Wednesday, March 6, 2013

Summer plans at the Biomarkers&Milk Lab

My crowdfunding application was approved last night by, one of the new crowdfunding science organizations – think but for research. It will be one of the first human biology research projects on the site. Check it out: MILK WITH ALTITUDE.

You’re probably wondering why I am trying this. Well, it can’t hurt, and in these uncertain times, I feel like grants are more miss than hit (actually, all are miss as of late) and despite putting a tremendous effort into applying for funding, I am coming up short for this summer’s field season.  I have some general ideas why some grants aren’t funded (apparently NatGeo does not find milk sexy). But we’re going ahead with the research anyway. Overall, funding for research on human milk is limited, despite dramatically new technological breakthroughs and physiological discoveries. I’m unbelievably happy that (the pump maker) funds the Hartmann group and there seems to be excellent funding for their continued work on understanding the physiology of the mammary gland and their new work on stem cells in human milk (see: Hassiotou et al 2012). But for comparative work between and within non-WEIRD populations, especially those dealing with unusual or extreme environments, the coffers are pretty empty. 

So this is an experiment in 2 parts: one the project itself and two – can we crowdsource a study on human milk composition?  Through Microryza, I am asking for $5000 for summer research on milk composition among ethnic Tibetans living at high (12600-7500ft) and intermediate (4600 ft) altitude in Nepal. $4000 of the funds are for the fieldwork itself – paying 3 field assistants for 2 months at good local wages ($20/day) and compensating the mothers for their time (we hope to recruit 120 women). I will pay for the living expenses of the field staff myself. The remaining $1000 is fund raising for a community based workshop on safe birthing and infant feeding practices that will be open to any and all women in the communities regardless of participation in the study. 

So here is the pitch: I want to investigate milk composition (nutrients, hormones) in 75 ethnically Tibetan women living at high altitude in the Nubri Valley of Nepal. Participants will be drawn from 5 villages in the Nubri Valley, where my collaborator and colleague, Geoff Childs has conducted research since 1998 including living in the village for more than a year.  A control sample (n=50) of lower altitude women, drawn from the Tibetan community in Kathmandu, will also be recruited. 

Figure 1: Images from Nubri, Nepal. Photos by Geoff Childs.

The project will be the first project EVER to look at milk composition in a high altitude adapted population. Prior work has investigated breastfeeding behaviors among high altitude populations (Dang et al., 2005; Wiley 2004) but never specifically looked at milk composition in any population or investigated ideas and beliefs about breastfeeding in this population. Unlike many other Tibetan populations living outside of Tibet, the population in Nubri is an old population – they likely migrated into the Nubri Valley at least 400 years ago (Childs, 2004). 

And it gets cooler – breast milk is frequently considered in Tibetan medicine. Given the increased rates of illness and mortality among high altitude living populations, including Tibetans (although genetic adaptations increase survival compared to more recent migrant groups) there considerable treatment of infant health in traditional Tibetan medicine. Amchi, trained Tibetan medical practitioners, even include mother’s milk in their analyses of infant illness, testing milk for its color and its suspension in water as measure of humoral balance (Wiley, 2004). This is actually pretty interesting, because milk with more immune proteins or fat should have a different color and density. We’ll be finding out more about this practice.

But the real meat of the study will be the work with the mothers and infants. Our plan is to conduct interviews on mothers about their health, their beliefs and practices regarding infant feeding, their diets, and their infants’ health and diets.  Interviews will be coupled with anthropometric measurements (measurements of weight, height, and body fat) on both mothers and infants. We’ll be investigating how maternal physiology and environmental pressures influence milk composition and how milk composition in turn may be associated with specific aspects of infant growth, such as increased body fat. We know it is energetically expensive to be a mother anywhere, and even more so at high altitude, where low oxygen induces a state of chronic hypoxia, it is often quite cold, food supplies may be limited and not very diverse, and we know that women have increased metabolic rates, possibly as a result of adaptations to hypoxia or cold stress (Beall, 1981). We want to know how they balance these increased energy demands over multiple pregnancies and if there is 1) an association between maternal physiology and the nutrients and hormones in milk and 2) we want to know if differences in the milk predict differences in infant size and health.

Want to help? Head over to Microryza and sponsor Milk with altitude – or one of the other great projects over there! Want to donate to NepalSEEDS directly? Head here and help them keep doing great work not only in Nubri but throughout Nepal. 

Just here for the science? Part 4 of our 4 part series on breastfeeding, this time focused on the infant side of the breastfeeding relationship will be up at the end of the week.   

And as always, thanks for reading & supporting science!

Beall, C.M. (1981) Growth in a population of Tibetan origin at high altitude. Ann Hum Biol, 8(1):31-8.  
Childs, G. (2004) Tibetan Diary: From Birth to Death and Beyond in a Himalayan Valley of Nepal. Berkeley: University of California Press.
Cvejic E, Ades S, Flexer W, Gray-Donald K.(1997) Breastfeeding practices and nutritional status of children at high altitude in Ladakh. J Trop Pediatr. 43(6):376. 
Dang S, Yan H, Yamamoto S, Wang X, Zeng L.(2005) Feeding practice among younger Tibetan children living at high altitudes. Eur J Clin Nutr. 59(9):1022-9.
Hassiotou F, Beltran A, Chetwynd E, Stuebe AM, Twigger AJ, Metzger P, Trengove N, Lai CT, Filgueira L, Blancafort P, Hartmann PE. (2012) Breastmilk is a novel source of stem cells with multilineage differentiation potential. Stem Cells 30(10):2164-74. doi: 10.1002/stem.1188. 
Wiley AS (2004) An ecology of high altitude infancy. Cambridge University Press.