Breastfeeding Medicine最新文献

Objective: Olfactory stimulation can be used for many purposes, such as providing comfort, improving sleep, and reducing pain in newborns. However, there are only a few studies in the literature examining the effect of olfactory stimulation on newborn growth. The aim of this study was to evaluate the effect of olfactory stimulation on growth parameters of newborns. Method: This systematic review used the PRISMA checklist. No date limitation was applied, and all studies were considered for inclusion. Pubmed, Web of Science, Scopus, and Medline databases were used for the search. Results: A total of 367 publications were found in the search. Eight studies that met the inclusion criteria were included in the study. The olfactory stimulations applied were maternal odor, maternal milk odor, cinnamon, aniseed, vanilla, and formula milk odors. Olfactory stimulation was found to have a positive effect on the weight gain of newborns in three of the eight studies, and maternal odor and maternal milk odor were used in these studies. In two of the three studies evaluating the effect of maternal odor and maternal milk olfactory stimulation on the height of newborns, the result was found to be significant. The effect of maternal milk olfactory stimulation on head circumference was found to be significant in one of the two studies. Conclusion and Recommendation: Maternal odorand maternal milk odor may have a positive effect on newborn growth parameters. Further studies on this subject are needed.

Background: Bronchopulmonary dysplasia (BPD) is a common complication of preterm very low birth weight (VLBW) infants. Mother's own milk (MOM) may mitigate the severity of BPD. Pasteurized donor human milk (PDHM) is often used as an alternative when MOM is unavailable with limited information on the influence of PDHM on BPD risk and severity. Objective: To compare the influence of MOM to PDHM on risk and severity of BPD in preterm VLBW infants. Design/Methods: A retrospective chart review of preterm (<34 weeks) and VLBW (<1,500 g) infants born at the Children's Hospital of Richmond from 2019 to 2021 was performed. The analysis included demographics, type and timing of nutrition received (MOM, PDHM, Formula), and incidence/severity of BPD based on National Institute of Child Health & Human Development (NICHD) definition. Data analysis used chi-square, linear regression, and a multinomial logistic regression test. Results: A total of 200 infants met inclusion criteria, of which 116 (58%) had no BPD, 34 (17%) had mild BPD, 32 (16%) had moderate BPD, and 18 (9%) had severe BPD. Infants exposed to MOM within the first 3 days and within the first 7 days of life had lower incidence of moderate to severe BPD when compared to those with no MOM exposure (p = 0.02, p = 0.04). The percent of MOM received throughout hospitalization moderated the incidence of BPD (p = 0.01, 95% Confidence Interval (CI) [-0.14, -0.02]), such that as the percent of MOM received increased, the effect of gestational age on severity of BPD decreased. In contrast, the percent of PDHM received throughout hospitalization did not moderate BPD incidence (p = 0.61, 95% CI [2.28, 3.43]). Conclusion: These results identify that earlier and greater total exposure to MOM, but not PDHM, was associated with decreased moderate to severe BPD in <34-week preterm VLBW infants.

Introduction: Donor human milk is increasingly being utilized for both preterm and term infants when mother's milk is unavailable. With the rising prevalence of maternal overweight and obesity, it is crucial to evaluate the relationship between maternal body mass index and the fat and energy content of donor human milk. Objectives: To assess the impact of maternal body mass index on human milk fat content. Methods: A cross-sectional study was carried out using retrospective data from women who made their first human milk donation at ≥15 days postpartum at a human milk bank in São Paulo, Brazil, from January 2018 to December 2020. Data of sociodemographic, obstetric, health, and anthropometric measures were collected by the human milk bank staff. Milk fat and energy content were determined using the crematocrit test. Analysis of variance and multiple linear regression were used to compare means of crematocrit and fat. We determined the p-values using a test of heterogeneity and linear trend and presented the one with the lower p-value. Results: Most donors were between 25 and 35 years old, had higher education, were employed, and lived with a partner. At the time of milk donation, 40.9% of women were overweight or obese. The fat (1.09 g/dL) and energy (9.83 kcal/dL) content of human milk were higher in obese donor compared with eutrophic donors. Conclusions: The fat and energy content of human milk were associated with maternal body mass index, suggesting the potential value for selective use of high fat and high calorie donor milk for very low birthweight or premature infants.

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.

Introduction: Many breastfeeding mothers fast during Ramadan month despite being exempted from fasting. This study aims to estimate the prevalence rate of Ramadan fasting during breastfeeding and detect its associated factors among Egyptian Muslim mothers. Methods: A cross-sectional study was conducted on 1,130 lactating mothers selected through a multistage stratified random sampling technique in Dakahlia Governorate, Egypt. The data were collected through a structured questionnaire including sociodemographic data, the Arabic Scale of Intrinsic Religiosity (ASIR), and data about breastfeeding and fasting practices during Ramadan. Binary logistic regression analysis was used to detect the significant predictors of fasting among lactating mothers. Results: Of 1,130 study participants, more than half (53.5%) were aged ≥27 years old and had secondary education (54.6%). About four in every five (83.7%) of them fasted during Ramadan. Secondary education (adjusted odds ratio [AOR] = 2.71, p ≤ 0.001), university and postgraduate education (AOR = 4.88, p ≤ 0.001), non-working (AOR = 1.88, p = 0.011), being in debt and just meeting routine expenses (AOR = 1.75, p = 0.007), having high intrinsic religiosity (AOR = 2.70, p ≤ 0.001), having infants aged 6 months and more (AOR = 2.60, p ≤ 0.001), giving prelacteal feeding (AOR = 2.56, p ≤ 0.001), giving supplements (AOR = 2.11, p ≤ 0.001), and breastfeeding on demand (AOR = 1.92, p = 0.01) were the significant predictors of the higher fasting rates among the lactating mothers. Conclusion: Fasting is a prevalent practice among breastfeeding mothers of infants during Ramadan. Ramadan fasting does not significantly influence maternal outcomes or infant weight. Therefore, it is advisable for lactating mothers to consult with healthcare professionals prior to deciding to fast during Ramadan.

Background: Social determinants of health account for racial inequities in breastfeeding rates in the United States. There is a gap in the role of neighborhood socioeconomic status (NSES) as it relates to breastfeeding disparities. Methods: Using longitudinal data from the Black Women's Health Study, we assessed associations of NSES with breastfeeding initiation and duration in a cohort of primiparous U.S. Black women. We also explored associations within strata of important economic indicators, including education, occupation, and marital status. Results: Breastfeeding initiation (n = 2,705) increased with NSES quartile, from 75.2% in the lowest quartile to 88.3% in the highest quartile (p < 0.0001). Compared with women living in the highest NSES quartile, those in the lowest quartile had a 41% (odds ratio: 0.59 [95% confidence interval: 0.43, 0.81]) decreased odds of initiating breastfeeding. For breastfeeding duration (n = 2,172), women residing in NSES quartiles 1-3 were significantly less likely (p < 0.0001) to breastfeed (44.4%) for 6+ months compared with those living in the highest quartile (62.8%). Adjusted relative risks for those in quartiles 1-3 compared with 4 (highest) were 0.63 (0.45, 0.87), 0.50 (0.37, 0.68), and 0.64 (0.47, 0.86), respectively (p = 0.0001). There was no statistically significant evidence of effect modification by education, occupation, marital status, and region (P_interaction = >0.05). Conclusion: Living in a lower NSES environment was associated with reduced breastfeeding initiation and duration compared with a higher NSES environment. Research is needed to understand the mechanisms by which neighborhood-level factors influence breastfeeding initiation and duration for Black women in the United States.

Objective: This study analyzes the impact and experiences of hospitalization for any reason on breastfeeding women. Methods: Cross-sectional online survey (November 2019-March 2020). Adults admitted to a Spanish hospital for at least one night, when actively breastfeeding, were included. The questionnaire aimed at assessing breastfeeding, breast complications, and support and perceived health care workers' attitudes to breastfeeding. Results: Of the 266 included participants, 70 (26%) stopped breastfeeding during hospitalization, and 13 (5%) interrupted it permanently. A total of 24 (10%) participants reported that hospitalization meant problems for later breastfeeding, and 67 (25%) reported experiencing breast complications. The most common negative comment was that the child was too old to be breastfed (median age, 15 months [interquartile range (IQR) 11-25]). Problems for later breastfeeding due to the hospitalization were more likely if breastfeeding was interrupted (odds ratio [OR] 3.68, 95% confidence interval [CI] 1.32-10.5) or breast problems were experienced (OR 4.11, 95% CI 1.51-11.7). Problems were less likely when patients felt encouraged (OR 0.38, 95% CI 0.21-0.69) and hospitalized in a surgical inpatient area (OR 0.15, 95% CI 0.03-0.65). Conclusions: Hospitalizations can cause breastfeeding and breast problems. Hospital services must update protocols to integrate breastfeeding into usual care.

Objectives: Rapid weight gain in infancy is associated with an increased risk of later adiposity. Very rarely, however, exclusively breastfed infants experience excessive weight gain (EWG) during the period of exclusive breastfeeding (EBF) when breast milk is the only source of nutrition. We investigated growth and body composition at 36 months in children experiencing EWG during EBF. Methods: Ten infants with EWG during the first 6 months of EBF were followed up at 36 months. The infants had been followed from age 5 months. Examinations included anthropometry, body composition by bioimpedance, and blood samples. Body composition and plasma leptin concentrations were available for eight and five children, respectively. Results: From 5 to 36 months, body mass index-for-age z-scores (BAZ) decreased from (mean ± standard deviation) 2.33 ± 0.94 to 1.48 ± 0.57, and only one child still being overweight (BAZ >2). Fat mass and fat mass index (FMI) decreased from 18 to 36 months (4.71 ± 0.56 to 3.57 ± 0.67 kg and 6.50 ± 0.34 to 3.66 ± 0.72 kg/m², respectively) with a concurrent 45% decrease in leptin. The increase in lean mass was higher than the increase in weight (5.27 versus 3.65 kg, respectively) due to fat loss. There was substantial conformity within the sample in the patterns of body composition change. Conclusion: This unusual group of children continued to decrease in BAZ and FMI with a concomitant increase in fat-free mass, indicating an ongoing normalization of body weight and composition.