The Origin of ‘Formula’: State of the Science, 1890s

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
In 1900, 13% of infants in the United States died before their first birthday, most of dehydration from diarrhea. As part of a nationwide effort to “save the babies,” pediatricians focused on several endeavors—experimenting with commercially made infant-food products; working with dairy farmers to clean up cows’ milk; lobbying to pass municipal and state legislation regulating the dairy industry; and devising mathematical “formulas” that represented instructions to chemists on how to “humanize” cows’ milk for the needs of a particular infant. Pediatricians dubbed the latter endeavor “percentage feeding” and, from the 1890s to the 1920s, they deemed percentage feeding a lifesaving scientific achievement. The complex, virtually infinite array of mathematical formulas that comprised this infant-feeding system is the origin of the word “formula” as used today to describe artificial baby milk.
Jacqueline H. Wolf

Galactogogues use Among Mothers With Preterm Births: A Systematic Review and Meta-Analysis

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
BackgroundPreterm mothers face unique challenges—the stress of preterm delivery and their premature babies’ inability to suckle directly from the breasts, culminating in poor milk supply. Galactogogues are substances believed to enhance human milk production. Evidence for their use in preterm mothers is insufficient.Research aimsTo (a) evaluate the influence of galactogogues on milk production among mothers with preterm birth, and (b) assess the safety of galactogogues for mother-infant dyads.MethodsA systematic search was conducted between January 2018 and May 2019 in nine electronic databases, with manual searches through reference lists of included articles. Randomized controlled trial studies addressing outcome measure of milk quantification were selected. Seven trials met the inclusion criteria and, using the Clinical Appraisal Skills program checklists and the modified Cochrane Collaboration tool for assessing risk of bias, each trial was critically appraised for content, bias in methodology, and reporting.ResultsFour herbal substances (fenugreek, silymarin, silymarin/galega, and stinging nettle) and domperidone used in intervention studies were analyzed. Fenugreek and silymarin used in isolation did not yield significant increase in milk production, while the combination herbal mixtures silymarin/galega and stinging nettle herbal tea increased milk production. Domperidone use resulted in an acute increase in milk production, which was not sustained with prolonged use. The reviewed studies reported no serious adverse effects on mother-infant dyads.ConclusionHerbal galactogogues may be more effective for longer term use, although there is still limited evidence to support its prescription to preterm mothers. Larger studies are required.
Beatrice Nkolika Ezenwa

The Associations Between Light Exposure During Pumping and Holder Pasteurization and the Macronutrient and Vitamin Concentrations in Human Milk

2 hónap 3 hét ago
Journal of Human Lactation, Ahead of Print.
Background:During pumping, storage, and pasteurization human milk is exposed to light, which could affect the concentrations of light-sensitive vitamins. Currently, milk banks do not regulate light exposure.Research Aim:The aim of this paper was to determine the influence of light exposure during pumping, storage, and pasteurization on (1) macronutrients, (2) select water-soluble vitamins, and (3) select fat-soluble vitamins.Methods:All 13 participants donated 4 milk samples each. Each sample underwent 1 of 4 treatments: raw and light protected, raw and light exposed, pasteurized and light protected, and pasteurized and light exposed. Samples were analyzed for macronutrients and Vitamins B1, B2, retinol, γ-tocopherol, α-tocopherol, and β-carotene.Results:β-carotene concentrations were not influenced by light exposure. Vitamin B1 was significantly (p < 0.05) affected by light-exposure (M = 0.23, SD = 0.01mg/L) compared to light-protected (M = 0.27, SD = 0.01mg/L) samples. Vitamin B2 concentrations were reduced (p < 0.05) by light-exposure in raw (M = 62.1, SD = 0.61µg/L) and pasteurized (M = 73.7, SD = 0.72µg/L) samples compared to light-protected raw samples (M = 99.7, SD = 0.66µg/L). No other tested nutrients were affected by light exposure.Conclusions:If milk is exposed to excessive amounts of light, Vitamins B1 and B2 concentrations may degrade below the current Adequate Intake recommendations for infants 0–6 months of age, increasing the risk of insufficient vitamin supply to the exclusively human milk-fed infant. Thus, pumped or processed human milk should be protected from light to preserve milk vitamin concentrations.
Hope K. Lima

Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review

2 hónap 3 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Lactational mastitis is a maternal morbidity that affects the wellbeing of women and their babies, including through breastfeeding discontinuation.Research Aim:To systematically review the available global literature on the frequency of lactational mastitis, and to summarize the evidence on risk factors for lactational mastitis. We also describe gaps in the evidence and identify priority areas for future research.Methods:We systematically searched and screened 6 databases and included 26 articles, conducted meta-analysis of disease frequency, and narratively synthesized evidence on risk factors.Results:In 11 (42%) articles researchers reported a measure of disease frequency; 5 (19%) reported risk factors, and 10 (39%) included both. Overall, the quality of studies was low, related to suboptimal measurement of disease frequency, high risk of bias, reverse causality, and incomplete adjustment for confounding. Meta-analysis was based on 3 studies (pooled incidence between birth and Week 25 postpartum: 11.1 episodes per 1,000 breastfeeding weeks; 95% CI [10.2–12.0]); with high heterogeneity across contexts and highest incidence in the first four weeks postpartum. Researchers assessed 42 potential risk factors; nipple damage was the most frequently studied and strongly associated with mastitis. There was a scarcity of studies from low-resource settings.Conclusions:Lactational mastitis is a common condition, but the wide variability in incidence across contexts suggested that a substantial portion of this burden might be preventable. Provision of care to breastfeeding women at risk for or affected by mastitis is currently constrained due to a critical lack of high quality epidemiological evidence about its incidence and risk factors.
Emily Wilson

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21 óra 10 perc ago
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
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