Breastfeeding Medicine最新文献

Breastfeeding medicine and lifestyle medicine are grounded in preventive health and holistic care, emphasizing early interventions that foster long-term wellness. Dr. Ruth Lawrence, a pioneer in breastfeeding medicine, recognized breastfeeding as a cornerstone of preventive care, advocating for its profound impact on maternal and infant health. Her seminal work, Breastfeeding: A Guide for the Medical Profession, and her role in founding the journal Breastfeeding Medicine have been instrumental in shaping the field, emphasizing both the nutritional and psychosocial benefits of breastfeeding. Breastfeeding provides optimal nutrition, immune protection, and metabolic programming, reducing the risk of acute infections, chronic diseases, and maternal conditions such as postpartum depression and cancer. Similarly, lifestyle medicine focuses on modifiable factors-nutrition, physical activity, stress management, and sleep hygiene-to improve lifelong health outcomes. These fields converge in their shared emphasis, for example, on the gut microbiome, a critical determinant of immune and metabolic health. Breastfed infants have more diverse and beneficial gut microbiota, which reduce the risk of obesity and metabolic disorders, a focus paralleled by lifestyle medicine's advocacy for plant-based, fiber-rich diets. This review explores the parallels between breastfeeding and lifestyle medicine, advocating for research that moves beyond isolated nutrient analysis to examining whole dietary patterns in breastfeeding mothers. Maternal diet during lactation enhances the bioactive components of breast milk, including prebiotics, probiotics, and immune factors, amplifying its preventive effects. By integrating Dr. Lawrence's forward-thinking principles with insights from lifestyle medicine, breastfeeding medicine can advance its understanding of how maternal nutrition and modifiable lifestyle factors optimize health outcomes for both mother and infant, underscoring the transformative potential of early interventions in shaping lifelong health.

Successful aging is a dynamic process shaped by genetic, environmental, and lifestyle factors that influence health and well-being across the lifespan. Pioneering researchers such as Dr. Ruth Lawrence have demonstrated how intentional choices in diet, physical activity, social engagement, and mental resilience contribute to longevity and quality of life. This review explores the concept of successful aging, tracing its origins in the groundbreaking work of Havighurst, Rowe, and Kahn, and incorporating insights from Dr. George Vaillant's longitudinal studies, including the Harvard Study of Adult Development and the Grant Study. These works highlight the profound impact of psychosocial factors, adaptability, and meaningful relationships in fostering vitality and emotional fulfillment throughout life. Drawing on evidence from meta-analyses, centenarian studies, and landmark intervention trials such as the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, this review examines how modifiable lifestyle factors influence aging trajectories. It also discusses emerging research linking maternal behaviors-such as breastfeeding-to long-term health benefits, including reduced risks of chronic diseases and cognitive decline. Dr. Lawrence's extraordinary century-long life exemplifies these principles, showcasing the interplay of genetics, lifestyle, and purpose in achieving successful aging. By synthesizing existing research and honoring Dr. Lawrence's legacy, this article highlights the importance of integrative approaches to aging well. It advocates for holistic strategies that combine individual health behaviors, community support, and systemic policy changes to promote longevity and health span. Dr. Lawrence's contributions to breastfeeding medicine and her embodiment of the six pillars of lifestyle medicine-nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections-serve as a testament to the power of lifestyle in shaping vibrant, fulfilling lives. Her example inspires a vision of aging as an opportunity for growth, connection, and continued impact.

Objective: To determine whether women with polycystic ovary syndrome (PCOS) were less likely to initiate breastfeeding or have shorter breastfeeding duration. Materials and Methods: Cross-sectional analysis was performed of the Pregnancy Risk Assessment Monitoring System dataset, a national questionnaire from the Centers for Disease Control and Prevention of postpartum women, from 2016 to 2018. Logistic regression assessed the odds of any breastfeeding initiation. Cox proportional hazards assessed duration of any breastfeeding. Results: Sample included 2,382,290 women (6.1% PCOS). In univariable analysis, PCOS was associated with increased odds of any breastfeeding initiation (89.9% versus 87.9%; odds ratio [OR]: 1.23 [95% confidence interval: 1.02, 1.47]; p = 0.03). This outcome remained significant after controlling for body mass index (BMI; OR_adj:1.3 [1.1, 1.6]; p = 0.005) but not after controlling for education and prior live births (OR_adj:1.10 [0.89, 1.37]; p = 0.37). With increasing BMI, the odds of any breastfeeding initiation decreased, with the lowest odds seen in women with class III obesity (OR_adj: 0.74 [0.60, 0.9]; p = 0.003). In a subanalysis of racial/ethnic groups, PCOS did not impact any breastfeeding initiation in White or Black non-Hispanic groups but increased odds of any breastfeeding initiation in Hispanic women (OR_adj: 2.0 [1.1, 3.7]; p = 0.03). In multivariable models, there was no difference in the duration of any breastfeeding in women with PCOS compared with those without. Conclusions: Understanding predictors of breastfeeding success is paramount. In this national survey measuring any breastfeeding, PCOS did not decrease breastfeeding initiation or duration, despite confirming the association between overweight/obesity and decreased breastfeeding. However, because the data did not distinguish between exclusive breastfeeding and supplementation, we cannot rule out the possibility that PCOS affects breastfeeding exclusivity or necessitates supplementation. This limitation suggests that important trends could be obscured, and therefore, our findings should be interpreted with caution regarding breastfeeding exclusivity. Interventions aimed at increasing breastfeeding should target populations that would benefit the most; our data support that PCOS-specific targeting is not needed. Additional prospective studies are necessary to fully understand the association between different PCOS phenotypes and breastfeeding.

Background: Pain management is an important issue in newborns. This study aimed to compare the effects of three different sensory interventions (mother's voice [hearing], mother's milk smell [smell], and mother's holding [touch]) during heel lance on pain levels in term newborns. Methods: In this randomized controlled trial, 120 term newborns included in the study were divided into four groups. Pain scores were assessed with Neonatal Infant Pain Scale during and after the procedure. Results: When compared in terms of interventions, newborns in mother's voice and mother's holding groups showed statistically significantly less pain response during the procedure compared with the control group (p = 0.005). But no significance was found in terms of mother's milk smell. Conclusion: In conclusion, mother's holding and mother's voice are effective methods to reduce pain during heel prick procedure in newborns. In addition, both maternal smell and maternal touch may have had an effect in the mother's holding group. Nevertheless, future studies with different designs on the effect of breast milk smell are recommended. (Trial registration: https://clinicaltrials.gov/study/NCT05526378.).

Objective: To investigate mother's own milk (MOM) feeding rates in the first year of life after neonatal intensive care unit (NICU) discharge for infants born <37 weeks gestational age and compare rates by race and ethnicity. Study Design: This was a retrospective study of preterm infants discharged from the NICU who sought care at a primary care clinic within our academic health system. Infant demographic characteristics and feeding at NICU discharge were extracted from the medical record. Post-discharge feeding history was extracted from health care maintenance (HCM) visit records at 2, 4, 6, 9, and 12 months for infants born between January 2018 and December 2019. Exclusion criteria included having a contraindication to MOM feeding or insufficient feeding documentation. Results: Of the 314 infants meeting inclusion criteria, 57% received any MOM and 24% received exclusive MOM at NICU discharge. At the 6-month HCM visit, MOM feeding rates decreased to 25% for any MOM and 12% for exclusive MOM. Statistically significant racial and ethnic differences in MOM feeding rates were observed at all HCM visits, with White infants having the highest and Black infants having the lowest MOM feeding rates. Conclusions: MOM feeding rates decreased from NICU discharge to the 12-month HCM visit. Disparities observed during the birth hospitalization persisted after discharge, with Black infants having consistently lower MOM feeding rates compared with Hispanic and White infants. These disparities highlight research opportunities to pinpoint factors contributing to the decline in MOM feedings and develop targeted interventions to address these disparities.

Surprisingly little is known about the effect of breastfeeding on the infant's immune system development. Systematic reviews have suggested the role of breastfeeding in the prevention against asthma, autoimmune diseases, inflammatory bowel disease, and childhood leukemia. However, studies on atopic disease suffer from reverse causation, small size, and those assessing food allergy (FA) have often relied on parent-reported outcomes. Randomized controlled trials (RCTs) are not possible for ethical reasons. In addition, epidemiological studies have not considered that there is a large interindividual variation in human milk (HM) composition and feeding at the breast versus pumped HM potentially impacting the effect of breastfeeding between mothers. While prevention strategies such as early introduction of highly allergenic food are impactful in preventing peanut and egg allergies, implementation of early introduction guidelines has been slow, and many infants are already sensitized by 4-6 months of age. To be more effective, primary prevention strategies must commence much earlier, during breastfeeding. There are studies that imply a definitive effect of breastfeeding on the gut microbiome and regulatory T cells (Tregs) as well as a higher rate of FA in populations with historically low rates of breastfeeding. These provide a strong rationale for assessing the effect of feeding HM in the context of HM composition and mode of feeding on immune development. The lack of well-conducted, large studies assessing the role of breastfeeding and HM composition in the development of immune system development is a significant gap when designing prevention strategies.

Introduction: Breastfeeding practices vary widely among different ethnic groups and are influenced by cultural, social, economic, and educational factors. The aim of this study was to compare the breastfeeding behaviors of mothers toward infants in different ethnic groups. Methods: This descriptive cross-sectional study included women of four ethnic groups (Assyrian, Turkish, Arab, and Kurdish) living in Mardin, Turkey. The study was completed with 180 Assyrian, 184 Turkish, 175 Arab, and 169 Kurdish women. In total, 708 women participated in this study. Data were collected between August 12, 2024, and September 22, 2024. Results: The highest rate of traditional breastfeeding practices was seen in Kurdish (99.4%), whereas this rate was 97.3% in Turkish, 96% in Arab, and 84.4% in Assyrian. The highest rate of giving breast milk immediately after birth was in Assyrian (71.7%), while this rate was 69.3% in Turkish, 61.9% in Kurdish, and 47% in Arab (p = 0.000). The rate of those who waited for three calls to prayer to feed the baby was 13.1% in Kurdish, 11.3% in Arab, 9.5% in Turkish, and 7.9% in Assyrian. The rate of those who did not give the first milk (colostrum) to the baby was 15.8% in Assyrian, 11.7% in Turkish, 6.5% in Kurdish, and 6% in Arab. The rate of those who give sugared water as the baby's first nutrient was 37.5% in Arab, 20.8% in Kurdish, 11.7% in Turkish, and 9.2% in Assyrian. Increased education levels were associated with decreased rates of the presence of traditional practices. Conclusion: This study provides novel results regarding the comparison of breastfeeding behaviors among ethnic groups living in the same city. Comparing breastfeeding practices across the four ethnic groups allowed us to better understand different breastfeeding practices, which could lead to the development of culturally sensitive interventions to improve the health of children and mothers. Educating the community about the benefits of breastfeeding and the risks associated with some traditional practices could contribute to public health.

Background: Usage of some medications while breastfeeding is supported with many clinical studies and proven to be safe for the mother-infant dyad, whereas knowledge on many medications' safety depends on pharmacokinetic data that are supported with only case series of real-life results. As data on rosuvastatin usage are limited, we present our case report with safe use of rosuvastatin in a breastfeeding mother of a 13-month-old infant. Case: Pretreatment assessments of the infant were performed. Complete blood count, kidney, and liver function tests were normal. The infant's lipid profile was evaluated before starting the mother's treatment, at 1 month of treatment, and at the fifth month of treatment in which the infant reached 18 months of age. All three evaluations resulted in normal ranges. At the 18-month follow-up of the infant of breastfeeding mother using rosuvastatin, no issues were detected in the child's development. Conclusions: In order for mothers with hypercholesterolemia not to neglect their own treatment while continuing to breastfeed, case reports should be included in the literature. In this case, it was shown that rosuvastatin treatment given to the mother did not affect the lipid profile and neurological development of the baby.

Background: Breastfeeding provides essential nutrition and disease protection for infants while reducing the risk of type 2 diabetes and breast cancer in mothers. Despite these benefits, significant racial and ethnic disparities exist in breastfeeding initiation, particularly among Black women. This study examines racial differences in the receipt of breastfeeding information from varying sources and their association with breastfeeding initiation. Methods: Data were obtained from the Phase 8 Core Pregnancy Risk Assessment Monitoring System for 2016-2020 (n = 163,724). The analysis focused on comparing the likelihood of breastfeeding initiation (yes/no) across racial groups and the impact of receiving breastfeeding information from varying clinical (mother's doctor/nurse/baby's doctor, etc.) and social sources (support group/family/friends, etc.). Univariate and multivariable analysis was conducted in SAS 9.4. Results: Black women consistently exhibited lower odds of breastfeeding initiation compared with other racial groups, across all informational sources. The study found that while information from both clinical and social sources increased breastfeeding initiation overall, Black women remained less likely to initiate breastfeeding than White women (p < 0.0001). Conclusion: Systemic barriers, including racism and bias in health care, contribute to the racial disparities in breastfeeding initiation. Culturally tailored interventions and improved health care provider training are necessary to address these gaps. Future efforts should aim to bridge the divide between clinical and social breastfeeding information sources to improve breastfeeding rates among minority women.