Hírolvasó

Timely initiation of breastfeeding can reduce neonatal morbidities and mortality. We aimed to study predictors for timely initiation of breastfeeding (within 1 h of birth) among neonates born in hospitals of N...

Journal of Human Lactation, Ahead of Print.
Background:Microwave heating can be effective in preventing cytomegalovirus infection transmitted via human milk. Temperature changes during microwaving using different containers, in different areas inside a container, or using milk from different mothers are not well studied.Research Aim:To determine temperature changes of human milk during microwaving using different containers, in different container areas, using different human milk, and in a 30-ml soft polypropylene bag (sachet) immersed in water.Methods:In this experimental in vitro study, human milk (100 ml) was poured into six different bottles. The temperature was monitored simultaneously at each bottle’s bottom and surface (microwaving at 600 W) and at nine places inside the container (microwaving at 500 W). Human milk (20 ml) from six participants was inserted into a sachet, then immersed in 80 ml of human milk or water in a bottle, and the temperatures inside and outside the sachet during microwaving (at 500 W) were monitored.Results:The temperature changes at the surface were significantly larger than those at the bottom. Temperatures at the bottoms of different bottles, of human milk from different participants, or inside and outside the sachet, did not differ significantly. No temperature outliers inside the bottle were observed.Conclusion:Microwaving at 500 W and 600 W for 60 s was not significantly different in temperature changes among different areas inside bottles or among milk from different participants. A small volume of human milk (up to 100 mL) can be heated using a sachet.

Breastfeeding is associated with lower incidence and severity of lower respiratory tract disease. However, little is known about the relationship between feeding type and breastfeeding duration with bronchioli...

It has been demonstrated that children who had been breastfed remain better protected against various infections, and notably respiratory tract infections, well beyond infancy. Since the role of breastfeeding ...

Despite numerous benefits, many mothers stop breastfeeding soon after birth. A common reason for this is the experience of pain or discomfort. One resource which women use to share their breastfeeding challeng...

Botswana updated its antiretroviral treatment (ART) guidelines in May 2016 to support breastfeeding for women living with HIV (WLHIV) on ART who have documented HIV RNA suppression during pregnancy.

You know that oxytocin and prolactin are critical to lactation outcomes. But how direct is the relationship? If you knew a parents’ oxytocin and prolactin levels following birth, could you make predictions about how soon their milk would come in, their baby’s milk transfer, or even their baby’s weight gain? This is the question Elise […]

Prelacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding but is understudied in Uganda. We examined the prevalence and factors associated with prelacteal feeding among postpartu...

The World Health Organization recommends breastfeeding for at least two years (24 months or more) after birth. In Vietnam, 22% of women continue breastfeeding for at least two years. The aim of this study was ...

Despite considerable policy actions at the national and hospital levels, rates of breastfeeding in the Middle East and North Africa (MENA) region remain below the global average. There is a need to explore the...

This study aimed to identify the differences in clinical characteristics, puncture efficacy, antibiotic use, treatment duration, breastfeeding post-illness, and recurrence of patients with breast abscesses cau...

The migratory flows in Spain have changed due to the arrival of a diverse migrant population. Among the new migrants the Latino collective predominate with more than half being women of childbearing age. There...

One of the most important protective health factors for children is breast-feeding, but the mechanisms for this effect are not fully elucidated. Our objective was to assess if the duration of breastfeeding inf...

Journal of Human Lactation, Ahead of Print.
Background:There is evidence that breastfeeding may provide protection against cardiovascular risk factors in mothers with a history of gestational diabetes mellitus and their children who were exposed in utero.Research Aim:To perform a systematic review and meta-analysis of observational studies to ascertain the effects of breastfeeding on cardiovascular risk factors in women with previous gestational diabetes mellitus and their children exposed in utero.Methods:Studies assessing conventional cardiovascular risk factors in women with previous gestational diabetes mellitus and children exposed in utero stratified by breastfeeding/no breastfeeding or breastfed/not breastfed were included. Gestational diabetes mellitus was defined based on the International Association of Diabetes in Pregnancy Study Group definition or previous accepted definitions. Breastfeeding was defined as reported in each study.Results:The literature search yielded 260 titles, of which 17 studies were selected to be in the review. Women with previous gestational diabetes mellitus who did not breastfeed had higher blood glucose (SMD: 0.32, 95% CI [0.12, 0.53]) and a greater risk of developing Type 2 diabetes mellitus (RR: 2.08 95% CI [1.44, 3.00]) compared to women with no history. There were not enough studies to conduct a meta-analysis on the effects of breastfeeding on risk factors for cardiovascular disease among children exposed to gestational diabetes mellitus in utero.Conclusion:Breastfeeding appears to be protective against cardiovascular risk factors among women who experience gestational diabetes mellitus.

Journal of Human Lactation, Ahead of Print.
Introduction:Medicalized Ketogenic Therapy is commonly used to treat refractory epilepsy. Patients have varying degrees of seizure or symptom relief, responding at individual levels of ketone production. Typically, initiating the therapy necessitates the discontinuation of breastfeeding. Our case study mother was keen to continue breastfeeding if possible. We were able to achieve this by placing the healthy mother on a ketogenic diet and altering the composition of the mother’s own milk.Main Lactation Issue:Pediatric Medicalized Ketogenic Therapy is delivered through a ketogenic diet consisting of up to 90% fat, measuring of ingredients to 0.1 g matching a food prescription of fat, protein, and carbohydrate. We placed the mother on a less stringent ketogenic diet achieving 61% fat and measured both infant and mother’s blood sugar levels and ketones. The hypothesis was that changes would occur in the mother’s own milk fat content, and/or ketones would be passed directly to the infant. If therapeutic levels of ketones were reached in the infant and a reduction in seizures observed, breastfeeding could continue.Management Overview:Over 3 months we achieved a calorific increase of the mother’s mature milk by an additional 134%. The infant was successfully put into nutritional ketosis and visible seizures eliminated.Conclusion:Medicalized Ketogenic Therapy can be safely used to treat seizures of breastfeeding infants diagnosed with epilepsy, through management of the mother on a ketogenic diet. Significantly increasing the mature mothers own milk fat component could have implications for other areas, including faltering growth.

Journal of Human Lactation, Ahead of Print.
Background:The COVID-19 pandemic presents unique challenges to maternity settings. Its effect on providing in-hospital lactation support has not been well described.Research Aim:To describe the experiences of healthcare workers as they provided in-hospital lactation support during the pandemic.Methods:A prospective, cross-sectional, online survey evaluated healthcare providers working with postpartum women and newborns affected by COVID-19 at an academic center during March–June 2020. Providers were queried regarding the influence of COVID-19 and COVID-19-specific policies on providing lactation support. Questions assessed guidance received, perceived stress, difficulty providing care, and solicited qualitative responses. The constant comparative method was used to analyze qualitative data.Results:Of 108 providers, 70 (65%) completed the survey. Of 57 providing direct lactation support to women affected by COVID-19, most (n = 39, 67%) reported increased stress. Participants reported lower stress scores when receiving guidance through shift meetings or email compared to those not receiving this guidance [stress score with shift meeting guidance (M [SD]): 3.10 (0.88); score without guidance: 3.83 (0.66); n = 39, p = .009; score with email guidance: 3.79 (0.58); score without guidance: 4.50 (0.58); n = 18, p = .045). Qualitative responses (n = 67; 96%) identified three themes: visitor restrictions allowed less distraction during lactation support; physical separation disrupted maternal/infant bonding; workflow challenges resulted from policy changes and supply access.Conclusions:Most participating staff providing lactation support to women affected by COVID-19 reported increased stress. Ensuring written or verbal guidance may reduce staff’s experiences of stress. Efforts to optimize lactation support during COVID-19 should consider reducing distractions, physical separation, and logistic challenges.

Journal of Human Lactation, Ahead of Print.
Background:The composition of the human milk microbiome is highly variable and multifactorial. Milk microbiota from various countries show striking differences. There is a paucity of data from healthy lactating Indian mothers.Research Aim:To describe the milk microbiota of healthy North Indian women, using a culture-independent, targeted metagenomic approach.Methods:We recruited exclusively breastfeeding mothers (N = 22) who had vaginally delivered full-term singleton infants in a tertiary care hospital less than 1 week previously and had not recently consumed systemic antibiotics. Milk samples (5 ml) were collected aseptically, and microbial deoxyribonucleic acid was extracted. Microbial composition and diversity were determined using a 454-pyrosequencing platform. Core genera were identified, and their relative abundances ranked. Heatmaps showing the variation of the ranked abundances and Shannon index were obtained using R.Results:Participants (all exclusively vegetarian) had a mean (SD) age of 27.2 (3.4) years, postnatal age of 3.9 (1.6) days and gestation 38 (1.2) weeks. The dominant phylum was Proteobacterium (relative abundance 84%) and dominant genus Pseudomonas (relative abundance 61.78%). Eleven species of Pseudomonas were identified, all generally considered nonpathogenic. Based on abundance patterns of the core genera, the milk samples could be grouped: (a) dominated by Pseudomonas with low diversity; (b) less Pseudomonas and high diversity; and (c) dominated by Pseudomonas but high diversity. All neonates were healthy and gaining weight well at 1 month of age.Conclusions:Healthy, lactating, vegetarian, North Indian women who deliver at term gestation and have no recent exposure to antibiotics, have a unique milk microbiome dominated by Pseudomonas.

Exclusive breastfeeding is widely accepted as a key intervention with proven efficacy for improving newborn survival. Despite international commitments and targets to support and promote breastfeeding, there a...

Optimal breastfeeding practices including early initiation of breastfeeding and exclusive breastfeeding (EBF) are associated with positive health outcomes. Socioeconomic inequalities in key breastfeeding indic...

Body image concerns have been widely documented in the literature as one reason why most women shorten the breastfeeding duration of their infants. Negative body image concerns among breastfeeding mothers may ...