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Roig J, Rekawek P, Doctor T, Naert MN, Cadet J, Monro J, Stone JL, Liu LY. Postpartum Hemorrhage after Vaginal Delivery is Associated with a Decrease in Immediate Breastfeeding Success. Am J Perinatol 2024. [PMID: 38802080 DOI: 10.1055/s-0044-1786750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
OBJECTIVE This study aimed to identify the impact of postpartum hemorrhage (PPH) after vaginal delivery on immediate breastfeeding success. STUDY DESIGN This is a retrospective cohort study examining the impact of PPH on breastfeeding for nulliparous patients after term, singleton, vaginal deliveries at a large academic institution from 2017 to 2018. Indicators of successful breastfeeding in the immediate postpartum period were measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life. RESULTS A total of 1,904 women met inclusion criteria during the study period, 262 (13.8%) of whom experienced PPH, defined as an estimated blood loss of 500 mL or greater after vaginal delivery. Women who had a PPH had significantly fewer breastfeeding sessions on average (β = -0.06, p-value 0.01) and required more time at each breastfeeding session (β = 0.08, p-value <0.002). Neonates of women with PPH had a larger percentage in weight loss over the first 2 to 3 days of life compared with those without PPH (β = 0.06, p = 0.008). CONCLUSION Women who experience PPH after vaginal delivery have a decreased number of breastfeeding sessions despite spending more time trying to breastfeed, and an increased percentage in neonatal weight loss over the first 2 to 3 days of life. Further work is needed to elicit the mechanism behind this association; however, it is possible that PPH results in decreased secretion of endogenous oxytocin from the hypothalamic-pituitary axis as a result of hypovolemia. These women may therefore require additional breastfeeding support for successful breastfeeding initiation in the immediate postpartum period. KEY POINTS · Women who experience PPH after vaginal delivery have decreased breastfeeding success.. · Further work is needed to elicit the mechanism behind this association.. · These women may require additional support for successful breastfeeding initiation postpartum..
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Affiliation(s)
- Jacqueline Roig
- Department of Gynecologic Surgery and Obstetrics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Patricia Rekawek
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman Long Island School of Medicine, NYU Langone Hospital-Long Island, Mineola, New York
| | - Tahera Doctor
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mackenzie N Naert
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Julie Cadet
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Monro
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanne L Stone
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lilly Y Liu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
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Choi ES, Lee JS, Lee H, Lee KS, Ahn KH. Association between breastfeeding duration and diabetes mellitus in menopausal women: a machine-learning analysis using population-based retrospective study. Int Breastfeed J 2024; 19:33. [PMID: 38745339 PMCID: PMC11092012 DOI: 10.1186/s13006-024-00642-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Breastfeeding resets insulin resistance caused by pregnancy however, studies on the association between breastfeeding and diabetes mellitus (DM) have reported inconsistent results. Therefore, we aimed to investigate the risk of DM according to breastfeeding duration in large-scale population-based retrospective study. In addition, machine-learning prediction models for DM and hemoglobin A1c (HbA1c) were developed to further evaluate this association. METHODS We used the Korean National Health and Nutrition Examination Surveys database, a nationwide and population-based health survey from 2010 to 2020. We included 15,946 postmenopausal women with a history of delivery, whom we divided into three groups according to the average breastfeeding duration: (1) no breastfeeding, (2) < 12 months breastfeeding, and (3) ≥ 12 months breastfeeding. Prediction models for DM and HbA1c were developed using an artificial neural network, decision tree, logistic regression, Naïve Bayes, random forest, and support vector machine. RESULTS In total, 2248 (14.1%) women had DM and 14,402 (90.3%) had a history of breastfeeding. The prevalence of DM was the lowest in the < 12 breastfeeding group (no breastfeeding vs. < 12 months breastfeeding vs. ≥ 12 months breastfeeding; 161 [10.4%] vs. 362 [9.0%] vs. 1,725 [16.7%], p < 0.001). HbA1c levels were also the lowest in the < 12 breastfeeding group (HbA1c: no breastfeeding vs. < 12 months breastfeeding vs. ≥ 12 months breastfeeding; 5.9% vs. 5.9% vs. 6.1%, respectively, p < 0.001). After adjustment for covariates, the risk of DM was significantly increased in both, the no breastfeeding (adjusted odds ratio [aOR] 1.29; 95% CI 1.29, 1.62]) and ≥ 12 months of breastfeeding groups (aOR 1.18; 95% CI 1.01, 1.37) compared to that in the < 12 months breastfeeding group. The accuracy and the area under the receiver-operating-characteristic curve of the DM prediction model were 0.93 and 0.95, respectively. The average breastfeeding duration was ranked among the top 15 determinants of DM, which supported the strong association between breastfeeding duration and DM. This association was also observed in a prediction model for HbA1c. CONCLUSIONS Women who did not breasted had a higher risk of developing DM than those who breastfed for up to 12 months.
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Affiliation(s)
- Eun-Saem Choi
- Department of Obstetrics & Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jue Seong Lee
- Department of Pediatrics, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Hwasun Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Korea University Anam Hospitald, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Ki Hoon Ahn
- Department of Obstetrics & Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea.
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Nielsen OH, Gubatan JM, Kolho KL, Streett SE, Maxwell C. Updates on the management of inflammatory bowel disease from periconception to pregnancy and lactation. Lancet 2024; 403:1291-1303. [PMID: 38458222 DOI: 10.1016/s0140-6736(24)00052-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 03/10/2024]
Abstract
Inflammatory bowel disease (IBD) affects reproductive planning due to psychological effects and mechanical problems related to surgery. Children of people with IBD have an increased risk of about 10% if one parent has IBD and up to 33% if both parents have IBD. The fertility of people with IBD is similar to the general population, but fertility might be reduced in individuals with active IBD, ileal pouch-anal anastomosis, or perianal Crohn's disease. Flaring disease during pregnancy increases complications, such as preterm birth. Thus, disease management with appropriate medications can optimise outcomes. As most medications have minimal fetal risks, people with IBD should be informed about the risks of stopping medications and the importance of maintaining remission. A period of disease remission is advisable before pregnancy and could reduce the risks for both the pregnant person and the fetus. Flexible endoscopy, intestinal ultrasound, and gadolinium-free magnetic resonance enterography are safe during pregnancy. We provide state-of-the-art knowledge on the basis of the latest evidence to ensure successful pregnancy outcomes in controlled IBD.
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Affiliation(s)
- Ole Haagen Nielsen
- Department of Gastroenterology, Medical Section, Herlev Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - John Mark Gubatan
- Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Kaija-Leena Kolho
- Department of Pediatrics, Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Sarah Elizabeth Streett
- Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Cynthia Maxwell
- Department of Obstetrics and Gynaecology, Women's College Hospital, Sinai Health, University of Toronto, ON, Canada
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Soda MA, Hamuli EK, Batina SA, Kandala NB. Determinants and spatial factors of anemia in women of reproductive age in Democratic Republic of Congo (drc): a Bayesian multilevel ordinal logistic regression model approach. BMC Public Health 2024; 24:202. [PMID: 38233820 PMCID: PMC10792821 DOI: 10.1186/s12889-023-17554-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND As a global public health problem, anemia affects more than 400 million women of reproductive age worldwide, mostly in Africa and India. In the DRC, the prevalence of anemia has decreased slightly from 52.9% in 2007, to 46.4% in 2012 and 42.4% in 2019. However, there is considerable regional variation in its distribution. The aim of this study is to determine the factors contributing to anemia in women of reproductive age and to explore its spatial distribution in the DRC. METHODS Based on the Bayesian Multilevel Spatial Ordinal Logistic Regression Model, we used the 2013 Democratic Republic of Congo Demographic and Health Survey (DHS-DRC II) data to investigate individual and environmental characteristics contributing to the development of anemia in women of reproductive age and the mapping of anemia in terms of residual spatial effects. RESULTS Age, pregnancy status, body mass index, education level, current breastfeeding, current marital status, contraceptive and insecticide-treated net use, source of drinking water supply and toilet/latrine use including the province of residence were the factors contributing to anemia in women of reproductive age in DRC. With Global Moran's I = -0.00279, p-value ≥ 0.05, the spatial distribution of anemia in women of reproductive age in DRC results from random spatial processes. Thus, the observed spatial pattern is completely random. CONCLUSION The Bayesian Multilevel Spatial Ordinal Logistic Regression statistical model is able to adjust for risk and spatial factors of anemia in women of reproductive age in DRC highlighting the combined role of individual and environmental factors in the development of anemia in DRC.
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Affiliation(s)
- Martin Abysina Soda
- Section de Sciences Infirmières Institut Supérieur des Techniques Médicales de Kisangani, Kisangani, Democratic Republic of the Congo.
- Institut Supérieur Des Techniques Médicales de Kinshasa, Kinshasa, Democratic Republic of the Congo.
- Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Witwatersrand, South Africa.
| | - Eugénie Kabali Hamuli
- Institut Supérieur Des Techniques Médicales de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Salomon Agasa Batina
- Département de Médecine Interne, Université de Kisangani, Kisangani, Democratic Republic of the Congo
| | - Ngianga-Bakwin Kandala
- Institut Supérieur Des Techniques Médicales de Kinshasa, Kinshasa, Democratic Republic of the Congo
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
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Flaherman VJ, Murungi J, Bale C, Dickinson S, Chen X, Namiiro F, Nankunda J, Pollack LM, Laleau V, Kim MO, Allison DB, Ginsburg AS, Braima de Sa A, Nankabirwa V. Breastfeeding and Once-Daily Small-Volume Formula Supplementation to Prevent Infant Growth Impairment. Pediatrics 2024; 153:e2023062228. [PMID: 38062778 DOI: 10.1542/peds.2023-062228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 01/02/2024] Open
Abstract
BACKGROUND Randomized controlled trials in Guinea-Bissau and Uganda have revealed that the intensive promotion of exclusive breastfeeding (EBF) impairs growth in early infancy. When newborn growth is impaired, small amounts of formula may be combined with breastfeeding to promote growth. METHODS To determine if breastfeeding combined with once-daily formula supplementation improves growth among at-risk newborns, we conducted a pilot randomized controlled trial in Bissau, Guinea-Bissau and Kampala, Uganda. We randomly assigned 324 healthy breastfeeding newborns who weighed 2000 g to 2499 g at birth or <2600 g at 4 days old to once-daily formula feeding through 30 days as a supplement to frequent breastfeeding followed by EBF from 31 days through 6 months, or to EBF through 6 months. The primary outcome was weight-for-age z score (WAZ) at 30 days. Other outcomes included weight-for-length z score (WLZ), length-for-age z score (LAZ), breastfeeding cessation, adverse events, and serious adverse events through 180 days. RESULTS Daily formula consumption in the intervention group was 31.9 ± 11.8 mL. The random assignment did not impact WAZ, WLZ, LAZ, breastfeeding cessation, adverse events, or serious adverse events through 180 days. In the intervention and control groups, 19 (12%) and 35 (21%) infants, respectively, reported nonformula supplementation in the first 30 days (P = .02). CONCLUSIONS Once-daily formula supplementation for 30 days was well-tolerated, but the small volume consumed did not alter growth through 180 days of age. Further research would be required to determine if larger formula volumes, longer duration of treatment, or more frequent feeding are effective at increasing growth for this at-risk population.
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Affiliation(s)
| | - Joan Murungi
- School of Public Health, Makerere University, Kampala, Uganda
| | - Carlito Bale
- International Partnership for Human Development, Bissau, Guinea-Bissau
| | | | - Xiwei Chen
- School of Public Health, Indiana University, Bloomington, Indiana
| | - Flavia Namiiro
- School of Public Health, Makerere University, Kampala, Uganda
| | - Jolly Nankunda
- School of Public Health, Makerere University, Kampala, Uganda
| | - Lance M Pollack
- School of Medicine, University of California, San Francisco, California
| | - Victoria Laleau
- School of Medicine, University of California, San Francisco, California
| | - Mi-Ok Kim
- School of Medicine, University of California, San Francisco, California
| | - David B Allison
- School of Public Health, Indiana University, Bloomington, Indiana
| | | | | | - Victoria Nankabirwa
- School of Public Health, Makerere University, Kampala, Uganda
- Centre for Intervention Science for Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Izumi C, Trigg J, Stephens JH. A systematic review of migrant women's experiences of successful exclusive breastfeeding in high-income countries. MATERNAL & CHILD NUTRITION 2024; 20:e13556. [PMID: 37584632 PMCID: PMC10750009 DOI: 10.1111/mcn.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
The World Health Organisation recommends exclusive breastfeeding for the first 6 months after childbirth. However, since breastfeeding is influenced by cultural practice, it differs between migrant mothers and nonmigrant mothers. This systematic review examined migrant mothers' perceptions and experiences impacting achievement of exclusive breastfeeding after immigration from a low-middle-income country to a high-income country. CINAHL, Medline, Scopus, Web of Science, PsycINFO and Emcare were searched for qualitative studies published from 2010 to August 2022. Eleven studies met inclusion criteria. We used meta-ethnographic synthesis to identify overarching themes, resulting in five themes: Migrant mothers (1) 'recognised the differences in breastfeeding practice between their home and host country'. During acculturation, mothers modify or stick to their breastfeeding practice in their host country based on their (2) 'breastfeeding knowledge' by combining their (3) 'original ethnic identity' with the (4) 'influence of family members, healthcare workers, infants, peers and workplace'. Although they face barriers, their (5) 'autonomy' motivated them to continue breastfeeding in a country where the breastfeeding norm differs from where they come from. Intrapersonal and interpersonal socio-ecological factors played a significant role in their breastfeeding practice in the host country. Findings indicate public health policy and practice to support breastfeeding for migrant women in high-income countries can be improved, particularly by emphasising the importance of providing affirmative, comprehensive and practical support from healthcare professionals.
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Affiliation(s)
- Chieko Izumi
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Ehime Prefectural University of Health SciencesEhimeJapan
| | - Joshua Trigg
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| | - Jacqueline H. Stephens
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
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Mazur D, Satora M, Rekowska AK, Kabała Z, Łomża A, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. Influence of Breastfeeding on the State of Meta-Inflammation in Obesity-A Narrative Review. Curr Issues Mol Biol 2023; 45:9003-9018. [PMID: 37998742 PMCID: PMC10670570 DOI: 10.3390/cimb45110565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Obesity has become an emerging health issue worldwide that continues to grow in females of reproductive age as well. Obesity, as a multisystem and chronic disease, is associated with metabolic inflammation, which is defined as chronic low-grade systemic inflammation mediated by, i.a., adipose tissue macrophages. Lactation has been proven to have a beneficial influence on maternal health and could help restore metabolic balance, especially in the state of maternal obesity. In this review, we aimed to analyze the influence of breastfeeding on chronic low-grade meta-inflammation caused by obesity. We performed a comprehensive literature review using the PubMed, Science Direct, and Google Scholar electronic databases. For this purpose, we searched for "metabolic inflammation"; "meta-inflammation"; "obesity"; "breastfeeding"; "fetal programming"; "energy metabolism"; "postpartum"; "immunity"; "immune system"; and "inflammation" keyword combinations. While the clinical impact of breastfeeding on maternal and offspring health is currently well known, we decided to gain insight into more specific metabolic effects of adiposity, lipid, and glucose homeostasis, and immunological effects caused by the activity of cytokines, macrophages, and other immune system cells. Further research on the immunological and metabolic effects of breastfeeding in obese patients is key to understanding and potentially developing obesity therapeutic strategies.
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Affiliation(s)
| | | | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-059 Lublin, Poland; (D.M.); (M.S.); (A.K.R.); (Z.K.); (A.Ł.); (B.L.-G.)
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Golan Y, Ilala M, Li L, Gay C, Hunagund S, Lin CY, Cassidy AG, Jigmeddagva U, Matsui Y, Ozarslan N, Asiodu IV, Ahituv N, Flaherman VJ, Gaw SL, Prahl M. Milk antibody response after 3 rd COVID-19 vaccine and SARS-CoV-2 infection and implications for infant protection. iScience 2023; 26:107767. [PMID: 37731614 PMCID: PMC10507209 DOI: 10.1016/j.isci.2023.107767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/28/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Little is known about the persistence of human milk anti-SARS-CoV-2 antibodies after 2nd and 3rd vaccine doses and infection following 3rd dose. In this study, human milk, saliva, and blood samples were collected from 33 lactating individuals before and after vaccination and infection. Antibody levels were measured using ELISA and symptoms were assessed using questionnaires. We found that after vaccination, milk anti-SARS-CoV-2 antibodies persisted for up to 8 months. In addition, distinct patterns of human milk IgA and IgG production and higher milk RBD-blocking activity was observed after infection compared to 3-dose vaccination. Infected mothers reported more symptoms than vaccinated mothers. We examined the persistence of milk antibodies in infant saliva after breastfeeding and found that IgA was more abundant compared to IgG. Our results emphasize the importance of improving the secretion of IgA antibodies to human milk after vaccination to improve the protection of breastfeeding infants.
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Affiliation(s)
- Yarden Golan
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, and Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - Mikias Ilala
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lin Li
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Caryl Gay
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Soumya Hunagund
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Christine Y. Lin
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Arianna G. Cassidy
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Unurzul Jigmeddagva
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Yusuke Matsui
- Gladstone Institute of Virology, Gladstone Institutes, San Francisco, CA, USA
- Michael Hulton Center for HIV Cure Research at Gladstone, San Francisco, CA, USA
| | - Nida Ozarslan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Nadav Ahituv
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, and Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - Valerie J. Flaherman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Mary Prahl
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Division of Pediatric Infectious Diseases and Global Health, University of California, San Francisco, San Francisco, CA, USA
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Nagel E, Elgersma KM, Gallagher TT, Johnson KE, Demerath E, Gale CA. Importance of human milk for infants in the clinical setting: Updates and mechanistic links. Nutr Clin Pract 2023; 38 Suppl 2:S39-S55. [PMID: 37721461 PMCID: PMC10513735 DOI: 10.1002/ncp.11037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/15/2023] [Accepted: 06/10/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Human milk (HM) is the optimal source of nutrition for infants and has been implicated in multiple aspects of infant health. Although much of the existing literature has focused on the individual components that drive its nutrition content, examining HM as a biological system is needed for meaningful advancement of the field. Investigation of the nonnutritive bioactive components of HM and the maternal, infant, and environmental factors which affect these bioactives is important to better understand the importance of HM provision to infants. This information may inform care of clinical populations or infants who are critically ill, hospitalized, or who have chronic diseases and may benefit most from receiving HM. METHODS In this narrative review, we reviewed literature examining maternal and infant influences on HM composition with a focus on studies published in the last 10 years that were applicable to clinical populations. RESULTS We found multiple studies examining HM components implicated in infant immune and gut health and neurodevelopment. Additional work is needed to understand how donor milk and formula may be used in situations of inadequate maternal HM. Furthermore, a better understanding of how maternal factors such as maternal genetics and metabolic health influence milk composition is needed. CONCLUSION In this review, we affirm the importance of HM for all infants, especially clinical populations. An understanding of how HM composition is modulated by maternal and environmental factors is important to progress the field forward with respect to mechanistic links between HM biology and infant health outcomes.
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Affiliation(s)
- Emily Nagel
- School of Public Health, University of Minnesota-Twin Cities, Minnesota, USA
| | | | | | - Kelsey E Johnson
- Department of Genetics, Cell Biology, and Development, University of Minnesota-Twin Cities, Minnesota, USA
| | - Ellen Demerath
- School of Public Health, University of Minnesota-Twin Cities, Minnesota, USA
| | - Cheryl A. Gale
- Department of Pediatrics, University of Minnesota-Twin Cities, Minnesota, USA
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10
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Uçar T, Çelik OT, Sabancı Baransel E, Barut S. Bibliometrics and Visual Analysis of the Research Status and Trends of Breastfeeding in Turkey. Turk Arch Pediatr 2023; 58:494-502. [PMID: 37553969 PMCID: PMC10544554 DOI: 10.5152/turkarchpediatr.2023.23067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/15/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The long- and short-term benefits of breastfeeding for mothers and infants are known, and the number of studies on this subject is increasing daily. This study aimed to reveal current research trends, hotspots, and future frontiers in research on breastfeeding in Turkey. MATERIALS AND METHODS The most productive institutions, influential authors, the journals with the most publications by the authors, core research teams, and keywords in Turkey in the field of breastfeeding were analyzed using bibliometric methods. Additionally, breastfeeding-related articles published in the Web of Science Core Collection between 1980 and 2022 were scanned. The collected data were analyzed with the R Bibliometrix package program and VOSviewer. RESULTS It was determined that research on breastfeeding has accelerated since 2004, and the number of citations has increased with the number of publications. The fields of most produc- tive writers in the area were found as social pediatrics, and the most influential institutions were İstanbul University and Hacettepe University. It was determined that there was no specializa- tion in research on breastfeeding among authors distributed based on their productivity. The results also revealed the most influential articles and journals. The word analysis revealed that the breastfeeding literature in Turkey is sensitive to current developments, whereas the current status of breastfeeding, the factors affecting breastfeeding, and the effects of breastfeeding are the top areas of research. It was observed that maternal attachment and coronavirus dis- ease-2019 (COVID-19) pandemic-related issues have been studied more in recent years. CONCLUSION This bibliometric analysis contributes to understanding the current status and development of breastfeeding research in Turkey.
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Affiliation(s)
- Tuba Uçar
- Department of Midwifery, İnönü University, Malatya, Turkey
| | | | | | - Sümeyye Barut
- Department of Midwifery, Fırat University, Elazığ, Turkey
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11
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Geller RJ, Inhofe NR, Crifase CC, Espinola JA, Gallegos C, Herrera N, Mitri E, Qi Y(S, Sullivan AF, Camargo CA. Case-control study of exclusive breast feeding and severe bronchiolitis in the United States. Paediatr Perinat Epidemiol 2023; 37:425-435. [PMID: 36882670 PMCID: PMC10483022 DOI: 10.1111/ppe.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/30/2023] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Bronchiolitis is a major cause of infant illness, with few known modifiable risk factors. Breast feeding may reduce risk of severe bronchiolitis, but the association of exclusive vs. partial breast feeding with severe bronchiolitis is unclear. OBJECTIVE To estimate the association of exclusive vs. partial breast feeding during ages 0-2.9 months with bronchiolitis hospitalisation during infancy. METHODS We conducted a case-control study as a secondary analysis of two prospective US cohorts in the Multicenter Airway Research Collaboration. Cases were enrolled in a 17-centre study of infants hospitalised for bronchiolitis during 2011-2014 (n = 921). Controls were enrolled in a five-centre study of healthy infants during 2013-2014 and 2017 (n = 719). Breast feeding history during ages 0-2.9 months was collected by parent interview. Among breastfed infants, the association of exclusive vs. partial breast feeding with odds of bronchiolitis hospitalisation was estimated using a multivariable logistic regression model adjusted for demographic variables, parental asthma history, and early-life exposures. As a secondary analysis, we estimated the associations of exclusive, predominant, and occasional breast feeding vs. no breast feeding with the odds of bronchiolitis hospitalisation. RESULTS Among 1640 infants, the prevalence of exclusive breast feeding was 187/921 (20.3%) among cases and 275/719 (38.3%) among controls. Exclusive vs. partial breast feeding was associated with 48% reduced odds of bronchiolitis hospitalisation (adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.39, 0.69). In the secondary analysis, exclusive vs. no breast feeding was associated with 58% reduced odds of bronchiolitis hospitalisation (OR 0.42, 95% CI 0.23, 0.77), whereas predominant breast feeding (OR 0.77, 95% CI 0.37, 1.57) and occasional breast feeding (OR 0.98, 95% CI 0.57, 1.69) were not associated with meaningfully reduced odds of bronchiolitis hospitalisation. CONCLUSION Exclusive breast feeding had a strong protective association against bronchiolitis hospitalisation.
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Affiliation(s)
- Ruth J. Geller
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Nancy R. Inhofe
- Department of Pediatrics, The University of Oklahoma School of Community Medicine – Tulsa, OK
| | | | - Janice A. Espinola
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Catalina Gallegos
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Nicole Herrera
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Elie Mitri
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Ying (Shelly) Qi
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Ashley F. Sullivan
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
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12
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Knight M, Ramakrishnan R, Ratushnyak S, Rivero-Arias O, Bell J, Bowler U, Buchanan P, Carter C, Cole C, Hewer O, Hurd M, King A, Juszczak E, Linsell L, Long AM, Mottram L, Murray D, Oddie S, Quigley M, Stalker V, Stanbury K, Welsh R, Hardy P. Frenotomy with breastfeeding support versus breastfeeding support alone for infants with tongue-tie and breastfeeding difficulties: the FROSTTIE RCT. Health Technol Assess 2023; 27:1-73. [PMID: 37839892 PMCID: PMC10591207 DOI: 10.3310/wbbw2302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Background Tongue-tie can be diagnosed in 3-11% of babies, with some studies reporting almost universal breastfeeding difficulties, and others reporting very few feeding difficulties that relate to the tongue-tie itself, instead noting that incorrect positioning and attachment are the primary reasons behind the observed breastfeeding difficulties and not the tongue-tie itself. The only existing trials of frenotomy are small and underpowered and/or include only very short-term or subjective outcomes. Objective To investigate whether frenotomy is clinically and cost-effective to promote continuation of breastfeeding at 3 months in infants with breastfeeding difficulties diagnosed with tongue-tie. Design A multicentre, unblinded, randomised, parallel group controlled trial. Setting Twelve infant feeding services in the UK. Participants Infants aged up to 10 weeks referred to an infant feeding service (by a parent, midwife or other breastfeeding support service) with breastfeeding difficulties and judged to have tongue-tie. Interventions Infants were randomly allocated to frenotomy with standard breastfeeding support or standard breastfeeding support without frenotomy. Main outcome measures Primary outcome was any breastmilk feeding at 3 months according to maternal self-report. Secondary outcomes included mother's pain, exclusive breastmilk feeding, exclusive direct breastfeeding, frenotomy, adverse events, maternal anxiety and depression, maternal and infant NHS health-care resource use, cost-effectiveness, and any breastmilk feeding at 6 months of age. Results Between March 2019 and November 2020, 169 infants were randomised, 80 to the frenotomy with breastfeeding support arm and 89 to the breastfeeding support arm from a planned sample size of 870 infants. The trial was stopped in the context of the COVID-19 pandemic due to withdrawal of breastfeeding support services, slow recruitment and crossover between arms. In the frenotomy with breastfeeding support arm 74/80 infants (93%) received their allocated intervention, compared to 23/89 (26%) in the breastfeeding support arm. Primary outcome data were available for 163/169 infants (96%). There was no evidence of a difference between the arms in the rate of breastmilk feeding at 3 months, which was high in both groups (67/76, 88% vs. 75/87, 86%; adjusted risk ratio 1.02, 95% confidence interval 0.90 to 1.16). Adverse events were reported for three infants after surgery [bleeding (n = 1), salivary duct damage (n = 1), accidental cut to the tongue and salivary duct damage (n = 1)]. Cost-effectiveness could not be determined with the information available. Limitations The statistical power of the analysis was extremely limited due to not achieving the target sample size and the high proportion of infants in the breastfeeding support arm who underwent frenotomy. Conclusions This trial does not provide sufficient information to assess whether frenotomy in addition to breastfeeding support improves breastfeeding rates in infants diagnosed with tongue-tie. Future work There is a clear lack of equipoise in the UK concerning the use of frenotomy, however, the effectiveness and cost-effectiveness of the procedure still need to be established. Other study designs will need to be considered to address this objective. Trial registration This trial is registered as ISRCTN 10268851. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment Programme (project number 16/143/01) and will be published in full in Health Technology Assessment; Vol. 27, No. 11. See the NIHR Journals Library website for further project information. The funder had no role in study design or data collection, analysis and interpretation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rema Ramakrishnan
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Svetlana Ratushnyak
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jennifer Bell
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ursula Bowler
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Phyll Buchanan
- PPI representative, The Breastfeeding Network, Paisley, UK
| | | | - Christina Cole
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Oliver Hewer
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Madeleine Hurd
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andy King
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ed Juszczak
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Louise Linsell
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Anna-May Long
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Linda Mottram
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David Murray
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sam Oddie
- Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Trust, Bradford, UK
| | - Maria Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Victoria Stalker
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kayleigh Stanbury
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Richard Welsh
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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13
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Muleka N, Maanaso B, Phoku M, Mphasha MH, Makwela M. Infant and Young Child Feeding Knowledge among Caregivers of Children Aged between 0 and 24 Months in Seshego Township, Limpopo Province, South Africa. Healthcare (Basel) 2023; 11:healthcare11071044. [PMID: 37046971 PMCID: PMC10094686 DOI: 10.3390/healthcare11071044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/26/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Appropriate infant and young child feeding (IYCF) involves the initiation of breastfeeding within an hour of delivery, exclusive breastfeeding for 6 months, introduction of complementary feeding at 6 months while continuing breastfeeding for 2 years or beyond. Adequate IYCF knowledge among caregivers is associated with improved practices, lowers risk of kids developing malnutrition, infection, morbidity, and mortality. Early introduction of solid foods, mixed feeding, inadequate breastfeeding, and complementary feeding are all prevalent in South Africa. These are related to caregivers' lack of IYCF knowledge. Hence, this study aims to determine the IYCF knowledge level of caregivers of children under 24 months in the semiurban Seshego Township, South Africa. METHODOLOGY Quantitative and cross-sectional design was applied. A total of 86 caregivers were selected using simple random sampling, which is representative of a target population of 110. Structured questionnaire was utilised to gather data, and analysed through statistical software, using descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval, where a p-value of < 0.05 was considered statistically significant. RESULTS Findings show that 67% of participants had good IYCF knowledge (a score of 81 to 100%) and there was a significant relationship between knowledge and education (p = 0.001). Moreover, 40.7% did not know that exclusive breastfeeding should be up to 6 months, and 90% mentioned that breastmilk protects the child against diseases. Most participants (82.6%) know that complementary feeding should be introduced at 6 months with continuation of breastfeeding. CONCLUSIONS Caregivers know that breastfeeding should begin immediately after birth, and that it protects against diseases. Moreover, they know that solid food should be introduced at 6 months. However, there is still a need to strengthen IYCF education, particularly on exclusive breastfeeding. Interventions to improve IYCF knowledge should be intertwined with improving educational and health literacy on breastfeeding and complementary feeding.
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Affiliation(s)
- Ndivhudzannyi Muleka
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | - Baatseba Maanaso
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | - Mafiwa Phoku
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
| | | | - Maishataba Makwela
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0790, South Africa
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14
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Kim M. Effect of Breastmilk After Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2023; 14:307-308. [PMID: 36972506 DOI: 10.1177/21501351231163530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Affiliation(s)
- Minso Kim
- Division of Pediatric Critical Care, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA
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15
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Mahoney SE, Taylor SN, Forman HP. No such thing as a free lunch: The direct marginal costs of breastfeeding. J Perinatol 2023; 43:678-682. [PMID: 36949157 DOI: 10.1038/s41372-023-01646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/19/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
Understanding costs associated with breastfeeding is critical to developing maximally effective policy to support breastfeeding by addressing financial barriers. Breastfeeding is not without cost; direct costs include those of equipment, modified nutritional intake, and time (opportunity cost). Breastfeeding need not require more equipment than formula feeding, though maternal equipment use varies by maternal preference. Meeting increased nutritional demands requires increased spending on food and potentially dietary supplementation, the marginal cost of which depends on a mother's baseline diet. The opportunity cost of the three to four hours per day breastfeeding demands may be prohibitively high, particularly to low-income workers. These costs are relatively highest for low-income individuals, a group disproportionately comprising racial and ethnic minorities, and who demonstrate lower rates of breastfeeding than their white and higher-income peers. Acknowledging and addressing these costs and their regressive nature represents a critical component of effective breastfeeding policy and promotion.
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Affiliation(s)
- Sarah E Mahoney
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Sarah N Taylor
- Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Howard P Forman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, USA
- Yale School of Management, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Economics, Yale University, New Haven, CT, USA
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16
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Lechosa-Muñiz C, Paz-Zulueta M, Irure-Ventura J, Mendez-Legaza JM, Cuesta González R, Gómez-Acebo I, López-Hoyos M, Llorca J, Cabero-Pérez MJ. Development of SARS-CoV-2 specific IgG and IgA antibodies in serum and milk with different SARS-COV-2 vaccines in lactating women. Int Breastfeed J 2023; 18:3. [PMID: 36627706 PMCID: PMC9831888 DOI: 10.1186/s13006-022-00536-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Our main objective was to determine the evolution of IgG and IgA antibodies directed against SARS-CoV-2 protein S in the blood of lactating women and in breast milk. METHODS A cohort of 110 uninfected and vaccinated breastfeeding women was followed-up for 6 months at the Marqués de Valdecilla University Hospital, Spain, in 2020. An additional group of 23 breastfeeding mothers who had no previously documented infection and had not been vaccinated against SARS-CoV-2 were included as a control group. The antibodies in blood and breast milk and their evolution at 6 months post-vaccination were analysed. RESULTS One hundred ten breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) received two doses of mRNA-1273, and 20 women (18.2%) received a single dose of ChAdOx1-S. No evidence of differences between concentrations of antibodies was found according to the type of vaccine, with the exception of serum IgA antibodies, which was higher in women vaccinated with mRNA-1273: mean [95%CI]: 0.05 AU/mL [0.03,0.06] with mRNA-1273, 0.02 AU/mL [0.01,0.03] with BNT162b2 and 0.01 AU/mL [0.00,0.03] with ChAdOx1-S, ANOVA p value = 0.03. The lack of difference between vaccines was also found when anti-S1 specific IgG in serum and breast milk were measured. CONCLUSIONS In lactating women vaccinated against COVID-19, anti-SARS-CoV-2 antibodies can be detected in both serum and breastmilk 6 months after receiving the second dose, although their concentrations decreased when compared with concentrations reached immediately after vaccination.
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Affiliation(s)
- Carolina Lechosa-Muñiz
- grid.7821.c0000 0004 1770 272XDepartamento de Enfermería, Universidad de Cantabria, Santander, Spain ,grid.411325.00000 0001 0627 4262Breastfeeding Coordinator, IBCLC, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - María Paz-Zulueta
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain. .,IDIVAL- Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, Cantabria, Spain.
| | - Juan Irure-Ventura
- grid.411325.00000 0001 0627 4262Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jose Manuel Mendez-Legaza
- grid.411325.00000 0001 0627 4262Department of Microbiology, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - Rocío Cuesta González
- grid.411325.00000 0001 0627 4262Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - Inés Gómez-Acebo
- grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.466571.70000 0004 1756 6246CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marcos López-Hoyos
- grid.411325.00000 0001 0627 4262Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.7821.c0000 0004 1770 272XLaboratory, Molecular Biology Department, University of Cantabria, Santander, Spain
| | - Javier Llorca
- grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.466571.70000 0004 1756 6246CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María Jesús Cabero-Pérez
- grid.411325.00000 0001 0627 4262Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain ,grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.413448.e0000 0000 9314 1427Red de Salud Materno Infantil y del Desarrollo – SAMID. Instituto de Salud Carlos III, Madrid, Spain
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17
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Vázquez-Frias R, Ladino L, Bagés-Mesa MC, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos MC, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez NE, Roda J, Sanabria MC, Sánchez-Valverde F, Santiago RJ, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:57-70. [PMID: 36737343 DOI: 10.1016/j.rgmxen.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/17/2022] [Indexed: 02/04/2023]
Abstract
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN.
| | - L Ladino
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - M C Bagés-Mesa
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - V Hernández-Rosiles
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN
| | - E Ochoa-Ortiz
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Departamento de Nutrición, Mexico City, Mexico
| | - M Alomía
- Posgrado de Pediatría, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - R Bejarano
- Servicio de Gastroenterología y Nutrición, Hospital de Especialidades Pediátricas, Ciudad de Panamá, Panama
| | - C Boggio-Marzet
- Grupo de Trabajo en Gastroenterología y Nutrición Pediátrica, Hospital General de Agudos "Dr. I. Pirovano", Buenos Aires, Argentina
| | | | - E Colindres-Campos
- Departamento de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - G Fernández
- Departamento de Gastroenterología, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - E García-Bacallao
- Sección de Pediatría, Instituto de Gastroenterología, Universidad de Ciencias Médicas, La Habana, Cuba
| | - I González-Cerda
- Servicio de Pediatría, Hospital Militar Escuela "Dr. Alejandro Dávila Bolaños", Managua, Nicaragua
| | - A Guisande
- Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - C Guzmán
- Hospital La Católica, San José, Costa Rica
| | - F Moraga-Mardones
- Unidad de Nutrición, Servicio de Pediatría, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - J Palacios-Rosales
- Facultad de Medicina, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - N E Ramírez-Rodríguez
- Facultad de Medicina, Departamento de Medicina y Salud Mental, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - J Roda
- Gastroenterología e Nutrição Pediátrica, Hospital Pediátrico - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M C Sanabria
- Cátedra y Servicio de Pediatría, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - F Sánchez-Valverde
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario de Navarra, NAVARRA BIOMED, Pamplona, Navarra, Spain
| | - R J Santiago
- Departamento de Pediatría y Unidad de Gastroenterología, Hepatología y Nutrición, Hospital Universitario de Valera "Dr. Pedro Emilio Carrillo", Universidad de Los Andes, Valera, Venezuela
| | - N Sepúlveda-Valbuena
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - J Spolidoro
- Escuela de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - P Valdivieso-Falcón
- Departamento de Pediatría, Servicio subespecialidades pediátricas, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru
| | | | - B Koletzko
- Departamento de Pediatría, Medical Centre of LMU Munich, Ludwig Maximilian University of Munich, Dr. von Hauner Children's Hospital, München, Germany
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18
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Vázquez-Frias R, Ladino L, Bagés-Mesa M, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos M, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez N, Roda J, Sanabria M, Sánchez-Valverde F, Santiago R, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consenso de alimentación complementaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica: COCO 2023. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2023. [DOI: 10.1016/j.rgmx.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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19
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Liu LY, Roig J, Rekawek P, Naert MN, Cadet J, Monro J, Stone JL. Comparison of Breastfeeding Success by Mode of Delivery. Am J Perinatol 2022. [PMID: 35863374 DOI: 10.1055/a-1906-8642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This article identifies how mode of delivery and the presence of labor affect the initiation and effectiveness of breastfeeding. STUDY DESIGN This is a retrospective cohort study of breastfeeding success after vaginal delivery, cesarean section after labor, and scheduled cesarean section in term, singleton deliveries in nulliparous patients at a large academic institution from 2017 to 2018. Exclusion criteria included major postpartum complications requiring admission to the surgical intensive care unit or neonatal intensive care unit, general anesthesia, and major fetal anomalies. Breastfeeding success in the immediate postpartum period, defined as the first 2 to 3 days postpartum prior to hospital discharge, was measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life. Multivariable linear and logistic regression were used to assess the association between mode of delivery and markers of breastfeeding success after adjusting for potential confounders. A Tukey's post hoc analysis with pairwise comparisons was performed to assess differences in breastfeeding outcomes between vaginal delivery, scheduled cesarean section, and cesarean section after labor. RESULTS A total of 2,966 women met inclusion criteria during the study period, 1,936 (65.3%) of whom underwent spontaneous vaginal delivery, 415 (14.0%) of whom delivered by scheduled cesarean section, and 615 (20.7%) of whom underwent cesarean section after labor. There were significant differences in maternal age, obesity, race/ethnicity, insurance status, gestational age at delivery, birth weight, and 1-minute Apgar's score less than 7 between vaginal delivery, scheduled cesarean section, and cesarean section after labor. There were also significant differences between indication for oxytocin, type of anesthesia, and postpartum hemorrhage between the three groups. After controlling for these factors, women who underwent vaginal delivery were more likely to have infants with decreased need for formula supplementation (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.52-1.93) and were less likely to switch from breast to formula feeding (aOR = 1.71, 95% CI: 1.04-1.31) in comparison to women who delivered via cesarean section in labor or scheduled cesarean section. The infants of these women also had an increased number of breastfeeding sessions on average (β = 0.06, p = 0.002), required fewer number of daily formula feedings (β = 0.14, p < 0.001), and experienced a smaller percentage in neonatal weight loss over the first 2 to 3 days of life (β = 0.18, p < 0.001) compared to those born after cesarean section and cesarean section after labor. These women comparatively required less time at each breastfeeding session (β = 0.06, p = 0.005), and produced fewer wet diapers and stools on average (β = 0.12, p < 0.001 and β = 0.12, p < 0.001, respectively). On post hoc analysis with pairwise comparisons, and on separate sensitivity analysis of only women who underwent cesarean delivery, there was no difference in breastfeeding outcome measures between scheduled cesarean section and cesarean section in labor. CONCLUSION Women who deliver by cesarean section, despite the presence or absence of labor, are less likely to maintain exclusive breastfeeding postpartum and are more likely to require formula supplementation. These women may need more support with breastfeeding after surgery in order to experience similar benefits for neonatal growth and weight gain. KEY POINTS · Women who deliver by cesarean section are less likely to maintain exclusive breastfeeding.. · Women who deliver by cesarean section are more likely to require formula supplementation.. · Women may need more support with breastfeeding after cesarean delivery..
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Affiliation(s)
- Lilly Y Liu
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jacqueline Roig
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Patricia Rekawek
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Winthrop Hospital, Mineola, New York
| | - Mackenzie N Naert
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Julie Cadet
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Monro
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanne L Stone
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
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20
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Golan Y, Ilala M, Gay C, Hunagund S, Lin CY, Cassidy AG, Jigmeddagva U, Li L, Ozarslan N, Asiodu IV, Ahituv N, Flaherman VJ, Gaw SL, Prahl M. Milk antibody response after 3rd dose of COVID-19 mRNA vaccine and SARS-CoV-2 breakthrough infection and implications for infant protection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.12.12.22283367. [PMID: 36561188 PMCID: PMC9774223 DOI: 10.1101/2022.12.12.22283367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Anti-SARS-CoV-2 antibodies have been found in human-milk after COVID-19 infection and vaccination. However, little is known about their persistence in milk after booster vaccination and breakthrough infection. In this study, human-milk, saliva and blood samples were collected from 33 lactating individuals before and after mRNA-based vaccination and COVID-19 breakthrough infections. Antibody levels were measured using ELISA and symptoms were assessed using questionnaires. Evaluation of maternal and infant symptomatology revealed that infected mothers reported more symptoms than vaccinated mothers. We found that after vaccination, human-milk anti-SARS-CoV-2 antibodies persisted for up to 8 months. In addition, distinct patterns of human milk IgA and IgG production we observed after breakthrough infection compared to 3-dose vaccination series alone, indicating a differential central and mucosal immune profiles in hybrid compared with vaccine-induced immunity. To investigate passively-derived milk antibody protection in infants, we examined the persistence of these antibodies in infant saliva after breastfeeding. We found that IgA was more abundant in infant saliva compared to IgG and persist in infant saliva longer after feeding. Our results delineate the differences in milk antibody response to vaccination as compared to breakthrough infection and emphasize the importance of improving the secretion of IgA antibodies to human milk after vaccination to improve the protection of breastfeeding infants.
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Affiliation(s)
- Yarden Golan
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, and Institute for Human Genetics, University of California, San Francisco, California, United States of America
| | - Mikias Ilala
- Department of Pediatrics, University of California, San Francisco, California, United States of America
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, California, United States of America
| | - Caryl Gay
- Department of Family Health Care Nursing, University of California, San Francisco, California, United States of America
| | - Soumya Hunagund
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Christine Y. Lin
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Arianna G. Cassidy
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Unurzul Jigmeddagva
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Lin Li
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Nida Ozarslan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, California, United States of America
| | - Nadav Ahituv
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, and Institute for Human Genetics, University of California, San Francisco, California, United States of America
| | - Valerie J. Flaherman
- Department of Pediatrics, University of California, San Francisco, California, United States of America
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, California, United States of America
| | - Mary Prahl
- Department of Pediatrics, University of California, San Francisco, California, United States of America
- Division of Pediatric Infectious Diseases and Global Health, University of California, San Francisco, California, United States of America
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21
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Hume-Nixon M, Ratu T, Clark S, Nguyen CD, Neal EFG, Pell CL, Bright K, Watts E, Hart J, Mulholland K, Fong J, Rafai E, Sakumeni K, Tuibeqa I, Satzke C, Steer A, Russell FM. Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial. BMJ Open 2022; 12:e061157. [PMID: 36456016 PMCID: PMC9716885 DOI: 10.1136/bmjopen-2022-061157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Infections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis. METHODS AND ANALYSIS We are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019. ETHICS AND DISSEMINATION This trial was approved and is being conducted according to the protocol approved by The Royal Children's Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER NCT03925480.
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Affiliation(s)
- Maeve Hume-Nixon
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Tupou Ratu
- Asia-Pacific Health, Murdoch Children's Research Institute, Suva, Fiji
| | - Stephanie Clark
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Cattram Duong Nguyen
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Eleanor F G Neal
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Casey L Pell
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kathryn Bright
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Emma Watts
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Hart
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kim Mulholland
- New Vaccines, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Ministry of Health and Medical Services, Suva, Fiji
| | - Eric Rafai
- Ministry of Health and Medical Services, Suva, Fiji
| | | | - Ilisapeci Tuibeqa
- Department of Paediatrics, Colonial War Memorial Hospital, Suva, Fiji
| | - Catherine Satzke
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Translational Microbiology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Steer
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Tropical Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Fiona M Russell
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Asia-Pacific Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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22
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Ahmmed F, Hossain MJ, Sutopa TS, Al-Mamun M, Alam M, Islam MR, Sharma R, Sarker MMR, Azlina MFN. The trend in exclusive breastfeeding practice and its association with maternal employment in Bangladesh: A multilevel analysis. Front Public Health 2022; 10:988016. [PMID: 36504941 PMCID: PMC9732371 DOI: 10.3389/fpubh.2022.988016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
Exclusive breastfeeding (EBF) is essential for infant and child health. This study aimed to explore the trend in the EBF over the last decade in Bangladesh and investigated if there was a significant association with maternal employment by analyzing the data extracted from three consecutive nationally representative surveys: Bangladesh Demographic and Health Surveys (BDHS) of 2011, 2014, and 2017-2018. Prevalence of EBF (95% confidence interval) with the Cochran-Armitage test was reported to see the trend in EBF. A chi-square (χ2) test was applied to find the potential factors associated with EBF. Finally, a three-level logistic regression was utilized to find the significant association between maternal employment and EBF while adjusting other covariates. We observed no increase in the practice of EBF over the last decade (P = 0.632). The prevalence of EBF was 64.9% (95% CI: 61.41, 68.18) in 2011, followed by 60.1% (95% CI: 56.25, 64) in 2014, and 64.9% (95% CI: 61.82, 67.91) in 2017. Regression results showed that employed mothers had 24% (p < 0.05) lower odds of EBF than unemployed mothers. Early initiation of breastfeeding was also found to be significantly associated [Adjusted odds ratio (AOR): 1.22, P < 0.05] with EBF. Government and policymakers must come forward with new interventions to increase the practice of EBF, providing basic education and campaigns on the topic of EBF. Maternity leave should be extended up to 6 months of the child's age to achieve an optimal level of EBF.
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Affiliation(s)
- Foyez Ahmmed
- Department of Statistics, Comilla University, Cumilla, Bangladesh
| | - Md. Jamal Hossain
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh,*Correspondence: Md. Jamal Hossain ;
| | | | - Md. Al-Mamun
- Department of Sociology, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Morshed Alam
- Institute of Education and Research, Jagannath University, Dhaka, Bangladesh
| | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | - Rohit Sharma
- Department of Rasashastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Mohd Fahami Nur Azlina
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,Mohd Fahami Nur Azlina
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23
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Hossain S, Mihrshahi S. Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14804. [PMID: 36429518 PMCID: PMC9691199 DOI: 10.3390/ijerph192214804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.
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24
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Early Life Beef Consumption Patterns Are Related to Cognitive Outcomes at 1–5 Years of Age: An Exploratory Study. Nutrients 2022; 14:nu14214497. [PMID: 36364760 PMCID: PMC9654367 DOI: 10.3390/nu14214497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/25/2022] Open
Abstract
Protein, iron, zinc, and choline affect early brain development and are found in beef. The aims of this study were to describe (1) early feeding practices related to introduction of beef in the rural US west (Idaho); (2) parental perceptions of beef as a first food, and (3) associations between early beef consumption and child cognition at 1–5 years. A total of 61 children and their parents were enrolled. Parents completed a survey and a food frequency questionnaire to assess perceptions of beef and early feeding practices along with their child’s dietary intake at 6–12 months. Children’s cognitive function was assessed using the Bayley-4 Scales of Infant and Toddler Development (12–35 months) and the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) (3–5 years). Parents introduced beef at 7.79 ± 2.65 months of age, primarily so that their children could eat what the family was eating. Higher intake of beef (r = 0.41, p = 0.02), zinc (r = 0.45, p = 0.01), and choline (r = 0.39, p = 0.03) at 6–12 months was associated with better attention and inhibitory control at 3–5 years of age. These findings support the role of beef as an early food for cognitive development, although controlled dietary intervention studies are needed.
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25
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Chellapandi K, Subbarayan S, De Mandal S, Ralte L, Senthil Kumar N, Dutta TK, Sharma I. Beneficial role of skim milk against drug-resistant Escherichia coli associated with pediatric diarrhoea. New Microbes New Infect 2022; 48:100999. [PMID: 35873064 PMCID: PMC9305617 DOI: 10.1016/j.nmni.2022.100999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/04/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background Antibiotic-resistance in E. coli is a global issue affecting humans especially the pediatric population. Antibiotic-resistant E. coli is a pathogen frequently pediatric population as well as healthy adults. Methods This study aimed to examine the antibiotic resistance of E. coli causing pediatric diarrhea and its drug-resistant rates, its adhering abilities to cell line in vitro, and inhibition efficiency of a few selected chemical compounds. Clinical strains were isolated from both the healthy and infected pediatric population of Mizoram. Results Adhesion is a significant pathogenic process during bacterial infections, which has been employed for pathotyping of DEC by comparing adhesion efficiency in both normal (CHO-k1) and cancer (HeLa) cell lines. E. coli adherent pathotypes were identified by both PCR assay and in-vitro cell adhesion assays; the study also evaluated the adhesion inhibition ability of human skimmed milk, gentamicin, and cephalexin in-vitro. Of all isolates, 20.05% of adherent DEC (EPEC, DAEC, and EIEC) and 11.39 % of non-adherent DEC (STEC and ETEC) were found to be associated with pediatric diarrhoea in Mizoram. Human skimmed milk has a high potential adhesion inhibition against EAEC (50.25/90.90 μg/mL), EPEC (53.42/259.70 μg/mL), and EIEC (59.13/30.30 μg/mL) in both cell lines in comparison with gentamicin and cephalexin. Conclusion This study concludes that as a dietary supplement-human skimmed milk has high potential to prevent adhesion of DEC pathotypes in cells in-vitro thus in in-vivo.
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Affiliation(s)
- K Chellapandi
- Dept. of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, 796014, Mizoram, India.,Department of Microbiology, Assam University, Silchar, 788011, Assam, India
| | - S Subbarayan
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - S De Mandal
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - L Ralte
- Department of MLT, RIPANS, Aizawl, 796017, Mizoram, India
| | - N Senthil Kumar
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - T K Dutta
- Dept. of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, 796014, Mizoram, India
| | - I Sharma
- Department of Microbiology, Assam University, Silchar, 788011, Assam, India
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26
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Meek JY, Noble L. Technical Report: Breastfeeding and the Use of Human Milk. Pediatrics 2022; 150:188348. [PMID: 35921641 DOI: 10.1542/peds.2022-057989] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 01/12/2023] Open
Abstract
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding or the provision of human milk a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond. These recommendations are consistent with those of the World Health Organization (WHO). Medical contraindications to breastfeeding are rare. The AAP recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention and The Joint Commission monitor breastfeeding practices in United States hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding. Efforts to improve breastfeeding rates must acknowledge existing disparities and the impact of racism in promoting equity in breastfeeding education, support, and services.
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Affiliation(s)
- Joan Younger Meek
- Department of Clinical Sciences, Florida State University College of Medicine, Orlando, Florida
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York.,New York City Health+Hospitals Elmhurst
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27
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Chitcharoen S, Sivapornnukul P, Payungporn S. Revolutionized virome research using systems microbiology approaches. Exp Biol Med (Maywood) 2022; 247:1135-1147. [PMID: 35723062 PMCID: PMC9335507 DOI: 10.1177/15353702221102895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Currently, both pathogenic and commensal viruses are continuously being discovered and acknowledged as ubiquitous components of microbial communities. The advancements of systems microbiological approaches have changed the face of virome research. Here, we focus on viral metagenomic approach to study virus community and their interactions with other microbial members as well as their hosts. This review also summarizes challenges, limitations, and benefits of the current virome approaches. Potentially, the studies of virome can be further applied in various biological and clinical fields.
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Affiliation(s)
- Suwalak Chitcharoen
- Program in Bioinformatics and Computational Biology, Graduate School, Chulalongkorn University, Bangkok 10330, Thailand,Research Unit of Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Pavaret Sivapornnukul
- Research Unit of Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand,Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sunchai Payungporn
- Research Unit of Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand,Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand,Sunchai Payungporn.
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28
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Abstract
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding, or the provision of human milk, a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond. These recommendations are consistent with those of the World Health Organization (WHO). Medical contraindications to breastfeeding are rare. The AAP recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention (CDC) and The Joint Commission monitor breastfeeding practices in US hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding.
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Affiliation(s)
- Joan Younger Meek
- Department of Clinical Sciences, Florida State University College of Medicine, Orlando, Florida
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, New York.,New York City Health+Hospitals/Elmhurst
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29
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Esteve-Palau E, Gonzalez-Cuevas A, Eugenia Guerrero M, Garcia-Terol C, Carmen Alvarez M, Garcia G, Moreno E, Medina F, Casadevall D, Diaz-Brito V. Quantification and progress over time of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with BNT162b2 Pfizer-BioNTech COVID-19 vaccine (LacCOVID). Open Forum Infect Dis 2022; 9:ofac239. [PMID: 35783685 PMCID: PMC9129184 DOI: 10.1093/ofid/ofac239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Several observational studies demonstrated the passage of postvaccine antibodies through breast milk in women vaccinated against coronavirus disease 2019 (COVID-19), mostly with messenger RNA (mRNA)–based vaccines, but lacked long-term data. Methods A 6-month prospective cohort study was performed to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine–induced antibody levels in the breast milk of 33 lactating healthcare workers at different timepoints after mRNA BNT162b2 Pfizer-BioNTech COVID-19 vaccination. Moreover, we examined the correlation of SARS-CoV-2 antibody levels between serum and breast milk, adverse events related to vaccination, and rate of SARS-CoV-2 infections. Results Mothers’ median age was 38 (interquartile range [IQR], 36–39) years and 15 (IQR, 10–22) months for infants. Median (IQR) SARS-CoV-2 immunoglobulin G (IgG) spike protein subunit S1 (S1) vaccine–induced levels at different timepoints for serum–milk pairs were 519 (234–937) to 1 (0–2.9) arbitrary units (AU)/mL at 2 weeks after first dose and 18 644 (9923–29 264) to 78 (33.7–128), 12 478 (6870–20 801) to 50.4 (24.3–104), 4094 (2413–8480) to 19.9 (10.8–51.9), 1350 (831–2298) to 8.9 (7.8–31.5) AU/mL at 2, 4, 12 and 24 weeks after second dose, respectively. We observed a positive correlation of antibody levels between serum and breast milk, no serious adverse events related to vaccination, and 2 (6%) COVID-19 vaccine breakthrough infections. Conclusions Women vaccinated with Pfizer-BioNTech transmit antibodies into breast milk with a positive correlation with serum levels. Both decreased over time in a 6-month follow-up.
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Affiliation(s)
- Erika Esteve-Palau
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | | | - M. Eugenia Guerrero
- Department of Microbiology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Clara Garcia-Terol
- Department of Obstetrics and Gynecology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - M. Carmen Alvarez
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Geneva Garcia
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Encarna Moreno
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Francisco Medina
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
| | - Vicens Diaz-Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
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30
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Chen HY, Chang YH, Ding DC. The Negative Association between Breastfeeding Duration and Infant Febrile Seizure: A Retrospective Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095495. [PMID: 35564887 PMCID: PMC9105559 DOI: 10.3390/ijerph19095495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022]
Abstract
Two to five percent of infants and children experience febrile seizures (FS). Breastfeeding is beneficial to the health of mothers and children. Nevertheless, the benefits of breastfeeding in reducing FS remain unclear; thus, the present study aimed to evaluate this association. The case group was selected from 2010 to 2019, and the selected population was children younger than 5 years (i.e., children born from 2005−2019). The control group was selected from newborn infants at our hospital born between 2005 and 2019. Finally, 55 children with FS and 110 children in the control group were recruited. The results show longer breastfeeding duration is associated with an increased risk of FS (adjusted odds ratio: 1.06, 95% confidence interval: 1.01−1.11, p = 0.028). When comparing cases of FS with the control group, the percentage of inclusive breastfeeding over 12 months (32.7% vs. 9.1%, p = 0.017) and longer duration of exclusive breastfeeding were higher (10.86 ± 11.82 vs. 5.40 ± 7.17 months, p < 0.001). However, the comparison of the prevalence of FS between the different breastfeeding duration groups did not reach statistical significance. In conclusion, our study showed that a longer breastfeeding duration was associated with a higher risk of FS. Future large-scale studies evaluating the association between breastfeeding duration and febrile seizures are needed.
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Affiliation(s)
- Hsi-Yu Chen
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Hualien 970, Taiwan;
| | - Yu-Hsun Chang
- Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Hualien 970, Taiwan
- Correspondence: (Y.-H.C.); (D.-C.D.); Tel.: +886-3-8561825 (ext. 12228) (Y.-H.C.); +886-3-8561825 (ext. 13383) (D.-C.D.)
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
- Correspondence: (Y.-H.C.); (D.-C.D.); Tel.: +886-3-8561825 (ext. 12228) (Y.-H.C.); +886-3-8561825 (ext. 13383) (D.-C.D.)
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31
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Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, Griffen A, McIntyre L, Byatt N, Moore Simas TA. The Effects of Breastfeeding on Maternal Mental Health: A Systematic Review. J Womens Health (Larchmt) 2022; 31:787-807. [PMID: 35442804 DOI: 10.1089/jwh.2021.0504] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Breastfeeding has many positive effects on the health of infants and mothers, however, the effect of breastfeeding on maternal mental health is largely unknown. The goal of this systematic review was to (1) synthesize the existing literature on the effects of breastfeeding on maternal mental health, and (2) inform breastfeeding recommendations. Materials and Methods: A literature search was conducted in electronic databases using search terms related to breastfeeding (e.g., breastfeeding, infant feeding practices) and mental health conditions (e.g., mental illness, anxiety, depression), resulting in 1,110 records. After reviewing article titles and abstracts, 339 articles were advanced to full-text review. Fifty-five articles were included in the final analysis. Results: Thirty-six studies reported significant relationships between breastfeeding and maternal mental health outcomes, namely symptoms of postpartum depression and anxiety: 29 found that breastfeeding is associated with fewer mental health symptoms, one found it was associated with more, and six reported a mixed association between breastfeeding and mental health. Five studies found that breastfeeding challenges were associated with a higher risk of negative mental health symptoms. Conclusions: Overall, breastfeeding was associated with improved maternal mental health outcomes. However, with challenges or a discordance between breastfeeding expectations and actual experience, breastfeeding was associated with negative mental health outcomes. Breastfeeding recommendations should be individualized to take this into account. Further research, specifically examining the breastfeeding experiences of women who experienced mental health conditions, is warranted to help clinicians better personalize breastfeeding and mental health counseling.
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Affiliation(s)
- Megan Yuen
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Olivia J Hall
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Grace A Masters
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Catherine Carr
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Leung
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Adrienne Griffen
- Maternal Mental Health Leadership Alliance, Arlington, Virginia, USA
| | | | - Nancy Byatt
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
| | - Tiffany A Moore Simas
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
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Domenici R, Vierucci F. Exclusive Breastfeeding and Vitamin D Supplementation: A Positive Synergistic Effect on Prevention of Childhood Infections? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052973. [PMID: 35270666 PMCID: PMC8910000 DOI: 10.3390/ijerph19052973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health.
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33
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Moyo GT, Thomas-Jackson SC, Childress A, Dawson J, Thompson LD, Oldewage-Theron W. Chrononutrition and Human Milk. CLINICAL LACTATION 2022. [DOI: 10.1891/cl.2021-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundBreastfed infants have a reduced risk of infections and allergies. The study of chrononutrition in human milk seeks to understand the circadian variation of various human milk immune factors.MethodsEmpirical studies on human milk, chrononutrition, and immune factors were searched through PUBMED, Google Scholar, and SCOPUS. Keywords included “chrononutrition,” “breastmilk composition,” “human milk,” “day-night cycles,” “sleep-wake cycles” and the names of various immune factors. After excluding duplicate articles, animal studies, studies looking at other human milk components, studies that did not collect human milk samples over a 24 hour period, and studies that were not in English, eleven studies on the topic remained and ten studies were included in the review. The excluded study had a sample size of two.ResultsThis review identified the circadian variation of certain immune factors found in human milk such as antibodies, complement proteins, cytokines, by-products of phagocyte activity, nucleotides, microRNAs, and antioxidants.ConclusionThe circadian variation observed in some human milk components highlights the unique ability of human milk to vary in composition based on the circadian rhythms of mothers and infants. The limited number of studies makes it difficult to make conclusive recommendations and creates an opportunity for further research in this growing field.
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Santosa A, Novanda Arif E, Abdul Ghoni D. Effect of maternal and child factors on stunting: partial least squares structural equation modeling. Clin Exp Pediatr 2022; 65:90-97. [PMID: 33957035 PMCID: PMC8841971 DOI: 10.3345/cep.2021.00094] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/27/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Stunting is affected by various factors from mother and child. Previous studies assessed only one or more influencing variables. Unfortunately, nor the significant influence of maternal and child factors nor the indicators contributing to maternal and child factors that affect the stunting incidence have ever been analyzed. PURPOSE This study analyzed the effect of maternal and child factors on stunting and the significant indicators that shape the maternal and child factors that impact stunting. METHODS This was a case-control study. Overall, 132 stunted children and 132 nonstunted children in Purbalingga Regency, Central Java Province, participated in the research. Direct interviews and medical record reviews were conducted to assess the studied variables. The research data were tested using the partial least squares structural equation with a formative model. RESULTS Maternal factors directly affected the occurrence of stunting (t=3.527, P<0.001) with an effect of 30.3%. Maternal factors also contributed a significant indirect effect on stunting through child factors (t=4.762, P<0.001) with an effect of 28.2%. Child factors affected the occurrence of stunting (t= 5.749, P<0.001) with an effect of 49.8%. The child factor was influenced by maternal factor with an effect of 56.7% (t=10.014, P<0.001). The moderation analysis results demonstrated that maternal and child factors were moderate predictive variables of stunting occurrence. CONCLUSION Child factors have more significant and direct effects on stunting than maternal factors but are greatly affected by them.
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Affiliation(s)
- Agus Santosa
- Universitas Muhammadiyah Purwokerto, Purwokerto, Indonesia
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35
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Zhang B, Li LQ, Liu F, Wu JY. Human milk oligosaccharides and infant gut microbiota: Molecular structures, utilization strategies and immune function. Carbohydr Polym 2022; 276:118738. [PMID: 34823774 DOI: 10.1016/j.carbpol.2021.118738] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022]
Abstract
Human milk oligosaccharides (HMOs) are a unique class of non-digestible carbohydrates present in the mother milk, which play a key role in the development of infant gut microbiota, epithelial barrier and immune function. The deficiency of HMOs in the bovine milk-based infant formula has been widely recognized as a major culprit for the much higher incidence of immune disorders of formula-fed infants. This report was to give an up-to-date review on the structure characteristics of HMOs and the possible mechanisms, and strategies for their cellular uptake, and metabolism by the gut bacteria and the associated effects on the infant gut microbiome, and immune function. Most previous studies have been carried out in animals or in vitro model systems on the utilization strategies for HMOs in infant bacteria and their roles in infant microbiome, and gut immune function. A few HMO molecules have been synthesized artificially and applied in infant formulas.
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Affiliation(s)
- Bin Zhang
- SCUT-Zhuhai Institute of Modern Industrial Innovation, School of Food Science and Engineering, Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health, South China University of Technology, Guangzhou 510640, China; Research Institute for Future Food, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Long-Qing Li
- Research Institute for Future Food, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Feitong Liu
- H&H Group Global Research and Technology Center, Guangzhou 510700, China.
| | - Jian-Yong Wu
- Research Institute for Future Food, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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36
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Branger B, Bainier A, Martin L, Darviot E, Forgeron A, Sarthou L, Wagner AC, Blanchais T, Brigly T, Troussier F. Breastfeeding and respiratory, ear and gastro-intestinal infections, in children, under the age of one year, admitted through the paediatric emergency departments of five hospitals. Front Pediatr 2022; 10:1053473. [PMID: 36874253 PMCID: PMC9975383 DOI: 10.3389/fped.2022.1053473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/19/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Breastfeeding is a protective factor against respiratory and intestinal infections in developing countries. In developed countries, proof of this protection is more difficult to show. The objective of the study is to compare the proportion of children breastfed during their first year in groups of children with infectious pathologies supposedly prevented by breastfeeding and children free of these infectious pathologies. METHOD Questionnaires about diet, socio-demographic data and the motive for consultation were given to the parents upon arrival in the paediatric emergency departments of 5 hospitals located in Pays de Loire (France) in 2018 and 2019. Children with lower respiratory tract infections, acute gastroenteritis and acute otitis media were included in the case group (A), children admitted for other reasons were included in the same control group (B). Breastfeeding was classified as exclusive or partial. RESULTS During the study period, 741 infants were included, of which 266 (35.9%) in group A. In this group, children were significantly less likely to have been breastfed at the time of admission than children in group B: for example, for children under 6 months, 23.3% were currently breastfed in group A, vs. 36.6% (weaned BF or formula diet) in group B [OR = 0.53 (0.34-0.82); p = 0.004]. Similar results were found at 9 and 12 months. After taking into account the age of the patients, the same results were confirmed with an aOR = 0.60 (0.38-0.94) (p = 0.02) at 6 months, but with when considering six variables six variables, aOR was not significative aOR = 0.65 (0.40-1.05); p = 0.08), meaning that factors such as the childcare out of home, socio-professional categories, and the pacifier decrease the protective effect of breastfeeding. Sensitivity analyses (age-matching, analysis by type of infection) showed the same protection effect provided by breastfeeding when it was pursued for at least 6 months and also that the protective effect of breastfeeding is especially true against gastro-enteritis. CONCLUSION Breastfeeding is a protective factor against respiratory, gastrointestinal and ear infections when pursued at least 6 months after birth. Other factors such as collective childcare, pacifiers and low parental professional status can reduce the protective effect of breastfeeding.
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Affiliation(s)
| | - Amaïa Bainier
- Department of Pediatrics, Centre Hospitalier Universitaire, Angers, France.,Department of Pediatrics, Centre Hospitalier Robert Bisson, Lisieux, France
| | | | - Estelle Darviot
- Department of Pediatrics, Centre Hospitalier Universitaire, Angers, France
| | - Aude Forgeron
- Department of Pediatrics, Centre Hospitalier, Le Mans, France
| | - Laurent Sarthou
- Department of Pediatrics, Centre Hospitalier, Cholet, France
| | | | - Thomas Blanchais
- Paediatrician, Centre Hospitalier, Boulevard Stéphane Moreau, La Roche-sur-Yon, Nantes, France.,Department of Pediatrics, Nantes, France
| | - Thomas Brigly
- Department of Pediatrics, Centre Hospitalier Universitaire, Angers, France.,Department of Pediatrics, Saint-Jean-de-Védas, France
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Sumantri E, Hidayanty H, Gustin D, Handayani S. Determinant factors of weight status among under two years children received the complementary feeding program. GACETA SANITARIA 2021; 35 Suppl 2:S370-S373. [PMID: 34929853 DOI: 10.1016/j.gaceta.2021.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The study explored determinant factors of weight status among children aged 12-24 months who received complementary feeding program of the Ministry of Health in Luwu Timur, South Sulawesi Province. METHODS The study used case-control design. It involved 82 children from poor families who received complementary feeding program. Forty-one children as a case group with constant body weight and forty-one children as a control group with increasing body weight within the last two months selected with a purposive sampling technique. RESULTS Exclusive breastfeeding (OR=3.485; 95% CI=1.380-8.798), the duration of complementary feeding consumption (OR=0.299; 95% CI=0.095-0.939), history of diarrhea (OR=3.071; 95% CI=1.174-8.028) and milk consumption pattern (OR=0.233; 95% CI=0.069-0.791) were significant determinant of body weight status. Exclusive breastfeeding was the most dominant variable for body weight status (B=6.152). CONCLUSIONS Exclusive breastfeeding during the first six months is crucial to support complementary feeding programs in increasing the body weight status of children aged 12-24 months.
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Affiliation(s)
- Eha Sumantri
- Public Health Study Program, Tamalatea College of Health Sciences, Makassar, Indonesia
| | - Healthy Hidayanty
- Nutrition Science Department, Public Health Faculty, Universitas Hasanuddin, Makassar, Indonesia.
| | - Deli Gustin
- Magister Study Program, Tamalatea College of Health Sciences, Makassar, Indonesia
| | - Sri Handayani
- Public Health Study Program, Tamalatea College of Health Sciences, Makassar, Indonesia
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Lechosa-Muñiz C, Paz-Zulueta M, Mendez-Legaza JM, Irure-Ventura J, Cuesta González R, Calvo Montes J, López-Hoyos M, Llorca J, Cabero-Pérez MJ. Induction of SARS-CoV-2-Specific IgG and IgA in Serum and Milk with Different SARS-CoV-2 Vaccines in Breastfeeding Women: A Cross-Sectional Study in Northern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168831. [PMID: 34444579 PMCID: PMC8393848 DOI: 10.3390/ijerph18168831] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
Breastfeeding mothers were excluded from the clinical trials conducted for vaccines against SARS-CoV-2. Since the start of the vaccination, some doubts have arisen regarding its compatibility with breastfeeding. The aim of this study was to analyse the presence of anti-SARS-CoV-2 antibodies in breast milk and serum (IgG and IgA) of vaccinated breastfeeding women. The main variables of the observational study were: adverse related events after vaccination and determination of the presence of IgG and IgA isotypes antibodies in serum and in breast milk of vaccinated women against the SARS-CoV-2 antigens. Results: 110 breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) with two doses of mRNA-1273, and 20 women (18.2%) with a single dose of ChAdOx1-S. Regarding adverse reactions and vaccine safety, 38 women had no adverse reactions; 20 (18.2%) had general malaise or adenopathies; 10 (9.1%) had a headache; and 7 (6.4%) had fever. When analysing IgG antibodies, significantly higher levels of antibodies were found in serum and breast milk from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (p < 0.001 and p = 0.001, respectively). Analysing IgA antibodies, significant differences were found when comparing mean values in serum from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (0.12, 0.16, and 0.02, respectively; p < 0.001) and breast milk of mothers vaccinated when comparing BNT16b2 vs. ChAdOx1-S. All vaccinated breastfeeding mothers had serum anti-S1 IgG antibodies in response to vaccination against SARS-CoV-2, regardless of the commercial vaccine administered. Conclusions: the anti-SARS-CoV-2 vaccines were well tolerated by the mothers and the breastfed infant. In addition, breastfeeding mothers offer their infants IgA and IgG isotype antibodies directed against SARS-CoV-2 protein S in breast milk.
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Affiliation(s)
- Carolina Lechosa-Muñiz
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Cantabria, Spain;
- Breastfeeding Coordinator, IBCLC, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain
| | - María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Cantabria, Spain;
- Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, IDIVAL, C/ Cardenal Herrera Oria s/n. C.P., 39011 Santander, Cantabria, Spain
- Correspondence:
| | - Jose Manuel Mendez-Legaza
- Department of Microbiology, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain; (J.M.M.-L.); (J.C.M.)
| | - Juan Irure-Ventura
- Department of Immunology, Hospital Universitario Marqués de Valdecilla, IDIVAL, C.P., 39008 Santander, Cantabria, Spain; (J.I.-V.); (M.L.-H.)
| | - Rocío Cuesta González
- Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain;
| | - Jorge Calvo Montes
- Department of Microbiology, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain; (J.M.M.-L.); (J.C.M.)
| | - Marcos López-Hoyos
- Department of Immunology, Hospital Universitario Marqués de Valdecilla, IDIVAL, C.P., 39008 Santander, Cantabria, Spain; (J.I.-V.); (M.L.-H.)
- Laboratory, Molecular Biology Department, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain
| | - Javier Llorca
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain; (J.L.); (M.J.C.-P.)
- CIBER Epidemiology and Public Health (CIBERESP), C.P., 28029 Madrid, Spain
| | - María Jesús Cabero-Pérez
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain; (J.L.); (M.J.C.-P.)
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain
- IDIVAL, C/ Cardenal Herrera Oria s/n. C.P., 39011 Santander, Cantabria, Spain
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Sangild PT, Strunk T, Currie AJ, Nguyen DN. Editorial: Immunity in Compromised Newborns. Front Immunol 2021; 12:732332. [PMID: 34381463 PMCID: PMC8350506 DOI: 10.3389/fimmu.2021.732332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Per T. Sangild
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
- Department of Neonatology, Rigshospitalet, Copenhagen, Denmark
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
| | - Tobias Strunk
- Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, Perth, WA, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- Neonatal Directorate, Child and Adolescent Health Service, Western, Australia
| | - Andrew J. Currie
- Neonatal Directorate, Child and Adolescent Health Service, Western, Australia
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, WA, Australia
| | - Duc Ninh Nguyen
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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Westmark CJ. Consumption of Breast Milk Is Associated with Decreased Prevalence of Autism in Fragile X Syndrome. Nutrients 2021; 13:nu13061785. [PMID: 34073785 PMCID: PMC8225095 DOI: 10.3390/nu13061785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
Breastfeeding is associated with numerous health benefits, but early life nutrition has not been specifically studied in the neurodevelopmental disorder fragile X syndrome (FXS). Herein, I evaluate associations between the consumption of breast milk during infancy and the prevalence of autism, allergies, diabetes, gastrointestinal (GI) problems and seizures in FXS. The study design was a retrospective survey of families enrolled in the Fragile X Online Registry and Accessible Research Database (FORWARD). There was a 1.7-fold reduction in the prevalence of autism in FXS participants who were fed breast milk for 12 months or longer. There were strong negative correlations between increased time the infant was fed breast milk and the prevalence of autism and seizures and moderate negative correlations with the prevalence of GI problems and allergies. However, participants reporting GI problems or allergies commenced these comorbidities significantly earlier than those not fed breast milk. Parsing the data by sex indicated that males exclusively fed breast milk exhibited decreased prevalence of GI problems and allergies. These data suggest that long-term or exclusive use of breast milk is associated with reduced prevalence of key comorbidities in FXS, although breast milk is associated with the earlier development of GI problems and allergies.
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Affiliation(s)
- Cara J. Westmark
- Department of Neurology, University of Wisconsin, Madison, WI 53706, USA; ; Tel.: +1-608-262-9730
- Molecular & Environmental Toxicology Center, University of Wisconsin, Madison, WI 53706, USA
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Laube R, Paramsothy S, Leong RW. Review of pregnancy in Crohn's disease and ulcerative colitis. Therap Adv Gastroenterol 2021; 14:17562848211016242. [PMID: 34046084 PMCID: PMC8135214 DOI: 10.1177/17562848211016242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/19/2021] [Indexed: 02/04/2023] Open
Abstract
Inflammatory bowel disease (IBD) frequently affects women of childbearing age and can have implications in pregnancy. Most women with IBD have comparable fertility with women in the general population. Fertility is reduced in women with active disease or previous ileal-pouch-anal anastomosis (IPAA) surgery and is temporarily reduced in men taking sulfasalazine. Women with IBD have an increased risk of preterm delivery, low birth weight, small-for-gestational-age infants and Cesarean section (CS) delivery, however, no increased risk of congenital abnormalities. These adverse outcomes are particularly prevalent for women with active IBD compared with those with quiescent disease. Conception should occur during disease remission to optimize maternal and fetal outcomes and reduce the risk of disease exacerbations during pregnancy. Pre-conception counseling is therefore pertinent to provide patient education, medication review for risk of teratogenicity and objective disease assessment. Most medications are safe during pregnancy and breastfeeding, with the exception of methotrexate, ciclosporin, allopurinol and tofacitinib. Delivery modality should be guided by obstetric factors in most cases; however, CS is recommended for women with active perianal disease and can be considered for women with inactive perianal disease or IPAA. In conclusion, most women with IBD have uncomplicated pregnancies. Active IBD is the predominant predictor of poor outcomes and disease exacerbations; therefore, maintenance of disease remission during and before pregnancy is crucial.
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Affiliation(s)
- Robyn Laube
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
- Department of Gastroenterology, Macquarie University Hospital, Sydney, NSW, Australia
| | - Sudarshan Paramsothy
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
- Department of Gastroenterology, Macquarie University Hospital, Sydney, NSW, Australia
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia
| | - Rupert W. Leong
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2137, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
- Department of Gastroenterology, Macquarie University Hospital, Sydney, NSW, Australia
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Moubareck CA. Human Milk Microbiota and Oligosaccharides: A Glimpse into Benefits, Diversity, and Correlations. Nutrients 2021; 13:1123. [PMID: 33805503 PMCID: PMC8067037 DOI: 10.3390/nu13041123] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Human milk represents a cornerstone for growth and development of infants, with extensive array of benefits. In addition to exceptionally nutritive and bioactive components, human milk encompasses a complex community of signature bacteria that helps establish infant gut microbiota, contributes to maturation of infant immune system, and competitively interferes with pathogens. Among bioactive constituents of milk, human milk oligosaccharides (HMOs) are particularly significant. These are non-digestible carbohydrates forming the third largest solid component in human milk. Valuable effects of HMOs include shaping intestinal microbiota, imparting antimicrobial effects, developing intestinal barrier, and modulating immune response. Moreover, recent investigations suggest correlations between HMOs and milk microbiota, with complex links possibly existing with environmental factors, genetics, geographical location, and other factors. In this review, and from a physiological and health implications perspective, milk benefits for newborns and mothers are highlighted. From a microbiological perspective, a focused insight into milk microbiota, including origins, diversity, benefits, and effect of maternal diet is presented. From a metabolic perspective, biochemical, physiological, and genetic significance of HMOs, and their probable relations to milk microbiota, are addressed. Ongoing research into mechanistic processes through which the rich biological assets of milk promote development, shaping of microbiota, and immunity is tackled.
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Affiliation(s)
- Carole Ayoub Moubareck
- College of Natural and Health Sciences, Zayed University, Dubai 19282, United Arab Emirates
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43
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Lucas R, Zhang Y, Walsh SJ, Starkweather A, Young E. OXTR rs53576 Variation with Breast and Nipple Pain in Breastfeeding Women. Pain Manag Nurs 2020; 22:369-376. [PMID: 33303340 DOI: 10.1016/j.pmn.2020.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/18/2020] [Accepted: 09/14/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Thirty percent of women who seek professional breastfeeding support require assistance with ongoing breast and nipple pain and < 50% of women report resolution of their pain. It is unknown if there is a molecular risk for ongoing breast and nipple pain during breastfeeding. Aim -To evaluate associations among breast and nipple pain sensitivity and candidate pain sensitivity single-nucleotide polymorphisms [SNPs], (COMT rs6269, rs4633, rs4818, rs4680 and OXTR rs2254298, rs53576) in breastfeeding women. Design - A secondary analysis of a pilot randomized controlled trial of a pain self-management intervention conducted over 6 weeks postpartum. Setting and Participants - Sixty women were recruited from two hospital settings after birth. Methods - All participants underwent standardized mechanical somatosensory testing for an assessment of pain sensitivity and provided baseline buccal swabs for genetic analysis. At 1, 2, and 6 weeks postpartum, women self-reported breast and nipple pain severity using a visual analogue scale. Results - Women with the minor allele OXTR rs53576 reported 8.18-fold higher breast and nipple pain severity over time. For every 1-unit increase in Mechanical detection threshold and windup ratio, women reported 16.51-fold and 4.82-fold higher breast and nipple pain severity respectively. Six women with the OXTR rs2254298 minor allele reported allodynia. Conclusion - The presence of OXTR alleles in women with enhanced pain sensitivity suggests a phenotype of genetic risk for ongoing breast and nipple with potential for pain-associated breastfeeding cessation. Somatosensory testing identified women who reported higher breast and nipple pain during the first weeks of breastfeeding.
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Affiliation(s)
- Ruth Lucas
- University of Connecticut School of Nursing, Storrs, Connecticut.
| | - Yiming Zhang
- University of Connecticut School of Nursing, Storrs, Connecticut
| | - Stephen J Walsh
- University of Connecticut School of Nursing, Storrs, Connecticut
| | | | - Erin Young
- University of Connecticut School of Nursing, Storrs, Connecticut; University of Kansas Medical Center, Kansas City, Kansas
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Christensen N, Bruun S, Søndergaard J, Christesen HT, Fisker N, Zachariassen G, Sangild PT, Husby S. Breastfeeding and Infections in Early Childhood: A Cohort Study. Pediatrics 2020; 146:peds.2019-1892. [PMID: 33097658 DOI: 10.1542/peds.2019-1892] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Studies on the association between breastfeeding and infections in children beyond the first year of life reveal conflicting results. In a population-based birth cohort, we investigated whether the duration of breastfeeding was associated with the number of hospitalizations due to infection and symptoms of infection at home. METHODS In the Odense Child Cohort, text message questionnaires were used to register information on breastfeeding (weekly until end of weaning) and symptoms of infection (biweekly; 12-36 months of age). Hospitalization data were obtained from the Danish National Patient Registry. RESULTS Of the 1087 invited, 815 mother-infant pairs were included. The median duration of any breastfeeding was 7.6 (interquartile range: 3.5-10.4) months and of exclusive breastfeeding was 2.1 (interquartile range: 0.7-4.4) months. Hospitalization due to infection was seen in 207 (25.4%) infants during the first 3 years of life. The adjusted incidence rate ratio (IRR) for hospitalization due to any infection decreased with a longer duration of any breastfeeding (adjusted IRR: 0.96; 95% confidence interval 0.93-0.99; P < .001). The strongest associations between the duration of any breastfeeding and hospitalizations due to infection were found within the first year of life, for lower respiratory tract infections, and other infections (P ≤ .05). For infants exclusively breastfed, the adjusted IRR for hospitalization was 0.88 (95% confidence interval: 0.80-0.96; P = .006). No protective associations were present between breastfeeding and infection symptoms registered at home from ages 12 to 36 months. CONCLUSIONS The results suggest that increased duration of breastfeeding, especially exclusive breastfeeding, protects against infections requiring hospitalization in the first year of life but not hospitalizations or symptoms of infection at home beyond the first year.
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Affiliation(s)
- Nikolas Christensen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences and
| | - Signe Bruun
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences and.,Strategic Business Unit Pediatric, Arla Foods Ingredients Group P/S, Viby, Denmark; and
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henrik Thybo Christesen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences and
| | - Niels Fisker
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences and
| | - Gitte Zachariassen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences and
| | - Per Torp Sangild
- Department of Clinical Research, Faculty of Health Sciences and.,Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; .,Department of Clinical Research, Faculty of Health Sciences and
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Peng X, Yao BZ, Wang S, Yu SQ, Fang CC, Xu YM. The Protective Effect of Breastfeeding on Febrile Seizures: A Case-Control Study. Breastfeed Med 2020; 15:709-714. [PMID: 32896162 DOI: 10.1089/bfm.2020.0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Our study was performed to analyze the interrelationship between breastfeeding for the first 6 months of life and the incidence of febrile seizures (FS). Study Design: A case-control study was conducted in Renmin Hospital of Wuhan University. Three hundred thirty-six patients diagnosed with FS were enrolled as the case group, and 336 febrile children with matched age and gender were enrolled as the control group. Clinical information of all cases was collected from the Electronic Medical Record, including feeding patterns. The primary outcome was the difference of feeding modes between cases and controls, while the secondary outcome included the difference of feeding patterns between simple FS (SFS) and complex FS (CFS). Results: The 336 patients with FS comprised 294 with SFS and 42 with CFS. The difference in feeding methods between the case group and the control group was statistically significant, and children who were breastfed exclusively had a lower risk of suffering from FS compared with formula feeding (odds ratio [OR], 0.504 and 95% confidence interval [CI], 0.303-0.841); although partial breastfeeding exhibited a slight protective effect against FS, the protective role was not statistically significant (OR, 1.016 and 95% CI, 0.560-1.846). In addition, our dates showed that feeding mode was not a risk factor in the occurrence of SFS or CFS (p > 0.05). Conclusion: Our data confirm that exclusive breastfeeding is an independent protective factor that can reduce the occurrence of FS.
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Affiliation(s)
- Xia Peng
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Bao-Zhen Yao
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Shun Wang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Shi-Qian Yu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Cong-Cong Fang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yu-Ming Xu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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46
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Tomori C, Gribble K, Palmquist AE, Ververs M, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. MATERNAL & CHILD NUTRITION 2020; 16:e13033. [PMID: 32458558 PMCID: PMC7267086 DOI: 10.1111/mcn.13033] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 12/16/2022]
Abstract
The World Health Organization (WHO) has provided detailed guidance on the care of infants of women who are persons under investigation (PUI) or confirmed to have COVID-19. The guidance supports immediate post-partum mother-infant contact and breastfeeding with appropriate respiratory precautions. Although many countries have followed WHO guidance, others have implemented infection prevention and control (IPC) policies that impose varying levels of post-partum separation and discourage or prohibit breastfeeding or provision of expressed breast milk. These policies aim to protect infants from the potential harm of infection from their mothers, yet they may fail to fully account for the impact of separation. Global COVID-19 data are suggestive of potentially lower susceptibility and a typically milder course of disease among children, although the potential for severe disease in infancy remains. Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding-a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post-discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long-standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS-CoV-2-positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world. Health services must consider the short-andlong-term impacts of separating mothers and infants in their policies.
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Affiliation(s)
- Cecília Tomori
- Johns Hopkins School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Karleen Gribble
- School of Nursing and MidwiferyWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Aunchalee E.L. Palmquist
- Gillings School of Global Public Health, Carolina Global Breastfeeding InstituteUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Mija‐Tesse Ververs
- Johns Hopkins Bloomberg School of Public Health, Center for Humanitarian HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Marielle S. Gross
- Johns Hopkins Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
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JANSEN SUSIANA, WASITYASTUTI WIDYA, ASTARINI FAJARDWI, HARTINI SRI. Mothers' knowledge of breastfeeding and infant feeding types affect acute respiratory infections. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E401-E408. [PMID: 33150229 PMCID: PMC7595061 DOI: 10.15167/2421-4248/jpmh2020.61.3.1499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023]
Abstract
Introduction World Health Organization (WHO) recommends exclusive breastfeeding for new-borns until 6 months of age. However, exclusive breastfeeding in Indonesia only reached 52.3% in 2014 and 65.16% in 2018. It is known that administration of infant formula and non-formula supplements to infants aged less than 6 months increases the risk of Acute Respiratory Infections (ARIs). In addition, the high prevalence of ARIs in infants in Sleman Regency, Indonesia indicates the need of optimal early prevention. Therefore, we conducted this study to confirm that mothers’ knowledge of breastfeeding and infant feeding types affect the prevalence of Acute Respiratory Infections (ARIs). Methods Data were collected through questionnaires from 50 mothers with infants aged 7-12 months who had experienced ARIs in the last 3 months (case group) and 50 mothers with healthy infants (control group). Collected data were then analysed using Chi-Square, Logistic Regression, Lambda, and Somers’ D tests. Results The results showed that types of infant feeding are associated with the prevalence of ARIs. Non-breastfed infants were 14 times riskier to contract ARIs. Mothers’ knowledge of exclusive breastfeeding influenced their preferences of feeding practice. However, their attitude towards breastfeeding did not appear to significantly affect their choices of feeding practice. Conclusions Exclusive breastfeeding during the first 6 months of an infant’s life can lower the prevalence of ARIs for when they are older. Mothers’ good knowledge of breastfeeding is associated with its practice.
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Affiliation(s)
- SUSIANA JANSEN
- PELNI Nursing Academy of Jakarta, Indonesia
- Master in Nursing Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - WIDYA WASITYASTUTI
- Department of Physiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
- Correspondence: Widya Wasityastuti, Department of Physiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Jl. Farmako, Senolowo, Sekip Utara, Mlati, Kabupaten Sleman, Daerah Istimewa Yogyakarta 55281, Indonesia - Tel. +62-274-6492492 - Fax. +62-274-631185 - E-mail:
| | - FAJAR DWI ASTARINI
- Master in Biomedical Sciences, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - SRI HARTINI
- Department of Pediatric Nursing and Maternity, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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48
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Is it compatible with breastfeeding? www.e-lactancia.org: Analysis of visits, user profile and most visited products. Int J Med Inform 2020; 141:104199. [DOI: 10.1016/j.ijmedinf.2020.104199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/08/2020] [Accepted: 05/24/2020] [Indexed: 12/12/2022]
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Rana MM, Islam MR, Karim MR, Islam AZ, Haque MA, Shahiduzzaman M, Hossain MG. Knowledge and practices of exclusive breastfeeding among mothers in rural areas of Rajshahi district in Bangladesh: A community clinic based study. PLoS One 2020; 15:e0232027. [PMID: 32384096 PMCID: PMC7209213 DOI: 10.1371/journal.pone.0232027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 04/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background World Health Organization (WHO) suggests that exclusive breastfeeding (EBF) is the best nutrition for the neonate. Still, it remains a big challenge to establish EBF not only in Bangladesh but also in any developing countries. Objective The aim of this study was to determine the level of knowledge and practices on EBF and its relationship between different socioeconomic and demographic factors among mothers having at least one child of aged 6–12 months in the rural area of Rajshahi District, Bangladesh. Methodology A community clinic (CC) based study has been conducted by using semi-structured questionnaire. A total of 513 mothers having at least one child aged 6–12 months from 32 different CC in the rural area of Rajshahi District, Bangladesh during September to December 2015. A composite index, chi-square test, and logistic regression model were utilized in this study. Results The prevalence of knowledge and practices on EBF were 34.5% and 27.9% among mothers having at least one child aged 6–12 months. From the analyses, mothers age of ≥21 years were (adjusted odds ratio (AOR) = 13.840, 95% CI: 7.394–25.904; p<0.001) times more likely to have knowledge on EBF and (AOR = 0.084, 95% CI: 0.050–0.143; p<0.05) times less likely to have practices of EBF compared to mother’s age ≤20 years. Service holders mothers were (AOR = 9.992, 95% CI: 4.485–22.260, p<0.05) times more likely to have practices than that of house wife. Home delivery mothers was (AOR = 0.208, 95% CI: 0.111–0.389; p<0.05) times less likely to have practices of EBF than that of the hospital delivery mothers. Those mothers monthly family income ≥10,000 Bangladeshi taka (BDT) currency was (AOR = 0.092, 95% CI: 0.050–0.168, p<0.05) times less likely to have practices of EBF compared to their counterparts. Conclusions This study was found poor knowledge and practices on EBF. This study suggested that education and EBF related intervention could play an important role to increase good knowledge and practices on EBF among mothers. Malnutrition will be decreased if EBF was widely established in Bangladesh.
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Affiliation(s)
- Md. Masud Rana
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md. Rafiqul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
- * E-mail:
| | - Md. Reazul Karim
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Ahmed Zohirul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | | | - Md. Shahiduzzaman
- Department of Electrical and Electronic Engineering, Northern University, Dhaka, Bangladesh
| | - Md. Golam Hossain
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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50
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Sorce LR, Curley MAQ, Kleinpell R, Swanson B, Meier PP. Mother's Own Milk Feeding and Severity of Respiratory Illness in Acutely Ill Children: An Integrative Review. J Pediatr Nurs 2020; 50:5-13. [PMID: 31670137 DOI: 10.1016/j.pedn.2019.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 03/25/2019] [Accepted: 09/10/2019] [Indexed: 12/19/2022]
Abstract
PROBLEM Breastfed infants experience less severe infections while actively breastfeeding. However, little is known about whether a history of prior breastfeeding affects severity of illness. Therefore, the purpose of this integrative review was to examine the relationship between previous exposure to mother's own milk (MOM) feeding and severity of respiratory infectious illness in infants and children. ELIGIBILITY CRITERIA Studies meeting the following criteria were included: human subjects, term birth, ages 0-35 months at time of study, diagnosis of pneumonia, bronchiolitis or croup, MOM feeding, and statistical analyses reporting separate respiratory infectious illness outcomes when combined with other infections. SAMPLE Twelve articles met eligibility criteria. RESULTS Major findings were inconsistent definitions of both dose and exposure period of breastfeeding and the severity of illness. In particular, the severity of illness measure was limited by the use of proxy variables such as emergency room visits or hospitalizations that lacked reliability and validity. However, given this limitation, the data suggested that exclusive breastfeeding for four to six months was associated with reduced severity of illness as measured by frequency of visits to the primary care provider office, emergency department or hospitalization. CONCLUSIONS Future research in this area should incorporate reliable and valid measures of MOM dose and exposure period and severity of illness outcomes in the critically ill child. IMPLICATIONS Among many positive outcomes associated with breastfeeding, an additional talking point for encouragement of exclusive breastfeeding for four to six months may be protective against severe respiratory infectious illness after cessation of breastfeeding.
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Affiliation(s)
- Lauren R Sorce
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
| | - Martha A Q Curley
- Ruth M. Colket Endowed Chair in Pediatric Nursing, Children's Hospital of Philadelphia, University of Pennsylvania School of Nursing, Anesthesia and Critical Care Medicine - Perelman School of Medicine, Philadelphia, PA USA.
| | - Ruth Kleinpell
- Rush University College of Nursing, Nashville, TN USA; Vanderbilt University School of Nursing, Nashville, TN USA.
| | - Barbara Swanson
- Adult Health & Gerontological Nursing, Nursing Science Studies, Journal of the Association of Nurses in AIDS Care, Rush University College of Nursing, Chicago, IL USA.
| | - Paula P Meier
- Neonatal Intensive Care, Pediatrics, Women, Children and Family Nursing, Rush University Medical Chicago, IL USA.
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