Scientific discoveries of recent years demonstrate a crucial role of the human microbiome in human health. The establishment of a healthy, functional gut microbiota of the newborn requires physiological conditions, one of which is breastfeeding. The role of breast milk as a “direct supplier” of live microbes for the establishment of the newborn gut microbiota became known only at the beginning of the new millennium, previously it was believed that the breast milk was sterile. Today, the breast milk microbiota can be defined as multi-species assemblage, in which microbes interact with each, representing a complex organized ecosystem, among which the genera Streptococcus and Staphylococcus are dominant. Lactobacillus, Pseudomonas, Bifidobacterium, Corynebacterium, Enterococcus, Acinetobacter, Rothia, Cutibacterium, Veillonella and Bacteroides are also often referred to the common bacterial genera. The article presents two theories of the origin of bacteria in the breast milk (endogenous and exogenous bacterial translocation pathways) and explains why both of them are true. The role of bacteria in the breast milk of healthy women, in the global sense, is viewed in the context of the establishment of the infant gut microbiota. The article lists the main producers of antibacterial peptides (bacteriocins) in the breast milk and considers the effective immunological protection using the example of the population of bifidobacteria and bacteroids prevailing in the breastfed infant gut. However, the breast milk microbiota is also important for women’s health. We tried to explain why infectious lactational mastitis is now considered to be the result of dysbiosis in the mammary ecosystem, which leads to the development of an inflammatory process, and why Streptococcus thermophilus (TCI633) shows promise in the fight against human ageing.
The review is devoted to the analysis of data on the effects of Lactobacillus reuteri DSM 17938, confirmed in clinical trials. Thanks to their antimicrobial activity, L. reuteri is able to inhibit colonization by pathogenic microorganisms and restore the composition of compensatory intestinal microbiota. Another study showed a positive protective effect of intestinal microbiota when administered L. reuteri simultaneously with antibiotics. In addition, L. reuteri supports the immune system of the human body. For example, some strains of L. reuteri may reduce the production of pro-inflammatory cytokines while stimulating the development and proliferation of regulatory T-lymphocytes. Adding L. reuteri to the diet may be attractive in terms of preventing the development of inflammatory bowel disease. The results of a recent meta-analysis confirmed the efficacy of L. reuteri in the treatment of infantile colic. Further research is aimed at finding evidence of the efficacy of L. reuteri use in children who are artificially fed, with infant colic and in children born by caesarean section.
Mastitis is one of the most common pyoinflammatory processes that occur in the postpartum. The mastitis incidence varies from 0.5% to 33%. Due to lack of standard algorithms, approaches to diagnosis and treatment of lactational mastitis vary between pediatricians and obstetrician-gynecologists. Plugged ducts is the basic factor that predisposes a woman to plugged milk ducts, which can lead to mastitis. Unfortunately, frequently prescribed antibacterial treatment has an adverse effect on human milk microbiota and creates subtherapeutic drug concentration in milk, which leads to antibiotic resistance in infants. Effective expression of breast milk is a key method to prevent and fight mastitis and plugged ducts. Recommendations for preferred method of breast milk expression require a personalized approach, the first of which depends on the assessment of breast nipples condition. According to some reports, 80–90% of breast-feeding women develop soreness and cracked nipples, which cause delayed or missed breastfeeding. Teaching correct breast-feeding techniques can prevent the chain of these adverse events: cracked nipples – plugged duct – lactation mastitis. Ideally, a healthy mature infant with active sucking reflex, who is breastfed effectively with a good technique, may perfectly ensure a problem-free lactation period.
На сегодняшний день является неоспоримым тот факт, что грудное вскармливание для младенца -это оптимальное пита-ние, обеспечивающее его гармоничные рост и развитие. Этот постулат подтверждается не только современными научны-ми данными, но и всей историей человечества от древнейших времен. Однако история свидетельствует и о том, что во все времена существовали различные факторы, помимо медицинских, препятствующие полноценному и повсеместно рас-пространенному грудному вскармливанию младенцев. Эти факторы носили как религиозный, так и социальный, и даже политический характер; они изменялись от одной эпохи к другой и от одной нации к другой, к сожалению, имея место и в современном обществе. Они нередко носили характер предрассудков и отражались на состоянии здоровья как младен-цев, так и их матерей. В данной статье представлен исторический обзор факторов, препятствующих грудному вскармли-ванию, знание которых может помочь педиатру понять и современные причины недостаточной распространенности естественного вскармливания. E. MARTYNENKO Russian Medical Academy of Continuing Postgraduate Education, Federal State Budgetary Institution of Higher Education of the Ministry of Health of Russia, Moscow HISTORY OF BREASTFEEDING: WHAT HAS BEEN PREVENTING THE NATURAL WAY TO FEED INFANTS FROM ANCIENT TIMES TO MODERN DAY?Presently, there is solid evidence that breast-feeding is ideal for the nutrition, harmonious physical and psychosocial development of the infants. This postulate is confirmed not only by modern scientific data, but also by the entire history of humanity from ancient times. However, history also shows that at all times there were various factors besides medical ones that prevent the appropriate and widespread breastfeeding of infants. These factors were both religious and social, and even political; they changed from one era to another and from one nation to another, and unfortunately, take place in modern society. They often had a character of prejudice and reflected on the health state of both infants and their mothers. This article presents a historical overview of the factors preventing breastfeeding, which can help the paediatrician understand the current causes of the insufficient prevalence of natural feeding.
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