Journal of Human Lactation最新文献

Background: A disrupted gut microbiome during an infant's first 1000 days of life can lead to long-lasting negative effects on child health. Cesarean delivery and formula feeding are two factors that can detrimentally impact infant microbiome development as well as maternal mental health. Donor human milk may be a superior supplementation alternative to formula.

Research aim: To examine donor human milk supplementation compared to formula supplementation in full-term infants born via Cesarean section and the impact on the infant gut microbiome, infant health outcomes, breastfeeding outcomes, and maternal mental health.Methods and Planned Analyses:We are conducting a pilot clinical randomized controlled trial, comparing donor human milk to formula supplementation for 187 full-term infants born via Cesarean section who are breastfeeding and require supplementation in the first postnatal week of life. Infant stool samples, breastfeeding outcomes, maternal mental health, and child health outcomes will be measured at 1-week, 3-, 6-, and 12-months postpartum. Additionally, child health and maternal mental health are being assessed at 18- and 36-months postpartum.

Discussion: This study will generate essential data on the association between supplementation types and the full-term infant microbiome, breastfeeding exclusivity and duration, and infant health. It will also provide preliminary data to inform a multi-site, longitudinal mixed-methods randomized controlled trial that will assess longer term child health outcomes. This evidence may be used to inform guidelines and policies that will increase accessibility to and raise awareness of donor human milk as a supplementation option in this population.

This article narrates a lived experience of how to write a case study. The essential ingredient to get started is wonder-some sparkle of awe. As International Board Certified Lactation Consultants, we are in privileged position as we witness how families find the strength and courage to overcome puzzling situations to forge their own breastfeeding paths. In addition to a story, the author explains that she also needed a map and compass to write her first case study. She explored the medical literature and read many cases studies where she found guidance on developing the backbone of her first case study. This article explains how writing should be accessible to all-even to those who are not in academia. One does not have to have a PhD to get published.

Introduction: Existing evidence on the effects of combined hormonal contraception on mothers' milk production is inconclusive. This report describes two breastfeeding Swedish women who used combined hormonal contraceptives containing drospirenone (3 mg) and ethinylestradiol (0.03 mg).

Main issue: Both participants experienced decreased milk production after initiating the combined hormonal contraceptives. The growth charts of their children show decreased growth during the same period and recovery after combined hormonal contraception was discontinued.

Management: Combined hormonal contraception was discontinued, and measures were taken to increase milk production and follow infant growth.

Conclusion: These cases follow two experiences of low milk production after initiation of combined oral contraceptives. In these cases, there was a resolution of infant weight gain with discontinuation of the medication.

Background: Media and advertising significantly shape mothers' infant feeding decisions, influencing whether to breastfeed or formula feed. Understanding these influences is crucial for promoting informed feeding practices.

Research aim: This study explored how media and advertisements influence Turkish mothers' decisions regarding breastfeeding or formula feeding.

Methods: This qualitative study, in which a phenomenological design was used, was conducted with 20 mothers of 0-12-month-old infants who were followed up in the healthy child clinic of a public hospital in the Bursa province located in the South Marmara region of Turkey. Descriptive characteristics were collected and semi-structured interviews were carried out and analyzed thematically.

Results: We identified four main themes: mothers' use of media apps, factors influencing breastfeeding, the influence of media and advertising on feeding choices, and mothers' expectations of media and health professionals. Mothers reported using the media to share their experiences of infant development and breastfeeding. They reported that the media often showed celebrities promoting infant formula, and this, combined with advice from health professionals and family members, strongly influenced their feeding decisions. Mothers emphasized the need for the media to take a more positive approach to promoting breastfeeding.

Conclusion: Reducing the impact of formula advertisements and offering accurate breastfeeding information through social media could better support mothers' feeding decisions. Health information would be clearer if policymakers and healthcare professionals prioritized regulating infant formula advertising and promoting breastfeeding on social platforms. Family health center professionals play a crucial role in comprehensive breastfeeding counseling.

Background: Antimicrobial resistance is a global concern. It is particularly impactful during breastfeeding infections when identifying risk factors and protective mechanisms is crucial.

Research aim: This study aimed to assess the prevalence of antibiotic resistance among breastfeeding women diagnosed with mastitis and breast abscesses.

Methods: A cross-sectional analysis of longitudinal data was conducted at a Level III medical center in Italy from January 2016 to December 2020. A total of 203 women were enrolled following diagnoses of mastitis or breast abscesses.

Results: Among the 156 women who tested positive for Staphylococcus aureus infection, culture antibiograms identified 29.6% as methicillin-resistant Staphylococcus aureus (MRSA). Additionally, six women exhibited clindamycin-resistant S. aureus. Exclusive breastfeeding at discharge (OR = 0.40, 95% CI [0.26, 0.84], p = 0.01) and rooming-in (OR = 0.34, 95% CI [0.15, 0.79], p = 0.01) were significantly associated with reduced odds of methicillin-resistant infections; although these findings are based on unadjusted odds ratios. Conversely, the use of breastfeeding aids in-hospital was not significantly associated with odds of resistant bacterial infections (OR 2.02, 95% CI [0.97, 4.18], p = 0.06).

Conclusion: This study underscores the antibiotic resistance scenario of microorganisms causing mastitis and abscesses in our setting. Implementing microbiological surveillance in mother-child settings could aid in identifying local resistance patterns.

Background: Human milk protects very preterm infants from many complications. While quality indicators are crucial for evaluating and improving breastfeeding practices, those specifically tailored for very preterm infants are lacking.

Research aim: To develop a set of practical and reliable indicators for evaluating and improving the quality of breastfeeding for very preterm infants.

Methods: This study employed a longitudinal, prospective survey design utilizing a two-round Delphi method employing the RAND Corporation/University of California Los Angeles Appropriateness Method. A systematic search of the literature was performed across multiple databases, including PubMed, Cochrane, Embase, and Wanfang, to identify potential quality indicators for breastfeeding in very preterm infants. A multidisciplinary expert panel then evaluated these through two Delphi rounds to establish relevance and feasibility.

Results: Twenty-two candidate quality indicators of breastfeeding were extracted for the Delphi process. The experts' authority coefficients for the two rounds were 0.84 and 0.83, respectively. Eleven indicators, encompassing breastfeeding outcome indicators (n = 1), mother's lactation status indicators (n = 3), the breastfeeding process indicators (n = 3), and balancing indicators (n = 4), were considered relevant and feasible and were incorporated into the set of quality indicators for breastfeeding.

Conclusions: This study developed a set of practical and reliable indicators for evaluating and improving the quality of breastfeeding for very preterm infants, based on the collective opinion of content experts. These quality indicators may facilitate an objective and quantitative assessment of breastfeeding quality for this vulnerable population.