Dietary Changes Among Breastfeeding Mothers

Social Networks, Health Support, and Dietary Intake in Mothers Receiving Home Visiting Services

Home visiting programs (HVPs) provide services to pregnant individuals and parents of young children to improve families' health and well-being. However, little is known about these families' social contexts. This study explores the social networks and dietary intake of mothers enrolled in a HVP, focusing on health support and health undermining. Cross-sectional data from 76 mothers enrolled in a HVP in Los Angeles County were collected by interview, using validated measures. Almost all mothers (95.7%) had one or more health supporters, while 55.1% had one or more health underminers. Some key findings related to health support were that mothers with higher income had more health supporters in their network (b = 1.36, p = 0.03), and network members were more likely to be health supporters if they were a romantic partner (OR = 3.41, p < 0.001), a resource-based connection (OR = 3.46, p < 0.01), or if they lived in the same neighborhood as the mother (OR = 1.68, p < 0.05). Further, having a health supporter who lived in the same neighborhood was associated with consuming more (1 + daily servings) vegetables (OR = 3.0, p < 0.05) and no sugar-sweetened beverages (OR = 0.29, p < 0.05). There were fewer findings related to health undermining: network members more likely to be underminers were romantic partners (OR = 8.93, p < .0001), and those perceived as having overweight or obesity (OR = 3.98, p < 0.001), but health undermining did not predict dietary intake. Overall, a broad set of network features were linked with health support, and given that some types of support were linked with better diet, network-based diet interventions leveraging health support may be effective in this priority population.

Is there a role for nutritional advice during breastfeeding for infant colic relief? A mixed-method study

Objective

This study aimed to explore the extent and impact of maternal dietary change for colic relief in a cohort of breastfeeding women.

Method

A mixed-method non-sequential approach was devised, including a web-based survey (n = 66) and three semi-structured interviews.

Results

Most women (70 %) changed their diet while breastfeeding a baby with colic and perceived a positive impact on their babies (63 %). The choice of foods eliminated was individual, based on a process of trial and error and on the perceived benefit to the baby. A sub-group of colicky babies, those with less intense colic symptoms, benefited significantly from the removal of cruciferous vegetables (p = 0.01) and were found to be 'less windy' (p = 0.10, ES0,20), a result trending towards statistical significance. Women felt unsupported while making changes to their diet. When dietary change brought relief to the baby, it turned into a coping tool for women facilitating extended breastfeeding.

Conclusions

Maternal dietary change can play a positive role in providing relief to breastfed babies with colic. Novel findings from this study revealed that different baby subtypes got relief from the elimination of different foods. This underscores the potential of personalised nutritional advice for colic relief in breastfed babies.

Current evidence around key underrepresented women's health topics in pregnancy and postpartum nutrition: a narrative review

Adequate nutrition during pregnancy and postpartum is critical to maternal and child health, but there is often a missing focus around health outcomes specifically for women. Women's health includes sex-specific biological attributes and socially constructed gender roles framing behaviours and practices. This narrative review aims to highlight key areas where women's health has been underrepresented in pregnancy and postpartum nutrition research. Current evidence and research gaps are discussed for nutritional requirements during pregnancy and lactation, maternal mortality and morbidity nutritional risk factors, preconception and postpartum nutrition, and gendered cultural norms and inequities in access to nutritious foods during pregnancy and postpartum. Important areas for future research include strengthening empirical evidence for nutritional requirements in pregnant and lactating populations, the relationship between maternal iron status, anaemia and maternal morbidities, linkages between nutrient status among women and adolescent girls to maternal health outcomes, postpartum nutrition for recovery, lactation, and long-term women's health outcomes, and strength-based cultural practices that can support adequate maternal nutrition. There is an ongoing need to include women in nutritional requirements research, and measure health outcomes for women to ensure creation of an evidence base on both sex and gender-based datasets.

Mothers' Awareness Towards Infantile Colic in Saudi Arabia

Background Infantile colic is defined as severe pain in the abdominal region of a baby primarily due to gastrointestinal implications and is believed to self-resolve with time. Recently established Rome IV criteria of diagnosis state that infantile colic should be diagnosed if there are symptoms like excessive crying, irritability and fussiness. Hence, this study aimed to assess the level of maternal awareness towards infantile colic in Saudi Arabia and to explore the relationship between the level of awareness and different socio-demographic factors like age, gender, nationality, etc. Methodology A cross-sectional study was carried out in Saudi Arabia from February to May 2021. An online self-administered questionnaire via Google Forms was used as the primary data collection tool. The generated link was randomly shared on electronic social media platforms including Facebook, WhatsApp, Telegram, and Twitter. Results A total of 425 participants were finally enrolled in the study. One-third of the participants (n=141, 33.2%) were aged more than 40 years and 399 were married (93.9%). Out of a total of 20 points, the mean score of maternal awareness was found to be 13.6±2.5. One-third of the participants (n=143, 33.6%) thought that rocking or carrying the baby would soothe the colic symptoms. Further, 175 participants (41.2%) used pain-relieving drugs and 7.8% sang lullabies. A total of 346 (81.4%) usually got frustrated/exhausted due to excessive crying sessions of the baby. Additionally, those who had received guidelines, educational programs or awareness sessions about the management of colic symptoms in babies had a significant awareness level (P-value = 0.032), while those who had not received education had poorer awareness. Conclusion Nearly one-third of the participants had good knowledge about infantile colic. More than one-third of the participants had previously received educational programs or awareness sessions about the management of colic symptoms in babies. More than half of the participants stated that postnatal maternal depression can occur as a result of infantile colic thereby psychological conflicts occur regarding the maternal role and inconsistent interaction styles with babies. Age, nationality, and marital status did not have a significant effect on the awareness level of the participants.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update - X - Breastfeeding a baby with cow's milk allergy

Cow's milk allergy is rare in exclusively breastfed infants. To support the continuation of breastfeeding an infant after diagnosis with a cow's milk allergy, it is critical to examine the evidence for and against any form of cow's milk elimination diet for lactating mothers. In this narrative review, we highlight the lack of high-quality evidence, hence subsequent controversy, regarding whether the minuscule quantities of cow's milk proteins detectable in human milk cause infant cow's milk allergy symptoms. Current clinical practice recommendations advise a 2-4 week trial of maternal cow's milk dietary elimination for: a) IgE-mediated cow's milk allergy only if the infant is symptomatic on breastfeeding alone; b) non-IgE-mediated associated symptoms only if the history and examination strongly suggest cow's milk allergy; and c) infants with moderate to severe eczema/atopic dermatitis, unresponsive to topical steroids and sensitized to cow's milk protein. There should be a clear plan for home reintroduction of cow's milk into the maternal diet for a period of 1 week to determine that the cow's milk elimination is responsible for resolution of symptoms, and then subsequent reoccurrence of infant symptoms upon maternal cow's milk reintroduction. The evidence base to support the use of maternal cow's milk avoidance for the treatment of a breastfed infant with cow's milk allergy is of limited strength due to a lack of high-quality, adequately powered, randomised controlled trials. It is important to consider the consequences of maternal cow's milk avoidance on reducing immune enhancing factors in breast milk, as well as the potential nutritional and quality of life impacts on the mother. Referral to a dietitian is advised for dietary education, along with calcium and vitamin D supplementation according to local recommendations, and a maternal substitute milk should be advised. However, for most breastfed infants with cow's milk allergy maternal cow's milk dietary elimination will not be required, and active support of the mother to continue breastfeeding is essential.