{'fraction_non_alphanumeric': 0.023685266961059815, 'fraction_numerical': 0.004014452027298274, 'mean_word_length': 5.23, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Book Review: Short and Long Term Effects of Breast Feeding on Child Health

Kirsi-Marjut Järvinen, a physician researcher, followed 100 breastfeeding mother-infant pairs, most of them prospectively from birth, to determine “the immunologically active components of human milk and to evaluate their possible association with the development of cow’s milk allergy (CMA) in the infant” (p. 36). All studies consisted of a group at high risk for food allergy (infants with siblings with severe food allergies) and those with low risk (no family history of atopic disease). Maternal milk macrophages are thought to present antigens to the immature infant T lymphocytes to stimulate tolerance. Mothers of infants with CMA had lower numbers of milk macrophages than healthy controls. The milk of some atopic mothers of infants with CMA also had a higher proportion of eosinophils. Upon cytolysis in the infant gut, eosinophils release highly cytotoxic mediators, such as eosinophil cationic protein, which have been shown to cause tissue damage and may contribute to immunoinflammation in the infant’s gut. Similarly, neutrophils, which are cytotoxic and tissue injuring, were found in significantly larger numbers in mothers of infants with CMA. Secretory IgA levels were significantly lower in early (< 2 weeks) milk from mothers of infants with cow milk allergies, possibly reducing the protection of the infant’s gut when it is most permeable. Macrophage activity was also lower in milk of mothers with infants with CMA, as demonstrated by lower expression of human leukocyte antigen DR and lower production of tumor necrosis factor alpha (TNF-α). Reduced levels of TNF-α was theorized to skew the T lymphocyte populations in the infant toward allergy. Of greatest interest to lactation consultants will be the finding of immune responses in exclusively breastfed infants with CMA to cow milk ingestion by their mothers after a 2to 4-week elimination diet, regardless of the presence of detectable beta-lactoglobulin in maternal milk. The author points out that “interestingly, the several abnormalities or deficiencies in human milk tended to coexist in the same mother” (p. 63). This doctoral dissertation is the first scientific document that correlates inadequacies in several immune components of maternal milk with the development of CMA in breastfed infants. Health care professionals working with allergic breastfeeding infants will find this thesis fascinating and educational reading.