Journal of Human Lactation, Ahead of Print.
The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level—healthcare, community, and workplace settings—and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.
Journal of Human Lactation, Ahead of Print.
Background:Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers.Methods and Planned Analysis:This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. During Phase 2, participants are randomized to ACE instruction via a pre-recorded online video or a one-on-one session with a midwife. Adjusted logistic regression analysis will be used to examine the relationship between ACE instruction and breastfeeding outcomes.Research Aims and Questions:Primary aim: (1) Does advising pregnant individuals to practice ACE and providing instruction improve exclusive breastfeeding rates at 4 months postpartum? Secondary research questions: (2) Do individuals who practice ACE have higher rates of exclusive breastfeeding during the initial hospital stay after birth? (3) Is teaching ACE via an online video non-inferior to one-on-one instruction from a midwife? (4) Does expressing colostrum in pregnancy influence time to secretory activation, or (5) result in any differences in the composition of postnatal colostrum?Discussion:Trial findings have important implications for maternity practice, with the online video providing an easily accessible opportunity for ACE education as part of standard antenatal care.
Journal of Human Lactation, Ahead of Print.
In 2015, Miriam Labbok, MD, MPH, entrusted Chele Marmet with the task of writing a chapter on the early history of the lactation consultant profession for the public health textbook she was preparing about lactation, saying, “I invited you to author it because you conceptualized and pioneered the profession, and there is nobody else I could ask who could do it justice,” (M. Labbok, personal communication, June 28, 2015). Chele Marmet envisioned the allied health field of lactation consulting, complete with international educational standards, professional organizations, and a scope of practice. She was an active contributing founder of the International Lactation Consultant Association, developed hundreds of test questions for the early International Board of Lactation Consultant Examiners (IBCLE), and co-founded the first academic (BA and MA) lactation education program, The Lactation Institute, to name only a few of her many innovations and contributions to the field of lactation we know today—a field that has grown exponentially globally since those early days in the 1970s when Chele began creating our profession. Her academic background in speech and hearing gave her the orientation to delve into infants’ oral-motor function. Additional education and experience followed as her passion for helping breastfeeding families grew. This is the first part of her interview; the second part will follow in the next JHL issue. Fortunately, Chele is working on her memoir, which will detail topics we could only briefly discuss in this interview. It was my honor to interview Chele Marmet.Joan E. Dodgson
Journal of Human Lactation, Ahead of Print.
Background:Disparities in breastfeeding rates and exclusivity exist across regions and countries despite multifaceted breastfeeding promotion efforts in recent decades. Markets for artificial milk formula continue to grow as its substitution for breastfeeding is common. A new approach is needed for breastfeeding promotion strategies.Research Aim:This state-of-the-art review aimed to describe the implications of not-breastfeeding on the environment within the context of food system sustainability.Method:A total of 19 peer-reviewed articles within a 20-year timeframe were included in this review. Authors searched five databases for articles including Science Direct, GreenFILE, Springer Link, ProQuest, and PubMed.Results:The demand for artificial milk formula production as a replacement for breastfeeding results in increased greenhouse gas emissions, water pollution, and waste, thereby aggravating problems with freshwater scarcity. A short duration of breastfeeding and limited exclusivity have been associated with close birth spacing and contributing to global population growth. Breastfeeding is a healthy, sustainable diet, and a culturally acceptable first food. It advances health equity and food security. Exclusive breastfeeding for the first 6 months of life can be promoted with emphasis on total carbon footprint reduction, prevention of waterway degradation, and natural birth spacing, thereby sustaining food systems at large.Conclusion:It is important to reform food, nutrition, and environmental policies to protect exclusive breastfeeding while decarbonizing artificial milk formula production. More research is needed to provide directions for new breastfeeding promotion strategies connecting breastfeeding with environmental stewardship.
The World Health Organization recommends breastfeeding as the best method for infant feeding. Known risk factors for breastfeeding non-initiation and early cessation of breastfeeding are diverse and include lo...
The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) in infants for the first 6 months of life. This analysis aims to estimate the proportion of Indian infants exclusively breastfed for...
During the breastfeeding period, important transient changes in calcium homeostasis are verified in the maternal skeleton, to meet the demand for calcium for breastmilk production. The literature is inconclusi...
Journal of Human Lactation, Ahead of Print.
Background:Infant feeding interventions that promote and support breastfeeding are considered important contributions to global public health. As these interventions often target private settings (e.g., individuals’ homes) and involve vulnerable populations (e.g., pregnant women, infants, and underprivileged families), a keen awareness of ethical issues is crucial.Research Aim:The purpose of this scoping review was to capture the key elements of the current ethical discourse regarding breastfeeding and lactation interventions.Method:A scoping review was conducted using Arksey and O’Malley’s (2005) methodology to identify the ethical issues of breastfeeding and lactation interventions as they are reflected in the scholarly literature published between January 1990 and October 2022. Abstracts (N = 3715) from PubMed, ScienceDirect, JSTOR and the Cochrane Database of Systematic Reviews were screened. The final sample consisted of 26 publications.Results:The recurring ethical issues identified in these studies were: the normative assumptions of motherhood; maternal autonomy and informed choice; information disclosure, balancing risks and benefits, and counseling practices; stigma and social context; ethics of health communication in breastfeeding campaigns; and the ethical acceptability of financial incentives in breastfeeding interventions.Conclusion:This review illustrated that, while a wide range of ethical arguments were examined, the emphasis has been primarily on accounting for mothers’ experiences and lactating persons’ choices, as well as achieving public health objectives relating to infant nutrition in breastfeeding interventions. To effectively and ethically implement breastfeeding and lactation interventions, we must consider the social, economic, and cultural contexts in which they occur. One key learning identified was that women’s experiences were missing in these interventions and, in response, we suggest moving beyond the dichotomous approach of individual health versus population health.
Journal of Human Lactation, Ahead of Print.
Background:Toxic trace elements could enter human milk through mothers’ food consumption, drinking water, air, or incidental soil ingestion, and are of concern to the nursing infant.Research Aim:To determine the concentration of toxic trace elements (lead and arsenic) in Peruvian mothers’ milk and their association with blood concentrations in their own infants 3–20 months old.Method:This exploratory, cross-sectional study, carried out in Peru, included breastfeeding mother/child dyads (N = 40). Following standardized protocols, biospecimens of human milk and child’s blood were collected.Results:Lead and arsenic concentrations in milk were above the method detection limits in 73% and 100% of samples with median concentrations of 0.26 µg/L (IQR = 0.10, 0.33 µg/L) and 0.73 µg/L (IQR = 0.63, 0.91 µg/L), respectively. Concentrations of lead and arsenic in blood were 2.05 µg/dL (SD = 1.35), and 1.43 µg/dl (geometric mean: SD = 1.39), respectively. Blood lead concentrations in 12.5% (n = 5) of the samples were above the U.S. Center for Disease Control and Prevention reference value (< 3.5 µg/dl), and over half of arsenic concentrations were above the acceptable levels of < 1.3 µg/dl (Mayo Clinic Interpretative Handbook). Our results showed that for every one-month increase in age, lead blood concentrations increased by 0.1 µg/dl (p = 0.023). Additionally, every 1 µg/L increase in the mother’s milk arsenic was associated with a 1.40 µg/dl increase in the child’s blood arsenic concentration.Conclusions:Implementing effective interventions to decrease the toxic exposure of reproductive-aged women is needed in Peru and worldwide.
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
Introduction:Non-puerperal adoptive lactation sometimes requires long preparation and substantial expense for pharmacological intervention to be successful, which are not feasible in refugee camps. Here we report two case studies of non-puerperal adoptive breastfeeding of two infants in the Rohingya Refugee Camp of Cox’s Bazar, Bangladesh.Main Issue:Two non-pregnant, non-breastfeeding caregivers with previous experience of breastfeeding brought two adopted infants—one a 12-day-old female with severe acute malnutrition, and the other a 2-day-old male with normal anthropometric measurements—to a nutritional stabilization center for feeding. After counseling, both families opted for adoptive lactation.Management:Both infants were treated with a modified Action Against Hunger protocol of in-patient management of severe acute malnutrition using the supplementary suckling technique, a procedure to feed the baby with supplementary feed. Diluted F100 was used as the supplementary feed; the energy and protein gained from it were just enough to maintain body physiology and were not responsible for any weight gain. When the infants gained weight, indicating that the caregivers were producing milk, we reduced the supplementary feed as per protocol guidelines. The caregivers were prescribed domperidone and counseled on their ability to breastfeed the infants. The cases required 35 days and 20 days, respectively, for the full establishment of breastfeeding.Conclusion:This is the first report of successful adoptive breastfeeding in a refugee camp. With proper counseling and motivation of the caregiver, induced lactation can be started without a preparatory period and with very low-cost intervention.
Journal of Human Lactation, Ahead of Print.
More women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant ...
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
Uganda surpasses many African nations and the global average in exclusive breastfeeding (EBF) rates. Yet, malnutrition is a critical issue, with stunting impacting roughly 29% of children under 5 years. Enhanc...
Journal of Human Lactation, Ahead of Print.
Given the limited availability of research on the association between COVID-19 infection and breastfeeding success, the primary objective of this study is to conduct a comprehensive evaluation of this relation...
Journal of Human Lactation, Ahead of Print.
