Patterns of milk macronutrients and bioactive molecules across lactation in a western lowland gorilla (Gorilla gorilla) and a Sumatran orangutan (Pongo abelii).

In addition to nutrients, milk contains signaling molecules that influence offspring development. Human milk is similar in nutrient composition to that of apes, but appears to differ in other aspects such as immune function. We examine the longitudinal patterns across lactation of macronutrients, the metabolic hormone adiponectin, the growth factors epidermal growth factor (EGF) and transforming growth factor ß2 (TGF-ß2), and two receptors for these growth factors (EGF-R and TGF-ß2-RIII) in milk samples collected between days 175 and 313 postpartum from a Sumatran orangutan (Pongo abelii) and between days 3 and 1,276 from a western lowland gorilla (Gorilla gorilla), and compare the results with human data from the literature. Milk macronutrients and hormones were measured using standard nutritional assays and commercially available enzyme immunoassay kits. Ape milk fat content was lower than human milk values, but protein and sugar were similar. Concentrations of all bioactive molecules were consistently detectable except for TGF-ß2 in orangutan milk. Concentrations of adiponectin, EGF, and TGF-ß2 in both ape milks were lower than found in human breast milk. Concentrations declined with infant age in orangutan milk; in gorilla milk concentrations were high in the first months, and then declined to stable levels until 2-3 years after birth when they increased. However, when expressed on a per energy basis milk constituent values did not differ with age for orangutan and the variation was reduced at all ages in gorilla. In orangutan milk, the ratio of EGF-R to EGF was constant, with EGF-R at 7.7% of EGF; in gorilla milk the EGF-R concentration was 4.4 ± 0.2% of the EGF concentration through 3 years and then increased. These data indicate that potent signaling molecules such as EGF and adiponectin are present in ape milk at physiological concentrations. However, human breast milk on average contains higher concentrations.

Primate milk: proximate mechanisms and ultimate perspectives.

To understand the evolutionary forces that have shaped primate lactation strategies, it is important to understand the proximate mechanisms of milk synthesis and their ecological and phylogenetic contexts. The lactation strategy of a species has four interrelated dimensions: the frequency and duration of nursing bouts, the period of lactation until weaning, the number and sex ratio of infants that a mother rears simultaneously, and the composition and yield of the milk that mothers synthesize. Milk synthesis, arguably the most physiologically costly component of rearing infants, remains the least studied. Energy transfer becomes energetically less efficient, transitioning from placental support to milk synthesis just as the energy requirements for infant growth, development, and behavioral activity substantially increase. Here we review primate lactation biology and milk synthesis, integrating studies from anthropology, biology, nutrition, animal science, immunology, and biochemistry, to identify the derived and ancestral features of primate milks and enhance our understanding of primate life history.

Proximate composition of milk from free-ranging mountain gorillas (Gorilla beringei beringei).

Published data on milk composition for nonhuman primates, especially great apes, are lacking. Milk composition data are important for understanding the physiology and evolution of mammalian milk production, as well as the nutritional requirements of infants. For many primate species these data have added relevance because of the need to hand raise infants orphaned by poaching or separated from their mothers in captivity. The proximate composition (dry matter (DM), protein, fat, sugar) of free-ranging mountain gorilla (MG) (Gorilla beringei beringei) milk was characterized from samples (N = 10) collected opportunistically during field procedures. The mean values for mid-lactation (1-50 months) milk samples from healthy MGs (N = 7) were: 10.7% DM, 1.9% fat, 1.4% crude protein, 6.8% sugar, and 0.53 kcal/g. These results are lower in fat and total energy than most other Hominidae, including humans. One early-lactation sample was high in protein content while the composition of two samples from gorillas with poor health and suspected poor milk quality both deviated from the normal, mid-lactation pattern. This survey adds to the data available for primate milk composition and suggests that wild MG infants normally consume milk that is lower in fat and total energy than human milk.

Chemical characterization of oligosaccharides in the milk of six species of New and Old World monkeys.

Human and great ape milks contain a diverse array of milk oligosaccharides, but little is known about the milk oligosaccharides of other primates, and how they differ among taxa. Neutral and acidic oligosaccharides were isolated from the milk of three species of Old World or catarrhine monkeys (Cercopithecidae: rhesus macaque (Macaca mulatta), toque macaque (Macaca sinica) and Hamadryas baboon (Papio hamadryas)) and three of New World or platyrrhine monkeys (Cebidae: tufted capuchin (Cebus apella) and Bolivian squirrel monkey (Saimiri boliviensis); Atelidae: mantled howler (Alouatta palliata)). The milks of these species contained 6-8% total sugar, most of which was lactose: the estimated ratio of oligosaccharides to lactose in Old World monkeys (1:4 to 1:6) was greater than in New World monkeys (1:12 to 1:23). The chemical structures of the oligosaccharides were determined mainly by (1)H-NMR spectroscopy. Oligosaccharides containing the type II unit (Gal(ß1-4)GlcNAc) were found in the milk of the rhesus macaque, toque macaque, Hamadryas baboon and tufted capuchin, but oligosaccharides containing the type I unit (Gal(ß1-3)GlcNAc), which have been found in human and many great ape milks, were absent from the milk of all species studied. Oligosaccharides containing Lewis x (Gal(ß1-4)[Fuc(α1-3)]GlcNAc) and 3-fucosyl lactose (3-FL, Gal(ß1-4)[Fuc(α1-3)]Glc) were found in the milk of the three cercopithecid monkey species, while 2-fucosyl lactose (5'-FL, Fuc(α1-2)Gal(ß1-4)Glc) was absent from all species studied. All of these milks contained acidic oligosaccharides that had N-acetylneuraminic acid as part of their structures, but did not contain oligosaccharides that had N-glycolylneuraminic acid, in contrast to the milk or colostrum of great apes which contain both types of acidic oligosaccharides. Two GalNAc-containing oligosaccharides, lactose 3'-O-sulfate and lacto-N-novopentaose I (Gal(ß1-3)[Gal(ß1-4)GlcNAc(ß1-6)]Gal(ß1-4)Glc) were found only in the milk of rhesus macaque, hamadryas baboon and tufted capuchin, respectively. Further research is needed to determine the extent to which the milk oligosaccharide patterns observed among these taxa represent wider phylogenetic trends among primates and how much variation occurs among individuals or species.

Milk composition of captive tufted capuchins (Cebus apella).

Little is known about the milk composition of nonhuman primates, and it has never been examined in capuchin monkeys (genus Cebus). This article reports on the macronutrient milk composition (fat, crude protein (CP), lactose, dry matter (DM), and total gross energy (GE)) of captive housed tufted capuchins (Cebus apella) (n=8). C. apella milk averaged 5.22% fat, 2.40% CP, 6.94% lactose, 16.48% DM, and 0.89 kcal/g. Fat was the most variable macronutrient and was significantly higher in samples collected after 2 months of lactation. To explore the adaptive significance of C. apella milk composition, results were compared with data on milk composition from a closely related cebid, Saimiri boliviensis boliviensis, and another large-brained anthropoid, Homo sapiens. C. apella milk was only significantly different from Saimiri milk in CP and the proportion of energy from CP. Compared with human milk, C. apella milk was lower in lactose but higher in fat, CP, DM, GE, and the proportion of energy from CP. Results from this small dataset suggest that among anthropoid primates, the macronutrient composition of milk is influenced by phylogeny, may vary relative to infant growth rates, but may not be related in any direct way to relative brain size.

Evolutionary modifications of human milk composition: evidence from long-chain polyunsaturated fatty acid composition of anthropoid milks.

Brain growth in mammals is associated with increased accretion of long-chain polyunsaturated fatty acids (LCPUFA) in brain phospholipids. The period of maximum accumulation is during the brain growth spurt. Humans have a perinatal brain growth spurt, selectively accumulating docosahexaenoic acid (DHA) and other LCPUFA from the third trimester through the second year of life. The emphasis on rapid postnatal brain growth and LCPUFA transfer during lactation has led to the suggestion that human milk LCPUFA composition may be unique. Our study tests this hypothesis by determining fatty acid composition for 11 species of captive anthropoids (n=53; Callithrix jacchus, Cebus apella, Gorilla gorilla, Hylobates lar, Leontopithecus rosalia, Macaca mulatta, Pan troglodytes, Pan paniscus, Pongo pygmaeus, Saimiri boliviensis, and Symphalangus syndactylus). Results are compared to previously published data on five species of wild anthropoids (n=28; Alouatta paliatta, Callithrix jacchus, Gorilla beringei, Leontopithecus rosalia, and Macaca sinica) and human milk fatty acid profiles. Milk LCPUFA profiles of captive anthropoids (consuming diets with a preformed source of DHA) are similar to milk from women on a Western diet, and those of wild anthropoids are similar to milk from vegan women. Collectively, the range of DHA percent composition values from nonhuman anthropoid milks (0.03-1.1) is nearly identical to that from a cross-cultural analysis of human milk (0.06-1.4). Humans do not appear to be unique in their ability to secrete LCPUFA in milk but may be unique in their access to dietary LCPUFA.

Fatty acid composition of wild anthropoid primate milks.

Fatty acids in milk reflect the interplay between species-specific physiological mechanisms and maternal diet. Anthropoid primates (apes, Old and New World monkeys) vary in patterns of growth and development and dietary strategies. Milk fatty acid profiles also are predicted to vary widely. This study investigates milk fatty acid composition of five wild anthropoids (Alouatta palliata, Callithrix jacchus, Gorilla beringei beringei, Leontopithecus rosalia, Macaca sinica) to test the null hypothesis of a generalized anthropoid milk fatty acid composition. Milk from New and Old World monkeys had significantly more 8:0 and 10:0 than milk from apes. The leaf eating species G. b. beringei and A. paliatta had a significantly higher proportion of milk 18:3n-3, a fatty acid found primarily in plant lipids. Mean percent composition of 22:6n-3 was significantly different among monkeys and apes, but was similar to the lowest reported values for human milk. Mountain gorillas were unique among anthropoids in the high proportion of milk 20:4n-6. This seems to be unrelated to requirements of a larger brain and may instead reflect species-specific metabolic processes or an unknown source of this fatty acid in the mountain gorilla diet.

The composition of milk from Bolivian squirrel monkeys (Saimiri boliviensis boliviensis).

Squirrel monkeys (genus Saimiri) give birth to relatively large neonates with large, fast-growing brains. Maternal energy expenditure during gestation and infant development is argued to be high, but may be offset by the provisioning of offspring by females other than the mother (allonursing). Milk composition is an important component of maternal energy expenditure, but has been examined in only a small number of primate species. Here, we report on the milk composition from laboratory-housed Bolivian squirrel monkey (Saimiri boliviensis boliviensis) dams (n = 6) and allomothers (n = 2). Milk samples (n = 16) representing mid-lactation were assayed for fat, sugar, dry matter (DM), crude protein (CP), and fatty acids. Gross energy (GE) was calculated from these constituents (excepting fatty acids). The goals of this project were: (1) to provide descriptive data on milk composition of squirrel monkeys, including the range of intraspecific variation; (2) to determine if milk produced by allomothers differs from milk from dams; and (3) to compare squirrel monkey milk to that of other small New World monkeys, the callitrichines. Squirrel monkey samples averaged 4.56% fat, 3.59% CP, 6.98% sugar, 16.59% DM, and 0.91 kcal/g. The proportion of the medium chain fatty acids 8:0 and 10:0 was 40 times greater than that reported for human milk samples, and 18:1 and 18:2n-6 comprise more than 60% of total fatty acids. Milk from allomothers was lower than dams in fat, DM, and GE, which may relate to variation in maternal condition between these two groups. Excluding allomothers, milk from squirrel monkeys was higher in mean GE than captive common marmosets, but did not differ in the proportion of energy from fat, CP, and sugar relative to total GE. The consistency in energy from protein between species suggests this may be a shared-derived trait of New World monkeys.

Managing nausea and vomiting of pregnancy: a survey of obstetrician-gynecologists.

OBJECTIVE: To assess obstetrician-gynecologists' treatment of nausea and vomiting of pregnancy and to compare it with recommendations in an American College of Obstetricians and Gynecologists (ACOG) evidence-based practice bulletin on the topic. STUDY DESIGN: A survey questionnaire was mailed to the 1075 ACOG fellows who constitute the Collaborative Ambulatory Research Network (CARN). RESULTS: The most frequently recommended treatments for a patient with moderate to severe nausea with occasional vomiting were: eat frequent, small meals (93%); snack on soda crackers (68.5%); and take vitamin B6 plus doxylamine (67.1%). Two of 3 (66.7%) respondents had read the ACOG practice bulletin; most of those who had read it found it helpful (67.0%) or very helpful (29.5%). Respondents who read the practice bulletin were generally more willing to treat nausea and vomiting of pregnancy aggressively. They were more likely to be aware that early treatment is recommended to prevent progression to hyperemesis gravidarum and more likely to recommend the use of ginger (59.7% vs. 47.9%, p = 0.014), and to prescribe vitamin B6 (84.1% vs. 73.8%, p = 0.005) and vitamin B6 plus doxylamine (70.9% vs. 59.3%, p = 0.009). CONCLUSION: Obstetrician-gynecologists' treatment and prescribing practices generally follow ACOG recommendations; the ACOG practice bulletin appears to have affected practice and knowledge.