Educational Resources:
Nature’s Best Food – Breast Milk

Learn more about the goodness of breast milk with insights from Dr Nancy Tan (Paediatrician, Paediatrics, Gastroenterologist, Singapore Baby and Child Clinic):

As a child grows older and turns one year old, milk becomes a supplement to a wholesome diet of solid foods. Breast milk contains all the essential nutrients, in the right proportions, to support not just growth, but also the development of a growing child’s immune system, gastrointestinal tract and brain.

Interestingly, a mother’s milk supply and the composition of breast milk changes constantly to meet the evolving needs of a growing child. What’s more, it is easily digested and has a natural laxative effect, thus, breastfed babies rarely become constipated. Research also suggests that breast milk contains enzymes (amylase and lipase) that aid digestion.

The unique structure of the fat molecules and the type of protein found in breast milk also confer beneficial effects. We checked with our invited expert, Dr Nancy Tan, a paediatric gastroenterologist who shared her insights on the goodness of breast milk.

Breast milk is nutritionally balanced, with the exact combination of water, protein, fats, carbohydrate, vitamins, minerals, enzymes and antibodies that a child requires. According to Dr Tan, milk fat is an important component, supplying 50%-60% of an young child’s dietary calorie requirement. Fats are also technically called triglycerides. A triglyceride consists of three fatty acids that are linked to a glycerol molecule. One of the most studied fatty acid in breast milk is palmitic acid.

Dr Tan said, “In breast milk fat, 70% of palmitic acid is located at the sn-2 position of the triglyceride. Palmitic acid at this position is associated with enhanced absorption of nutrients, softer stools and better gut health.” Indeed, the palmitic acid at the sn-2 position (also called sn-2 palmitate) is a unique fat molecular structure that is highly conserved in all women and is probably responsible for the easy absorption of milk fat.

There are two types of protein in breast milk: casein and whey. Whey proteins are easier to digest when compared to casein proteins. Both types of proteins are important and contain amino acids essential for growth and development. “Unlike cow’s milk protein which typically contains A1 and A2 type β-caseins, most of the casein in breast milk is more of the A2 type; when breast milk undergoes digestion, β-casein do not break down into peptides that can cause abdominal discomfort,” Dr Tan adds.

Breast milk also contains carbohydrates, such as lactose, which serve as an energy source. Lactose also aids the absorption of calcium. Breast milk also contains non-digestible carbohydrates, called oligosaccharides, that help to promote the growth of good bacteria in the gut to support the development of the digestive as well as the immune system.

All in all, breast milk’s composition is extremely complex, with a lot of components yet to be identified. Research shows that the benefits of breastfeeding extend well beyond basic nutrition; several components in breast milk help to protect young children against infection and disease. This is why a number of health organisations — including the World Health Organisation (WHO), American Academy of Paediatrics (AAP), and the Health Promotion Board (HPB) — recommend exclusive breastfeeding for the first six months of a baby’s life. Thereafter, the HPB encourages mothers to continue breastfeeding as long as mutually desired, together with the introduction of nutritionally adequate and safe complementary food from 6 months of age.


Reference: https://www.healthhub.sg/live-healthy/1141/pregnancy-feeding-your-baby-breastfeeding

Learn more about sn-2 Palmitate
a unique lipid structure

The molecular structure of palmitic acid in a triglyceride molecule

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Absorption process in the intestines

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Palmitic acids positioned at sn-2 are less likely to bind with calcium to form insoluble calcium soap. This enables the body to better absorb key nutrients, like calcium and fats.

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Palmitic acids positioned at sn-1 and sn-3 position are more likely to bind with calcium, forming insoluble calcium soaps which are generally associated with hard stools.

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sn-2 Palmitate Helps to:

*Calcium and Fat

  1. Kennedy K, Fewtrell MS, Morley R, Abbott R, Quinlan PT, Wells JC, et al. Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stoolbiochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr 1999;70:920–7.
  2. Litmanovitz I, Davidson K, Eliakim A, Regev RH, Dolfin T, Arnon S, et al. High beta-palmitate formula and bone strength in term infants: a randomized, double-blind, controlled trial. Calcif Tissue Int 2013;92:35–41.
  3. Yao M, Lien EL, Capeding MR, Fitzgerald M, Ramanujam K, Yuhas R, et al. Effects of term infant formulas containing high sn-2 palmitate with and without oligofructose on stool composition, stool characteristics, and bifidogenicity. J Pediatr Gastroenterol Nutr 2014;59:440–8
  4. Yaron S, Shachar D, Abramas L, Riskin A, Bader D, Litmanovitz I, et al. Effect of high β-palmitate content in infant formula on the intestinal microbiota of term infants. J Pediatr Gastroenterol Nutr 2013;56:376–81
  5. Litmanovitz I, Davidson K, Eliakim A, Regev RH, Dolfin T, Arnon S, et al. High beta-palmitate formula and bone strength in term infants: a randomized, double-blind, controlled trial. Calcif Tissue Int 2013;92:35–41.
  6. Fabiana Bar-Yoseph1*, Yael Lifshitz1 , Tzafra Cohen1 , Patrice Malard2 , et al. SN2-Palmitate Improves Crying and Sleep in Infants Fed Formula with Prebiotics: A Double-Blind Randomized Clinical Trial Clinics Mother Child Health 2017, 14:2

Learn more about A2 ß-casein

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Protein fragment

In breast milk, β-casein is of the A2 type.
During digestion, both breast milk β-casein and A2 β-casein do not release a particular protein molecule, which may cause adverse effects like gastrointestinal discomfort and flatulence.7,8

^ Massella E, et al. Ital J Food Saf 2017; 6:6904

A2 β-casein Helps to Support
Gastrointestinal Well-Being

  1. Sun Jianqin, Xu Leiming, Xia Lu, et al. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutrition Journal (2016) 15:35.
  2. Mei He, Jianqin Sun, Zhuo Qin Jiang, Yue Xin Yang. Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicenter, randomized controlled study. Nutrition Journal (2017) 16:72.

Expert Interview with Dr Ang Ai Tin

Understanding more about Sn-2 palmitate and A2 β-casein.