Breastfeeding Medicine最新文献

Introduction: Brexpiprazole (BPZ), an antipsychotic drug introduced in 2018, is often used to manage psychiatric conditions. However, the effect of its use on infants whose mothers are receiving BPZ during lactation remains uncertain. Given the limited data on its effects on infants, this study evaluated the safety of its use by mothers during lactation.

Materials and methods: Three mother-infant pairs were assessed between 2018 and 2023 at Tohoku University Hospital. Each mother continued BPZ monotherapy (1-2 mg/day) during pregnancy and lactation within the first month postpartum, and data on maternal and infant health, as well as withdrawal symptoms or adverse events in newborns and infants, were collected from medical records.

Results: No withdrawal symptoms or severe adverse events were noted in any of the three newborns or infants. Mild cases of neonatal jaundice and acne were observed in all three newborns and infants; however, they were considered unrelated to BPZ exposure. Nonetheless, it appears that the drug might have decreased milk supply, as supplemental formula feeding was occasionally necessary.

Conclusion: This study suggests that BPZ monotherapy (1-2 mg/day) during lactation does not lead to withdrawal symptoms or serious adverse events in newborns or infants within the first month postpartum. This initial evidence may help inform breastfeeding decisions among mothers receiving BPZ monotherapy.

Background: Breast milk is the optimal source of nutrition for newborns, especially preterm infants, and its temperature during feeding may influence both physiological stability and clinical outcomes. Although individual studies suggest potential benefits of warmed milk, evidence remains inconsistent and has not been comprehensively synthesized.

Objective: To systematically review and analyze the effects of administering breast milk at different temperatures on physiological responses, feeding tolerance, and clinical outcomes in newborns.

Methods: This systematic review and meta-analysis followed the Cochrane Handbook (version 6.0) and PRISMA guidelines. A comprehensive search of nine databases (CINAHL, CENTRAL, Web of Science, PubMed, Scopus, ScienceDirect, ERIC, EBSCO, OVID) was conducted for studies published between 2010 and 2025 in English. Data extraction and risk of bias assessment were performed independently by two reviewers using RoB-2 and ROBINS-I tools. Meta-analyses were conducted using Stata 16.0, applying fixed- or random-effects models based on I² heterogeneity values.

Results: Five studies involving 373 infants met the inclusion criteria. Meta-analyses revealed no statistically significant effects of breast milk temperature on heart rate, oxygen saturation, or body temperature at 5 or 30 minutes after feeding. A small short-term decrease in body temperature (5 minutes post-feeding) was noted in the intervention group, but this was not sustained. Time to achieve full enteral feeding was also not significantly different between groups. Heterogeneity was substantial for several outcomes (I² > 85%). Risk of bias ranged from low to serious across included studies.

Conclusions: Current evidence indicates that administering breast milk at different temperatures does not produce clinically meaningful differences in short-term physiological parameters or clinical outcomes in newborns. Milk at room temperature, near-body temperature, or alternative warming methods appears to be equally well tolerated.

Background: Magnesium sulfate is widely prescribed postpartum for seizure prophylaxis in women with preeclampsia and other hypertensive disorders of pregnancy, yet its potential effects on lactation outcomes remain underexplored.

Objectives: To evaluate and synthesize the current evidence on how postpartum magnesium sulfate therapy affects lactation outcomes, including breastfeeding initiation, exclusivity, duration, pumping habits, and secretory activation (SA).

Methods: This integrative review followed PRISMA guidelines and Whittemore and Knafl's framework. Literature was obtained from five databases without date restrictions. A total of 11 studies met the inclusion criteria. Methodological quality was evaluated using the Joanna Briggs Institute tools and Melnyk and Fineout-Overholt's hierarchy of evidence.

Results: Data were synthesized from 11 studies published between 1993 and 2023, encompassing 2,842 participants across diverse hospital settings. Findings indicate that extended postpartum magnesium sulfate administration is associated with delayed breastfeeding initiation, delayed maternal perception of SA, and greater reliance on milk expression. Most researchers did not report maternal side effects or quantitatively measure the frequency of breastfeeding or pumping. Studies reported hospital policies that restricted rooming-in and breastfeeding during magnesium infusion.

Conclusions: Postpartum magnesium sulfate administration is associated with delays in lactation initiation, missing the evidence-based critical window for frequent early milk removal. However, studies in this review rarely examine maternal side effects or feeding frequency in detail. Future research should use standardized definitions, document both frequency and mode of milk removal, evaluate objective measures of SA, evaluate maternal experience, and hospital policies.

Background: Human milk is critical for maternal-infant health, yet concerns about cannabis exposure through milk may discourage breastfeeding. We examined the relationship between breastfeeding and developmental outcomes among infants with prenatal cannabis exposure. Methods: We used a regional perinatal data repository from an academic hospital system with universal maternal urine drug testing. Breastfeeding status was obtained from birth certificates. Developmental delay was identified through ICD-9/10 billing codes for delayed milestones or speech disorders. Infants whose mother tested positive for cannabis at delivery were included. Descriptive statistics compared demographic characteristics by breastfeeding status, and logistic regression estimated the odds of developmental delay. Results: Among 1,520 infants born from 2013 to 2019 with a maternal positive drug test for cannabis at delivery, 818 (54%) were not breastfed, and 702 (46%) were breastfed. In unadjusted analysis, not breastfeeding was associated with increased odds of developmental delay (OR: 1.32, 95% CI: 1.00-1.76). After adjusting for maternal tobacco use, prematurity, and birth year, this association was no longer statistically significant (OR: 1.24, 95% CI: 0.93-1.67). Conclusion: In this study, developmental outcomes did not differ by breastfeeding status among infants with prenatal cannabis exposure. These findings support current guidance from professional organizations that cannabis use is not a contradiction to breastfeeding. Further research with larger sample sizes and detailed longitudinal data is needed to better assess the potential protective role of breastfeeding against developmental delay and safety in the context of maternal cannabis use.

Background: Diaper dermatitis (DD) is a very common problem in infants between 1 and 6 months. While it rarely causes long-lasting problems, it can cause serious short-term problems for both infants and parents. Accordingly, this study compared the effect of breast milk and diaper rash cream containing Hamamelis virginiana (12 mg/100 g) on the healing process in 0-6 month-old infants with DD. Methods: This randomized, single-blinded trial was conducted with 60 infants aged 0-6 months diagnosed with DD. Participants were assigned to either the breast milk group (BG) or the comparison group (CG) receiving Hamamelis virginiana cream. Demographic characteristics and DD severity were assessed using a structured demographic questionnaire and the validated Assessment of the Severity of Uncomplicated DD in Infants Scale. Statistical analyses included Shapiro-Wilk, Mann-Whitney U, Wilcoxon signed rank, Chi-square, and Fisher's exact tests. Significance was set at p < 0.05. Results: Before the intervention, the mean scale score was 5.17 ± 0.46 in the BG, 2.83 ± 1.37 in the CG, which was a statistically significant difference. After the intervention, there was a significant decrease in the mean scale score in the BG to 0.03 ± 0.18, whereas the mean decrease was smaller in the CG (1.53 ± 1.11). The difference in the mean scale scores between the groups was statistically significant (p < 0.001). Furthermore, the postintervention mean scale score of the BG was significantly lower than that of the CG. However, baseline severity differences limit direct comparison of treatment efficacy. Conclusions: Topically applied breast milk appears to be a safe, accessible, and cost-effective option for treating uncomplicated DD, with greater improvement than cream containing Hamamelis virginiana. However, baseline severity differences limit direct comparison. Further studies using block randomization are recommended.

Background: Cannabis use has increased among reproductive-aged women, including those who are breastfeeding. However, aside from the appearance of cannabinoids in milk, almost nothing is known about how cannabis use might affect human milk composition. This study explored the short-term effects of maternal cannabis use on milk macronutrient content. Methods: Breastfeeding women who used cannabis (cases, n = 20) were matched by body mass index and time postpartum with breastfeeding women who did not use cannabis (controls, n = 19). After abstaining from cannabis use for ≥12 hours, cases collected a baseline milk sample, used cannabis as desired, and collected additional samples 30-≤40 minutes, 1-<2 hours, 2-<4 hours, 4-<6 hours, and 8-<12 hours after use. Controls collected milk at matched time points. Delta-9-tetrahydrocannabinol (Δ⁹-THC) and lipid concentrations were quantified in all samples, and fatty acids, lactose, and protein concentrations were quantified in baseline, 1-2 hours, and 8-12 hours samples. Results: There were no differences between controls and cases in the concentration of any macronutrient at baseline. After cannabis use, concentrations of lipids and 10 of the 39 identified fatty acids were lower in milk from cases compared to controls. Milk lactose levels increased over time in controls but not in cases. Protein levels were not different between groups at any timepoint. In milk produced by cases, Δ⁹-THC levels were positively correlated with lipids and negatively correlated with lactose. Conclusion: Cannabis use may transiently influence lipid, fatty acid, and lactose concentrations, highlighting the need for further research to understand the physiology of these alterations.

Introduction: Ultra-processed foods (UPFs) are increasingly present in children's diets; however, little is known about how early feeding practices influence UPF consumption in childhood. We aimed to evaluate the association between infant feeding during the first 4 months of life (breastfeeding vs. infant formula) and UPF consumption in toddlers. Methods: This prospective study included 186 exclusively breastfed and 284 exclusively formula-fed infants recruited in Santiago, Chile. At the age of 2 years, dietary intake was assessed through 24-hour recall. The caloric contribution of UPF was estimated using the Nova food classification. Associations were evaluated using fractional probit regression models adjusted for potential confounders, including child, maternal, and household characteristics. Results: UPFs contributed 44.6% of the caloric intake of toddlers. The caloric proportion of UPFs in formula-fed children was 51.0% compared with 35.5% in breastfed children. After adjustment, formula-fed children had a 15.4 percentage point higher mean UPF intake (95% CI: 12.0-19.6; p < 0.001), mainly due to the higher intake of UPF dairy products. Around half of the breastfed children continued to receive breast milk at 2 years, accounting for 15% of the total energy intake of this group. Compared with breastfed children, formula-fed children consumed more infant or follow-up formula (11.0% vs. 6.8%, p = 0.002) and milk-based drinks (23.1% vs. 15.3%, p < 0.001) at 2 years. Conclusions: Exclusive breastfeeding in early infancy was associated with lower UPF consumption in toddlerhood. These findings support breastfeeding promotion as a strategy to reduce early exposure to UPFs and foster healthier eating habits during childhood.

Objective: Oral colostrum administration (OCA) for neonates is easy, simple, and safe. Previous studies have reported that OCA decreases the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants. However, the optimal duration of OCA has not been established. This study aimed to investigate the effect of OCA for different durations on the incidence of NEC (stage ≥2) and other morbidities. Methods: This randomized controlled study recruited premature infants born before 32 weeks of gestation. The infants were categorized into the following three groups: noncolostrum group, did not receive OCA; short-term colostrum group, received oral colostrum for 3 days; and extended colostrum group, received oral colostrum for 10 days. For additional analyses, the infants were also classified into two broader categories: colostrum (combining short-term and extended groups) and noncolostrum groups. Results: In this study, 138 infants (46 in each group) were recruited. The incidence rates of NEC in the noncolostrum, short-term colostrum, and extended colostrum groups were 10.9% (n = 5), 4.3% (n = 2), and 0% (n = 0), respectively. Infants in the groups receiving colostrum exhibited a decreased incidence of NEC, although the difference was not significant when analyzed according to duration (OR: 0.19; 95% CI: 0.11-0.0.32, p = 0.057). Compared with the noncolostrum group, infants in the colostrum group achieved full enteral feeding earlier, had a shorter antibiotic duration, and exhibited lower rates of LOS (p = 0.004, p < 0.001, p = 0.004, respectively). The extended colostrum group exhibited the highest exclusive breastfeeding rate at discharge (p = 0.003). Conclusion: OCA improved feeding tolerance and reduced LOS in preterm infants. Although the effect on NEC was not significant, extended administration enhanced exclusive breastfeeding rates at discharge.