International Lactation Consultant Association News Brief
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation - online first articles
International Lactation Consultant Association News Brief
Journal of Human Lactation, Ahead of Print.
Assessment of Breastfeeding Promotion in Maternity Hospitals Based on Specified International Recommendations—Experiences From Germany
Journal of Human Lactation, Ahead of Print.
Background:The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the ...
Background:The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the ...
Assessment of Breastfeeding Promotion in Maternity Hospitals Based on Specified International Recommendations—Experiences From Germany
Journal of Human Lactation, Ahead of Print.
Background:The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).Research Aim:To identify specific hospital practices and structures that are in compliance with the recommendations and those that still need to be improved.Method:A cross-sectional survey and descriptive analysis was conducted in 109 German hospitals. This web-based questionnaire examined the structural conditions and usual handling of breastfeeding support. Recommendations were reported using sub-criteria.Results:The implementation of the sub-criteria ranged from less than 25% to more than 90%. Hospitals were more likely to have a breastfeeding policy (85.3%, n = 93) than a breastfeeding coordinator (73.4%, n = 80). Immediate skin-to-skin contact after birth and early breastfeeding initiation were implemented more frequently after a vaginal (89.9%, n = 98 and 71.6%, n = 78) than after Cesarean delivery (45.9%, n = 50 and 54.1%, n = 59). Additional feeding of fluids was usually restricted to a medical indication (70.6%, n = 77), however, the decision to feed formula was rarely made by hospital staff alone (27.5%, n = 30). Large hospitals (> 1000 births/year) had a written breastfeeding policy and a breastfeeding coordinator more frequently than smaller hospitals (p < 0.01, Fisher’s exact test).Conclusion:The use of sub-criteria of WHO recommendations helped identify critical parts of breastfeeding promotion in hospitals, providing concrete starting points for targeted interventions. This differentiated approach could be promising for future analyses of breastfeeding promotion.
Background:The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).Research Aim:To identify specific hospital practices and structures that are in compliance with the recommendations and those that still need to be improved.Method:A cross-sectional survey and descriptive analysis was conducted in 109 German hospitals. This web-based questionnaire examined the structural conditions and usual handling of breastfeeding support. Recommendations were reported using sub-criteria.Results:The implementation of the sub-criteria ranged from less than 25% to more than 90%. Hospitals were more likely to have a breastfeeding policy (85.3%, n = 93) than a breastfeeding coordinator (73.4%, n = 80). Immediate skin-to-skin contact after birth and early breastfeeding initiation were implemented more frequently after a vaginal (89.9%, n = 98 and 71.6%, n = 78) than after Cesarean delivery (45.9%, n = 50 and 54.1%, n = 59). Additional feeding of fluids was usually restricted to a medical indication (70.6%, n = 77), however, the decision to feed formula was rarely made by hospital staff alone (27.5%, n = 30). Large hospitals (> 1000 births/year) had a written breastfeeding policy and a breastfeeding coordinator more frequently than smaller hospitals (p < 0.01, Fisher’s exact test).Conclusion:The use of sub-criteria of WHO recommendations helped identify critical parts of breastfeeding promotion in hospitals, providing concrete starting points for targeted interventions. This differentiated approach could be promising for future analyses of breastfeeding promotion.
Breastfeeding Measurement—What Does It Mean to “Wean?”
Journal of Human Lactation, Ahead of Print.
The term “weaning” is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also ...
The term “weaning” is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also ...
Breastfeeding Measurement—What Does It Mean to “Wean?”
Journal of Human Lactation, Ahead of Print.
The term “weaning” is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also commonly used to describe any gradual transition between milks, foods, or feeding modalities. In an epidemiological context, it may also refer to changing breastfeeding rates within a cohort. The meaning of weaning has changed over time and may vary by the scientific assumptions applied to this period of human development. For these reasons, we propose that investigators avoid using the term weaning, and substitute it with more precise terminology. We present a series of proposed standard terms with corresponding definitions to guide more precise and accurate reporting of the various potential meanings of the term in the scientific literature. The objective is to improve reporting and reproducibility of research in the field of breastfeeding and human lactation.
The term “weaning” is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also commonly used to describe any gradual transition between milks, foods, or feeding modalities. In an epidemiological context, it may also refer to changing breastfeeding rates within a cohort. The meaning of weaning has changed over time and may vary by the scientific assumptions applied to this period of human development. For these reasons, we propose that investigators avoid using the term weaning, and substitute it with more precise terminology. We present a series of proposed standard terms with corresponding definitions to guide more precise and accurate reporting of the various potential meanings of the term in the scientific literature. The objective is to improve reporting and reproducibility of research in the field of breastfeeding and human lactation.
BFHI Association News
Journal of Human Lactation, Ahead of Print.
BFHI Association News
Journal of Human Lactation, Ahead of Print.
JHL News
Journal of Human Lactation, Ahead of Print.
JHL News
Journal of Human Lactation, Ahead of Print.
Assessment of Cell Isolation From Human Milk Using Immunomagnetic Beads
Journal of Human Lactation, Ahead of Print.
Background:There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking....
Background:There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking....
Assessment of Cell Isolation From Human Milk Using Immunomagnetic Beads
Journal of Human Lactation, Ahead of Print.
Background:There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking.Research Aim:Our aim was to systematically compare available cell isolation techniques to isolate T lymphocytes from human milk samples.Methods:This repeated measures study design compared three cell isolation methods using human milk samples: (1) centrifugation, (2) immunomagnetic bead isolation, and (3) a combination of both methods. We assessed the proportion and viability of CD3+, CD4+, CD25+ and regulatory T cells using flow cytometry in isolated cells to compare the performance of these isolation methods.Results:Immunomagnetic separation is a feasible method to isolate T lymphocytes in human milk, similar to blood. It improves target cell enrichment and cell viability compared to centrifugation, which may be an advantage when the goal is to characterize rare cell types or when cells are further used in functional assays. No excess cell activation (CD25 positivity) was observed with the use of magnetic beads.Conclusion:Immunomagnetic separation of human milk T lymphocytes may have advantages over centrifugation depending on the intended downstream use of cells.
Background:There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking.Research Aim:Our aim was to systematically compare available cell isolation techniques to isolate T lymphocytes from human milk samples.Methods:This repeated measures study design compared three cell isolation methods using human milk samples: (1) centrifugation, (2) immunomagnetic bead isolation, and (3) a combination of both methods. We assessed the proportion and viability of CD3+, CD4+, CD25+ and regulatory T cells using flow cytometry in isolated cells to compare the performance of these isolation methods.Results:Immunomagnetic separation is a feasible method to isolate T lymphocytes in human milk, similar to blood. It improves target cell enrichment and cell viability compared to centrifugation, which may be an advantage when the goal is to characterize rare cell types or when cells are further used in functional assays. No excess cell activation (CD25 positivity) was observed with the use of magnetic beads.Conclusion:Immunomagnetic separation of human milk T lymphocytes may have advantages over centrifugation depending on the intended downstream use of cells.
The Utility of Secondary Data Analysis in Breastfeeding Research: Opportunities and Challenges
Journal of Human Lactation, Ahead of Print.
Secondary data analysis has emerged as an important approach for researchers seeking to explore new research questions using existing datasets. These datasets often comprise large and diverse, as well as longitudinal data, enabling comprehensive analyses that might be impractical through primary data collection alone. This paper discusses the importance of secondary data analysis in breastfeeding research, provides examples of publicly available and restricted datasets containing breastfeeding variables, outlines the methodological steps in conducting secondary data analysis, and discusses common limitations associated with this approach. By emphasizing both the utility and challenges of secondary data analysis, the paper aims to encourage informed use of secondary data analysis to advance knowledge and address important research questions in breastfeeding.
Secondary data analysis has emerged as an important approach for researchers seeking to explore new research questions using existing datasets. These datasets often comprise large and diverse, as well as longitudinal data, enabling comprehensive analyses that might be impractical through primary data collection alone. This paper discusses the importance of secondary data analysis in breastfeeding research, provides examples of publicly available and restricted datasets containing breastfeeding variables, outlines the methodological steps in conducting secondary data analysis, and discusses common limitations associated with this approach. By emphasizing both the utility and challenges of secondary data analysis, the paper aims to encourage informed use of secondary data analysis to advance knowledge and address important research questions in breastfeeding.
Mothers’ Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study
Journal of Human Lactation, Ahead of Print.
Background:Shifts in women’s maternal roles may contribute to the global low prevalence of exclusive breastfeeding.Research Aim:To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China.Methods:Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding.Results:The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding (OR = 1.34, 95% CI [1.04, 1.72]), particularly for female infants (OR = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children (Beta = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters (OR = 1.50, 95% CI [1.00, 2.25]).Conclusion:Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.
Background:Shifts in women’s maternal roles may contribute to the global low prevalence of exclusive breastfeeding.Research Aim:To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China.Methods:Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding.Results:The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding (OR = 1.34, 95% CI [1.04, 1.72]), particularly for female infants (OR = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children (Beta = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters (OR = 1.50, 95% CI [1.00, 2.25]).Conclusion:Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.
Development of Nipple Trauma Evaluation System With Deep Learning
Journal of Human Lactation, Ahead of Print.
Background:No research has been conducted on the use of deep learning for breastfeeding support.Research Aim:This study aims to develop a nipple trauma evaluation system using deep learning.Methods:We used an exploratory data analysis approach to develop a deep-learning model for medical imaging. Employing object detection and classification, this Japanese study retrieved 753 images from a previous study. The classification protocol, based on the “seven signs of nipple trauma associated with breastfeeding,” categorized the images into eight classes. For practical purposes, the eight original classes were consolidated into four broader categories: “None,” “Minor,” “Moderate,” and “Severe,” using data augmentation procedures that were consistent with the original classification system. The Precision, Recall, Overall Accuracy, and Area Under the Curve (AUC) were calculated, and the model’s efficiency was evaluated using Frames Per Second (FPS).Results:The object detector’s high mean average precision and frames per second rate for nipple and areola detection, confirmed exceptional accuracy. The eight-class image classifier returned notable AUC values, with fissures, peeling, purpura, and scabbing exceeding 0.8. The highest average recall and precision was for scabbing, and the lowest for blistering. The four-class classifier accurately predicted severe conditions, with an average AUC > 0.7, whereas categories without classifications and those deemed minor had lower recall and precision rates.Conclusions:A sophisticated deep learning system detects and classifies nipple trauma automatically, potentially aiding breastfeeding caregivers through objective image assessment and operational improvements.Abstract in Japanese背景： 母乳育児支援における深層学習の活用に関する研究は行われていない。目的： 本研究は、深層学習を用いた乳頭損傷評価システムの開発を目的とした。方法： 本研究では、医療画像を用いた深層学習モデルを開発するため、探索的データ分析アプローチを用いた。物体検出および画像分類の技術を用い、日本で行われた先行研究で撮影された753枚の画像を二次解析した。「授乳に伴う乳頭組織の７所見」に基づき、画像を8クラスに分類した。実用性を考慮し、4つの主要カテゴリ「なし」、「軽度」、「中等度」、「重度」の4つのカテゴリに統合し、元の分類システムに一致するデータ拡張を行った。精度、再現率、Overall Accuracy、AUC（曲線下面積）を算出し、モデルの効率はFPS（Frames Per Second）で評価した。結果： 物体検出における高いmAP（平均精度）とFPSが示され、乳頭および乳輪の検出精度が確認された。8クラスの画像分類は、亀裂、皮膚剝離、紫斑、痂皮で0.8を超える顕著なAUC値が得られた。再現率と精度が最も高かったのは痂皮であり、水疱で最も低かった。4クラスの画像分類は重度の状態を正確に予測し、平均AUCは0.7を超えたが、傷なしや軽度とされるカテゴリは再現率と精度が低い結果となった。結論： 深層学習を活用したこの高度なシステムは、乳頭損傷の検出と分類を自動で行うことができ、客観的な画像評価を通じて、母乳育児支援者の教育と業務改善をサポートする有望なツールとなり得る。Back Translation Completed by Hiroko Hongo, MSW, PhD, IBCLC
Background:No research has been conducted on the use of deep learning for breastfeeding support.Research Aim:This study aims to develop a nipple trauma evaluation system using deep learning.Methods:We used an exploratory data analysis approach to develop a deep-learning model for medical imaging. Employing object detection and classification, this Japanese study retrieved 753 images from a previous study. The classification protocol, based on the “seven signs of nipple trauma associated with breastfeeding,” categorized the images into eight classes. For practical purposes, the eight original classes were consolidated into four broader categories: “None,” “Minor,” “Moderate,” and “Severe,” using data augmentation procedures that were consistent with the original classification system. The Precision, Recall, Overall Accuracy, and Area Under the Curve (AUC) were calculated, and the model’s efficiency was evaluated using Frames Per Second (FPS).Results:The object detector’s high mean average precision and frames per second rate for nipple and areola detection, confirmed exceptional accuracy. The eight-class image classifier returned notable AUC values, with fissures, peeling, purpura, and scabbing exceeding 0.8. The highest average recall and precision was for scabbing, and the lowest for blistering. The four-class classifier accurately predicted severe conditions, with an average AUC > 0.7, whereas categories without classifications and those deemed minor had lower recall and precision rates.Conclusions:A sophisticated deep learning system detects and classifies nipple trauma automatically, potentially aiding breastfeeding caregivers through objective image assessment and operational improvements.Abstract in Japanese背景： 母乳育児支援における深層学習の活用に関する研究は行われていない。目的： 本研究は、深層学習を用いた乳頭損傷評価システムの開発を目的とした。方法： 本研究では、医療画像を用いた深層学習モデルを開発するため、探索的データ分析アプローチを用いた。物体検出および画像分類の技術を用い、日本で行われた先行研究で撮影された753枚の画像を二次解析した。「授乳に伴う乳頭組織の７所見」に基づき、画像を8クラスに分類した。実用性を考慮し、4つの主要カテゴリ「なし」、「軽度」、「中等度」、「重度」の4つのカテゴリに統合し、元の分類システムに一致するデータ拡張を行った。精度、再現率、Overall Accuracy、AUC（曲線下面積）を算出し、モデルの効率はFPS（Frames Per Second）で評価した。結果： 物体検出における高いmAP（平均精度）とFPSが示され、乳頭および乳輪の検出精度が確認された。8クラスの画像分類は、亀裂、皮膚剝離、紫斑、痂皮で0.8を超える顕著なAUC値が得られた。再現率と精度が最も高かったのは痂皮であり、水疱で最も低かった。4クラスの画像分類は重度の状態を正確に予測し、平均AUCは0.7を超えたが、傷なしや軽度とされるカテゴリは再現率と精度が低い結果となった。結論： 深層学習を活用したこの高度なシステムは、乳頭損傷の検出と分類を自動で行うことができ、客観的な画像評価を通じて、母乳育児支援者の教育と業務改善をサポートする有望なツールとなり得る。Back Translation Completed by Hiroko Hongo, MSW, PhD, IBCLC
Systematic Review on the Efficacy of Moisturizing Therapy in Treating Nipple Trauma and Nipple Pain
Journal of Human Lactation, Ahead of Print.
Background:Nipple trauma and pain pose a challenge, leading to premature discontinuation of breastfeeding. Moisturizing therapies, including lanolin and hydrogel dressings, have been proposed for nipple trauma and pain management. Despite the availability of multiple approaches, evidence for moisturizing therapy is lacking.Research Aim:This review aimed to determine the efficacy of moisturizing therapy in treating nipple trauma and nipple pain in lactating women.Methods:A systematic review based on the PRISMA-P guidelines was conducted. Seven databases were systematically searched and screened, and 24 studies were analyzed. The interventions were categorized as high, moderate, or low, based on their moisturization levels. Sample characteristics, interventions, and outcomes were examined.Results:A total of 21 interventions were identified: high moisturization (two types), moderate moisturization (12 types), and low moisturization (seven types). Hydrogel dressings, lanolin, and breast milk are commonly used interventions. Although intervention and effectiveness evaluation methods differed between studies and could not be compared, results in 10 (41%) of the studies demonstrated that one intervention with more moistening was more effective. Of the three studies categorized as including high moistening interventions, two (66%) supported their effectiveness compared to low moistening interventions; however, two of the three studies were judged to be at high risk of bias, and some reported adverse events.Conclusions:Moisturization interventions show promise for treating nipple trauma and pain more than drying nipples or using breast milk, but high moisturization needs cautious use due to few rigorous trials and the presence of reported risks. Methodological challenges and the lack of robust trials hinder evidence synthesis and robust conclusions.Abstract in Japanese背景： 乳頭損傷や乳頭痛は産褥早期に授乳を断念する要因である。その対処法として、ラノリンやハイドロジェルドレッシングによる保湿療法が提案されている。しかし、乳頭損傷や乳頭痛に対する保湿療法の効果に関する検討は不足している。目的： 本システマティックレビューは、授乳中の乳頭損傷と乳頭痛の治療における保湿の有効性を検討することを目的とした。方法： PRISMA-Pガイドラインに基づく系統的レビューを実施した。7つのデータベースを用いて、体系的に検索とスクリーニングを行い、最終的に24件の文献を対象とした。介入方法を保湿レベルに基づいて高保湿、中保湿、低保湿に分類し、サンプル特性や、介入、および結果について検討した。結果： 高保湿（2種類）、中保湿（12種類）、低保湿（7種類）の合計21種類の介入が特定された。ハイドロジェルドレッシング、ラノリン、母乳の塗布が一般的な介入として使用されていた。介入および効果の測定方法は研究間で異なり、結果の統合は困難であったが、10件（41％）でより高い保湿の介入が効果的であるとされていた。高保湿に分類された3件のうち2件（66％）が低保湿の介入と比較して効果的であるとされたが、2件（66％）はバイアスリスクが高いと判定された文献であり、有害事象の報告もあった。結論： 保湿療法は乾燥や母乳の塗布と比較して乳頭損傷や乳頭痛の対処法として有望であるが、高保湿の対処法には厳密な無作為化比較試験の不足と有害事象の報告があり、慎重な検討が必要である。堅牢な実験研究の不足と方法論的な課題が、結果の統合とエビデンスの確立の妨げとなっている。Back translated by Katsumi Mizuno, PhD, MD, IBCLC
Background:Nipple trauma and pain pose a challenge, leading to premature discontinuation of breastfeeding. Moisturizing therapies, including lanolin and hydrogel dressings, have been proposed for nipple trauma and pain management. Despite the availability of multiple approaches, evidence for moisturizing therapy is lacking.Research Aim:This review aimed to determine the efficacy of moisturizing therapy in treating nipple trauma and nipple pain in lactating women.Methods:A systematic review based on the PRISMA-P guidelines was conducted. Seven databases were systematically searched and screened, and 24 studies were analyzed. The interventions were categorized as high, moderate, or low, based on their moisturization levels. Sample characteristics, interventions, and outcomes were examined.Results:A total of 21 interventions were identified: high moisturization (two types), moderate moisturization (12 types), and low moisturization (seven types). Hydrogel dressings, lanolin, and breast milk are commonly used interventions. Although intervention and effectiveness evaluation methods differed between studies and could not be compared, results in 10 (41%) of the studies demonstrated that one intervention with more moistening was more effective. Of the three studies categorized as including high moistening interventions, two (66%) supported their effectiveness compared to low moistening interventions; however, two of the three studies were judged to be at high risk of bias, and some reported adverse events.Conclusions:Moisturization interventions show promise for treating nipple trauma and pain more than drying nipples or using breast milk, but high moisturization needs cautious use due to few rigorous trials and the presence of reported risks. Methodological challenges and the lack of robust trials hinder evidence synthesis and robust conclusions.Abstract in Japanese背景： 乳頭損傷や乳頭痛は産褥早期に授乳を断念する要因である。その対処法として、ラノリンやハイドロジェルドレッシングによる保湿療法が提案されている。しかし、乳頭損傷や乳頭痛に対する保湿療法の効果に関する検討は不足している。目的： 本システマティックレビューは、授乳中の乳頭損傷と乳頭痛の治療における保湿の有効性を検討することを目的とした。方法： PRISMA-Pガイドラインに基づく系統的レビューを実施した。7つのデータベースを用いて、体系的に検索とスクリーニングを行い、最終的に24件の文献を対象とした。介入方法を保湿レベルに基づいて高保湿、中保湿、低保湿に分類し、サンプル特性や、介入、および結果について検討した。結果： 高保湿（2種類）、中保湿（12種類）、低保湿（7種類）の合計21種類の介入が特定された。ハイドロジェルドレッシング、ラノリン、母乳の塗布が一般的な介入として使用されていた。介入および効果の測定方法は研究間で異なり、結果の統合は困難であったが、10件（41％）でより高い保湿の介入が効果的であるとされていた。高保湿に分類された3件のうち2件（66％）が低保湿の介入と比較して効果的であるとされたが、2件（66％）はバイアスリスクが高いと判定された文献であり、有害事象の報告もあった。結論： 保湿療法は乾燥や母乳の塗布と比較して乳頭損傷や乳頭痛の対処法として有望であるが、高保湿の対処法には厳密な無作為化比較試験の不足と有害事象の報告があり、慎重な検討が必要である。堅牢な実験研究の不足と方法論的な課題が、結果の統合とエビデンスの確立の妨げとなっている。Back translated by Katsumi Mizuno, PhD, MD, IBCLC
Association Between Breastfeeding Peer Support and Confidence in Breastfeeding
Journal of Human Lactation, Ahead of Print.
Background:Peer support programs may be effective for supporting breastfeeding among diverse groups, and in reducing disparities. This study provides insight regarding the implementation and outcomes of a peer breastfeeding support program.Research Aims:(1) to examine how participation affected the outcomes of breastfeeding motivation, confidence, and coping strategies; and (2) to evaluate satisfaction with the program.Method:This was a cross-sectional, retrospective study. Seven pilot sites in the United States uniquely implemented a federally-funded peer support program for low-income women. Data were collected using a survey and focus groups/interviews. Over 12 months, 1,296 women participated, comprising 615 peer support pairs. A total of 401 women responded to the survey. Twenty-three focus groups and 63 interviews were conducted across the seven sites.Results:Participants who enrolled in the program during pregnancy: t (189) = −6.55, p < 0.001, and after the baby was born: t (170) = −2.59, p = 0.001, gained confidence in breastfeeding. More satisfied participants were more likely to breastfeed longer: F (7,352) = 12.75, p < 0.001, and cope with breastfeeding challenges: F (7,352) = 7.83, p < 0.001.Conclusion:Effective operation strategies of the peer breastfeeding support program have significantly influenced participant satisfaction. Introducing peer support for low-income women to share their breastfeeding experiences would be beneficial in enhancing breastfeeding rates. However, the generalizability of these findings may be limited to this U.S. federally-funded peer support program.
Background:Peer support programs may be effective for supporting breastfeeding among diverse groups, and in reducing disparities. This study provides insight regarding the implementation and outcomes of a peer breastfeeding support program.Research Aims:(1) to examine how participation affected the outcomes of breastfeeding motivation, confidence, and coping strategies; and (2) to evaluate satisfaction with the program.Method:This was a cross-sectional, retrospective study. Seven pilot sites in the United States uniquely implemented a federally-funded peer support program for low-income women. Data were collected using a survey and focus groups/interviews. Over 12 months, 1,296 women participated, comprising 615 peer support pairs. A total of 401 women responded to the survey. Twenty-three focus groups and 63 interviews were conducted across the seven sites.Results:Participants who enrolled in the program during pregnancy: t (189) = −6.55, p < 0.001, and after the baby was born: t (170) = −2.59, p = 0.001, gained confidence in breastfeeding. More satisfied participants were more likely to breastfeed longer: F (7,352) = 12.75, p < 0.001, and cope with breastfeeding challenges: F (7,352) = 7.83, p < 0.001.Conclusion:Effective operation strategies of the peer breastfeeding support program have significantly influenced participant satisfaction. Introducing peer support for low-income women to share their breastfeeding experiences would be beneficial in enhancing breastfeeding rates. However, the generalizability of these findings may be limited to this U.S. federally-funded peer support program.
Immunological Factors and Macronutrient Content in Human Milk From Women With Subclinical Mastitis
Journal of Human Lactation, Ahead of Print.
Background:Subclinical mastitis is an asymptomatic inflammatory condition of the lactating mammary glands possibly associated with premature interruption of breastfeeding and poor weight gain in infants. However, data on human milk composition in mothers with subclinical mastitis are limited and inconsistent. Although human milk from donors with subclinical mastitis may be used after pasteurization if it meets the criteria, whether the composition is suitable for donor human milk remains unknown.Research Aims:This study assessed the human milk composition of participants with subclinical mastitis and verified the safety of donor human milk, including that from mothers with subclinical mastitis.Methods:This cross-sectional survey included 106 milk samples collected between March 2022 and January 2023. Subclinical mastitis status was assessed using the sodium-potassium ratio, which was measured using an ion-selective electrode. The concentrations of lactoferrin and secretory Immunoglobulin A were analyzed using an enzyme-linked immunosorbent assay. True protein, fat, carbohydrate, and energy levels were analyzed using a mid-infrared transmission spectroscopy.Results:In human milk from the subclinical mastitis group, lactoferrin and true protein concentrations were significantly increased compared to those without subclinical mastitis. A positive correlation was observed between lactoferrin and secretory Immunoglobulin A levels.Conclusions:Increased immunological substances and protein concentrations in human milk are similar to those observed in clinical mastitis, indicating an inflammatory response in the body, even in asymptomatic individuals. Immunological substances and proteins are beneficial for preterm infants. Therefore, human milk from mothers with subclinical mastitis is suitable for use by milk banks.
Background:Subclinical mastitis is an asymptomatic inflammatory condition of the lactating mammary glands possibly associated with premature interruption of breastfeeding and poor weight gain in infants. However, data on human milk composition in mothers with subclinical mastitis are limited and inconsistent. Although human milk from donors with subclinical mastitis may be used after pasteurization if it meets the criteria, whether the composition is suitable for donor human milk remains unknown.Research Aims:This study assessed the human milk composition of participants with subclinical mastitis and verified the safety of donor human milk, including that from mothers with subclinical mastitis.Methods:This cross-sectional survey included 106 milk samples collected between March 2022 and January 2023. Subclinical mastitis status was assessed using the sodium-potassium ratio, which was measured using an ion-selective electrode. The concentrations of lactoferrin and secretory Immunoglobulin A were analyzed using an enzyme-linked immunosorbent assay. True protein, fat, carbohydrate, and energy levels were analyzed using a mid-infrared transmission spectroscopy.Results:In human milk from the subclinical mastitis group, lactoferrin and true protein concentrations were significantly increased compared to those without subclinical mastitis. A positive correlation was observed between lactoferrin and secretory Immunoglobulin A levels.Conclusions:Increased immunological substances and protein concentrations in human milk are similar to those observed in clinical mastitis, indicating an inflammatory response in the body, even in asymptomatic individuals. Immunological substances and proteins are beneficial for preterm infants. Therefore, human milk from mothers with subclinical mastitis is suitable for use by milk banks.
Considerations When Measuring Exclusive Breastfeeding
Journal of Human Lactation, Ahead of Print.
Exclusive breastfeeding, as recommended by the World Health Organization (WHO) for the first 6 months of life, is a critical metric for evaluating maternal and infant feeding practices and health outcomes. Despite its importance, inconsistencies in defining and measuring breastfeeding exclusivity present challenges for research comparability and interpretation. Equally, research design, outcomes of interest, and study resources are necessary considerations when collecting and analyzing exclusive breastfeeding data, and may require the adaption of standardized questions and techniques to individual situations. This paper explores key considerations for researchers when operationalizing and measuring exclusive breastfeeding. We address the nuances of point prevalence and since-birth measures, highlighting their influence on study outcomes and data interpretation. Statistical approaches for analyzing exclusivity data, including logistic regression, survival analysis, and Kaplan-Meier methods, are also discussed. By outlining best practices for precise definitions, tailored data collection, and transparent reporting, this paper aims to provide an overview for precise definition, effective data collection, and clear interpretation.
Exclusive breastfeeding, as recommended by the World Health Organization (WHO) for the first 6 months of life, is a critical metric for evaluating maternal and infant feeding practices and health outcomes. Despite its importance, inconsistencies in defining and measuring breastfeeding exclusivity present challenges for research comparability and interpretation. Equally, research design, outcomes of interest, and study resources are necessary considerations when collecting and analyzing exclusive breastfeeding data, and may require the adaption of standardized questions and techniques to individual situations. This paper explores key considerations for researchers when operationalizing and measuring exclusive breastfeeding. We address the nuances of point prevalence and since-birth measures, highlighting their influence on study outcomes and data interpretation. Statistical approaches for analyzing exclusivity data, including logistic regression, survival analysis, and Kaplan-Meier methods, are also discussed. By outlining best practices for precise definitions, tailored data collection, and transparent reporting, this paper aims to provide an overview for precise definition, effective data collection, and clear interpretation.
Bridging the Gap Between Lactation Care and Research in Human Lactation
Journal of Human Lactation, Ahead of Print.
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
SubscribeFeliratkozás a következőre: Journal of Human Lactation - online first articles hírcsatorna
Ha tetszik, oszd meg!
Mamami podcast
Breastfeeding Medicine Podcast
JHL podcast
