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Oligosaccharides (small sugar chains larger than lactose) are unique to human
breast milk. These small sugar chains are present in amounts as high as 18
grams per litre of breast milk which is much higher than protein at 10 to 12
gram per litre. The most common sugars making up these short chains are
N-acetyl-D-glucosamine, sialic acid (a 9 carbon amino sugar) and fucose.
Fifteen percent of the sugar content is protein bound and 85% is free in the
form of oligosaccharides, with chain lengths varying from 3 to 11 units1.
Sugar Constituents of Human Breast Milk (Grams per Litre of Milk)
| N-Acetyl-D-Glucosamine |
1.5 |
0.6 |
| Sialic Acid |
0.9 |
0.3 |
| Fucose |
0.7 |
0.4 |
| Lactose |
55.4 |
64.9 |
As can be seen from the table there is a temporal relationship to the amount of sugars present in breast milk. It is believed that this reflects the needs of the infant for these sugars.
N-acetyl-D-glucosamine content is the highest of the three non-lactose sugars. One of the roles of N-acetyl-D-glucosamine is the determination of intestinal flora. Bifidobacteria, which makes up 99% of gut flora in the breast fed infant requires N-acetyl-D-glucosamine for growth. This organism is important for a healthy gastrointestinal tract. Other roles of this important sugar have not yet been elucidated.
Human milk oligosaccharides act as free receptor analogs and prevent the adhesion of disease causing organisms to gut mucosa. Infants whose mothers produce breast milk low in fucosyloligosaccharides have more E. coli associated diarrhea than infants fed milk high in fucosyloligosaccharides2.
Sialic acid in human milk is believed to be important in brain development. Sialic acid in milk is a supplemental source for the production of sialoglycoproteins and ganglioside components of brain. Although the human infant can produce sialic acid directly the supplemental source is needed for the very rapid brain development in the first few weeks of life. This may explain the decline in sialic acid milk content of over time.
1 Miller, J. B., S. Bull, et al. (1994). "The oligosaccharide composition of human milk: temporal and individual variations in monosaccharide components." J Pediatr Gastroenterol Nutr 19(4): 371-6.
2 Newburg, D. S., G. M. Ruiz-Palacios, et al. (2004). "Innate protection conferred by fucosylated oligosaccharides of human milk against diarrhea in breastfed infants." Glycobiology 14(3): 253-63.
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