There
is general agreement that breast milk of the
mother is the best food for infant, exclusive
breast feed for the first 6 months without any
additional feed of water is considered ideal
for all newborns. However, changing social
and cultural patterns in the last 4 decades
have led to change from breast to formula feed
specially among urban elites and working mothers.
In the west, there is again a reversal of the
phenomenon and more and more mothers are now
preferring to breast feed their babies.
There are some factors which influence a mother
to start formula feed e.g. employed mother,
fear of failure of nursing limitation of the
activities and even loss of breast tone.
All the above factors are not genuine reason
to start formula feeds. However, in following
situations breast milk may not be available
or contraindicated or need to be supplemented
and there is need to search for an ideal milk
formula.
Conditions
where formula feed may be indicated
1. Death
of the mother.
2. Serious
illness in the mother e.g. HIV/AIDS, human T-cell
lymphographic virus type 1 and type 2 and diseases
like cancer, severe post partum psychosis.
3.
Maternal ingestion of drugs e.g. anticancer,
radioactive drugs in therapeutic doses and drugs
of abuse.
4. As
a supplement to breast milk, formula milk may
be used in very low birth weight preterm babies.
Comparison
of Cow’s Milk and human milk
Average
values for the various constituents of human
milk and the whole fresh cow’s milk are listed
in table 1. Both differ during the various
stages of lactation and among individuals.
However, the differences in human milk from
woman with adequate diets are insignificant.
Colostrum
The
secretion of the breasts during the latter part
of pregnancy and for the 2-4 days after delivery
is called colostrums. This is deep lemon
yellow coloured and about 10-40 ml is being
secreted per day. Both cow and human colostrums
contains very high protein and minerals but
less carbohydrate and fat. In addition,
human colostrums is rich in immunologic factors
which prevent infection in the newborn babies.
Colostrum, therefore, is essential for human
nutrition and should not be discarded.
Water
and Calories
The
relative amounts of water and solids in human
and cow’s milk are about the same. The
energy value of each milk vary slightly and
is approximately 20 Kcal/ounce or 0.67 Kcal/ml.
Protein,
Carbohydrate and fat
Human milk contains only 1-1.5% protein compared
to 3.3% in cow’s milk. The increased protein
content of cow’s milk is largely due to 6 fold
higher content of casein. On the other
hand, human milk kprotein consists of approximately
65% whey proteins largely lactalbumins
and 35% casein.
Human milk contains 6.5-7% and cow’s milk contains
4.5% lactose. The fat contents of both
milk are about 3.5%. In human milk, the
fat content varies somewhat with material diet
and during a single nursing. It is higher
in latter part of the feeding (hind milk).
The milks of different breeds of cattle vary
in fat content. Most market milk specially
in urban areas are now pooled and fat content
adjusted to a standard level. The quality
of fat varies in both human and cow’s milk.
The more absorbable fat (Olein) is twice as
much in human milk and volatile fatty acids
are less in human milk (1.3%) compared to 9%
in cow’s milk.
Minerals
Cow’s milk contains more minerals except iron
copper, than human milk. The total mineral
content of cow’s milk is 0.7-0.75% in contrast
to human milk (0.15-0.25%). Cow’s milk
iron content is low and poor bio-availability
for infants. Although, the iron content
of human milk is also low, the absorption is
better. Although the need for calcium
and phosphorus is great during period of rapid
growth, adequate balances are maintained on
breast milk despite its low content of these
minerals.
Vitamins
Vitamin
contents of each ;milk vary with the maternal
intake. Cow’s milk is low in Vit. C and
D. Cow’s milk contains more Vit. K than
human milk. Both types of milk seem to
contain adequate amounts of Vit.A and the B
Complex to meet the nutritional requirements
of young infants.
Bacterial
Content
Human
milk is essentially uncontaminated by bacteria
and is therefore most suitable. Cow’s
milk is regularly contaminated with harmful
bacterial and is a very good culture media for
various organisms. Therefore, terminal
sterilization or boiling the milk before feeding
is advisable.
Digestibility
The
stomach empties more rapidly after human milk
than after cow’s milk. However, no appreciable
difference in gastrointestinal passage time
exists between human milk and processed milk
formulas during the first 45 days of life.
The curd of cow’s milk is reduced in size boiling.
The fat of cow’s milk is less readily digested
than that of breast milk.
Growth
and Development
Objective nutritional studies of growing infants
in terms of rate of growth in weight and length,
performance in metabolic studies and body composition
show relatively very minor differences between
infants fed human milk or these fed cow’s milk.
However, in developing countries it has been
observed that infants fed on cow’s or other
formula milk suffer from more morbidities and
mortalities than infants fed on human milk.
This is not because of the fault in cow’s milk
or formula but the technique and the dilution
in which cow’s milk is being fed.
Milk
used in Formulas
-
Raw milk
- Pasteurized milk
-
Homogenized milk
-
Evaporated milk
-
Prepared powdered milk
-
Condensed milk
Conclusion
Human
milk is the best option for infant feeding.
However, in certain situation other milk may
need to be used. Cow’s milk is the best
alternative option in such a situation.
In developed countries fresh cow’s milk is not
used in infants less than 1 year and cow’s milk
based formula is used. In India, boiled
whole cow’s milk is routinely used without any
significant problem. The milk should not
be diluted and there is no place of bottle in
infant feeding. The milk can be given
to the newborn and infants with cup and spoon
or directly from cup. In developing countries
like ;Inida where protein energy malnutrition
is very common in children under the age of
5 years, cow’s milk with its high protein content
and biological value and easy availability would
be extremely beneficial as nutritional rehabilitation
of these children.
Table-1:
Comparison of Cow’s and Human Milk
|
|
Mature Human Milk
|
Cow’s
Milk
|
|
Calories
|
747
|
701
|
|
Kcal/litre
|
|
|
|
Protein
|
|
|
|
gl
|
10.6
|
32.46
|
|
Casein
3.724.9
|
|
|
|
Lactalbumin
|
3.6
|
2.4
|
|
Carbohydrate
|
|
|
|
Gl
|
|
