by : dr.ROSA LELYANA, M.Si.

Med

CONSIDERABLE EVIDENCE
In the breast fed infant
:
-prevent infection
-prevalence and incidence
of illness is lower than
in formula fed
-duration of the illness is
shorter than in
formula fed
-protect the infant
against infections

Newborn infants
Highly susceptible to infection

during early life

Is the the result of delayed
development of the immune function

Component of the immune

function to be lower
Neutrophil
functioninfant:
during
early
Macrophage activation
Production of SIg A
Formation of T cell
Ig G antibody

Component of the immune

function to be lower
Amounts early
of cytokines
during
infant :
Granulocyte/macrophage
Interferon (IF- )
IL-3
IL-4
IL-6
TNF- (Tumor Necrosis Factor- )

Various Factors associated

with the process of breast
feeding and importance to
preventing illness :

1.Exposure to pathogens
2.Several component in the breast milk
that participate in the immune function
3. The lack of exposure of the exclusively
breast fed infants to various Ag,
dietary,environmental

Maternal immunity
Ig
Anti idiotypic Ab
Activated and

memory T cell

Human Milk
Antibodi : SIgA predominant class

Component in breast milk

1.Lactoferrin an iron binding protein
(1-2gr/L or 10-20% of total protein
content)
bacteriostatic effect
against
E.Colli
bactericidal agents
V.cholera, Salmonella,
Staphilococus

Lactoferin fortified
formula
Failed! to show the effects on the

microbial flora in the infant gut

Because the bovine lactoferrin was
use
Not human lactoferrin

Component in breast milk

2. Lysozyme :

active enzym
0,1-0,3 g/L
function :-degrade the cell
walls of
gr(+) bacteria
-antimicrobial

Lysozym + Lactoferrin
Synergistic effect

Lactoferrin : bind the LPS from the outer

membrane
Lysozym : degrade the cell walls of
gr(+) bacteria gets access to
the underlying proteoglycan
matrix
lysis bacteria

Component in breast milk

3. Nucleotida :
e.c synthesis Nucleotida is immature
in newborn
Fx :
help nucleic acid synthesis cell
growth
and proliferation
enhance integrity of the mucosal
barier

Nucleotide fortified
formula
Fx :

1.had higher concentration of NK cell

and IL-2
2. lower prevalence of infections
3. lower total number of days being
sick

Component in breast milk

4.Oligasakarida

Function :
inhibited binding of the bacteria to
the mucosal surface -
inhibition of adherence
enterotoxigenic E.colli, H.influenza,
Streptococus Pneumonia, V.cholera

Component in breast milk

5. - casein
6.lactoperoxidase
7.polyamine

1-7 antimikroba and

imunostimulator

The difference between

the gut of breast milk
infant with the gut of
infant
formula
The bacterialfed
population

THE SEVERAL COMPONENTS in

breast milk, stimulate the
growth of Lactobacillus and
Bifidobacteria
THE SEVERAL COMPONENTS are :
1. Oligosakarida
2. Lactoferin
3. Lysozym
4. Nukleotida
These bacterias Lactobacillus and Bifidobacteria
called BIFIDO-FLORA

How Bifido -Flora work?

Decrease the ph of the gut
Their production of lactic acid

Inhibit /limits the growth of many

pathogen (E.colli, Staphilococus, etc)

COMPONENT OF THE BREAST MILK

THAT CAN AFFECT THE IMMUNE
SYSTEM OF NEWBORN INFANT
1. ANTIGEN EXPOSURE
2. Maternal Immunity : SIgA,netrofil, makrofag,
Anti idiotypic Ab, Activated and Lymphocyt (memory
T cell)
3. antimicrobial factor : lactoferin, lysozym,nukleotida,
oligosakrida, gut mikroflora
4. Immunomodulating agent
5. Anti inflammatory factors
6. Allergy aspect prevalence of manifest atopy,
highest in the grup of no breast feeding/little
breast fed