Breast milk quality and quantity: Everything you need to know

Breast Milk Quality & Quantity: Breast milk composition

Isn’t it amazing how babies can solely depend on the mother’s milk for the first six months of their lives and derive all the nutrients they need from this milk? However, you need to remember that the quantity and quality of breast milk determine how steadily your little one will grow and develop. Now, the quantity and quality of breast milk depends on several factors. So, read on to know all about breast milk composition, supply, and the impact of maternal nutrition on this milk.

Composition of breast milk

Breast milk consists of around 200 recognized compounds and several essential nutrients that are important for the growth of the baby. A large quantity of breast milk is made up of water (87%) along with lactose (7%), fat (4%) and protein (1%). Breast milk has benefits beyond nutrition too. They have several bioactive components that help in the development of the immune system, gastrointestinal tract, and brain of the baby. The milk also has elements that protect the baby against bacteria, viruses, and other pathogens. They help in reducing the risk of metabolic diseases like diabetes, later in life.

Constituents of breast milk and their supporting functions:

  • Elements to support growth - Proteins and growth factors
  • Elements to boost immunity - Antibodies and immune cells
  • Elements to establish the microbiome (bacterial colony) - good bacteria and probiotics
  • Elements that provide nutrition - Vitamins (A, D, K, E, C, thiamine, riboflavin and niacin, B6, B12, folate, biotin, and pantothenic acid) and minerals (calcium, phosphorus, and magnesium)
  • Elements that provide energy – Protein, fat, and carbohydrates
  • Electrolytes - Sodium, potassium, and chloride
  • Trace minerals – Iron, copper, zinc, manganese, selenium, fluoride, and iodine

Factors that affect milk production

The average level of milk production is approximately 750 to 800 ml/day. Successful lactation in the initial months depends on the way the baby latches on to the breast, the timing of the feed, and the frequency.

Initially, you should feed your baby more frequently as it will increase milk production. Nurse your baby eight to twelve times per day to increase the stimulation of the mammary glands. It is important to note that the increase in the frequency of feeding will not necessarily increase the milk intake of your baby. Babies can consume an adequate amount of milk by feeding just four to five times a day.

You should time the feed to match the baby’s desire to suckle. Remember that sore nipples can cause discomfort, and so you need to take some precautionary measures.

Factors that affect milk volume and milk intake

  1. Infant factors

    The birth weight of the baby can affect his sucking strength and your milk volume. Bigger infants have better milk intake due to their sucking strength, and the ability to feed multiple times and for a longer time period. Milk intake is more influenced by the baby’s demand than by the maternal capacity to produce milk. When the milk supply is ample, the infant's milk intake is positively associated with infant weight. Any illness of the infant may reduce appetite and therefore milk intake. The reduced milk intake by infants during the wet season is usually associated with infections during this period.

  2. Maternal factors

    The mother’s age has little or no effect on milk production. Her mood and stress level can however influence milk production. So, it is very important to stay relaxed. It has been observed that maternal nutritional status or maternal energy intake is not related to milk volume. Some studies have indicated an association between protein intake and improvement in milk volume. Also, mothers who are physically active or who exercise regularly produce an adequate volume of milk. Smoking cigarettes and excessive alcohol consumption can affect milk production and hence should be avoided.

Factors that affect milk composition

The composition and breast milk quality changes during each feed. The first milk is expressed as foremilk, which has a thinner consistency, and helps to quench the baby’s thirst. This is followed by the fattier hindmilk, which has all the essential nutrients. The sucking of the baby helps in the transition from foremilk to hindmilk. The fat content is diluted in fuller breasts when the quantity of milk is high. The fat content becomes more concentrated in a drained breast.

The breast milk quality changes with age too, to match the nutritional requirements of the growing baby. In the first few days, it is thick and sticky yellow and called colostrum. It is rich in quality but low in quantity of milk. It has a high composition of immunity-related and nutritional elements to protect the baby against infections. This is followed by transitional milk, which is creamier and ideal for the growing baby. The volume of this milk is more compared to the colostrum. Transitional milk is followed by mature milk after around 4 weeks. It is rich in proteins, lactose, vitamins, and minerals.

The composition of the milk is affected by the time of day too, and also depends on the last feed and quantity of milk consumed by the baby. The fat content decreases with an increase in milk volume. Breast milk is rich in fat mid-morning. Baby’s birth weight, mother’s age, and mother’s diet are also believed to affect the composition of milk.

Impact of maternal nutrition on milk composition

Mammary glands that produce breast milk utilise nutrients from the mother’s diet or her body’s stores of nutrients. Maternal nutrition can modify the milk composition and can affect the health and nutritional status of the baby. If the mother is undernourished for a long period, the nutrients passed on to the baby are replaced by the mother’s reserves or body tissues.

So, a poor diet might not affect the baby, but will leave the mother at nutritional risk. The nutrients that are maintained at the expense of maternal stores include macronutrients, minerals, and folate. Low nutritional intake by mothers can also influence the levels of vitamins A, D, B6, and B12 in her milk. If you have any concerns about undernutrition, you should speak to your doctor or nutritionist to get advice on dietary changes or supplements.

Breastfeeding mothers might need to eat more too, an additional 330 to 400 calories say, to maintain energy levels during breastfeeding. If you are a vegetarian, make sure that vitamin B12 and vitamin D are replenished through alternative dietary sources. Add protein-rich foods to your diet like meat, eggs, dairy, and seafood, if you are a non-vegetarian. You can also include whole grains along with fruits and vegetables. Adding variety to your diet will also help your baby develop a taste for different foods. Drink water frequently to stay hydrated. Excessive intake of vitamin D or iodine through supplements should be avoided as they may be passed on to the baby at toxic levels.

In conclusion, your doctor can guide you best regarding the recommended dietary allowance (RDA) for each nutrient. It is not harmful if your nutrient intake is low on some days. It will not harm the baby as the nutrient content of the milk decreases slowly, or in some cases, it does not get affected at all, in the short term.