Breastfeeding Medicine最新文献

Objective: This study evaluates the impact of various processing steps in the human milk (HM) donation chain on nutritional composition and oxidative biomarkers, specifically focusing on triacylglycerols, glucose, polyphenols, and lipid peroxides. Materials and Methods: A total of 68 HM samples were collected from the Human Milk Bank of Córdoba (Argentina) between 2022 and 2023. The effects of storage and pasteurization using the Holder method were assessed. Biochemical analyses were conducted to measure nutrient levels and oxidative markers. Statistical analyses included time-related modeling and paired t tests to evaluate the effects of storage and pasteurization, respectively. Results: Triacylglycerol levels were markedly reduced during home storage (R² = 0.802, p = 0.0210), whereas glucose, lipid peroxides, and polyphenols remained stable (R² < 0.3, p > 0.05). Storage at the bank did not affect these biomarkers (R² < 0.25, p > 0.05). Pasteurization resulted in increased glucose levels (p = 0.0292) and decreased triacylglycerol levels (p = 0.0073), along with a significant reduction in lipid peroxides (p < 0.0001). Conclusions: The findings indicate that home storage conditions significantly diminish triacylglycerol levels in HM, highlighting the need for improved storage practices among donors. Pasteurization provides antioxidant benefits by reducing lipid peroxides while maintaining nutritional integrity.

Background: Pasteurized donor human milk must be provided when mother's own milk (MOM) is not available for preterm infants. There are concerns that human milk banks (HMBs) and the use of donor milk may potentially reduce breastfeeding rates. Objective: To compare feeding during hospitalization and at discharge before and after the opening of a HMB and to evaluate the proportion of milk provided by mothers of premature babies, comparing the intake of MOM in infants born of donor and no donor mothers. Methods: Retrospective observational cohort study. Data on milk intake and feeding at discharge of newborns <1,500 grams and/or 32 weeks gestational age. Results: There were significant differences in the intake of preterm formula (PF) between the two groups in the first 28 days of life (87.8% versus 54.2%; p = 0.000) and at discharge (34% versus 18.2%; p = 0.000). The intake of MOM during hospitalization (90.5% versus 100%; p = 0.008) and exclusive breastfeeding at discharge (18.7% versus 61.8%; p = 0.000) increased and the intake of PF (71.4% versus 33.8%; p = 0.000) and exclusive PF (EPF) at discharge decreased (27.5% versus 7,3%; p = 0.000) for babies whose mothers were or were not donors. Mothers of preterm babies donated 57.6% of the total milk received by the milk bank. Conclusion: After the opening of a HMB, there was a decrease in PF intake during hospitalization and an increase in MOM intake at discharge in preterm babies, especially for those whose mothers were milk donors.

Background: Interchangeable terminology and definitions of breastfeeding difficulties may inadvertently influence premature cessation of breastfeeding. Lactation failure is a distinct concept from breastfeeding cessation, and it is vital to differentiate between them, especially in educating health care professionals in communicating and supporting mothers perinatally. Purpose: Comprehensively review varying terminology and definitions, providing a more nuanced understanding of lactation failure versus breastfeeding cessation, and highlighting physiological and social, emotional, mental, and commercial factors that influence breastfeeding outcomes. Method: A scoping review of published literature from medical and scientific databases such as MEDLINE (via PubMed), Scopus, and Web of Science from 2000 to 2023. Results: N = 476 publications were collected during the identification phase; N = 49 from 28 countries around the world met the inclusion criteria and were used in the review. Only N = 13 studies ventured definitions for the terms used. Factors affecting breastfeeding were categorized as physiological leading to lactation failure and distinguished from social, mental, emotional, or commercial factors leading to breastfeeding cessation. Recommendations and Conclusions: Understanding the complexity of the factors underlying lactation failure and breastfeeding cessation can be improved by delineating the terminology and definitions variations used to communicate, provide awareness, education, design and delivery of interventions and support for initiation, and continuation of breastfeeding. Further in-depth research and analysis of the complex issues and factors influencing breastfeeding practices is required.

Objective: This study examined the effect of breast milk on oral care practices in neonatal intensive care units. Methods: This study involved 64 preterm infants (intervention/breast milk: 32, control/distilled water: 32) and was carried out with a prospective, parallel, randomized controlled design. The "Newborn Oral Health Assessment Tool (NOHAT)" was used to assess oral care. The Mann-Whitney U test, continuity correction test, Fisher's exact test, independent-samples T test, and Wilcoxon signed ranks test were used to analyze the data. Results: Examining the oral care performed using breast milk and distilled water with NOHAT scores, it was determined that there was a significant difference in the intervention group (p < 0.05). Conclusions: It is recommended to use breast milk for oral care.

Purpose: It is known that despite the benefits of breast milk and breastfeeding, children with Down syndrome (DS) are breastfed less than other children are. More information is needed to reveal the problems experienced regarding breastfeeding in this group of children and take precautions. The purpose of this study was to learn about the breastfeeding experiences of mothers of children with DS. Methods: The study was carried out by conducting in-depth interviews with 17 women who met the inclusion criteria in Turkey between September 1 and December 1, 2023. Content analysis was used to analyze the data. Results: As a result of the content analysis, five themes emerged. These themes were changing of body and emotions, why doesn't my baby suck?, I have to breastfeed my baby, I am not alone, and experiences should be shared. Conclusions: It was determined that mothers of children with DS experienced problems/difficulties due to individual, baby-related, and environmental factors. The positive effects of breastfeeding children with DS can be made prevalent in society by supporting these mothers.

Background: Breastfeeding is a key public health priority with known racial inequities. Despite the well-described and far-reaching health benefits of breastfeeding for mothers and infants, rates of breastfeeding initiation, continuation, and exclusivity lag meaningfully among African American and Black (AA/B) women compared with other racial and ethnic groups due in main to current and historical structural racism. Methods: The study objective was to assess the replicability of Breast for Success (BFS) on breastfeeding rates among home-visited low-income predominantly AA/B mothers. The BFS Excels a Second Time (BEST) trial was an observational study conducted at the Neighborhood Health Association, Toledo, OH, enrolling expectant women (June 2022-March 2023, followed to October 2023) participating in the Moms and Babies First (MBF) Community Health Worker (CHW)-led home visiting program. The exposure, BFS, includes 11 CHW-delivered breastfeeding-supportive modules, breastfeeding supplies, and a postnatal lactation visit. All MBF mothers received BFS; those who agreed to data sharing were BEST participants. The outcomes were breastfeeding initiation, and breastfeeding continuation, and exclusivity at 1 month. Results: The majority of participants were AA/B (48, 83%), had an income <200% poverty level (55, 95%), and were unmarried (57, 98%); mean age was 25.8 years (SD 5.5). Of the 58 participants, 57 (98%) initiated breastfeeding and continued breastfeeding at 1 month postpartum; 53 (91%) were exclusively breastfeeding at 1 month postpartum. Discussion: BFS piggybacks seamlessly onto CHW-led home-visiting curricula and increased breastfeeding rates among women at high risk for not breastfeeding. Public health programs can add BFS to fill a critical curricular and impact gap with respect to breastfeeding support.

Background: Unintended pregnancy increases adverse perinatal health outcomes. Limited studies exist on the influence of pregnancy intention on breastfeeding. This study examines the interaction of Race and couples' pregnancy intention on breastfeeding initiation and duration. Methods: Using the National Survey of Family Growth (2017-2019), we categorized breastfeeding into three categories (never breastfed, breastfed for 6 months or less, and breastfed for more than 6 months). Multinomial logistic regression and probability marginal effects were estimated across racial categories (Hispanics, non-Hispanic [NH] White, Black, and NH-others or multiracial). Results: The probability (Pr.) of never breastfeeding was the greatest among NH-Black women for all pregnancy intentions-both intended (Pr.: 0.34), mother-only (Pr.: 0.27), father-only (Pr.: 0.45), ambivalent (Pr.: 0.55), and neither intended (Pr.: 0.37). The probability of breastfeeding for 6 months or less is highest for Hispanics for both intended (Pr.: 0.41), NH-White for mother-only intended (Pr.: 0.49), Hispanics for father-only intended (Pr.: 0.56), ambivalent pregnancy intentions (Pr.: 0.60), and NH-others or multiracial for neither intended pregnancies (Pr.: 0.48). The probability of breastfeeding for more than 6 months is highest for NH-others or multiracial for both intended (Pr.: 0.50), ambivalent (Pr.: 0.49), and neither intended (Pr.: 0.36), while highest for NH-Black for mother-only intended (Pr.: 0.43). Conclusions: Our study demonstrates the interaction of Race and couples' pregnancy intention on breastfeeding initiation and duration. Owing to the high volume of unintended pregnancies in the United States, the current study might help maternal and child healthcare providers understand the interaction between race and pregnancy intentions on breastfeeding initiation and duration in the United States.

Introduction: Human breast milk macronutrients play a vital role in the development of breastfed infants and are known to be influenced by several factors. There is limited information on the influence of cannabis use during lactation on these macronutrients. Given the rising use of cannabis among lactating women with its widespread legalization, this study aimed to examine the association of cannabis use during lactation on breast milk macronutrients. Materials and Methods: A cross-sectional study design was used and 637 breast milk samples with measured macronutrients were utilized. Of these, 165 samples that had detectable cannabis metabolites were defined as the study group, and 472 samples from mothers who did not report cannabis use and from mothers who reported cannabis use but did not have measurable metabolites of cannabis in their milk samples were defined as the control group. Multivariable linear regression models were used to assess the association of presence of cannabis metabolites with protein, carbohydrates, fat, and calories in breast milk. Results: Greater protein levels (95% confidence interval [CI]: 0.112-0.376; p < 0.001) and lower fat levels (95% CI: -0.217, -0.018; p = 0.020) were found in the milk exposed to cannabis compared with reported nonexposure. The presence of cannabis was associated with an increase of 0.244 mg/dL in protein and a reduction of 11% in fats in breast milk. The levels of energy and carbohydrates were not significantly different among the two groups. Conclusions: This study demonstrated a statistically significant association between the presence of metabolites of cannabis in breast milk and protein and fat concentrations in breath milk. Further studies are required toward building the body of evidence to determine safety of cannabis use during lactation.

Recent litigation against the two major U.S. formula manufacturers regarding their products liability, in Gill v Abbott Laboratories and Watson v Mead Johnson, juries in two U.S. states have determined that these manufacturers' created products liability by their failure to warn parents and medical professionals that their formulas posed an increased risk for necrotizing enterocolitis (NEC). They asserted that their products are safe and effective. Juries in state courts in both cases awarded substantial monetary awards for punitive damage, economic and emotional harms to parents whose infant died after being fed "premature special care formulas." The company's defense attorneys unsuccessfully asserted the doctrine of learned intermediaries, namely that it was neonatologists who ordered and/or administered these products to premature infants, thus causing NEC. The Food and Drug Administration (FDA) has regulatory authority over the formula manufacturing processes but does not grant "approval" status, as the FDA classifies these "special care formulas" as exempt because they are nutritional agents. While both cases are being appealed, the impact of these legal actions may discourage further "special care formula" development and may pose the future risk of physician malpractice allegations when an infant develops NEC after receiving a "special care formula." In accordance with American Academy of Pediatrics recommendations, obtaining informed consent for formula use may mitigate some legal risks for neonatologists and other medical providers.

Background: There is limited evidence on whether the interaction of mothers staying in double rooms (DRs) in the hospital after birth affects breastfeeding attitudes and milk production. Research Aim: To compare the breastfeeding attitudes and milk production of mothers staying in a DR in the hospital after birth with mothers staying in a single room (SR). Materials and Methods: In the study, 181 mothers who gave birth at term were included. Of them, 92 stayed in SRs, and 89 stayed in DRs. The milk production and breastfeeding attitudes of the mothers were considered as dependent variables. Results: The mothers staying in SRs needed health care professional support more (83.7%) than did the mothers staying in DRs (71.9%; p < 0.05). Milk production was more in the mothers staying in SRs (χ_mean: 14.16 ± 3.34) than it was in the mothers staying in DRs (χ_mean: 10.13 ± 2.42; p < 0.05). There were no significant differences between the breastfeeding attitudes of the participants in terms of the type of the room they stayed in. Conclusions: While most mothers prefer staying in a SR in terms of privacy and comfort, some mothers prefer staying in a multiple-bed room because social interactions they have positively affect their breastfeeding attitudes. Health care institutions may consider incorporating shared or DRs into their postpartum care protocols, which creates comfortable and supportive environments for breastfeeding mothers.