Hanson Lars A, Korotkova Marina, Telemo Esbjörn
Department of Clinical Immunology, Göteborg University, Göteborg, Sweden.
Ann Allergy Asthma Immunol. 2003 Jun;90(6 Suppl 3):59-63. doi: 10.1016/s1081-1206(10)61662-6.
Breast-feeding provides many advantages to the offspring, but presently there is an ongoing debate whether or not it prevents allergy any better than certain formulas. This report reviews the mechanisms involved and discusses how breast-feeding may protect against allergy.
The review builds on an internet-based literature search in addition to our own data.
Human milk is the food best adapted to the needs of the offspring, also because it provides efficient protection against infections and actively stimulates the development of the infant's own immune system. The major host defense system is provided via the secretory IgA antibodies produced in the mammary glands by lymphocytes, which have migrated there from the mother's gut mucosa. Therefore, these antibodies in the milk are primarily directed against the microbes in the mother's gut and her food proteins. As a result, breast-feeding starting directly after delivery will provide an excellent defense against the microbes normally meeting the neonate and needed to induce development of its immune system. The milk also contains numerous components, which seem to enhance the infant's host defense as well as capacity to develop tolerance, helping to avoiding allergic reactivity to foods, etc.
Several studies show that breast-feeding prevents allergic diseases, but there are also good disagreeing studies. Supported by animal data, it seems that protection is enhanced in areas with more advantageous fat intake, inter alia lower ratio of n-6/n-3 fatty acids. Breast-feeding seems to protect against future development of allergic diseases, but possibly less so in countries with an untoward maternal fat intake.
母乳喂养对后代有诸多益处,但目前对于母乳喂养在预防过敏方面是否比某些配方奶粉更具优势仍存在争议。本报告回顾了其中涉及的机制,并探讨了母乳喂养预防过敏的方式。
除了我们自己的数据外,本综述还基于互联网文献搜索。
母乳是最适合后代需求的食物,这还因为它能有效预防感染,并积极刺激婴儿自身免疫系统的发育。主要的宿主防御系统是通过淋巴细胞在乳腺中产生的分泌型IgA抗体提供的,这些淋巴细胞从母亲的肠道黏膜迁移至乳腺。因此,母乳中的这些抗体主要针对母亲肠道中的微生物及其食物蛋白。这样一来,产后直接开始母乳喂养能为新生儿抵御通常会接触到的微生物并诱导其免疫系统发育提供极佳的防御。母乳还含有许多成分,这些成分似乎能增强婴儿的宿主防御能力以及产生耐受性的能力,有助于避免对食物等产生过敏反应。
多项研究表明母乳喂养可预防过敏性疾病,但也有持不同意见的研究。在动物数据的支持下,在脂肪摄入更有益的地区,尤其是n-6/n-3脂肪酸比例较低的地区,保护作用似乎会增强。母乳喂养似乎能预防过敏性疾病的未来发展,但在母亲脂肪摄入不良的国家,这种保护作用可能较弱。