Breastfeeding Medicine最新文献

Background: Diaper dermatitis (DD) is a common inflammatory skin condition in infants, typically managed with supportive care and anti-inflammatory treatments. This study aimed to evaluate the efficacy of topical breast milk combined with zinc oxide versus zinc oxide alone in treating DD in infants. Methods: A randomized clinical trial was conducted at Bahrami Children's Hospital from 2022 to 2023. Forty-two infants with clinically diagnosed DD were randomly assigned to two groups: the control group received 25% zinc oxide ointment, while the case group received 25% zinc oxide combined with topical breast milk. Both treatments were applied for 7 consecutive days. The severity of DD was assessed daily using the Buckley Diaper Dermatitis Severity Scale, and lesion improvement was documented. Results: The mean age of the infants was 2.93 ± 7.41 months, and 52.4% were male. No significant differences were observed between the two groups in baseline characteristics. Complete and partial recovery rates in the case group were 61.9% and 38.1%, respectively, compared to 66.6% and 19.1% in the control group. Notably, no non-responders were found in the case group, while 14.3% in the control group showed no response to treatment. The case group experienced faster lesion resolution (2.52 ± 0.67 days vs. 3.28 ± 1.14 days, p = 0.012). Conclusion: Topical breast milk combined with zinc oxide may reduce recovery time in treating diaper dermatitis. This approach is safe, cost-effective, and accessible. Larger randomized trials are needed to confirm these results and establish standardized treatment protocols.

Objective: In this study, it was aimed to investigate the effects of listening to music, including nature sounds, on mothers' breastfeeding self-efficacy in the postpartum period and on their exclusive breastfeeding behaviors before discharge. Method: This quasi-experimental study with a control group was conducted between April 2024 and October 2024. The mothers in the music group (n = 55) listened to 30 minutes of instrumental music, including nature sounds, at 6 and 12 hours postpartum in addition to the standard breastfeeding counseling, while the mothers in the control group (n = 64) received only standard breastfeeding counseling. Measurements were made using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The exclusive breastfeeding rate was determined according to the World Health Organization criteria. Differences between groups were analyzed using the chi-square and independent samples t tests. Results: The mean score obtained from the BSES-SF by the participants in the music group before discharge was significantly higher (63.65 ± 4.91) than that obtained by the participants in the control group (56.07 ± 7.08) (p = 0.017; Cohen's d = 1.23). The exclusive breastfeeding rate was significantly higher in the music group (65.5%) than it was in the control group (26.6%) (p < 0.001). Conclusion: Music therapy, including nature sounds, increased mothers' breastfeeding self-efficacy levels and exclusive breastfeeding rates. Integration of music-based interventions into postpartum care is recommended since it is a clinically applicable, low-cost, and non-invasive support method.

Objectives: Characterize the experiences of lactating gynecologic surgeons, identify common challenges, and propose solutions to address barriers. Methods: In this mixed-methods, cross-sectional study, a novel survey was electronically distributed to measure lactation experiences among gynecologic surgeons. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used for the qualitative data analysis. Results: Eighty-six survey respondents reported having been pregnant and met the eligibility criteria. The rate of breastfeeding was 95% (n = 82) among women who had given birth, and 91% (n = 75) of surgeons breastfed after returning to work. Of the 66 surgeons who shared lactation experiences, 97% (n = 64) reported challenges faced at work, and 86% (n = 57) faced more than one challenge. Most respondents were fellowship trained (85%, n = 56) and half delivered within the last 2 years (48%, n = 32). Analysis yielded eight themes and nine subthemes. The most common themes were time constraints (n = 48), difficulty balancing clinical responsibilities (n = 53), and pumping logistics (n = 59). Surgeons suffered from emotional distress (n = 14) and physical challenges included decreased supply, engorgement, and leakage (n = 16). Conclusions: Gynecologic surgeons face multiple challenges when lactating at work. This research highlights the lack of protection and support for the lactating surgeon. We propose solutions to address these workplace inequities, including allotted time for milk expression, adequate facilities, institutional and national policy and protections, and creation of a culture of support.

Background: A breastfeeding-friendly city is one with a synchronous and enabling environment for breastfeeding. A scoping review and interviews with breastfeeding mothers identified numerous potential indicators of a breastfeeding-friendly city. Objective: To determine a set of indicators of a breastfeeding-friendly city through consensus. Methods: A modified two-round online Delphi survey was conducted with three stakeholder groups-experts, policymakers, and families. In Round 1, participants rated 52 potential indicators identified from earlier studies. They were asked to also suggest additional indicators. In Round 2, participants were shown the ratings of the other participants from Round 1 and asked to rate the items again with the choice of changing their original ratings. Consensus was defined as more than 70% of participants rating an item as critical (rating of 7-9) or not important (rating of 1-3). Items without consensus were discussed in a final consensus meeting. Results: A total of 107 participants from 14 countries completed the survey. After both rounds, 50 of 56 items reached consensus. Following the consensus meeting, a final list of 52 indicators was agreed upon. These were grouped into five sectors: city administration (e.g., policy, leadership, budget), community (e.g., peer support, breastfeeding rooms), health care (e.g., hospital, clinic, pharmacy), workplace (e.g., time, space), and collaboration. Conclusion: Using a systematic approach, we identified a comprehensive list of indicators that reflect the warm chain. These indicators offer cities a practical framework for evaluating and strengthening breastfeeding-friendly environments, with the potential to improve global breastfeeding outcomes.

Background: Preterm infants experience increased oxidative stress and possess limited endogenous antioxidant reserves. Breastmilk provides critical protection, but its composition under maternal nutritional stress remains poorly characterized. Objectives: To evaluate the nutritional and antioxidant profile of colostrum and mature milk from mothers with preterm births and under nutritional stress. Methods: Breastfeeding mothers from Veracruz, México, who delivered preterm infants were recruited. Dietary intake was evaluated using a food frequency questionnaire. From the total cohort (n = 42), a subset of mothers (n = 32) provided colostrum and mature milk samples which were analyzed for total proteins, total polyphenols, and antioxidant capacity using 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays. Associations with maternal body mass index, dietary intake, gestational age, and socioeconomic status were examined. Results: Mothers experienced nutritional stress, with low diversity, energy dense, and nutrient-poor dietary pattern dominated by consumption of ultra-processed foods. Despite this, breastmilk retained adequate levels of protein, polyphenols, and antioxidant capacity in both colostrum and mature milk. Conclusion: Even under maternal nutritional stress, breastmilk composition remained functionally resilient, delivering adequate levels of nutritional and antioxidant components, sufficient to meet the elevated demands of preterm infants.

Background: The National Lactation Study Center was established by Ruth Lawrence, MD, in 1981 to offer consultations on complex breastfeeding and lactation issues. In 2018, a REDCap® database was developed to track cases. Methods: We conducted a retrospective, observational review of cases from June 2018 to December 2024. We report frequencies of exposures (medication and toxin), along with geographic area, provider type, and lactation concerns. Results: We recorded 4,965 consultations (4,791 exposures and 174 breastfeeding management encounters). There were 4,941 cases from 44 states (United States), and 24 cases from other countries. Most occurred by telephone (n = 3,394; 71%), with fewer by email (n = 1,522; 28%). There were 4,049 (82%) from providers and 916 cases (18%) from consumers/patients. Of these, lactation consultants were the primary users (n = 2,915; 72%), with physicians accounting for 14% (n = 578). There were 10,435 total medications reviewed, with most cases involving ≤2 medications (n = 6,395; 61%). Drugs with central nervous system (CNS) activity accounted for the largest portion of queries (n = 5,389; 52%). Most lactation management cases were primarily maternal-side concerns such as low milk supply or oversupply (n = 116; 85%), fewer were primarily infant concerns, such as rare metabolic and cardiac conditions (n = 21; 15%), and questions related to human milk, including milk storage and properties (n = 17; 11%). Conclusion: Inquiries regarding medications with CNS activity were the most prevalent. Of management concerns, most were related to low or oversupply of milk. The use of this service reflects an ongoing need for information on medication use and complex concerns in lactation.

Background: In southern China, little is known about the macronutrient content of donor human milk (DHM), which varies among donor mothers. Research Aim: This study aimed to evaluate the association of mother and infant characteristics with the macronutrient content of DHM. Methods: A retrospective analysis was conducted on the anthropometric data, age of delivery, and mode of delivery of 365 healthy donor mothers. In addition, the gender, birth weight, and age of the infants were also recorded. Finally, the relationship between these variables and the macronutrient content in DHM was analyzed. Results: When comparing DHM macronutrient content with age of delivery, mode of delivery, and birth weight, there was no statistical significance. DHM from the obese mother group contained a higher level of macronutrient content (fat, p = 0.025; dry matter, p = 0.020; energy, p = 0.002) than all other groups, including overweight, normal-weight, and low-weight groups. DHM from mothers in the early stage of lactation had a higher amount of total protein (p < 0.001) and true protein (p < 0.001). Statistically significant differences were observed for total protein (p = 0.034), true protein (p = 0.022), and dry matter (p = 0.011) when comparing infant's gender and DHM macronutrient content, with male infants showing higher values. Conclusion: This study indicated that the characteristics of mothers and infants may influence the macronutrient content of DHM. It is important to monitor factors that could affect the nutritional quality of DHM.