Milk cytokines and subclinical breast inflammation in Tanzanian women: effects of dietary red palm oil or sunflower oil supplementation

Abstract

Previously, we have found that subclinical breast inflammation, as indicated by raised breastmilk concentrations of sodium and the inflammatory cytokine, interleukin-8 (IL-8), was highly prevalent in Bangladesh and associated with poor infant growth. In order to investigate further the prevalence of subclinical breast inflammation and to assess the impact of dietary intervention, we studied rural Tanzanian women taking part in a study of dietary sunflower or red palm oil supplementation during late pregnancy and lactation. We measured breastmilk concentrations of IL-8, the anti-inflammatory cytokine, transforming growth factor-beta2 (TGF-beta) and the ratio of sodium to potassium. We also estimated systemic inflammation by plasma concentrations of the acute phase proteins, alpha1-acid glycoprotein and C-reactive protein. There were highly significant intercorrelations among milk Na/K ratio and concentrations of IL-8 and TGF-beta, the last only after treatment with bile salts which also improved TGF-beta recovery in the enzyme-linked immunosorbent assay (ELISA). Plasma acute phase protein concentrations tended to correlate with milk Na/K ratio and IL-8, suggesting that subclinical breast inflammation was related to systemic inflammation. Dietary supplementation with vitamin E-rich sunflower oil but not provitamin A-containing red palm oil decreased milk Na/K, IL-8 and TGF-beta at 3 months postpartum; however, the effect was significant only for Na/K ratio. The results suggest that milk Na/K ratio, IL-8, and TGF-beta all measure the same phenomenon of subclinical breast inflammation but that Na/K ratio, having the lowest assay variability, is the most useful. Subclinical breast inflammation may result in part from systemic inflammation and may be improved by increased dietary intake of vitamin E-rich sunflower oil.

Subclinical mastitis occurs frequently in association with dramatic changes in inflammatory/anti-inflammatory breast milk components

“…Antileukoproteinase 1 is secreted during experimental mastitis in animals [42]. α-defensins are microbicidal peptides produced notably by weight gain or lower breast milk intake has been reported [43] [17] [44]. SCM occurs frequently in one breast in human, making possible for the unaffected breast to increase the milk output to maintain milk intake.…”

Taste of Milk from Inflamed Breasts of Breastfeeding Mothers with Mastitis Evaluated Using a Taste Sensor

“…We then compared the taste of milk between the inflamed and contralateral asymptomatic breasts of mothers with unilateral mastitis. Although the asymptomatic breasts of mothers with unilateral mastitis might not be completely healthy because of the presence of subclinical inflammation, 27,28 their inclusion helped to control for the influences of confounding factors. Saltiness and umami increased in the inflammatory breasts.…”

Treatments for breast engorgement during lactation

“…The main reasons for exclusion were that studies examined the prevention of breast engorgement in women whose breasts were not yet engorged, or examined interventions to suppress lactation in women who did not intend to breastfeed, rather than examining interventions to treat the symptoms of engorgement in women who were breastfeeding their babies (Booker 1970;Filteau 1999;Garry 1956;King 1958;Phillips 1975;Roser 1966;Ryan 1962). One excluded study included a small number of women intending to breastfeed, but the majority of the sample recruited were not breastfeeding their babies during the intervention period, and results were not reported separately for the former group (Kee 1989).…”

“…Each woman put cabbage leaves on 1 breast and a cold gel pack on the other Outcomes Pre and post-test pain rating for each breast rated on a "pain ruler" (a VAS with numbers from 0-10, labelled with descriptions 0 = no pain, 5 = moderate pain, and 10 = excruciating pain) Notes Analysis was at the breast level and results were at high risk of bias and difficult to interpret. We have not included data in the data tables Booker 1970 This study focused on the suppression of lactation in women who did not intend to breastfeed Filteau 1999 This study was examining interventions to prevent breast engorgement. Women in three villages were assigned three different treatments…”