Journal of Human Lactation最新文献

Background: Breastfeeding rates in Ireland are among the lowest in the world. Social support networks influence initiation and duration.

Research aim: To describe pregnant and postpartum women's encounters and experiences with health care professionals, family, or friends around breastfeeding in Ireland.

Method: Using a qualitative framework design, data were collected as part of a wider study. Online diary entries were collected between October 2021 and May 2022. Participants reflected on their breastfeeding encounters, focusing on timing, context, and feelings evoked about breastfeeding support. These a priori categories were the starting point for analysis.

Results: Participants (N = 27) produced a total of 91 diary entries entered while participants were from 13 weeks pregnant to 30 weeks postpartum. Most interactions recorded were with family members, friends, and lactation support providers. Three themes were identified: (1) Family Circle of Influence, (2) It Takes a Village, and (3) Maternity Service Providers. "Family Circle of Influence" included reflections on the influence of those closest to participants on their breastfeeding journey. Partners and female relatives were generally supportive and provided emotional support, despite having concerns about the decision to breastfeed. "It Takes a Village" covered troubleshooting feeding issues with friends and support groups. Experiences within this wider community group were influential, positively and negatively. "Maternity Service Providers" captured information sources, skills provision, and conflicting advice, which sometimes undermined maternal confidence.

Conclusion: Participants' breastfeeding journeys included encounters with family, social networks, and wider health services. Cumulative diary entries provided reflections on the emotional impact of supportive or undermining interactions on breastfeeding decisions.

Introduction: The World Health Organization recommends exclusive breastfeeding in the first 6 months of life. Substances used by the nursing mother may be transported through human milk (HM) and absorbed through the infant's gastrointestinal tract; thus, a mother's exposure to illicit drugs such as cocaine (COC) may pose a risk to the breastfeeding child's health.

Main issue: On January 19, a 10-day-old newborn girl was admitted at 9 am to the municipal emergency room with cyanosis, abundant sialorrhea (drooling or salivation), and without clinical response even after being stimulated. The mother reported offering the baby supplementary feeding with formula at 4 am and breast milk at 5:30 am The mother admitted dependence on COC and reported that she had inhaled six lines of COC hydrochloride powder between 6 pm on January 18 and midnight on January 19.

Conclusion: Case reports of lactational intoxications are frequent, especially with drugs, like COC, which can build up in acidic body fluids, like human milk, without the ability to disperse. Development of new biomarkers for early diagnosis of intoxication are needed for substances with toxic potential, such as COC. An increase in activated Partial Thromboplastin Time (aTTP) time may be associated with lactational COC intoxication and may serve as an early biomarker for liver damage. Furthermore, immunochromatography assays serve as alternative screening tools, particularly well-suited for emergency scenarios involving suspected drug exposure, employing biological samples to enable rapid assessment. More studies are needed to assess the influence of COC exposure on coagulation parameters.

Background: Human milk shapes neonatal immunity through antibodies, transferring passive immunity to the infant, mainly by secretory IgA (sIgA). sIgA provides antimicrobial defense in the infant's gastrointestinal tract, protecting the newborn against infections and mediating much of the potential of human milk to decrease disease risk. Although maternal nutrition may influence some human milk characteristics, the influence of specific maternal macro and micronutrient intake on sIgA concentrations in colostrum is unknown.

Research aim: To evaluate the association of maternal nutrient intake with sIgA in colostrum and neonatal feces of full-term newborns from healthy mothers.

Method: We used a cross-sectional design to study the colostrum of healthy mothers with uncomplicated pregnancies (N = 17) and the neonatal feces of their term infants. Maternal intake at term was assessed, and the concentration of sIgA was measured by ELISA.

Results: The mean (SD) concentration of sIgA in colostrum was 3.42 (6.0) mg/ml, and 8.5 (1.93) mg/g in neonatal feces. The concentration of sIgA in colostrum did not correlate with fecal sIgA concentrations (r = -0.166 p = 0.606). sIgA concentrations in colostrum or feces were similar by sex and delivery method (p = 0.880 and p = 0.0946 respectively). Maternal macro and micronutrient intake was not associated with colostrum or fecal sIgA. Concentrations of sIgA in colostrum and feces were not correlated with maternal age, pregestational BMI, or gestational weight gain. Also, no correlations between colostrum sIgA concentrations and neonatal anthropometry were found. Interestingly, fecal sIgA was negatively associated with birth weight (R² = 0.433, p = 0.032), independent of gestational age.

Conclusions: These results suggest that colostrum maintains its immunological properties, independently of maternal nutritional intake at term, and that the presence of sIgA in the newborn's intestine may be related to the newborn's weight. These findings can encourage women to establish lactation as early as possible and continue with it, confident that their dietary habits prior to birth do not affect their colostrum's immune potential.

Introduction: Preterm infants frequently face challenges in breastfeeding, leading to lower initiation rates and shorter durations compared to full-term infants. It is unclear how prematurity shapes breastfeeding behavior with subsequent births.

Research aims: This study aims to determine how preterm birth of firstborn or second-born children moderated the association between first-birth breastfeeding experience and breastfeeding outcomes after a second birth.

Methods: This retrospective cohort study used 2011-2019 National Survey of Family Growth data and included individuals (N = 6,031) ages 18-49 with at least two singleton live births. Study outcomes were assessed for second-born children and included breastfeeding initiation and duration. The primary exposure was breastfeeding experience with the firstborn child, defined as the firstborn child receiving human milk for at least 1 week. Multivariable logistic regression was used to evaluate the interaction between the prematurity of the first or second child and the breastfeeding experience.

Results: Breastfeeding experience with the first child increased the odds of breastfeeding initiation for the second child (OR = 16.98; 95% CI [13.53, 21.30]). The association was smaller if the first child was born preterm (OR = 12.09; 95% CI [7.15, 20.45]) or if the second child was born preterm (OR = 10.72; 95% CI [6.09, 18.87]). However, neither interaction term was statistically significant for preterm birth of first or second child. Additionally, prematurity did not moderate the association of breastfeeding experience with the breastfeeding duration of second children.

Conclusion: Helping primiparous individuals overcome barriers to breastfeeding increases the odds of breastfeeding in first- and second-born children, irrespective of prematurity.

Background: Individuals with hypertensive disorders of pregnancy are at a significantly increased risk for chronic hypertension and premature cardiovascular disease. Although breastfeeding may have cardiovascular benefits, those with hypertensive disorders of pregnancy tend to have lower rates of breastfeeding initiation, duration, and exclusivity. A deeper understanding of their breastfeeding experiences is necessary to inform effective interventions that support lactation.

Research aim: This study aimed to explore breastfeeding challenges, enablers, and factors influencing breastfeeding confidence among individuals with hypertensive disorders of pregnancy.

Method: This study employs a descriptive, qualitative approach. Semi-structured telephone interviews were conducted between 2 and 8 months postpartum with a convenience sub-sample of 18 individuals enrolled in a pilot randomized controlled trial of a breastfeeding support intervention in Quebec, Canada. The interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis. Data were coded and grouped under three categories related to the main interview questions (breastfeeding challenges, enablers, and factors influencing breastfeeding confidence).

Results: Perinatal complications, struggles with milk supply, high rates of formula supplementation, and lack of consistent or skilled breastfeeding support challenged early breastfeeding experiences. Breastfeeding enablers included hands-on support with feedings, accessible breastfeeding information and support, and being determined to breastfeed. Discouragement to breastfeed from family or health professionals diminished breastfeeding confidence whereas learning from the breastfeeding experiences of others and positive reinforcement for breastfeeding efforts helped build breastfeeding confidence.

Conclusions: Skilled, proactive lactation support targeting breastfeeding confidence may help optimize breastfeeding outcomes among individuals with hypertensive disorders of pregnancy, potentially mitigating their longer-term cardiovascular risks.

Helen Ball is professor of anthropology and Director of the Durham Infancy & Sleep Centre. She obtained her PhD in anthropology from the University of Massachusetts, Amherst, in 1992. Her new book How babies sleep: A factful guide to the first 365 days and nights was published by Penguin Random House in May 2025. Helen studies infant sleep and the parent-infant sleep relationship from a biosocial perspective, focusing on the sleep ecology of infants, young children, and their parents. She pioneers the translation of academic research on infant sleep into evidence for use by parents and healthcare staff via Basis-the Baby Sleep Information Source website. She serves on the Lullaby Trust Scientific Advisory Group, and the United Nations Children's Fund (UNICEF) UK Baby Friendly Initiative Qualifications Board, and was recently appointed as a National Mentor (United States) for the Betty Irene Moore Fellowship in Leadership and Innovation Program. She has previously served as an associate editor for the journal Sleep Health, and as an editorial board member for the Journal of Human Lactation. From 2016 to 2025, she was Chair of the Lullaby Trust Research & Grants Committee, and from 2018 to 2024, she was elected as a board member of the International Society for the Study and Prevention of Infant Deaths (ISPID). In 2013, Helen received an award for Outstanding Impact in Society from the Economic and Social Research Council, and in 2018, Durham University received the Queen's Anniversary Prize for her research and outreach on parent-infant sleep.

Background: Relactation is the process of re-establishing a breast milk supply that has diminished or ceased.

Aim: This study aimed to determine the effects of a relactation support program on milk secretion among mothers who had ceased any milk production, mother-infant attachment, and maternal roles.

Methods: This single-group quasi-experimental study was conducted with 34 mothers who had 1-4-month-old infants, and who had stopped breastfeeding for at least 15 days and, at most, 3 months with complete cessation of milk secretion. The relactation support program consisted of eight home visits and seven telephone support sessions over 15 days. Mothers were taught relactation techniques, including nipple stimulation, skin-to-skin contact, and the finger feeding method. Data were assessed using the Mother-Infant Monitoring Form, Maternal Attachment Inventory (MAI), and the Barkin Index of Maternal Functioning (BIMF).

Results: Milk secretion returned in 64.7% (n = 22) of the participants, with first milk secretion occurring on Day 6 (mean first secretion: 8.95, SD = 2.17 days). Overall, study activities including daily nipple stimulation (χ² = 42.087, p < 0.001) and frequency of putting the baby to the breast (χ² = 134.93, p < 0.001) increased, as did milk secretion (χ² = 303.604, p < 0.001). A shorter weaning period increased the chance of re-lactation (U = 24.00, z = -4.011, p < 0.001). Both maternal function (BIMF; z = -5.088, p < 0.001) and maternal attachment (MAI; z = -5.013, p < 0.001) scores increased significantly over the study period. Participants who were able to relactate had better maternal functions (U = 44.50, z = -3.160, p = 0.002) and higher maternal attachment levels than those who did not (U = 73.50, z = -2.110, p = 0.034).

Conclusion: This study demonstrates that relactation can be achieved and has maternal benefits beyond simply the return of milk secretion.