128-411: A milkmaid , milk maid , milkwoman , dairymaid , or dairywoman is a girl or woman who works with milk or cows. She milks cows and also uses the milk to prepare dairy products such as cream , butter , and cheese . Many large houses employ milkmaids instead of having other staff do the work. The term milkmaid is not the female equivalent of milkman in the sense of one who delivers milk to
256-872: A membrane . Each fat globule is composed almost entirely of triacylglycerols and is surrounded by a membrane consisting of complex lipids such as phospholipids , along with proteins. These act as emulsifiers which keep the individual globules from coalescing and protect the contents of these globules from various enzymes in the fluid portion of the milk. Although 97–98% of lipids are triacylglycerols, small amounts of di- and monoacylglycerols, free cholesterol and cholesterol esters, free fatty acids, and phospholipids are also present. Unlike protein and carbohydrates, fat composition in milk varies widely due to genetic, lactational, and nutritional factor difference between different species. Fat globules vary in size from less than 0.2 to about 15 micrometers in diameter between different species. Diameter may also vary between animals within
384-401: A band of tissue, known as the frenulum , attaches the tongue to the base of the mouth, restricting the tongue's vertical movement and preventing the infant from pressing the breast and nipple into the soft palate . A posterior tongue-tie is a band of tissue that can only be felt on exam, and tends to impact breastfeeding less severely than its anterior counterpart. If it is determined that
512-416: A delay in their milk coming in should consult with a lactation specialist and their pediatrician, as they may need to supplement with donor milk or formula to help the infant gain weight and pump to encourage milk to come in sooner and in greater volume. Breast milk supply augments in response to the baby's demand for milk, and decreases when milk is allowed to remain in the breasts. When considering
640-461: A food product. Initially, the ability to digest milk was limited to children as adults did not produce lactase , an enzyme necessary for digesting the lactose in milk. People therefore converted milk to curd , cheese, and other products to reduce the levels of lactose. Thousands of years ago, a chance mutation spread in human populations in northwestern Europe that enabled the production of lactase in adulthood . This mutation allowed milk to be used as
768-412: A greenish color, which sometimes can be discerned in skimmed milk or whey products. Fat-free skimmed milk has only the casein micelles to scatter light, and they tend to scatter shorter-wavelength blue light more than they do red, giving skimmed milk a bluish tint. In most Western countries, centralized dairy facilities process milk and products obtained from milk , such as cream, butter, and cheese. In
896-400: A large number of active enzymes. Both the fat globules and the smaller casein micelles, which are just large enough to deflect light, contribute to the opaque white color of milk. The fat globules contain some yellow-orange carotene, enough in some breeds (such as Guernsey and Jersey cattle) to impart a golden or "creamy" hue to a glass of milk. The riboflavin in the whey portion of milk has
1024-468: A method of killing harmful bacteria in beverages and food products. He developed this method while on summer vacation in Arbois , to remedy the frequent acidity of the local wines. He found out experimentally that it is sufficient to heat a young wine to only about 50–60 °C (122–140 °F) for a brief time to kill the microbes, and that the wine could be nevertheless properly aged without sacrificing
1152-410: A mother's breastfeeding capability or the volume of milk she will produce. The process of milk production, termed lactogenesis , occurs in 3 stages. The first stage takes place during pregnancy, allowing for the development of the breast and production of colostrum, the thick, early form of milk that is low in volume, but rich in nutrition. The birth of the baby and the placenta triggers the onset of
1280-407: A naturally warm environment that helps them regulate their temperature. It is also beneficial to the mother, as it may improve the development of her milk supply and be beneficial for her mental health. Newborn babies usually breastfeed 8 to 12 times every 24 hours, and they typically express hunger cues every one to three hours for the first two to four weeks of their lives. A newborn has
1408-469: A new source of nutrition which could sustain populations when other food sources failed. Milk is processed into a variety of products such as cream , butter , yogurt , kefir , ice cream and cheese . Modern industrial processes use milk to produce casein , whey protein , lactose, condensed milk , powdered milk , and many other food-additives and industrial products. Whole milk, butter, and cream have high levels of saturated fat . The sugar lactose
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#17327973134181536-628: A number of benefits to both mother and baby that infant formula lacks. Increased breastfeeding to near-universal levels in low and medium income countries could prevent approximately 820,000 deaths of children under the age of five annually. Breastfeeding decreases the risk of respiratory tract infections , ear infections , sudden infant death syndrome (SIDS) , and diarrhea for the baby, both in developing and developed countries . Other benefits have been proposed to include lower risks of asthma , food allergies , and diabetes . Breastfeeding may also improve cognitive development and decrease
1664-478: A number of factors as described in the Process "Delay in milk 'coming in'" subsection below. Oxytocin , which signals the smooth muscle of the uterus to contract during pregnancy, labor, birth and following delivery, is also involved in the process of breastfeeding. Oxytocin also contracts the smooth muscle layer of band-like cells surrounding the milk ducts and alveoli to s the newly produced milk through
1792-591: A pacifier beginning at birth or after lactation was established did not significantly affect the duration of exclusive and partial breastfeeding up to four months of age. The CDC, however, currently (2022) reports that early use of pacifiers can have a negative outcome on the success of breastfeeding and they suggest that it should be delayed until breastfeeding is firmly established. Ankyloglossia, also called "tongue-tie" may cause shallow latch, poor milk transfer, and other problems with breastfeeding. There are two types of tongue-ties; an anterior tongue-tie occurs when
1920-401: A poor, shallow latch, the infant latches close to or at the nipple, causing the mother intense pain during latching that is relieved with infant release from the breast. While the infant is at the breast, the first indicators of a shallow latch are having the areola be largely visible outside the infant's mouth and a narrow infant mouth angle. Additional signs result from poor positioning when
2048-535: A possibly low milk supply, it is important to consider the difference between "perceived low milk supply" and "true low milk supply". Perceived low milk supply occurs when mothers, for a variety of reasons, believe that they are not making enough milk to feed their infant. These reasons may include fussiness, colic , preference for the bottle as opposed to the breast, long nursing duration, decreased sensation of breast fulness, and even decreased frequency of infant stools. However, in these cases, it important to reassure
2176-493: A process which leads to a first breastfeed. Shortly after birth, the infant relaxes and makes small movements of the arms, shoulders and head. If placed on the mother's abdomen the baby gradually inches towards the breast, called the breast crawl and begins to feed. After feeding, it is normal for a baby to remain latched to the breast while resting. This is sometimes mistaken for lack of appetite. Absent interruptions, all babies follow this process. Rushing, by picking up and moving
2304-462: A required daily commodity. Over the last three decades of the 19th century, demand for milk in most parts of the country doubled or, in some cases, tripled. Legislation in 1875 made the adulteration of milk illegal – This combined with a marketing campaign to change the image of milk. The proportion of rural imports by rail as a percentage of total milk consumption in London grew from under 5% in
2432-847: A separate secondary products revolution in the fourth millennium BC. Sherratt's model is not supported by recent findings, based on the analysis of lipid residue in prehistoric pottery, that shows that dairying was practiced in the early phases of agriculture in Southwest Asia, by at least the seventh millennium BC. From Southwest Asia domestic dairy animals spread to Europe (beginning around 7000 BC but did not reach Britain and Scandinavia until after 4000 BC), and South Asia (7000–5500 BC). The first farmers in central Europe and Britain milked their animals. Pastoral and pastoral nomadic economies, which rely predominantly or exclusively on domestic animals and their products rather than crop farming, were developed as European farmers moved into
2560-407: A small scale and presents significant opportunities for diversification of income sources by small farms. Local milk collection centers, where milk is collected and chilled prior to being transferred to urban dairies, are a good example of where farmers have been able to work on a cooperative basis, particularly in countries such as India. FAO reports Israel dairy farms are the most productive in
2688-483: A small stomach capacity, approximately 20 ml. The amount of breast milk that is produced is timed to meet the infant's needs in that the first milk, colostrum, is concentrated but produced in only very small amounts, gradually increasing in volume to meet the expanding size of the infant's stomach capacity. Many newborns will typically feed for 10 to 15 minutes on each breast, however feeds may last up to 45 minutes depending on infant wakefulness and efficiency. It
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#17327973134182816-484: A species and at different times within a milking of a single animal. In unhomogenized cow's milk, the fat globules have an average diameter of two to four micrometers and with homogenization, average around 0.4 micrometers. The fat-soluble vitamins A , D , E , and K along with essential fatty acids such as linoleic and linolenic acid are found within the milk fat portion of the milk. Normal bovine milk contains 30–35 grams of protein per liter, of which about 80%
2944-400: A tenth of a micrometer across. There are four different types of casein proteins: αs1-, αs2-, β-, and κ-caseins. Most of the casein proteins are bound into the micelles. There are several competing theories regarding the precise structure of the micelles, but they share one important feature: the outermost layer consists of strands of one type of protein, k-casein , reaching out from the body of
3072-786: Is collected from farm animals , mostly cattle . In 2011, dairy farms produced around 730 million tonnes (800 million short tons) of milk from 260 million dairy cows. India is the world's largest producer of milk and the leading exporter of skimmed milk powder. New Zealand, Germany, and the Netherlands are the largest exporters of milk products. Between 750 and 900 million people live in dairy-farming households. The term milk comes from "Old English meoluc (West Saxon), milc (Anglian), from Proto-Germanic * meluks "milk" (source also of Old Norse mjolk , Old Frisian melok , Old Saxon miluk , Dutch melk , Old High German miluh , German Milch , Gothic miluks )". Since 1961,
3200-457: Is a disaccharide composite of two simple sugars , glucose and galactose . Bovine milk averages 4.8% anhydrous lactose, which amounts to about 50% of the total solids of skimmed milk. Levels of lactose are dependent upon the type of milk as other carbohydrates can be present at higher concentrations than lactose in milks. Other components found in raw cow's milk are living white blood cells , mammary gland cells, various bacteria, vitamin C, and
3328-436: Is about 54 Calories/100mL. The second type of milk is transitional milk, which is produced during the transition from colostrum to mature breast milk. As the breast milk matures over the course to several weeks, the protein content of the milk decreases on average. The caloric content of breastmilk is reflective of the caloric requirements of the infant, increasing steadily after 12 months. The caloric content of breastmilk in
3456-483: Is already lower than the average by between 0.7 and 4 kg in July (the hottest month of the year), and by 2070, it may decline by up to 50% (or 7.2 kg) due to climate change. Heatwaves can also reduce milk yield, with particularly acute impacts if the heatwave lasts for four or more days, as at that point the cow's thermoregulation capacity is usually exhausted, and its core body temperature starts to increase. It
3584-422: Is arranged in casein micelles . Total proteins in milk represent 3.2% of its composition (nutrition table). The largest structures in the fluid portion of the milk are "casein micelles" : aggregates of several thousand protein molecules with superficial resemblance to a surfactant micelle , bonded with the help of nanometer-scale particles of calcium phosphate . Each casein micelle is roughly spherical and about
3712-448: Is called colostrum , contains antibodies and immune-modulating components that strengthen the immune system against many diseases. The US CDC agency recommends that children over the age of 12 months (the minimum age to stop giving breast milk or formula ) should have two servings of dairy (milk) products a day, and more than six billion people worldwide consume milk and milk products. As an agricultural product, dairy milk
3840-509: Is defined as "an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk and no foods) except for vitamins, minerals and medications." Supplementation with human donor breastmilk may be indicated in some specific cases, as discussed below. After solids are introduced at around six months of age, continued breastfeeding is recommended. The American Academy of Pediatrics recommends that babies be breastfed at least until 12 months, or longer if both
3968-657: Is desired. Indications for use of donor breastmilk are very closely outlined by the American Academy of Pediatrics (AAP). Due to low availability and high cost of donor breastmilk, the AAP recommends prioritizing the use of the milk for infants born with a weight of less than 1500g (approximately 3lb 5oz), as it is helpful in decreasing rates of the severe intestinal infection, necrotizing enterocolitis , in this population. Effective positioning and technique for latching on are necessary to prevent nipple soreness and allow
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4096-705: Is down 30 cents per US gallon (7.9 ¢/L; 36 ¢/imp gal) from 2007 and below the break-even point for many cattle farmers. Milk is an emulsion or colloid of butterfat globules within a water-based fluid that contains dissolved carbohydrates and protein aggregates with minerals. Because it is produced as a food source for the young, all of its contents provide benefits for growth. The principal requirements are energy (lipids, lactose, and protein), biosynthesis of non-essential amino acids supplied by proteins (essential amino acids and amino groups), essential fatty acids, vitamins and inorganic elements, and water. The pH of cow's milk, ranging from 6.7 to 6.9,
4224-422: Is formed. Under the second theory, proposed by Horne, the growth of calcium phosphate nanoclusters begins the process of micelle formation, but is limited by binding phosphopeptide loop regions of the caseins. Once bound, protein-protein interactions are formed and polymerization occurs, in which K-casein is used as an end cap to form micelles with trapped calcium phosphate nanoclusters. Some sources indicate that
4352-514: Is found only in milk, and possibly in forsythia flowers and a few tropical shrubs. Lactase, the enzyme needed to digest lactose, reaches its highest levels in the human small intestine immediately after birth, and then begins a slow decline unless milk is consumed regularly. Those groups who continue to tolerate milk have often exercised great creativity in using the milk of domesticated ungulates , not only cattle, but also sheep, goats, yaks , water buffalo , horses, reindeer and camels . India
4480-413: Is important for parents to recognize the difference between Nutritive and Non-Nutritive Sucking. Nutritive Sucking follows a slow, rhythmic pattern, with 1–2 sucks per swallow. Non-nutritive sucking is a faster-paced sucking pattern with few swallows. This swallow pattern is often observed at the beginning and/or the end of a feed. At the beginning of the feed, this pattern triggers milk letdown, while at
4608-405: Is important to have the mother-infant dyad evaluated by a breastfeeding specialist or pediatrician to determine the true cause of the symptoms and determine the need for supplementation. Often, these symptoms are caused by poor milk transfer at the breast, and can be solved with adjustments to the latch, but occasionally they may be caused by other processes, unrelated to breastfeeding, so evaluation
4736-418: Is less expensive than infant formula, but its impact on mothers' ability to earn an income is not usually factored into calculations comparing the two feeding methods. It is also common for women to experience generally manageable symptoms such as; vaginal dryness, De Quervain syndrome , cramping, mastitis , moderate to severe nipple pain and a general lack of bodily autonomy. These symptoms generally peak at
4864-540: Is necessary. Supplementation with formula is associated with decreased rates of exclusive breastfeeding at 6 months, and overall decreased length of breastfeeding. In terms of what to supplement with, the first choice is always the mother's own breastmilk, save any medical contraindications to its use. The second best option for supplementation is pasteurized human donor milk . Finally, specific formulas may be used for supplementation if maternal or donor breastmilk are not options. One situation where this may be
4992-472: Is not possible, expressing or pumping to empty the breasts can help mothers avoid plugged milk ducts and breast infection , maintain their milk supply, resolve engorgement , and provide milk to be fed to their infant at a later time. Medical conditions that do not allow breastfeeding are rare. Mothers who take certain recreational drugs should not breastfeed, however, most medications are compatible with breastfeeding. Current evidence indicates that it
5120-447: Is present in excess and often, much greater excess of solubility of solid calcium phosphate. In addition to calcium, milk is a source of many vitamins: Vitamins A, B1, B2, B5 B6, B7, B12, and D. For many years the most widely accepted theory of the structure of a micelle was that it was composed of spherical casein aggregates, called submicelles, that were held together by calcium phosphate linkages. However, there are two recent models of
5248-407: Is rare, with studies showing that mothers from malnourished regions still produce amounts of milk of similar quality to that of mothers in developed countries. There are many reasons a mother may not produce enough breast milk . The amount of milk produced depends on how often the mother is nursing and/or pumping : the more the mother nurses her baby or pumps, the more milk is produced. In
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5376-430: Is relatively consistent. Breastmilk is made from nutrients in the mother's bloodstream and bodily stores. It has an optimal balance of fat, sugar, water, and protein that is needed for a baby's age appropriate growth and development. That being said, a variety of factors can influence the nutritional makeup of breastmilk, including gestational age, age of infant, maternal age, maternal smoking, and nutritional needs of
5504-636: Is similar to cow's milk and perfectly suitable for human consumption. The main reasons for this are that milking a sow's numerous small teats is very cumbersome, and that sows cannot store their milk as cows can. A few pig farms do sell pig cheese as a novelty item; these cheeses are exceedingly expensive. In 2012, the largest producer of milk and milk products was India, followed by the United States of America, China, Pakistan and Brazil. All 28 European Union members together produced 153.8 million tonnes (169.5 million short tons) of milk in 2013,
5632-422: Is similar to other bovines and non-bovine mammals . Full fat milk contains about 33 grams of fat per liter, including about 19 grams of saturated fat, 1.2 grams of omega 6 fatty acids, and 0.75 grams of omega 3 fatty acids per liter. The amount of fat varies for products where (some of) the fat has been removed, such as in skimmed milk. Initially milk fat is secreted in the form of a fat globule surrounded by
5760-540: Is the largest producer and consumer of cattle milk and buffalo milk in the world. Humans first learned to consume the milk of other mammals regularly following the domestication of animals during the Neolithic Revolution or the development of agriculture. This development occurred independently in several global locations from as early as 9000–7000 BC in Mesopotamia to 3500–3000 BC in
5888-556: Is the process where breast milk is fed to a child. Breast milk may be from the breast, or may be pumped and fed to the infant. The World Health Organization (WHO) recommend that breastfeeding begin within the first hour of a baby's birth and continue as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D , are typically given. The WHO recommends exclusive breastfeeding for
6016-415: Is their primary source of nutrition; and humans obtain milk from other mammals for consumption by humans of all ages, as one component of a varied diet. In almost all mammals, milk is fed to infants through breastfeeding , either directly or by expressing the milk to be stored and consumed later. The early milk from mammals is called colostrum . Colostrum contains antibodies that provide protection to
6144-402: Is unlikely that COVID-19 can be transmitted through breast milk. Smoking tobacco and consuming limited amounts of alcohol and/or coffee are not reasons to avoid breastfeeding. Breast development starts in puberty with the growth of ducts, fat cells , and connective tissue. The ultimate size of the breasts is determined by the number of fat cells. The size of the breast is not related to
6272-777: The Pontic–Caspian steppe in the fourth millennium BC, and subsequently spread across much of the Eurasian steppe . Sheep and goats were introduced to Africa from Southwest Asia, but African cattle may have been independently domesticated around 7000–6000 BC. Camels, domesticated in central Arabia in the fourth millennium BC, have also been used as dairy animals in North Africa and the Arabian Peninsula. The earliest Egyptian records of burn treatments describe burn dressings using milk from mothers of male babies. In
6400-423: The "golden hour" during the immediate postpartum period, assists in the mother–child bonding for both mother and baby, and is thought to encourage instinctual breastfeeding behavior in the infant. Newborns who are immediately placed on their mother's skin have a natural instinct to latch on to the breast and start nursing, typically within one hour of birth. Success with breastfeeding in this "golden hour" increases
6528-649: The 1605 voyage made by George Weymouth to New England reported that the Wabanaki people Weymouth captured in Maine milked "Rain-Deere and Fallo-Deere." But Journalist Avery Yale Kamila and food historians said Rosier "misinterpreted the evidence." Historians report the Wabanaki did not domesticate deer. The tribes of the northern woodlands have historically been making nut milk . Cows were imported to New England in 1624. The growth in urban population, coupled with
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#17327973134186656-461: The 1860s to over 96% by the early 20th century. By that point, the supply system for milk was the most highly organized and integrated of any food product. Milk was analyzed for infection with tuberculosis . In 1907 180 samples were tested in Birmingham and 13.3% were found to be infected. The first glass bottle packaging for milk was used in the 1870s. The first company to do so may have been
6784-487: The Americas. People first domesticated the most important dairy animals – cattle, sheep and goats – in Southwest Asia, although domestic cattle had been independently derived from wild aurochs populations several times since. Initially animals were kept for meat, and archaeologist Andrew Sherratt has suggested that dairying, along with the exploitation of domestic animals for hair and labor, began much later in
6912-580: The New York Dairy Company in 1877. The Express Dairy Company in England began glass bottle production in 1880. In 1884, Hervey Thatcher, an American inventor from New York, invented a glass milk bottle , called "Thatcher's Common Sense Milk Jar," which was sealed with a waxed paper disk. In 1932, plastic-coated paper milk cartons were introduced commercially. In 1863, French chemist and biologist Louis Pasteur invented pasteurization,
7040-578: The US National Bison Association, American bison (also called American buffalo) are not milked commercially; however, various sources report cows resulting from cross-breeding bison and domestic cattle are good milk producers, and have been used both during the European settlement of North America and during the development of commercial Beefalo in the 1970s and 1980s. Swine are almost never milked, even though their milk
7168-1002: The US, these dairies usually are local companies, while in the Southern Hemisphere facilities may be run by large multi-national corporations such as Fonterra . Pasteurization is used to kill harmful pathogenic bacteria such as M. paratuberculosis and E. coli 0157:H7 by heating the milk for a short time and then immediately cooling it. Types of pasteurized milk include full cream, reduced fat, skim milk, calcium enriched, flavored, and UHT. The standard high temperature short time (HTST) process of 72 °C (162 °F) for 15 seconds completely kills pathogenic bacteria in milk, rendering it safe to drink for up to three weeks if continually refrigerated. Dairies print best before dates on each container, after which stores remove any unsold milk from their shelves. Breastfeeding#Expressed milk Breastfeeding , also known as nursing ,
7296-483: The United States include Ayrshire , Brown Swiss , Guernsey , Jersey and Milking Shorthorn (Dairy Shorthorn). Aside from cattle, many kinds of livestock provide milk used by humans for dairy products. These animals include water buffalo , goat , sheep , camel , donkey , horse , reindeer and yak. The first four respectively produced about 11%, 2%, 1.4% and 0.2% of all milk worldwide in 2011. In Russia and Sweden, small moose dairies also exist. According to
7424-698: The United States, 22.4% of babies are breastfed for 12 months, the minimum amount of time advised by the American Academy of Pediatrics . In India , mothers commonly breastfeed for 2 to 3 years. Supplementation is defined as the use of additional milk or fluid products to feed an infant, in addition to breastmilk, during the first 6 months of life. The Academy of Breastfeeding Medicine recommends only supplementing when medically indicated, as opposed to mixing use of formula and breastmilk for reasons that are not necessarily medical indications. Some medical indications for supplementation include low blood sugar, dehydration, excessive weight loss or poor gain, and jaundice in
7552-625: The Western world, cow's milk is produced on an industrial scale and is, by far, the most commonly consumed form of milk. Commercial dairy farming using automated milking equipment produces the vast majority of milk in developed countries . Dairy cattle , such as the Holstein , have been bred selectively for increased milk production. About 90% of the dairy cows in the United States and 85% in Great Britain are Holsteins. Other dairy cows in
7680-448: The aforementioned fluid accumulation in the breast tissue, can cause severe pain. If breastfeeding is suddenly stopped a woman's breasts are likely to become engorged. Pumping small amounts to relieve discomfort helps to gradually train the breasts to produce less milk. There is presently no safe medication to prevent engorgement, but cold compresses and ibuprofen may help to relieve pain and swelling. Pain should go away with emptying of
7808-460: The amount of milk produced. In 2011, FAO estimates 85% of all milk worldwide was produced from cows. Human milk is not produced or distributed industrially or commercially; however, human milk banks collect donated human breastmilk and redistribute it to infants who may benefit from human milk for various reasons (premature neonates, babies with allergies, metabolic diseases , etc.) but who cannot breastfeed. Actual inability to produce enough milk
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#17327973134187936-598: The baby from her breast for a short time until the flow becomes less forceful. Milk may also let-down unexpectedly when a mother hears her baby cry or even only thinks about the baby. Nursing pads may be made or purchased to absorb unexpected milk flows. Infants of mothers with inverted nipples can still achieve a good latch with perhaps a little extra effort. For some women, the nipple may easily become erect when stimulated. Other women may require modified breastfeeding techniques, and some may need extra devices, such as nipple shells, modified syringes, or breast pumps to expose
8064-552: The baby to foods that the mother has eaten and decrease the risk of diarrheal illness . Although the baby has received some antibodies ( IgG ) through the placenta, colostrum contains a substance which is new to the newborn, secretory immunoglobulin A (IgA). IgA works to attack germs in the mucous membranes of the throat, lungs, and intestines, which are most likely to come under attack from germs. Additionally, colostrum and mature breast milk contain many antioxidant and anti-inflammatory enzymes and proteins that decrease
8192-423: The baby to obtain enough milk. Babies can successfully latch on to the breast from multiple positions. Each baby may prefer a particular position. The "football" hold places the baby's legs next to the mother's side with the baby facing the mother. Using the "cradle" or "cross-body" hold, the mother supports the baby's head in the crook of her arm. The "cross-over" hold is similar to the cradle hold, except that
8320-439: The baby to open their mouth with a wide gape. One way to help the infant achieve a deep latch is to compress the breast tissue into a "U" or "hamburger shape," so that the infant can fit the breast tissue into their mouth. This is done by the mother placing her thumb and fingers in line with the infant's nose and mouth respectively and using this grip to compress the breast tissue. If the newborn seems to need help in latching on,
8448-473: The birth of an infant is followed by massive fluid shifts to both offload excess fluid, which had been used to supply oxygen and nutrients to the fetus through the placenta, which is no longer needed, and supply additional fluid to the breasts in order to start the process of making milk. These fluid shifts often result in some of this excess fluid leaking into the breast tissue. Finally, milk "coming in" can create an uncomfortably full feeling, which combined with
8576-503: The brain, namely estrogen , progesterone , prolactin , which gradually increase throughout the pregnancy, and result in the structural development of the alveolar (milk-producing) tissue and the production of colostrum . While prolactin is the predominant hormone in milk production, progesterone , which is at high levels during pregnancy, blocks the prolactin receptors in the breast, thus inhibiting milk from "coming in" during pregnancy. Many other physiologic changes occur under
8704-429: The breast tissue due to accumulation of fluid in the tissue surrounding and supporting the milk-producing cells and ducts. Engorgement most frequently occurs as milk "comes in" and during the weaning process. As milk is coming in, several processes occur. At the end of pregnancy there is dilation of the blood vessels which supply the breast, allowing for leaking into the tissue or interstitial space . Additionally,
8832-434: The breasts, decreases blood flow to the alveoli and signals the milk-producing cells to produce less milk. The content of breast milk should be discussed in two separate categories – the nutritional content and the bioactive content, that is the enzymes , proteins , antibodies , and signaling molecules that assist the infant in ways outside of nutrition. The pattern of intended nutrient content in breast milk
8960-558: The breasts. If symptoms continue and comfort measures are not helpful a woman should consider the possibility that a blocked milk duct or infection may be present and seek medical intervention. Although very common, nipple pain and nipple trauma (cracking, open sores) should not be normalized, as these are often signs of a shallow latch or other underlying problem that can be evaluated and fixed . In addition to shallow latch, other causes of nipple pain include, but are not limited to, skin infection or inflammation , blood vessel spasm or
9088-482: The case is in cases of infant metabolic diseases, such as galactosemia . The Academy of Breastfeeding Medicine recommends that supplementation only be used when medically indicated and when overseen by a medical professional, such as a pediatrician or family physician, and after consultation with an IBCLC. Without sufficient breast stimulation, supplementation can reduce the mother's milk production, so pumping would be indicated in these cases if continued breastfeeding
9216-426: The casein micelle that refute the distinct micellular structures within the micelle. The first theory, attributed to de Kruif and Holt, proposes that nanoclusters of calcium phosphate and the phosphopeptide fraction of beta-casein are the centerpiece to micellar structure. Specifically in this view unstructured proteins organize around the calcium phosphate, giving rise to their structure, and thus no specific structure
9344-469: The chin will be close to the breast, and the forehead and nose should be far from the breast. Another sign of a good latch is the contour of the infant's cheeks; the cheeks should be rounded all the way to the edge of the mouth, rather than dimpled or creased at the edge of the mouth. This is a good indicator of effective suck mechanics. Additionally, in order to achieve a deep latch, the infant's mouth must be open wide, preferably wider than 140 degrees. In
9472-467: The consumer; it is the female equivalent of milkman in the sense of cowman or dairyman . In 1600s-1800s English "milkmaids" sold milk wearing a yoke holding two milk pails and vending vessels, and also decorated themselves for the London May Day procession. As a result of exposure to cowpox , which conveys a partial immunity to the disfiguring (and often fatal) disease smallpox , it
9600-457: The control of progesterone and estrogen. These changes include, but are not limited to, dilation of blood vessels, increased blood flow to the uterus, increased availability of glucose (which subsequently is passed through the placenta to the fetus), and increased skin pigmentation, which results in darkening of the nipples and areola , formation of the linea nigra , and onset of melasma of pregnancy . The third stage of labor describes
9728-402: The duct system and out through the nipple. This process is known as the milk ejection reflex , or let-down. Because of oxytocin's dual activity at the breast and the uterus, breastfeeding mothers may also experience uterine cramping at the time of breastfeeding, for the first several days to weeks. Prolactin and oxytocin are vital for establishing milk supply initially, however, once
9856-507: The end of the feed, this may be a signal of the infant tired or becoming relaxed with a slower milk velocity. Numerous health organizations, including, but not limited to, the CDC, WHO, National Health Service, Canadian Pediatric Society, American Academy of Pediatrics, and American Academy of Family Physicians, recommend breastfeeding exclusively for six months following birth, unless medically contraindicated. Exclusive breastfeeding
9984-693: The equivalent of Raynaud Syndrome in the breast, mastitis , plugged ducts, and nipple blebs . Pain caused by a problem deep in the breast may also present with nipple pain due to the paths of nerves in the breast. In addition to the serious nature of many of these causes, nipple pain is a common reason for a mother stopping breastfeeding, so it is important that mothers experiencing nipple pain be evaluated. While milk normally "comes in" by 3 days after birth, there are several reasons this may be delayed. Risk factors for this delay include maternal diabetes , stressful delivery, retained placenta , prolonged labor and birth by C-section . Mothers experiencing
10112-462: The expansion of the railway network in the mid-19th century, brought about a revolution in milk production and supply. Individual railway firms began transporting milk from rural areas to London from the 1840s and 1850s. Possibly the first such instance was in 1846, when St Thomas's Hospital in Southwark contracted with milk suppliers outside London to ship milk by rail. The Great Western Railway
10240-543: The final quality. In honor of Pasteur, the process became known as "pasteurization". Pasteurization was originally used as a way of preventing wine and beer from souring. Commercial pasteurizing equipment was produced in Germany in the 1880s, and producers adopted the process in Copenhagen and Stockholm by 1885. All mammal species have females who can produce milk for some time after giving birth. Cow milk dominates
10368-415: The first 12 months of breastfeeding is approximated to be 58-72 Calories/100mL. Comparatively, the caloric content after 48 months is approximately 83-129 Calories/100mL. When a mother has her full milk supply and is feeding her infant, the first milk to be expressed is called the foremilk. Foremilk is typically thinner and less rich in calories. The hindmilk that follows is rich in calories and fat. If
10496-415: The first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond. Breastfeeding has
10624-501: The inability to latch on properly is related to ankyloglossia, a simple surgical procedure to clip the frenulum can correct the condition. The Academy of Breastfeeding Medicine and the Australian Dental Association have raised concern over the growing trend of oral tie surgeries, due to evidence for benefit being low-quality, inconsistent, or unsupported. Engorgement is the swelling and stretching of
10752-435: The infant comes toward the breast to latch. If the infant leads with their brow or forehead, they are likely to flex their neck; this mechanism of latching causes the nipple to point down and then hit the hard palate during sucking. From an external view, this manifests as the nose and forehead being close to the breast and the chin far from the breast. This neck flexion also obstructs the normal swallowing mechanism, preventing
10880-411: The infant from drinking efficiently. In addition to not being able to swallow properly, this shallow latch prevents the infant from adequately compressing the glandular tissue behind the nipple and stimulating milk flow; thus, they may begin to apply more suction, which manifests externally as cheek dimpling, or sucking their cheeks in. When the baby suckles muscles in the breast squeeze milk towards
11008-1323: The infant to the breast, or interrupting the process, such as removing the baby to weigh him/her, may complicate subsequent feeding. Activities such as weighing, measuring, bathing, needle-sticks, and eye prophylaxis wait until after the first feeding. Children who are born preterm (before 37 weeks), children born in the early term period (37 weeks–38 weeks and 6 days), and children born with low muscular tone, such as those with chromosomal abnormalities like Down syndrome or neurological conditions like Cerebral palsy , may have difficulty in initiating breast feeds immediately after birth. These late preterm (34 weeks –36 weeks and 6 days) and early term (37 weeks–38 weeks and 6 days) infants are at increased risk for both breastfeeding cessation and complications of insufficient milk intake (e.g., dehydration, hypoglycemia, jaundice, and excessive weight loss). They are often expected to feed like term babies, but they have less strength and stamina to feed adequately. By convention, such children are often fed on expressed breast milk or other supplementary feeds through tubes, supplemental nursing systems , bottles, spoons or cups until they develop satisfactory ability to suck and swallow breast milk. Regardless of feeding method chosen, human milk feedings, whether from
11136-407: The infant's immune system. Produced during pregnancy and the first days after childbirth, colostrum is easy to digest and has laxative properties that help the infant to pass early stools. This aids in the excretion of excess bilirubin , which helps to prevent jaundice . Colostrum also helps to seal the infants gastrointestinal tract from foreign substances and germs, which may sensitize
11264-413: The infant's mouth should be asymmetric , meaning most of the "bottom" of the areola should be in the infants mouth and much more of the "top" of the areola should be visible. This position is helpful in pointing the nipple toward the roof of the infant's mouth, helping the infant recruit more milk. The baby's lips should be flanged out. The neck should be extended to facilitate swallowing, and as such,
11392-665: The infant. The first type of milk produced is called colostrum . The volume of colostrum produced during each feeding is appropriate for the size of the newborn stomach and is sufficient, calorically, for feeding a newborn during the first few days of life. Produced during pregnancy and the first days after childbirth, colostrum is rich in protein and Vitamins A, B12 and K, which supports infants' growth, brain development, vision, immune systems, red blood cells, and clotting cascade. The breast milk also has long-chain polyunsaturated fatty acids which help with normal retinal and neural development. The caloric content of colostrum
11520-561: The infant; true low milk supply; severe nipple pain unrelieved by interventions; and medical contraindications to breastfeeding, as described below. Supplements can be delivered at the breast through a supplemental nursing system in order to stimulate the production of the mother's own milk and to preserve the breastfeeding relationship. Some parents may desire to supplement proactively if early signs of insufficient intake, such as decreased urination, dry mucous membranes, or persistent signs of hunger, are noticed. If these signs are noticed, it
11648-408: The largest by any politico - economic union. Increasing affluence in developing countries, as well as increased promotion of milk and milk products, has led to a rise in milk consumption in developing countries in recent years. In turn, the opportunities presented by these growing markets have attracted investments by multinational dairy firms. Nevertheless, in many countries production remains on
11776-452: The latch process, the infant should be aligned with their abdomen facing their mother, which can be remembered as "tummy-to-mummy," and with their hips, shoulders and head aligned. This alignment helps to facilitate proper, efficient swallowing mechanics. Latching refers to how the baby fastens onto the breast while feeding. Sebaceous glands called Glands of Montgomery located in the areola secrete an oily fluid that lubricate and protect
11904-434: The likelihood of successful breastfeeding at discharge. Skin-to-skin mother-baby contact should still occur, even if the baby is born by Cesarean surgery. The baby is placed on the mother in the operating room or the recovery area. If the mother is unable to immediately hold the baby a family member can provide skin-to-skin care until the mother is able. According to studies cited by UNICEF , babies naturally follow
12032-514: The loss reaching 0.54 kg for 25–30 °C (77–86 °F). Research in a humid tropical climate describes a more linear relationship, with every unit of heat stress reducing yield by 2.13%. In the intensive farming systems, daily milk yield per cow declines by 1.8 kg during severe heat stress. In organic farming systems, the effect of heat stress on milk yields is limited, but milk quality suffers substantially, with lower fat and protein content. In China, daily milk production per cow
12160-464: The micelle into the surrounding fluid. These kappa-casein molecules all have a negative electrical charge and therefore repel each other, keeping the micelles separated under normal conditions and in a stable colloidal suspension in the water-based surrounding fluid. Milk contains dozens of other types of proteins beside caseins and including enzymes. These other proteins are more water-soluble than caseins and do not form larger structures. Because
12288-438: The milk supply is well established, the volume and content of the milk produced is controlled locally. Although prolactin levels are higher on average among breastfeeding mothers, prolactin levels themselves do not correlate to milk volume. At this stage, production of milk is triggered by milk drainage from the breasts. The only way to maintain milk supply is to drain the breasts frequently. Infrequent or incomplete drainage of
12416-494: The mother and child wish. The World Health Organization's guidelines recommend "continue[d] frequent, on-demand breastfeeding until two years of age or beyond. Extended breastfeeding means breastfeeding after the age of 12 or 24 months, depending on the source. In Western countries such as the United States , Canada , and Great Britain , extended breastfeeding is relatively uncommon and can provoke criticism. In
12544-656: The mother is not herself deficient in vitamins, breast milk normally supplies her baby's needs, with the exception of Vitamin D. The CDC , National Health Service (UK), Canadian Paediatric Society , the American Academy of Pediatrics , and the American Academy of Family Physicians all agree that breast milk alone does not provide infants with an adequate amount of Vitamin D, thus they advise parents to supplement their infants with 400 IU Vitamin D daily. Providing this quantity of Vitamin D to breastfeeding infants has been shown to reduce rates of Vitamin D insufficiency (defined as 25-OH vitamin D < 50 nmol/L). However, there
12672-496: The mother or a donor, are important in the brain development of premature infants, and the NICU having a standardized protocol for feeding is protective against dangerous gastrointestinal infections ( necrotizing enterocolitis ) in these infants. Frequent breastfeeding and/or small amounts of supplementation may be needed for successful outcomes; breast pumping and/or hand expression is often helpful in providing adequate stimulation to
12800-416: The mother should focus on helping the infant by bringing their chin to the breast first. This facilitates a deep, asymmetric latch, and also helps the infant extend their neck and tilt their forehead back to maintain this deep latch and ease the swallowing process. In a good latch, a large amount of the areola, in addition to the nipple, is in the baby's mouth. The amount of areola visible on either side of
12928-521: The mother supports the baby's head with the opposite hand. The mother may choose a reclining position on her back or side with the baby lying next to her. No matter the position the parent-infant dyad finds most comfortable, there are a few components of every position which will help facilitate a successful latch . One key component is maternal comfort. The mother should be comfortable while breastfeeding, and should have her back, feet, and arms supported with pillows as necessary. Additionally, when starting
13056-745: The mother's breasts. Starting to breastfeed may be challenging for mothers of preterm infants, especially those born before 34 weeks, because their breasts may still be developing (in Lactogenesis I, see Breastfeeding Physiology). Additionally, mother–infant separation and the stressful environment of the NICU are also barriers to breastfeeding. Availability of a lactation specialist in the NICU can be helpful for mothers trying to establish their milk supply. Additionally, skin-to-skin (Kangaroo Care) has been shown to be safe and beneficial to both mother and baby. Kangaroo Care stabilizes newborn premature infants' vital signs, such as their heart rate, providing
13184-484: The newborn baby as well as nutrients and growth factors. The makeup of the colostrum and the period of secretion varies from species to species. For humans, the World Health Organization recommends exclusive breastfeeding for six months and breastfeeding in addition to other food for up to two years of age or more. In some cultures it is common to breastfeed children for three to five years, and
13312-403: The nipple during latching. The visible portions of the glands can be seen on the skin's surface as small round bumps. The rooting reflex is the baby's natural tendency to turn towards the breast with the mouth open wide. When preparing to latch, mothers should make use of this reflex by gently stroking the baby's philtrum, the area between the upper lip and the nose, with their nipple to induce
13440-403: The nipple. La Leche League and Toronto Public Health offer several techniques to use during pregnancy or even in the early days following birth that may help to bring a flat or inverted nipple out. The World Health Organization's Ten Steps to Successful Breastfeeding recommends total avoidance of pacifiers for breastfeeding infants. In 2016 a large review of studies reported that the use of
13568-421: The nipples. This is called the let-down reflex. Some women report that they do not experience anything while others report a tingling feeling which is sometimes described as quite strong. The baby may be seen to respond to the beginning of the flow of milk by changing from quick sucks to deep rhythmic swallows. Sometimes the let-down is so strong that the baby splutters and coughs and the mother may need to remove
13696-403: The nutritional benefits of breastmilk, breast milk also provides enzymes, antibodies, and other substances that support the infant's growth and development. The bioactive makeup of breastmilk also changes based on the needs of the infant; for example, when an infant is recovering from an upper respiratory infection , local signaling allows for increased passage of immune cells and proteins to aid
13824-420: The parent that infant weight gain is absolute proof of adequate milk intake. Thus, if the infant breastfeeding exclusively, and is gaining weight appropriately, then the parent can be reassured that they are producing enough milk. True low milk supply can be either primary (caused by medical conditions or anatomical issues in the mother), secondary (caused by not thoroughly and regularly removing milk from
13952-654: The period between the birth of the baby and the delivery of the placenta, which normally lasts less than 30 minutes. The delivery of the placenta causes an abrupt drop off of placental hormones. This drop, specifically in progesterone, allows prolactin to work effectively at its receptors in the breast, leading to an array of changes over the next several days that allow the milk to "come in"; these changes are known collectively as Lactogenesis II. Colostrum continues to be produced for these next few days, as Lactogenesis II occurs. Milk may "come in" as late as five days after delivery; however, this process may be delayed due to
14080-466: The period may be longer. Fresh goats' milk is sometimes substituted for breast milk , which introduces the risk of the child developing electrolyte imbalances, metabolic acidosis , megaloblastic anemia , and a host of allergic reactions . In many cultures, especially in the West , humans continue to consume milk beyond infancy, using the milk of other mammals (especially cattle, goats and sheep) as
14208-411: The placenta is delivered. Although traditionally, lactation occurs following pregnancy, lactation may also be induced with hormone therapy and nipple stimulation in the absence of pregnancy. Changes in pregnancy , starting around 16 weeks gestational age , prepare the breast for lactation. These changes, collectively known as Lactogenesis I , are directed by hormones produced by the placenta and
14336-480: The possibility that the already recorded stagnation of dairy production in both China and West Africa can be attributed to persistent increases in heat stress caused by climate change . This is a plausible hypothesis , because even mild heat stress can reduce daily yields: research in Sweden found that average daily temperatures of 20–25 °C (68–77 °F) reduce daily milk yield per cow by 0.2 kg, with
14464-600: The production obtained. New Zealand cows with the lowest yield per year grazed all year, in contrast to Israel with the highest yield where the cows ate in barns with an energy-rich mixed diet. The milk yield per cow in the United States was 9,954 kg (21,945 lb) per year in 2010. In contrast, the milk yields per cow in India and China – the second and third largest producers – were respectively 1,154 kg (2,544 lb) and 2,282 kg (5,031 lb) per year. The IPCC Sixth Assessment Report mentions
14592-679: The proteins remain suspended in whey , remaining when caseins coagulate into curds, they are collectively known as whey proteins . Lactoglobulin is the most common whey protein by a large margin. The ratio of caseins to whey proteins varies greatly between species; for example, it is 82:18 in cows and around 32:68 in humans. Bovine milk contains a variety of cations and anions traditionally referred to as "minerals" or "milk salts". Calcium, phosphate, magnesium, sodium, potassium, citrate, and chloride are all included and they typically occur at concentrations of 5–40 mM . The milk salts strongly interact with casein, most notably calcium phosphate. It
14720-473: The rest of the world (i.e., East and Southeast Asia, the Americas and Australia), milk and dairy products were historically not a large part of the diet, either because they remained populated by hunter-gatherers who did not keep animals or the local agricultural economies did not include domesticated dairy species. Milk consumption became common in these regions comparatively recently, as a consequence of European colonialism and political domination over much of
14848-530: The risk of obesity in adulthood. Benefits for the mother include less blood loss following delivery , better contraction of the uterus, and a decreased risk of postpartum depression . Breastfeeding delays the return of menstruation , and in very specific circumstances, fertility , a phenomenon known as lactational amenorrhea . Long-term benefits for the mother include decreased risk of breast cancer , cardiovascular disease , diabetes , metabolic syndrome , and rheumatoid arthritis . Breastfeeding
14976-490: The risk of gastrointestinal allergies to food, respiratory allergies to air particles like pollen, and other atopic diseases , such as asthma and eczema . It is recommended for mothers to initiate breastfeeding within the first hour after birth. Uninterrupted skin-to-skin contact and breastfeeding can begin immediately after birth, and should continue for at least one hour after birth. This period of infant-mother interaction, known generally as kangaroo care , or
15104-459: The same period increased from 7,726 to 8,550 kg (17,033 to 18,850 lb) per cow in these developed countries. The lowest average production was in New Zealand at 3,974 kg (8,761 lb) per cow. The milk yield per cow depended on production systems, nutrition of the cows, and only to a minor extent different genetic potential of the animals. What the cow ate made the most impact on
15232-449: The second stage of milk production, triggering the milk to come in over the next several days. The third stage of milk production occurs gradually over several weeks, and is characterized by a full milk supply that is regulated locally (at the breast), predominately by the infant's demand for food. This differs from the second stage of lactogenesis, which is regulated centrally (in the brain) by hormone feedback loops that naturally occur after
15360-496: The start of breastfeeding but disappear or become considerately more manageable after the first few weeks. Feedings may last as long as 30–60 minutes each as milk supply develops and the infant learns the Suck-Swallow-Breathe pattern. However, as milk supply increases and the infant becomes more efficient at feeding, the duration of feeds may shorten. Older children may feed less often. When direct breastfeeding
15488-480: The term milk has been defined under Codex Alimentarius standards as "the normal mammary secretion of milking animals obtained from one or more milkings without either addition to it or extraction from it, intended for consumption as liquid milk or for further processing." The term dairy refers to animal milk and animal milk production. There are two distinct categories of milk consumption: all infant mammals drink milk directly from their mothers' bodies, and it
15616-415: The trapped calcium phosphate is in the form of Ca 9 (PO 4 ) 6 ; whereas others say it is similar to the structure of the mineral brushite , CaHPO 4 ·2H 2 O. Milk contains several different carbohydrates , including lactose , glucose , galactose , and other oligosaccharides . The lactose gives milk its sweet taste and contributes approximately 40% of the calories in whole cow's milk's. Lactose
15744-461: The world in the last 500 years. In the Middle Ages , milk was called the "virtuous white liquor" because alcoholic beverages were safer to consume than the water generally available. Incorrectly thought to be blood diverted from the womb to the breast, it was also known as "white blood", and treated like blood for religious dietary purposes and in humoral theory . James Rosier's record of
15872-511: The world, with a yield of 12,546 kilograms (27,659 lb) milk per cow per year. This survey over 2001 and 2007 was conducted by ICAR (International Committee for Animal Recording) across 17 developed countries. The survey found that the average herd size in these developed countries increased from 74 to 99 cows per herd between 2001 and 2007. A dairy farm had an average of 19 cows per herd in Norway, and 337 in New Zealand. Annual milk production in
16000-495: Was an early and enthusiastic adopter, and began to transport milk into London from Maidenhead in 1860, despite much criticism. By 1900, the company was transporting over 25 million imperial gallons (110 million litres; 30 million US gallons) annually. The milk trade grew slowly through the 1860s, but went through a period of extensive, structural change in the 1870s and 1880s. Urban demand began to grow, as consumer purchasing power increased and milk became regarded as
16128-559: Was insufficient evidence in the most recent Cochrane Review , to determine if this quantity reduced rates of Vitamin D deficiency (defined as 25-OH vitamin D < 30 nmol/L) or rickets . Term infants typically do not need iron supplementation. Delaying clamping of the cord at birth for at least one minute improves the infants' iron status for the first year. When complementary (solid) foods are introduced at about 6 months of age, parents should make sure to choose iron-rich foods to help maintain their children's iron stores. In addition to
16256-629: Was noticed that milkmaids lacked the scarred, pockmarked complexion common to smallpox survivors. This observation led to the development of the first vaccine . Milk Milk is a white liquid food produced by the mammary glands of mammals . It is the primary source of nutrition for young mammals (including breastfed human infants) before they are able to digest solid food. Milk contains many nutrients, including calcium and protein , as well as lactose and saturated fat . Immune factors and immune-modulating components in milk contribute to milk immunity . Early- lactation milk, which
16384-642: Was reported in 2007 that with increased worldwide prosperity and the competition of bio-fuel production for feed stocks, both the demand for and the price of milk had substantially increased worldwide. Particularly notable was the rapid increase of consumption of milk in China and the rise of the price of milk in the United States above the government subsidized price. In 2010 the Department of Agriculture predicted farmers would receive an average of $ 1.35 per US gallon ($ 0.36/L; $ 1.62/imp gal) of cow's milk, which
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