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Gilbreath D, Hagood D, Alatorre-Cruz GC, Andres A, Downs H, Larson-Prior LJ. Effects of Early Nutrition Factors on Baseline Neurodevelopment during the First 6 Months of Life: An EEG Study. Nutrients 2023; 15:1535. [PMID: 36986265 PMCID: PMC10055905 DOI: 10.3390/nu15061535] [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: 02/27/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Throughout infancy, the brain undergoes rapid changes in structure and function that are sensitive to environmental influences, such as diet. Breastfed (BF) infants score higher on cognitive tests throughout infancy and into adolescence than formula fed (FF) infants, and these differences in neurocognitive development are reflected in higher concentrations of white and grey matter as measured by MRI. To further explore the effect diet has on cognitive development, electroencephalography (EEG) is used as a direct measure of neuronal activity and to assess specific frequency bands associated with cognitive processes. Task-free baseline EEGs were collected from infants fed with human milk (BF), dairy-based formula (MF), or soy-based formula (SF) at 2, 3, 4, 5, and 6 months of age to explore differences in frequency bands in both sensor and source space. Significant global differences in sensor space were seen in beta and gamma bands between BF and SF groups at ages 2 and 6 months, and these differences were further observed through volumetric modeling in source space. We conclude that BF infants exhibit earlier brain maturation reflected in greater power spectral density in these frequency bands.
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Affiliation(s)
- Dylan Gilbreath
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72207, USA
| | - Darcy Hagood
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
| | - Graciela Catalina Alatorre-Cruz
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72207, USA
| | - Aline Andres
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72207, USA
| | - Heather Downs
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
| | - Linda J. Larson-Prior
- Arkansas Children’s Nutrition Center (ACNC), Little Rock, AR 72202, USA
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72207, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72207, USA
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Exploring Effect of Postdischarge Developmental Support Program on Preterm Infant Neurodevelopment and BDNF Gene DNA Methylation. Adv Neonatal Care 2022; 23:E50-E58. [PMID: 36409665 DOI: 10.1097/anc.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although developmental supportive care is an effective approach to improve the long-term psychomotor and/or neurobehavioral function of preterm infants, very limited studies have focused on the impact of after-discharge developmental support. The underlying epigenetic changes are unclear. PURPOSE This study aimed to explore the preliminary effect of an evidence-based Postdischarge Developmental Support Program (PDSP) on preterm infant neurodevelopment and underlying epigenetic changes, including brain-derived neurotrophic factor (BDNF) gene-related DNA methylation and expression. METHODS In this randomized controlled pilot trial, the preterm infant-parent dyads were randomized into either the intervention group/PDSP group (n = 22) or the control group/usual care group (n = 22). The neurodevelopmental outcomes of preterm infants were measured by Ages & Stages Questionnaires. Urine BDNF concentration level was tested by the enzyme-linked immunosorbent assay. Infant saliva specimens were collected to analyze the methylation level of BDNF gene promoter I at pre- and postintervention test. RESULTS After PDSP intervention, the total neurodevelopmental and the 5 domain scores of the PDSP group were all significantly higher than those of the control group ( P < .05). The BDNF levels decreased significantly only within control group ( P = .01). The difference in BDNF concentration and methylation levels between groups was not statistically significant. IMPLICATIONS FOR PRACTICE AND RESEARCH Postdischarge Developmental Support Program may promote the neurodevelopment of preterm infants but has no effect on BDNF's expression and gene methylation level at 3 months of corrected age. The epigenetic mechanism of PDSP needs further study using a larger sample and longer follow-up.
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Martysiak-Żurowska D, Puta M, Kiełbratowska B, Wesołowska A. Neurotrophic Factors in Human Milk in Early Lactation and the Effect of Holder and Microwave Pasteurization on Their Concentrations. J Pediatr Gastroenterol Nutr 2021; 72:900-905. [PMID: 33976087 DOI: 10.1097/mpg.0000000000003071] [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] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The objective of this study was to determine the level of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) in human milk in the first 2 weeks of breast-feeding and compare the effects of Holder pasteurization (HoP, 62.5 °C, 30 minutes) and microwave pasteurization (MP) at constant temperature (62.5 °C) on the concentraion of both neurotrophic factors (NFs). METHODS Concentration of NFs in human milk was determined using a commercially available ELISA assay. RESULTS The average concentration of BDNF and GDNF in milk was 11 ± 6 ng/mL and 336 ± 238 pg/mL, respectively. There was a positive correlation between the concentrations of BDNF and GDNF in human milk and day of lactation (r = 0.441, P < 0.05 and r = 0.482, P < 0.05, respectively). In addition, there was a significant correlation between the levels of BDNF and GDNF (r = 0.366, P < 0.05). HoP and MP for 10 minutes affected both NF levels similarly, causing degradation of BDNF by about 24% and 17%, and GDNF by 47% and 45%, respectively. Use of MP for 5 minutes resulted in preservation of nearly 91% BDNF and 79% GDNF in human milk. CONCLUSIONS In the pasteurization processes carried out, results showed that GDNF is more susceptible to degradation under the influence of high temperature. To the authors' best knowledge, this is the first study evaluating the effects of HoP and MP at constant temperature on the concentration of NFs in human milk. It was found that the MP for 5 minutes is the optimal method.
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Affiliation(s)
- Dorota Martysiak-Żurowska
- Department of Chemistry, Technology and Biotechnology of Food, Faculty of Chemistry, Gdansk University of Technology
| | - Małgorzata Puta
- Department of Chemistry, Technology and Biotechnology of Food, Faculty of Chemistry, Gdansk University of Technology
| | | | - Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Neonatology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
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Demers-Mathieu V, Hines DJ, Hines RM, Lavangnananda S, Fels S, Medo E. Influence of Previous COVID-19 and Mastitis Infections on the Secretion of Brain-Derived Neurotrophic Factor and Nerve Growth Factor in Human Milk. Int J Mol Sci 2021; 22:3846. [PMID: 33917718 PMCID: PMC8068104 DOI: 10.3390/ijms22083846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 04/06/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) play a critical role in neurodevelopment, where breast milk is a significant dietary source. The impact of previous COVID-19 infection and mastitis on the concentration of BDNF and NGF in human milk was investigated. METHODS Concentrations of BDNF and NGF were measured via ELISA in human milk samples collected from 12 mothers with a confirmed COVID-19 PCR, 13 mothers with viral symptoms suggestive of COVID-19, and 22 unexposed mothers (pre-pandemic Ctl-2018). These neurotrophins were also determined in 12 mothers with previous mastitis and 18 mothers without mastitis. RESULTS The NGF concentration in human milk was lower in the COVID-19 PCR and viral symptoms groups than in the unexposed group, but BDNF did not differ significantly. Within the COVID-19 group, BDNF was higher in mothers who reported headaches or loss of smell/taste when compared with mothers without the respective symptom. BDNF was lower in mothers with mastitis than in mothers without mastitis. CONCLUSIONS Previous COVID-19 and mastitis infections changed differently the secretion of NGF and BDNF in human milk. Whether the changes in NGF and BDNF levels in milk from mothers with infection influence their infant's development remains to be investigated.
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Affiliation(s)
- Veronique Demers-Mathieu
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Dustin J. Hines
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (D.J.H.); (R.M.H.)
| | - Rochelle M. Hines
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (D.J.H.); (R.M.H.)
| | - Sirima Lavangnananda
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Shawn Fels
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
| | - Elena Medo
- Department of Neonatal Immunology and Microbiology, Medolac Laboratories A Public Benefit Corporation, Boulder City, NV 89005, USA; (S.L.); (S.F.); (E.M.)
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Berlanga-Macías C, Sánchez-López M, Solera-Martínez M, Díez-Fernández A, Ballesteros-Yáñez I, Castillo-Sarmiento CA, Martínez-Ortega IA, Martínez-Vizcaíno V. Relationship between exclusive breastfeeding and brain-derived neurotrophic factor in children. PLoS One 2021; 16:e0248023. [PMID: 33662047 PMCID: PMC7932083 DOI: 10.1371/journal.pone.0248023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/13/2021] [Indexed: 11/19/2022] Open
Abstract
Objective A positive relationship between breastfeeding and brain-derived neurotrophic factor (BDNF) in infants has been suggested due to the presence of BDNF in human milk. This study aimed to determine the relationship between exclusive breastfeeding and BDNF serum levels in Spanish schoolchildren. Methods A cross-sectional analysis including 202 schoolchildren, aged eight to 11 years, from Cuenca, Spain, was conducted. Information on sociodemographic and anthropometric variables, sexual maturation, birth weight and exclusive breastfeeding (‘no exclusive breastfeeding’, and exclusive breastfeeding for ≤6 and >6 months), and BDNF serum levels using an ELISA method were obtained. Covariance analyses (ANCOVA) were conducted to examine the relationship between serological BDNF and exclusive breastfeeding after controlling for potential confounders. Results ANCOVA models showed no significant differences in BDNF levels between children who were exclusively breastfed for more than six months versus those who were not (p > 0.05). No significant differences were observed by age group (eight to nine years versus 10 to 11 years; p > 0.05). Additionally, no clear negative trend in BDNF serum levels according to sexual maturation categories was found (p > 0.05). Conclusion These findings suggest that exclusive breastfeeding does not have a significant positive association on BDNF from eight to 11 years, since children who were exclusively breastfed did not have significantly higher BDNF levels than those who were not exclusively breastfed. Likewise, BDNF levels were not found to be negatively affected by hormonal development. Future research should examine the influence of exclusive breastfeeding on BDNF over the different developmental stages.
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Affiliation(s)
- Carlos Berlanga-Macías
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | | | - Ana Díez-Fernández
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | | | | | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
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Dangat K, Khaire A, Joshi S. Cross talk of vascular endothelial growth factor and neurotrophins in mammary gland development. Growth Factors 2020; 38:16-24. [PMID: 32646254 DOI: 10.1080/08977194.2020.1792469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
During the period of lactation, there is extensive growth and development of the mammary gland in order to fulfil the increased demands of milk for the growing infant. Angiogenesis plays a key role in alveolar development and facilitates optimal milk production. Vascular endothelial growth factor (VEGF) is one of the key growth factors regulating angiogenesis in mammary gland. Apart from VEGF, neurotrophins are also known to regulate angiogenesis through direct or indirect mechanisms. Few studies have demonstrated mRNA levels of neurotrophins and their receptors in mammary gland both in humans and rodents. A cross talk between VEGF and neurotrophins has been described in placental development. The enteric and central nervous system are not fully developed at birth, making it imperative to have appropriate levels of angiogenic factors and neurotrophins during postnatal period. The current review summarises studies which describe the role of neurotrophins and angiogenic factors in the mammary gland development.
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Affiliation(s)
- Kamini Dangat
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune, India
| | - Amrita Khaire
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune, India
| | - Sadhana Joshi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be) University, Pune, India
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Perrin MT, Pawlak R, Dean LL, Christis A, Friend L. A cross-sectional study of fatty acids and brain-derived neurotrophic factor (BDNF) in human milk from lactating women following vegan, vegetarian, and omnivore diets. Eur J Nutr 2019; 58:2401-2410. [PMID: 30051170 DOI: 10.1007/s00394-018-1793-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/22/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Essential fatty acids are critical for brain growth and neurodevelopment in infancy. Maternal diet and supplement use have a significant impact on the fat composition of human milk. The objective of this study is to assess supplement utilization patterns and fatty acid and brain-derived neurotrophic factor (BDNF) concentrations in the breast milk of women following vegan, vegetarian, and omnivore diet patterns. METHODS This is a cross-sectional, observational study of 74 lactating women in the United States following a vegan (n = 26), vegetarian (n = 22), or omnivore (n = 26) diet pattern. A single breast milk sample was collected from each participant and assessed for fatty acids and BDNF. RESULTS Median unsaturated fatty acids in the breast milk of vegan, vegetarian, and omnivores, as a percentage of total fatty acids, was 66.0, 57.8, and 56.2%, respectively (p < 0.001). Total omega-3 percentages were 2.29% for vegans, 1.55% for vegetarians, and 1.46% for omnivores (p < 0.001). Docosahexaenoic acid percentages were not different by diet pattern, but over 80% of participants had milk concentrations below 0.30% of total fatty acids. Reports of omega-3 supplements use (10/74) and weekly seafood consumption (3/74) were limited. BDNF was not detectable in any samples. CONCLUSIONS Breast milk from vegans had significantly higher unsaturated fat and total omega-3 fats, and lower saturated fats, trans fats, and omega-6 to omega-3 ratios than their vegetarian and omnivore counterparts. Docosahexaenoic acid concentrations in breast milk were low regardless of maternal diet pattern, and were reflective of low seafood intake and supplement use.
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Affiliation(s)
- Maryanne T Perrin
- Department of Nutrition, University of North Carolina Greensboro, 318 College Avenue, Greensboro, NC, 27412, USA.
| | - Roman Pawlak
- Department of Nutrition Science, East Carolina University, Health Sciences Building, Greenville, NC, 27834, USA
| | - Lisa L Dean
- Market Quality and Handling Research Unit, USDA/Agricultural Research Service, Southeast Area (LLD), 400 Dan Allen Drive, Raleigh, NC, 27606, USA
| | - Amber Christis
- Department of Nutrition, University of North Carolina Greensboro, 318 College Avenue, Greensboro, NC, 27412, USA
| | - Linda Friend
- Department of Nutrition, University of North Carolina Greensboro, 318 College Avenue, Greensboro, NC, 27412, USA
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Kucera J, Ruda-Kucerova J, Zlamal F, Kuruczova D, Babinska Z, Tomandl J, Tomandlova M, Bienertova-Vasku J. Oral administration of BDNF and/or GDNF normalizes serum BDNF level in the olfactory bulbectomized rats: A proof of concept study. Pharmacol Rep 2019; 71:669-675. [DOI: 10.1016/j.pharep.2019.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/08/2019] [Accepted: 03/11/2019] [Indexed: 12/13/2022]
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Anderson G, Vaillancourt C, Maes M, Reiter RJ. Breastfeeding and the gut-brain axis: is there a role for melatonin? Biomol Concepts 2017; 8:185-195. [DOI: 10.1515/bmc-2017-0009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/05/2017] [Indexed: 12/12/2022] Open
Abstract
AbstractThe benefits of breastfeeding over formula feed are widely appreciated. However, for many mothers breastfeeding is not possible, highlighting the need for a significant improvement in the contents of formula feed. In this article, the overlooked role of melatonin and the melatonergic pathways in breast milk and in the regulation of wider breast milk components are reviewed. There is a growing appreciation that the benefits of breastfeeding are mediated by its effects in the infant gut, with consequences for the development of the gut-brain axis and the immune system. The melatonergic pathways are intimately associated with highly researched processes in the gut, gut microbiome and gut-brain axis. As the melatonergic pathways are dependent on the levels of serotonin availability as a necessary precursor, decreased melatonin is linked to depression and depression-associated disorders. The association of breastfeeding and the gut-brain axis with a host of medical conditions may be mediated by their regulation of processes that modulate depression susceptibility. The biological underpinnings of depression include increased levels of pro-inflammatory cytokines, oxidative stress, kynurenine pathway activity and dysregulation of the hypothalamic-pituitary adrenal axis, all of which can decrease melatonergic pathway activity. The inclusion of the melatonergic pathways in the biological interactions of breast milk and gut development has significant theoretical and treatment implications, as well as being important to the prevention of a host of infant-, child- and adult-onset medical conditions.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SWIV 1PG, UK
| | - Cathy Vaillancourt
- INRS-Armand-Frappier Institute and Center for Interdisciplinary Research on Well-Being, Health, Society and Environment (CINBIOSE), Laval, QC, Canada
| | - Michael Maes
- Deakin University, Department of Psychiatry, Geelong, Australia
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Breastfeeding duration and offspring conduct problems: The moderating role of genetic risk. Soc Sci Med 2016; 166:128-136. [PMID: 27551827 DOI: 10.1016/j.socscimed.2016.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 01/12/2023]
Abstract
RATIONALE A sizable body of research has examined associations between breastfeeding and various facets of offspring development, including childhood behavioral problems. Notwithstanding the number of studies on the topic, breastfeeding has not consistently been linked to child misbehaviors. Moreover, empirical examinations of whether breastfeeding is differentially predictive of conduct problems among individuals with varying degrees of genetic risk are lacking. OBJECTIVE The present study examines whether a short duration of breastfeeding and genetic risk interact to predict conduct problems during childhood. METHODS A genetically informative design is employed to examine a subsample of twins from the Early Childhood Longitudinal Study: Birth Cohort (ECLS-B), a nationally representative sample of American children. RESULTS The findings suggest that a shorter duration of breastfeeding only enhances the risk of offspring conduct problems among children who possess high levels of genetic risk. Conversely, longer breastfeeding durations were found to protect against childhood behavioral problems when genetic risk was high. CONCLUSIONS Indicators of genetic risk may help to distinguish individuals whose behavioral development is most sensitive to the duration of breastfeeding. Future research should seek to replicate and extend these findings by considering genetic factors as potential markers of differential susceptibility to breastfeeding duration.
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Rochat TJ, Houle B, Stein A, Coovadia H, Coutsoudis A, Desmond C, Newell ML, Bland RM. Exclusive Breastfeeding and Cognition, Executive Function, and Behavioural Disorders in Primary School-Aged Children in Rural South Africa: A Cohort Analysis. PLoS Med 2016; 13:e1002044. [PMID: 27328132 PMCID: PMC4915617 DOI: 10.1371/journal.pmed.1002044] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 05/05/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is associated with early child health; its longer-term benefits for child development remain inconclusive. We examine the associations between EBF, HIV exposure, and other maternal/child factors and the cognitive and emotional-behavioural development of children aged 7-11 y. METHODS AND FINDINGS The Vertical Transmission Study (VTS) supported EBF in HIV-positive and HIV-negative women; between 2012 and 2014, HIV-negative VTS children (332 HIV exposed, 574 HIV unexposed) were assessed in terms of cognition (Kaufman Assessment Battery for Children Second Edition [KABC-II]), executive function (Developmental Neuropsychological Assessment Second Edition [NEPSY-II]), and emotional-behavioural functioning (parent-reported Child Behaviour Checklist, [CBCL]). We developed population means by combining the VTS sample with 629 same-aged HIV-negative children from the local demographic platform. For each outcome, we split the VTS sample into scores above or at/below each population mean and modelled each outcome using logistic regression analyses, overall and stratified by child sex. There was no demonstrated effect of EBF on overall cognitive functioning. EBF was associated with fewer conduct disorders overall (adjusted odds ratio [aOR] 0.44 [95% CI 0.3-0.7], p ≤ 0.01), and there was weak evidence of better cognition in boys who had been exclusively breastfed for 2-5 mo versus ≤1 mo (Learning subscale aOR 2.07 [95% CI 1.0-4.3], p = 0.05). Other factors associated with better child cognition were higher maternal cognitive ability (aOR 1.43 [95% CI 1.1-1.9], p = 0.02, Sequential; aOR 1.74 [95% CI 1.3-2.4], p < 0.001, Planning subscales) and crèche attendance (aOR 1.96 [95% CI 1.1-3.5], p = 0.02, Sequential subscale). Factors positively associated with executive function were home stimulation (aOR 1.36 [95% CI 1.0-1.8], p = 0.04, Auditory Attention; aOR 1.35 [95% CI 1.0-1.8], p = 0.05, Response Set) and crèche (aOR 1.74 [95% CI 1.0-3.0], p = 0.05, Animal Sorting). Maternal mental health problems and parenting stress were associated with increased emotional-behavioural problems on the total CBCL (aOR 2.44 [95% CI 1.3-4.6], p = 0.01; aOR 7.04 [95% CI 4.2-11.9], p < 0.001, respectively). Maternal HIV status was not associated with any outcomes in the overall cohort. Limitations include the nonrandomised study design and lack of maternal mental health assessment at the child's birth. CONCLUSIONS EBF was associated with fewer than average conduct disorders and weakly associated with improved cognitive development in boys. Efforts to improve stimulation at home, reduce maternal stress, and enable crèche attendance are likely to improve executive function and emotional-behavioural development of children.
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Affiliation(s)
- Tamsen J. Rochat
- Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa
- Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, Oxford University, Oxford, United Kingdom
- Developmental Pathways to Health Research Unit, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa
| | - Brian Houle
- MRC/Wits Rural Public Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Demography, The Australian National University, Canberra, Australia
- CU Population Center, Institute of Behavioural Science, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - Alan Stein
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, Oxford University, Oxford, United Kingdom
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Hoosen Coovadia
- MatCH Health Systems (Maternal, Adolescent and Child Health), KwaZulu-Natal, South Africa
| | - Anna Coutsoudis
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - Chris Desmond
- Human and Social Development Research Programme, Human Sciences Research Council, Durban, South Africa
| | - Marie-Louise Newell
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ruth M. Bland
- Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Royal Hospital for Sick Children and Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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Ismail AM, Babers GM, El Rehany MA. Brain-derived neurotrophic factor in sera of breastfed epileptic infants and in breastmilk of their mothers. Breastfeed Med 2015; 10:277-82. [PMID: 26057553 DOI: 10.1089/bfm.2015.0008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human milk contains leukocytes expressing brain-derived neurotrophic factor (BDNF), which may facilitate epileptogenesis. Our study aimed to estimate levels of BDNF in the sera of breastfed infants with idiopathic epilepsy and in breastmilk of their mothers and to assess its value as a marker of epilepsy severity. PATIENTS AND METHODS Thirty breastfed infants <2 years of age with idiopathic epilepsy and 15 control healthy breastfed infants were recruited for the study. Patients were subjected to thorough medical history, clinical examination, and assessment of disease severity. Routine laboratory and radiological investigations, including, liver, renal, and thyroid screen, brain magnetic resonance imaging, and measurement of serum and breastmilk BDNF levels, were performed. RESULTS Serum BDNF levels of epileptic infants and milk BDNF levels of their mothers were significantly higher than values for controls (p=0.0001). They were positively correlated with age, weight, length, and head circumference of epileptic children. Also, serum and milk BDNF levels were significantly increased with increased duration of illness and frequency of seizures. There was a significant positive correlation between serum and breastmilk levels of BDNF and significantly higher levels in severe cases of epilepsy. CONCLUSIONS Serum and milk BDNF levels are higher in epileptic infants than in controls and may be used as a marker of disease severity.
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Affiliation(s)
- Ahlam M Ismail
- 1 Pediatrics Department, Faculty of Medicine, South Valley University , Qena, Egypt
| | - Gihan M Babers
- 2 Pediatrics Department, Faculty of Medicine , Minia University, Minia, Egypt
| | - Mahmoud A El Rehany
- 3 Biochemistry Department, Faculty of Pharmacy, Deraya University , Minia, Egypt
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Filonenko AV, Vasilenko AM, Khan MA. [Sensitivity and specificity of the cerebral blood flow reactions to acupuncture in the newborn infants presenting with hypoxic ischemic encephalopathy]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2015; 92:27-31. [PMID: 25876431 DOI: 10.17116/kurort2015127-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the effects of acupuncture integrated into the standard therapy, the condition of cerebral blood flow, and other syndromes associated with cerebral ischemia in the newborn infants. MATERIAL AND METHODS. A total of 131 pairs of puerperae and newborns with hypoxic ischemic encephalopathy were divided into four treatment groups. 34 children of the first group were given standard therapy (control), in the second group comprised of 33 mothers and children the standard treatment was supplemented by acupuncture, the third group included only 32 mothers given the acupuncture treatment alone, and the fourth group contained only 32 newborn infants treated by acupuncture. Each course of acupuncture treatment consisted of five sessions. Sensitivity and specificity of cerebral blood flow reactions were determined based on the results of the ROC-analysis and the area under the curve before and after the treatment. RESULTS The treatment with the use of acupuncture greatly improved the cerebrospinal hemodynamics (p < 0.05). Other symptoms, viz. sleep disorders, vegetative reactivity and excitability were significantly reduced. The ROC analysis confirmed the effectiveness of acupuncture as a tool for the treatment of the impaired cerebral blood flow in the newborn babies. The high level of sensitivity (84.4-94.8%) associated with good specificity makes it possible to distinguish between the true positive and true negative cases. CONCLUSION Acupuncture integrated into the treatment of "mother-baby" pairs presenting with hypoxic ischemic encephalopathy can be used to improve the initially low level of cerebral blood flow in neonates presenting with this condition.
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Affiliation(s)
- A V Filonenko
- Federal state budgetary educational institution of higher professional education 'I.N. Ul'yanov Chuvash State University', Russian Ministry of Education and Science, Cheboksary
| | - A M Vasilenko
- Federal state budgetary institution 'Russian Research Centre of Medical Rehabilitation and Balneotherapeutics', Russian Ministry of Health, Moscow
| | - M A Khan
- Federal state budgetary institution 'Russian Research Centre of Medical Rehabilitation and Balneotherapeutics', Russian Ministry of Health, Moscow
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Walfisch A, Sermer C, Cressman A, Koren G. Breast milk and cognitive development--the role of confounders: a systematic review. BMJ Open 2013; 3:e003259. [PMID: 23975102 PMCID: PMC3753522 DOI: 10.1136/bmjopen-2013-003259] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ. DESIGN Systematic review of the literature. SETTING AND PARTICIPANTS Any prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included. PRIMARY AND SECONDARY OUTCOME MEASURES Extracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants' age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well. RESULTS 84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive-diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%). CONCLUSIONS Much of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions.
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Affiliation(s)
- Asnat Walfisch
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Corey Sermer
- University of Western Ontario, London, Ontario, Canada
| | - Alex Cressman
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Gideon Koren
- The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics and Pharmacology, University of Toronto, Toronto, Ontario, Canada
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Dangat K, Kilari A, Mehendale S, Lalwani S, Joshi S. Higher levels of brain derived neurotrophic factor but similar nerve growth factor in human milk in women with preeclampsia. Int J Dev Neurosci 2013; 31:209-13. [PMID: 23337827 DOI: 10.1016/j.ijdevneu.2012.12.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/26/2012] [Accepted: 12/08/2012] [Indexed: 01/16/2023] Open
Abstract
Children born to mothers with preeclampsia have consistently been suggested to be at risk for cognitive and behavioral disorders in later life. Breastfeeding is said to be associated with better neurodevelopment outcomes. Our earlier studies indicated higher levels of docosahexaenoic acid (DHA) in human milk in women with preeclampsia. DHA is known to regulate the expression of neurotrophins and together they play a vital role in neurodevelopment and cognitive performance. The present study examines the levels of maternal plasma and milk neurotrophins [(nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF)] in women with preeclampsia and compares them with normotensive women who served as controls. Singleton pregnant women diagnosed with preeclampsia (n=72) and controls (n=102) were recruited for this study from Bharati Hospital, Pune. Plasma and milk samples were analyzed for NGF and BDNF levels using the Emax Immuno Assay System using promega kits. Maternal plasma NGF and BDNF levels were lower (p<0.01 for both) in women with preeclampsia as compared to the control women. Milk NGF levels were similar while milk BDNF levels were higher (p<0.05) in the preeclampsia group as compared to controls. Plasma NGF levels were positively correlated with milk NGF levels in the control group. Our results indicate the differential regulation of milk NGF and BDNF levels in women with preeclampsia. The present study suggests a role for both NGF and BDNF in human milk for postnatal brain development. Further studies need to examine the associations of DHA and BDNF in human milk with cognition at later ages.
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Affiliation(s)
- Kamini Dangat
- Department of Nutritional Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth University, Pune 411043, India
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Affiliation(s)
- Tonse N K Raju
- Pregnancy and Perinatology Branch, Center for Developmental Biology and Perinatal Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA.
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