Download treatment with human milk for adults conditions

GENERAL REVIEW
TREATMENT WITH HUMAN MILK FOR ADULTS CONDITIONS
Mihaela N. Niță
Romanian Lactation Consultants Association
Address for correspondence:
Mihaela N. Niță MD, IBCLC
E-mail: [email protected]
Received: 14.05.2016
Accepted: 01.06. 2016
Med Con June 2016 Vol 11, No 2, 49-52
Abstract
Breastfeeding is the standard method of feeding
infants and small children. When own mother’s milk is
not available, the first choice, if available, is donated
human milk. Human milk banks prioritize deliveries of
donated human milk. Among the indications of human
milk are also adults with various medical conditions. In
their case, using human milk is therapeutical,
nutritional, preventive and paleative. The article’s aim is
to summarize the conclusions of expert articles on the
use of human milk by adults.
Keywords: human milk, donated human milk,
HAMLET, stem cells
Introduction
It is recognized that breastfeeding is the standard
method of feeding infants at term exclusively until 6
months of age, followed by complemantary feeding along
with breastfeeding until the age of 2 years and beyond.
The benefits of breastfeeding for healthy babies at term
and their mothers are well known. Own mother’s milk is
the first choice for all infants, including premature
neonates, but when it is not available or not in sufficient
quantity donated breast milk is the next option [1].
Breast milk is not only optimal nutrition for
neonates and infants but is used prophylactically and
therapeutically against many diseases of infants and
young children and in certain circumstances even for
adults [2]. Using donated milk can be divided into
nutritional, medicinal, therapeutic and preventive. In
Treatment with Human Milk for Adults Conditions

practice, donated milk can serve many purposes to the
same beneficiary [3].
Breast milk can be considered a biological dynamic
system species-specific, which contains specific bioactive
factors and immunomodulators: gastrointestinal
hormones, immunoglobulins, lactoferrin, lysozyme,
oligosaccharides, nucleotides, growth factors, enzymes,
antioxidants and cellular components that provide host
defense against infections, modulates the immune
response and changes the intestinal bacterial flora [4,5].
Using donated breast milk for adults
Studies concentrated on cultural variations in
breastfeeding say that historically it is not uncommon
for women to breastfeed the elderly from their families
[6]. The theme of breastfeeding the elderly was used in
art. For example, the canvas „Roman Charity” presented
in Rijkmuseum, Amsterdam shows how the lactating
mother breastfeeds her father enprisoned and sentenced
to death by starvation.
The scientific basis for this practice were until not
long ago unknown.
The study elaborated by a team of researchers from
the University of Gothenburg and Lund, Sweden,
wanted to investigate the antimicrobial activity of
human milk. The study found that breast milk killed
cancer cells in vitro, a property due to an alphalactalbumin - multimeric protein.
This protein together with a fatty acid, oleic acid, is
forming the compound of HAMLET (Human Alphalactalbumin Made Lethal to Tumour cells). This
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GENERAL REVIEW
formation occurs after treating human milk in casein in
low pH [7,8]. Childrens’ gastric acidity promotes the
formation of HAMLET. This mechanism may
contribute to the anticancer effect of breastfeeding
against tumors in childhood [9]. Laboratory experiments
have shown that this compound kills 40 types of cancer
cells. The anticancer activity affects embryonic cells, but
not the mature cells [8,10].
Based on this discovery HAMLET compound has
been used in patients with bladder cancer. Excretion in
the urine of dead cancer cell was observed every time
HAMLET was used, leading to hopes for future
development of bladder cancer treatment [8,11].
Because malignant brain tumors represent a major
therapeutic challenge, the study by Fischer and his
colleagues tested the intratumoral administration of
HAMLET, noting prolonged survival in a human
glioblastoma xenograft model by inducing selective
apoptosis of tumor cells. HAMLET therapy reduced
tumor volume and delayed signs of intracranial
hypertension. In vivo HAMLET caused apoptosis of
the tumoral cells but not of the adjacent brain tissue and
astrocytes, and did not have apparent toxic side effects.
The study identified HAMLET as a new candidate in
anticancer therapy for controlling progression of
glioblastomas [12].
Programmed cell death in response to HAMLET is
independent of caspases, p53 and Bcl-2, even if
HAMLET activates an apoptotic response. Using other
mechanisms of apoptosis allows HAMLET to have an
activity that is not affected by anti-apoptotic strategies
present in tumor cells [13].
Recent study by Zang and al. investigated the anticancer activity of alpha-lactalbumine and oleic acid
complex (Compound HAMLET). By using modern,
innovative techniques, the study concluded that HAMLET
affects the stability of the cytoskeleton, cell motility, inhibits
the DNA, lipids and synthesis of adenosine triphosphate,
leading to cell stress and activation of apoptosis, thus
establishing the theoretical basis for its action with
possibilities for use in cancer therapy [14].
The study by Petterson and al. aimed to see if
HAMLET-like complexes are present in other species.
They studied human milk, bovine, equine and porcine
milk. The conclusion was that the natural formation of
complexes HAMLET is unique to human milk casein,
which has the highest oleic acid content [7].
Donated milk may help to recolonize the digestive
tract in people who have had gastrointestinal side effects
after anticancer conventional treatment. It can protect
the gastrointestinal mucosa of subsequent aggression
[10].
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Using donated milk may be beneficial for adults
with cancer and other medical conditions.
Small amounts of donated milk may improve IgA
levels in individuals with imunodeficiencies as those
who undergo treatments such as radiotherapy and
chemotherapy [10].
Breast milk is the richest source available in IgA
being used successfully for infants, children and adults
with immunodeficiencies [15].
IgA deficiency is associated with high mortality
(42% to 120 days) after liver transplantation. Most of
the deaths were related to intestinal infections. Breast
milk or donated human milk have beneficial effects
because of the protection against microbial translocation
and enteric infections [16].
In a study, two IgA deficient patients received breast
milk orally for 10 days perioperative after liver
transplantation. Both patients had a postoperative
period without infection, with increased levels of IgA.
Researchers have concluded that breast milk can be used
in IgA deficient patients after liver transplantation to
reduce infectious complications in the postoperative
period [16].
Donated human milk is used for liver regeneration.
A liver transplant unit in Oklahoma Cityis is using
donated human milk to treat adult patients with
transplants. Donated milk is infused into the surgical
field and in the intestinal tract during surgery. The
patient then received daily oral doses of donated milk to
improve the levels of IgA. Surgeons have noticed that it
has improved immunological status of patients and that
fewer cases of transplant reject occurred [10].
The relationship between breastfeeding and better
post-transplant outcomes has been established in the
case of breastfed children receiving renal transplants
from their mothers [17].
Breast milk promotes maturation of the
gastrointestinal tract and protects babies against
gastrointestinal diseases.
An article published the case of a 24 year old man
who has had two episodes of severe gastro-esophageal
reflux with no digestive tolerance not even for
rehydration salts. After the administration of milk or
donated human milk his condition and digestive
tolerance was greatly improved [18].
Breast milk contains several compounds that may
explain the evolution of the case presented above. These
compounds are growth factors, anti-inflammatory
factors and opioid-like peptides. Epidermal growth
factor (EGF) is one of the most active peptides in
human milk. It increases mitosis and proliferation of
epithelial cells in the lungs, the gastrointestinal system
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GENERAL REVIEW
MEDICAL CONNECTIONS • NUMBER 2 (42) • JUNE 2016
and in other tissues of epidermal origin. Accelerates
wound healing of the cornea and other epidermal tissue
of origin. In addition, EGF inhibits histaminestimulated secretion of gastric acid, thereby helping the
healing of gastric ulcers [18].
Growth factors in human milk stimulates the
production of mucus in the stomach and duodenum, a
dose-dependent effect of protecting the intestinal
mucosa. EGF is stable during pasteurization in the
presence of acid and is resistant to enzymatic digestion.
In tissue culture, EGF stimulated DNA synthesis in the
cells which have stopped growing [18].
The anti-inflammatory properties of human milk
are important in limiting the immune responses to
reduce inflammation.
Opioid-like peptides, prostaglandins and mucinlike compounds have cytoprotective effect on the
gastrointestinal mucosa that is less exposed to aggressive
factors. It is possible that these compounds act in a
synergistic manner.
Breast milk could enter în the therapeutic aproaches
of serious gastrointestinal diseases in adults [18].
Breast milk can be used to improve the quality of
life of cancer patients and to alleviate the side effects of
medication. In a study in which milk has been used for
cancer patients, the pacients stated that it was very well
tolerated, they experienced an alleviation of difficulties
in swallowing, reduced episodes of nausea and vomiting,
weakness and lethargy usually occured after initiation of
chemotherapy. Patients reported an improvement of
their general condition, energy levels, respiratory
function and apetite.
The improvement of the quality of life is an important
factor for patients with cancer. Patients in this study, with
moderate and severe forms of cancer, have noted an
improvement in the quality of life- physical, mental and
spiritual. Currently, milk banks are able to meet the needs
of cancer patients who use this therapy [19]. Using
donated milk for adults is temporary and not in large
amounts as to influence deposits of donated human milk
for infants [10]. The average quantity of milk received by
adult cancer patients from 11 Human milk banks
members of Human Milk Bank Association of North
America in 2005 was low, from 4% to 4.5% of the total
human milk donated that year [19].
The presence of stem cells in breast milk was
discovered by dr. Cregan in 2007. These cells had a
marker, nestin, characteristic of stem cells. The presence
of such cells indicates that the milk can become an
available, non-invasive stem cells source that can be
used both in biological research of the mammary gland
and in the stem cell biology [20].
Treatment with Human Milk for Adults Conditions

Mammary stem cells are responsible for the changes
through which the mammary gland passes during lactation.
They are present in breast milk and the breastfed infant
ingested them. These cells are pluripotent stem cells and
can differentiate not only into specific cells in the breast
but also into other types of cells such as neuronal-like cells.
They can be used in the „cell replacement therapies” for
patients suffering from central nervous system injury, with
possible applications in regenerative medicine, in diseases
such as diabetes and Parkinson’s disease [21].
The results of studying the components of breast
milk does not cease to surprise us.
The implications of these findings go beyond the
nutriton of infants and small children to the
therapeutical effects on the medical conditions in adults.
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