Breastfeeding's protection against illness-induced anorexia is mediated partially by docosahexaenoic acid

The "weanling's dilemma" revisited: Evolving bodies of evidence and the problem of infant paleodietary interpretation

Breastfeeding is known to be a powerful mediator of maternal and childhood health, with impacts throughout the life course. Paleodietary studies of the past 30 years have accordingly taken an enduring interest in the health and diet of young children as a potential indicator of population fertility, subsistence, and mortality patterns. While progress has been made in recent decades toward acknowledging the agency of children, many paleodietary reconstructions have failed to incorporate developments in cognate disciplines revealing synergistic dynamics between maternal and offspring biology. Paleodietary interpretation has relied heavily on the "weanling's dilemma," in which infants are thought to face a bleak choice between loss of immunity or malnutrition. Using a review of immunological and epidemiological evidence for the dynamic and supportive role that breastfeeding plays throughout the complementary feeding period, this article offers context and nuance for understanding past feeding transitions. We suggest that future interpretative frameworks for infant paleodietary and bioarchaeological research should include a broad knowledge base that keeps pace with relevant developments outside of those disciplines.

Prospects on the Use of Schizochytrium sp. to Develop Oral Vaccines

Although oral subunit vaccines are highly relevant in the fight against widespread diseases, their high cost, safety and proper immunogenicity are attributes that have yet to be addressed in many cases and thus these limitations should be considered in the development of new oral vaccines. Prominent examples of new platforms proposed to address these limitations are plant cells and microalgae. Schizochytrium sp. constitutes an attractive expression host for vaccine production because of its high biosynthetic capacity, fast growth in low cost culture media, and the availability of processes for industrial scale production. In addition, whole Schizochytrium sp. cells may serve as delivery vectors; especially for oral vaccines since Schizochytrium sp. is safe for oral consumption, produces immunomodulatory compounds, and may provide bioencapsulation to the antigen, thus increasing its bioavailability. Remarkably, Schizochytrium sp. was recently used for the production of a highly immunoprotective influenza vaccine. Moreover, an efficient method for transient expression of antigens based on viral vectors and Schizochytrium sp. as host has been recently developed. In this review, the potential of Schizochytrium sp. in vaccinology is placed in perspective, with emphasis on its use as an attractive oral vaccination vehicle.

Oral administration of docosahexaenoic acid attenuates interleukin-1β response and clinical course of septic neonates

OBJECTIVE

To analyze cytokine responses and the clinical course of septic neonates orally supplemented with docosahexaenoic acid as well as to evaluate fatty acid incorporation into leukocytes.

METHODS

A quasiexperimental study was conducted in neonates who developed sepsis following a surgical procedure. Selected neonates were randomly assigned to receive 100 mg docosahexaenoic acid (G-DHA) daily or olive oil (G-OO) as placebo for 14 d throughout a sepsis episode. At selection (baseline), blood samples were obtained to determine interleukin-1 (IL-1)β, interleukin-6 (IL-6), and tumor necrosis factor-α as well as the leucocyte fatty acid profile. Measurements were repeated at 7 (D7) and 14 d (D14) of follow-up. Within- and between-group comparisons were conducted with parametric statistics after logarithmic transformation. Repeated measurement analyses with a general linear model procedure were used, adjusting according to human milk intake, use of anti-inflammatory drugs, and nutritional status.

RESULTS

Sixty-three neonates were included: 29 in G-DHA group and 34 in G-OO group. Although decreases of cytokines during hospitalization were similar in both groups, there was a greater decrease of IL-1β in the G-DHA group than in the G-OO group after adjusting by confounders (P = 0.028). Leukocyte docosahexaenoic acid increased from 4.96 ± 2.96 at baseline to 5.52 ± 3.05 and 5.92 ± 2.8 at D7 and D14, respectively, in the G-DHA group (P = 0.044). Illness severity was inversely associated with the proportion of docosahexaenoic acid in leukocytes throughout follow-up (P = 0.034).

CONCLUSIONS

Oral supplementation with docosahexaenoic acid to neonates attenuates IL-1β response and the clinical course of sepsis. This may be an additional strategy to further benefit ill neonates even if they are not candidates for parenteral nutrition.

Breastfeeding and risk for fever after immunization

OBJECTIVE

The objective of this study was to evaluate the effects of breastfeeding on the risk for fever after routine immunizations.

METHODS

A prospective cohort study was conducted at a pediatric vaccination center in Naples, Italy. The mothers of the infants scheduled to receive routine immunizations were instructed on how to measure and record infant temperature on the evening of the vaccination and for the subsequent 3 days. The information about the incidence of fever was obtained by telephone on the third day after vaccination. The relative risk for fever in relation to the type of breastfeeding was estimated in multivariate analyses that adjusted for vaccine dose, maternal education and smoking, and number of other children in the household.

RESULTS

A total of 460 infants were recruited, and information on the outcome was obtained for 450 (98%). Fever was reported for 30 (25%), 48 (31%), and 94 (53%) of the infants who were being exclusively breastfed, partially breastfed, or not breastfed at all, respectively (P < .01). The relative risk for fever among infants who were exclusively and partially breastfed was 0.46 (95% confidence interval: 0.33-0.66) and 0.58 (95% confidence interval: 0.44-0.77), respectively. The protection conferred by breastfeeding persisted even when considering the role of several potential confounders.

CONCLUSIONS

In this study, breastfeeding was associated with a decreased incidence of fever after immunizations.

Prenatal and postnatal mercury exposure, breastfeeding and neurodevelopment during the first 5 years

OBJECTIVE

We evaluated the association between infant hair-Hg and Gesell schedules (GS).

BACKGROUND

Longitudinal assessment of prenatal and postnatal Hg exposure during the first 60 months.

METHODS

We used hair-Hg as a marker of postnatal Hg exposure (inorganic and methyl-Hg from breast milk, and ethyl-Hg from thimerosal) and GS measured at 6, 36, and 60 months.

RESULTS

Hair-Hg at 6 months responded to events related to Hg exposure and breastfeeding. However, most neurodevelopment delays observed at 6 months were overcome with infant growth; at 60 months 87% of children showed adequate GS (>85). Length of lactation and hair-Hg were each significantly correlated with GS, but in opposite ways: length of lactation was positive and significantly correlated with all GS at 60 months; hair-Hg concentrations were negative and significantly correlated with GS at 6 months (r=-0.333; P=0.002) and 60 months (r=-0.803; P=0.010), but not at 36 months. Multiple regression models showed that the GS outcome at 60 months depended on GS at 36 months that in turn was influenced by infants' developmental and Hg exposure variables. GS at 6 months was significantly influenced by prenatal (maternal and infant hair-Hg at birth) and postnatal Hg exposure at 6 months.

CONCLUSIONS

Until there is more refined approach to recognize children sensitive to Hg exposure, and in situations of uncertainty (EtHg exposure), the neurodevelopment benefit of breastfeeding should be recommended.

Breastfeeding is an essential complement to vaccination

AIM

This article explores the role of breastfeeding in different aspects of vaccination in the first 6 months when infants are still developing: (1) pain management; (2) immunomodulation of infants' vaccine responses; (3) metabolism of thimerosal.

METHODS

Major databases were searched for studies that addressed outcomes of related issues.

RESULTS

Studies reveal that breastfeeding can: (1) help mothers and infants to cope with the stressful situations that accompany parenteral vaccines; (2) improve response to vaccines in the still maturing immunologic and enterohepatic systems of infants; (3) influence physiologic parameters that can change metabolism of ethylmercury derived from some vaccines.

CONCLUSION

Health promotion that supports vaccinations should also emphasize early initiation and maintenance of exclusive breastfeeding up until 6 months for maximum protection of the infants with a possible beneficial effect on the vaccine response. Paediatric professionals should inform mothers of the proven benefits of breastfeeding and its importance in complementing vaccination and lowering stress and the risk of untoward reactions on susceptible infants.