Breastfeeding Medicine最新文献

Background: Breastfeeding and Lactation Medicine (BFLM) programs at academic medical centers are uncommon but expanding. Our academic medical center, with a long legacy of leadership in BFLM, established a BFLM program in 2016 and launched a dedicated division in 2022. Objectives: To describe the strategy, services, measures, and challenges facing our multidisciplinary academic BFLM program in its first 8 years. Methods: To support the development of the Division, we proved clinical need, built capacity, and determined key outcomes. We organized partnerships across clinical and research programs and developed leadership and reporting structures. These services and programs coalesced to form the first Division of Breastfeeding and Lactation Medicine in 2022, including multiple specialties (pediatrics, obstetrics, family medicine, nutrition research, toxicology, public health, dentistry) and provider types (nursing, lactation consultants, physicians, midwife, nurse practitioner, PhD, dentist). Challenges included variable buy-in, staff training, reimbursement, medical record infrastructure, and data reports. Challenges to research included funding and clinical integration. Conclusion: A multidisciplinary BFLM Division at a large academic medical center was formed, spanning our clinical, research, and educational missions. Integration into traditional academic structures brings essential resources, enables participation in medical center leadership, and promotes the sustainability of divisional activities.

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 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.