheInstituteofMedicineoftheU.S.NationalAcademyof
Sciences(1991),eachliterofmaturebreastmilkalsocontains
cholesterolinconcentrationsrangingfrom100to150mg/L
calciuminconcentrationsrangingfrom254to306mg/L
sodiuminconcentrationsrangingfrom140to220mg/L
phosphorusinconcentrationsrangingfrom188to262mg/L
vitaminCinconcentrationsof50to60mg/L(assumingthemotherconsumes
morethan100mgvitaminCeachday)
magnesiuminconcentrationsofabout35mg/L
andmuchsmalleramountsofzinc,pantothenicacid,nicotinicacid,iodine,andvitaminA
andcopper.Breastmilkcontainstraceamountsofothervitaminsandminerals(including
E,K,D,andtheBvitamins)andahostofhormones,growthfactors,andantiinfectious
agents(InstituteofMedicine,NationalAcademyofSciences1991).
Whataboutiron?
Ironconcentrationsmayrangefrom0.2to0.9mg/L,andtheyseemtodependonthe
mother'sironstatusandthelengthoftimeawomanhasbeenbreastfeeding.Inone
studyofFinnishmothers,milkexpressedinthefirstweekspostpartumhadabouttwice
theironcontentasmilkproduced9monthslater(Siimesetal2008).

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Caloriesinbreastmilk:Nutritionalinformation

Caloriesinbreastmilk:Aroughguideforassessingchangesinyourown
milk
Precisemeasurementsofthecaloriesinbreastmilkrequirefancylabequipment.Butyou
cangetaroughideaofhowthecaloriesinbreastmilkchangeovertimebycollecting
milkfromabreastpump.AstudybyWangetal(1999)hasdemonstratedthatcaloriesin
breastmilkcanbeestimatedfromtheamountofcreamthatfloatstothetopofcollected
milk.
Theresearchersusedacentrifugetoseparatethecreamfromthemilk.Youprobably
don'thaveone,butyoucanstillobservetheamountofcreamthatformsatthetopofa
cupoffreshlyexpressedmilk.
Afterpumping,putthemilkinatransparentcontainer(soyoucanobservethecream
columnfromtheside).Leaveinacoolplacefor1224hours.Thiswillpermitthecream
torise.Forbestresults,thecontainershouldberelativelyshallow,sothecreamdoesnt
havetotravelveryfar.
Measurethelengthofthecreamcolumn.Thehigherthecolumn,themorefatand
caloriesinbreastmilk.
Youcantakeaseriesofmeasurementsovertimetoobservehowthecaloriesinbreast
milkchange.Byusingthismethod,youmaybeabletodeterminewhattimeofdayis
associatedwithapeakinyourmilkfat.Youcanalsoseeifthecaloriesinbreastmilk
increaseordecreasedependingonchangesyoumakeinyourdietorbreastfeeding
schedule(seebelow).

Improvingthequalityofyourbreastmilk
Thereisnoconvincingevidencethatyoucansignificantlychangethelactosecontentof
yourmilk.
Butstudiessuggestthatdietandbreastfeedingpracticescaninfluencetheprotein,
vitamin,andfattyacidcompositionofbreastmilk(InstituteofMedicine,National
AcademyofSciences1991Woolridge1995).
Herearesomeideasforincreasingthequalityandcaloriesinbreastmilk.
Takeprenatalvitamins.Donttakeadditionalsupplementswithoutconsultingadoctor.
SomevitaminslikeAandDcanhavetoxiceffectsinhighdoses.
Dontskimponprotein.Althoughproteinlevelsremainprettystableacrossawiderange
ofdiets,populationssubsistingonverylowproteindietsareassociatedwithlowprotein
breastmilk.
Limitsaturatedfats.Westerndietsareveryhighinsaturatedfats.Babieswhoconsume
breastmilkhighinsaturatedfatmaybeatincreasedriskofdevelopinghighblood
pressureandhighcholesterollevelslaterinlife(Leesonet2001Mottetal1990).
IncreaseyourDHAintake.TheDHAlevelsinAmericanbreastmilkareamongthe
lowestintheworld.ThepopulationswiththehighestDHAlevelsarethosethateat
significantquantitiesoffish(Brennaetal2007).Ifyoudontlikefish,youcanbuyDHA
supplementsinpillform.However,Ifeelcautiousaboutthis.Checkwithyourphysician.
Breastfeedondemand.Thispermitsyourbabytoadjustintakeinresponsetochanges
inyourbreastmilk.Inaddition,morefrequentfeedingsmayboostthefatcontentofyour
milk.Formoreinformation,seemyarticleontheinfantfeedingschedule.
Letyourbabytakehisorhertimeateachbreast.Asnotedabove,prematurebreast
switchingcanrobbabiesofhigherfat"hind"milk.
Ifyoufoundthisarticleonthenutrientsandcaloriesinbreastmilkhelpful,checkoutthe
otherbreastfeedingarticlesatParentingScience.com.

References:Nutrientsandcaloriesinbreastmilk
Forveryextensiveinformationonthenutrientsandcaloriesinbreastmilk,Irecommend
NutritionDuringLactation.Thisvolumeisavailableonline.Auestadetal.2001.Growth
andDevelopmentinTermInfantsFedLongChainPolyunsaturatedFattyAcids:ADouble
Masked,Randomized,Parallel,Prospective,MultivariateStudy.Pediatrics108(2):372
381
Auestadetal2003.Visual,Cognitive,andLanguageAssessmentsat39Months:A
FollowupStudyofChildrenFedFormulasContainingLongChainPolyunsaturatedFatty

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1.8.2016.

Caloriesinbreastmilk:Nutritionalinformation

Acidsto1YearofAge.Pediatrics112(3):e177e183
BenShaulDM.1962.Thecompositionofthemilkofwildanimals.InternationalZoo
Yearbook4:333342.
BernhartFW.1961.Correlationsbetweengrowthrateofthesucklingofvariousspecies
andthepercentageoftotalcaloriesfromproteininthemilk.Nature191:358360.
BrennaTJetal.2007.Docosahexaenoicandarachidonicacidconcentrationsinhuman
breastmilkworldwide.AmJClinicalNutrition85:14571464.
DepartmentofHealthandSocialSecurity.1988.Presentdaypracticeininfantfeeding:
thirdreport:reportofaWorkingPartyofthePanelonChildNutrition,Committeeon
MedicalAspectsofFoodPolicy:ReportonHealthandSocialSubjects32.HerMajesty's
StationeryOffice,London.
GopalanC,RamasastriBV,andBalasubramanianSC.2000.NutritivevalueofIndian
foods.Hyderabad,India:NIN,ICMR.
GuthrieAH.1989.IntroductoryNutrition.St.Louis,MO:TimesMirror/MosbyCollege
Publishing.
HaddersAlgraM.BouwstraH,vanGoorSA,DijckBrouwerDAandMuskietFA.Prenatal
andearlypostnatalfattyacidstatusandneurodevelopmentaloutcome.2007.Journalof
PerinatalMedicine35Suppl1:S2834.
InstituteofMedicine,NationalAcademyofSciences.1991.Nutritionduringlactation.
Washington,DC:NationalAcademyPress.
Jenness1974.Biosynthesisandcompositionofmilk.Journalofinvestigative
dermatology.63:109118.
LeesonCPM,KatterhornM,DeanfieldJEandLucasA.2001.Durationofbreastfeedingand
arterialdistensibilityinearlyadultlife:populationbasedstudy.BMJ322:6437.
Makridesetal1994.Fattyacidcompositionofbrain,retina,anderythrocytesinbreast
andformulafedinfants.AmJournalClinicalNutrition60:189194.
MandelD,LubetskyR,DollbergS,BarakS,MimouniFB.2005.Fatandenergycontents
ofexpressedhumanbreastmilkinprolongedlactation.Pediatrics116:e432e435.
MottGE,JacksonEM,McMahanCA,McGillHZ.1990.Cholesterolmetabolisminadult
baboonsisinfluencedbyinfantdiet.JNutrition.120:243251
PondWG.2003.DietaryFattyAcidsandCholesterolinNormalBrainDevelopment.
CommentsonTheoreticalBiology,8(1):3768.
SiimesMA,VuoriE,KuitunenP.2008.Breastmilkironadecliningconcentrationduring
thecourseoflactation.ActaPdiatrica68(1):2931.
WangCD,ChuPS,MellenBG,andShenatJP.1999.Creamotocritandthenutrient
compositionofhumanmilk.JournalofPerinatology19(5):343346.
WoolridgeMW.1995.Babycontrolledbreastfeeding:Bioculturalimplications.In:
Breastfeeding:Bioculturalperspectives.P.StuartMacadamandKADettwyler(eds).New
York:AldinedeGruyter.
Contentlastmodified6/10

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Attachment
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