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Zakarija-Grković I, Cattaneo A, Bettinelli ME, Pilato C, Vassallo C, Borg Buontempo M, Gray H, Meynell C, Wise P, Harutyunyan S, Rosin S, Hemmelmayr A, Šniukaitė-Adner D, Arendt M, Gupta A. Are our babies off to a healthy start? The state of implementation of the Global strategy for infant and young child feeding in Europe. Int Breastfeed J 2020; 15:51. [PMID: 32493416 PMCID: PMC7271477 DOI: 10.1186/s13006-020-00282-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022] Open
Abstract
Background To protect children’s right to optimal nutrition, WHO/UNICEF developed a Global Strategy for Infant and Young Child Feeding, endorsed by all 53 WHO/EURO Member States. The World Breastfeeding Trends Initiative (WBTi) is a tool for monitoring implementation of the Global Strategy. It comprises 15 indicators, ten referring to policies and programmes, and five to feeding practices. Each is scored on a scale of 10, giving a total score of 150 for Global Strategy implementation. To date, 18 WHO/EURO Member States – Armenia, Austria, Belgium, Bosnia and Herzegovina, Croatia, France, Georgia, Germany, Italy, Lithuania, North Macedonia, Malta, Moldova, Portugal, Spain, Turkey, Ukraine and United Kingdom – have conducted a WBTi assessment and produced a report. Methods Between June 2018 and May 2019, all 18 WBTi European reports were carefully read and analysed by a group of national WBTi coordinators. Descriptive data analysis, including inter-country comparisons, was conducted using frequencies and percentages. This paper summarises the findings. The full 88-page report will be published on the WBTi website. Results Three-quarters of 18 European countries have adequate maternity protection, and two-thirds have breastfeeding initiation rates of 50% or higher. However, ‘Preparedness and planning for appropriate and safe Infant and Young Child Feeding (IYCF) in emergencies’ is seriously neglected. Breastfeeding duration is far below WHO recommendations, with an average of 8.7 months. Only three European countries have a budget allocated for implementing IYCF policies and plans, and a third currently have no Baby-friendly designated maternity facilities. Bottle feeding is prevalent, despite its inherent risks, monitoring of IYCF practices is inadequate, with most countries not routinely collecting data, and violations of the International Code of Marketing of Breast-milk Substitutes are commonplace. Conclusions European governments are not doing enough to protect, promote and support sound infant and young child feeding practices. Political commitment at the highest level and adequate funding are required to ensure optimal IYCF for Europe’s babies. This report highlights worrying gaps, thereby providing governments, international organisations and other concerned parties with an opportunity to invest in priority areas and, by doing so, hopefully create a better future for our babies.
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Affiliation(s)
| | | | - Maria Enrica Bettinelli
- IBFAN Italia and University of Milan, School of Medicine, Via Festa del Perdono 7, 20122, Milan, Italy
| | | | - Charlene Vassallo
- Health Promotion and Disease Prevention Directorate, St Luke's Square, Guardamangia, PTA 1010, Pietà, Malta
| | - Mariella Borg Buontempo
- Health Promotion and Disease Prevention Directorate, St Luke's Square, Guardamangia, PTA 1010, Pietà, Malta
| | - Helen Gray
- Lactation Consultants of Great Britain, 6 Livingstone Terrace, Bath, BA2 3LE, UK
| | - Clare Meynell
- Lactation Consultants of Great Britain, 6 Livingstone Terrace, Bath, BA2 3LE, UK
| | | | - Susanna Harutyunyan
- Yerevan State Medical University after Mkhitar Heratsi, 2 Koruni str, 0025, Yerevan, Armenia
| | - Stefanie Rosin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Neonatologie, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Andrea Hemmelmayr
- Austrian Alliance of Lactation Consultants, Ortsstraße 144/8/2, 2331, Vösendorf, Austria
| | - Daiva Šniukaitė-Adner
- Lithuanian Lactation and Breastfeeding Consultants Association, Pušų str.32, 08116, Vilnius, Lithuania
| | - Maryse Arendt
- IBFAN Luxembourg, 17 rue Charlemagne, 1328, Luxembourg, Luxembourg
| | - Arun Gupta
- Breastfeeding Promotion Network of India (BPNI), BP-33 Pitampura, Delhi, 110034, India
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152
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Does early weaning shape future endocrine and metabolic disorders? Lessons from animal models. J Dev Orig Health Dis 2020; 11:441-451. [PMID: 32487270 DOI: 10.1017/s2040174420000410] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Obesity and its complications occur at alarming rates worldwide. Epidemiological data have associated perinatal conditions, such as malnutrition, with the development of some disorders, such as obesity, dyslipidemia, diabetes, and cardiovascular diseases, in childhood and adulthood. Exclusive breastfeeding has been associated with protection against long-term chronic diseases. However, in humans, the interruption of breastfeeding before the recommended period of 6 months is a common practice and can increase the risk of several metabolic disturbances. Nutritional and environmental changes within a critical window of development, such as pregnancy and breastfeeding, can induce permanent changes in metabolism through epigenetic mechanisms, leading to diseases later in life via a phenomenon known as programming or developmental plasticity. However, little is known regarding the underlying mechanisms by which precocious weaning can result in adipose tissue dysfunction and endocrine profile alterations. Here, the authors give a comprehensive report of the different animal models of early weaning and programming that can result in the development of metabolic syndrome. In rats, for example, pharmacological and nonpharmacological early weaning models are associated with the development of overweight and visceral fat accumulation, leptin and insulin resistance, and neuroendocrine and hepatic changes in adult progeny. Sex-related differences seem to influence this phenotype. Therefore, precocious weaning seems to be obesogenic for offspring. A better understanding of this condition seems essential to reducing the risk for diseases. Additionally, this knowledge can generate new insights into therapeutic strategies for obesity management, improving health outcomes.
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153
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Breastfeeding in Hospitals: Factors Influencing Maternal Choice in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103575. [PMID: 32443713 PMCID: PMC7277836 DOI: 10.3390/ijerph17103575] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess the factors influencing women in their decisions to breastfeed during hospitalization after delivery. We conducted an observational study on 3813 questionnaires administered to mothers of newborns during their hospital stay from the years 2016 to 2018 in eight hospitals of various types. The average maternal age was 31.3 years ± 5.8. Sixty-nine percent of women did not attend a prenatal course. From childbirth to discharge, the percentage of women who breastfed was 88%, of whom 45% did exclusive breastfeeding. Only 35% of women who had a caesarean section adopted exclusive breastfeeding. In our experience, rooming-in was not associated with an increase in breastfeeding. We observed that both attendance to prenatal courses and the mother's education level played a minor role in influencing the mother's decision in breastfeeding A fairly high percentage of exclusive breastfeeding, 75%, was attained just in one hospital, where dedicated staff was deployed to encourage breastfeeding. The lowest percentage (12%) of exclusive breastfeeding was observed in a large private accredited health facility. Hospital presence of professionals trained in human lactation is a smart investment for society.
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154
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Zhou Q, Chen H, Younger KM, Cassidy TM, Kearney JM. "I was determined to breastfeed, and I always found a solution": successful experiences of exclusive breastfeeding among Chinese mothers in Ireland. Int Breastfeed J 2020; 15:47. [PMID: 32434576 PMCID: PMC7240908 DOI: 10.1186/s13006-020-00292-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 05/13/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of exclusive breastfeeding for at least 4 months was previously found to be very low among Chinese immigrants in Ireland, at 5.8% (Zhou et al., Front Public Health 6:351, 2018). This study investigates the successful experiences of Chinese mothers living in Ireland who exclusively breastfeed for between four and 6 months. METHODS Participants were recruited from the sample of the Ireland Chinese Mother Survey. Qualitative in-depth interviews were conducted with fourteen participants in their homes or public places. RESULTS A content analysis revealed that various factors contributed to a successful experience of exclusive breastfeeding among the group of Chinese immigrant mothers, including strong self-determination; appropriate physical conditions; awareness of the benefits of exclusive breastfeeding; a lack of time constraints; and family, professional and policy support. The barriers that the mothers faced included the difficulty of balancing breastfeeding and employment, infant health issues, language barriers, an inability to consume the traditional Chinese postpartum diet and a lack of public breastfeeding facilities. Measures taken to overcome these barriers included seeking family support, resting during the lactation period, and pumping breast milk to feed from a bottle when outside the home. CONCLUSIONS This study highlights unique factors affecting exclusive breastfeeding among Chinese mothers in Ireland, which may be useful to health care professionals working with Chinese immigrant women internationally.
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Affiliation(s)
- Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Haoyue Chen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Katherine M Younger
- School of Biological and Health Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
| | - Tanya M Cassidy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
| | - John M Kearney
- School of Biological and Health Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
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155
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Lyons-Reid J, Ward LC, Kenealy T, Cutfield W. Bioelectrical Impedance Analysis-An Easy Tool for Quantifying Body Composition in Infancy? Nutrients 2020; 12:E920. [PMID: 32230758 PMCID: PMC7230643 DOI: 10.3390/nu12040920] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022] Open
Abstract
There has been increasing interest in understanding body composition in early life and factors that may influence its evolution. While several technologies exist to measure body composition in infancy, the equipment is typically large, and thus not readily portable, is expensive, and requires a qualified operator. Bioelectrical impedance analysis shows promise as an inexpensive, portable, and easy to use tool. Despite the technique being widely used to assess body composition for over 35 years, it has been seldom used in infancy. This may be related to the evolving nature of the fat-free mass compartment during this period. Nonetheless, a number of factors have been identified that may influence bioelectrical impedance measurements, which, when controlled for, may result in more accurate measurements. Despite this, questions remain in infants regarding the optimal size and placement of electrodes, the standardization of normal hydration, and the influence of body position on the distribution of water throughout the body. The technology requires further evaluation before being considered as a suitable tool to assess body composition in infancy.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand;
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia;
| | - Timothy Kenealy
- Department of Medicine and Department of General Practice and Primary Health Care, The University of Auckland, Auckland 1023, New Zealand;
| | - Wayne Cutfield
- Liggins Insitute and A Better Start – National Science Challenge, The University of Auckland, Auckland 1023, New Zealand
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156
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Ma J, Qiao Y, Zhao P, Li W, Katzmarzyk PT, Chaput JP, Fogelholm M, Kuriyan R, Lambert EV, Maher C, Maia J, Matsudo V, Olds T, Onywera V, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Hu G. Breastfeeding and childhood obesity: A 12-country study. MATERNAL AND CHILD NUTRITION 2020; 16:e12984. [PMID: 32141229 PMCID: PMC7296809 DOI: 10.1111/mcn.12984] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 01/24/2023]
Abstract
This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend = .020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend = .012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries.
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Affiliation(s)
- Jian Ma
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yijuan Qiao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Pei Zhao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Wei Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | | | - Jean-Philippe Chaput
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Estelle V Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Carol Maher
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jose Maia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal
| | - Victor Matsudo
- Center of Studies from the Physical Fitness Research Laboratory, de São Caetano do Sul, Sao Paulo, Brazil
| | - Timothy Olds
- Alliance for Research In Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Vincent Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya
| | | | - Martyn Standage
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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157
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Kakleas K, Christodouli F, Karavanaki K. Nonalcoholic fatty liver disease, insulin resistance, and sweeteners: a literature review. Expert Rev Endocrinol Metab 2020; 15:83-93. [PMID: 32212870 DOI: 10.1080/17446651.2020.1740588] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 03/06/2020] [Indexed: 12/21/2022]
Abstract
Introduction: Sweeteners are substances used to replace sugar. They can either be chemically produced (artificial sweeteners) or extracted from plants (natural sweeteners). In the last two decades, there is an increased popularity in their role as sugar substitutes in individuals to promote weight loss or maintain glycemic control. However, despite their favorable effects, there is concern regarding their side effects and especially their influence in the development of nonalcoholic fatty liver disease (NAFLD).Areas covered: A comprehensive literature search was conducted on Medline including systematic reviews, longitudinal controlled studies, and retrospective cohort studies. We present an up-to-date systematic review of the current literature regarding the safety in artificial and natural sweeteners use as a means of weight loss or diabetes control.Expert opinion: Natural sweeteners have not been associated directly with NAFLD, and on the contrary, some, such as stevia, and trehalose, may have a protective effect. Rare sugars and polyols can be used safely and have significant benefits that include anti-oxidant effect and optimal glycemic control. Artificial sweeteners, due to their effect on NAFLD development and insulin resistance, are not indicated in patients with obesity or diabetes. Further studies in human subjects are required to verify the above findings.
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Affiliation(s)
- Konstantinos Kakleas
- Pediatric Department, Leicester Royal Infirmary, University Hospitals Leicester, Leicester, UK
| | - Foteini Christodouli
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, Athens, Greece
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158
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Buges NM, Klinger KDSA, Pereira RJ. New mothers and their understanding about breast milk donation. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objective: to analyze the understanding of mothers about the donation of human milk. Methods: a qualitative and quantitative study with 13 potential milk donors who answered a sociodemographic and obstetric background questionnaire, as well as a semi-structured interview guide on milk donation. Mothers were approached in the hospital environment, after delivery and the visit of the milk bank. Data were analyzed in Statistical Package for Social Sciences 20.0 and NVivo 11 Starter. Results: the mean age was 24.62 ± 3.95 years; 84.6% had more than eleven years of formal education; 38.5% declared themselves housewives; 46.2% were in a stable union and 76.9% had an income of up to two minimum wages. Most of the mothers (69.2%) experienced previous pregnancy; 76.9% had 6 or more prenatal consultations and 62.5% had previously breastfed. The motivating factors of the donation were altruism; empathy with other mothers; recognition of the primacy of breast milk; the child's understanding of breast milk need; excess milk production and family support. Unawareness of the process, limited time available, and lack of transportation and collection points can make donation difficult. Conclusions: there was a desire for information and support for breastfeeding and donation, which made the donation act complex and distant from reality.
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159
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Lin W, Hsieh C, Chang F, Wang C, Lin C, Chuang H. Effects of workplaces receiving "accreditation of health workplaces" on breastfeeding promotion, parental leave, and gender equality. J Occup Health 2020; 62:e12140. [PMID: 32856781 PMCID: PMC7453313 DOI: 10.1002/1348-9585.12140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/17/2020] [Accepted: 06/03/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Work is often a barrier for women to continue breastfeeding after they have given birth. Breastfeeding support is an important part of workplace health promotion. We investigated the implementation of breastfeeding promotion and gender equality polices in workplaces with the Taiwan Badge of Accredited Healthy Workplace. METHODS Our samples consisted of 1648 corporations with the badge of Accredited Healthy Workplace issued by the Bureau of Health Promotion from 2007 to 2008. Concomitantly, 2000 corporations without accreditation were randomly selected from the National Business Directory as the control group. Data were collected from self-administered questionnaires. Logistic regression was used to examine the association with breast-feeding promotion and other variables in Taiwanese workplaces. RESULTS Members of accredited group of 1089/1648 (66.1%) and the control group of 526/2000 (26.3%) responded to the questionnaire. The accredited companies had more mother-friendly settings, including breastfeeding policies and documents, appropriate breastmilk preserving equipment and settings in the workplace. In the accredited group, breastfeeding rate of mothers returning to work after giving birth was 64.3% in 2008 (1 year after giving birth) and 60.4% in 2009 (1 year after giving birth), while the rate of the control group was 59.1% in 2008 and 51% in 2009. CONCLUSION Accredited corporations are better at breastfeeding support than those of the control group. This might be related to the company size, location, and the implementation of tobacco control and/or occupational health promotion policies, which may increase awareness of healthy workplaces and influence maternal protection positively.
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Affiliation(s)
- Wei‐Ting Lin
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Chia‐Chen Hsieh
- Department of Public HealthCollege of Health Sciences Kaohsiung Medical UniversityKaohsiungTaiwan
| | - Fong‐Ching Chang
- Department of Health Promotion and Health EducationNational Taiwan Normal UniversityTaipeiTaiwan
| | - Chao‐Ling Wang
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Chia‐I Lin
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
| | - Hung‐Yi Chuang
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
- Department of Public HealthCollege of Health Sciences Kaohsiung Medical UniversityKaohsiungTaiwan
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160
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Riedlová J, Paulová M, Vignerová J, Brabec M, Sedlak P, Schneidrová D. The Low Prevalence of Overweight and Obesity in Czech Breastfed Infants and Young Children: An Anthropological Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4198. [PMID: 31671517 PMCID: PMC6862631 DOI: 10.3390/ijerph16214198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/17/2019] [Accepted: 10/24/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study is to evaluate the prevalence of overweight and obesity in a sample of children who were exclusively or predominantly breastfed for at least 6 months compared to Czech references that were constructed based on a representative sample of children, regardless of their mode of feeding. Between 2008 and 2011, a longitudinal study on the growth of breastfed infants was carried out in the Czech Republic. Forty-three GP pediatricians addressed parents at 18-month preventive examinations and collected data on the families' socio-economic conditions and the infants' feeding conditions. The children were measured (length, weight, and head circumference), and anthropometric measurements from 10 previous preventive examinations were obtained from the health records. Out of the collected 1775 questionnaires, 960 children were selected according to the criteria of the WHO Multicentre Growth Reference Study. For the purpose of this study, 799 children who were exclusively or predominantly breastfed for at least 6 months were selected. We found that the proportions of children who were classified as overweight (>90th percentile) or obese (>97th percentile) at 6, 12, and 18-month examinations were far below the proportions of the Czech references. An update of the Czech references and growth charts is highly recommended by GP pediatricians for the valid assessment of growth and nutritional status, including a screening of overweight and obesity in primary preventive health care.
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Affiliation(s)
- Jitka Riedlová
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Markéta Paulová
- Department of Hygiene of Children and Adolescents, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic.
| | - Jana Vignerová
- National Lactation Centre, Thomayer Hospital, Vídeňská 800, 140 59 Prague 4, Czech Republic.
| | - Marek Brabec
- Institute of Computer Science, Czech Academy of Sciences, Pod Vodárenskou věží 271/2, 182 00 Prague 8, Czech Republic.
| | - Petr Sedlak
- Division of Child Health Promotion, Department of Hygiene, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Dagmar Schneidrová
- Division of Child Health Promotion, Department of Hygiene, Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic.
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161
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Impact of Fenugreek on Milk Production in Rodent Models of Lactation Challenge. Nutrients 2019; 11:nu11112571. [PMID: 31653107 PMCID: PMC6893785 DOI: 10.3390/nu11112571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 12/15/2022] Open
Abstract
Fenugreek, a herbal remedy, has long been used as galactologue to help mothers likely to stop breastfeeding because of perceived insufficient milk production. However, few studies highlight the efficacy of fenugreek in enhancing milk production. The aims of our study were to determine whether fenugreek increased milk yield in rodent models of lactation challenge and if so, to verify the lack of adverse effects on dam and offspring metabolism. Two lactation challenges were tested: increased litter size to 12 pups in dams fed a 20% protein diet and perinatal restriction to an 8% protein diet with eight pups’ litter, with or without 1 g.kg−1.day−1 dietary supplementation of fenugreek, compared to control dams fed 20% protein diet with eight pups’ litters. Milk flow was measured by the deuterium oxide enrichment method, and milk composition was assessed. Lipid and glucose metabolism parameters were assessed in dam and offspring plasmas. Fenugreek increased milk production by 16% in the litter size increase challenge, resulting in an 11% increase in pup growth without deleterious effect on dam-litter metabolism. Fenugreek had no effect in the maternal protein restriction challenge. These results suggest a galactologue effect of fenugreek when mothers have no physiological difficulties in producing milk.
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162
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Free Amino Acid Content in Human Milk is Associated with Infant Gender and Weight Gain during the First Four Months of Lactation. Nutrients 2019; 11:nu11092239. [PMID: 31533347 PMCID: PMC6770539 DOI: 10.3390/nu11092239] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/20/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background: There is a growing interest regarding the physiological role of free amino acids (FAA) present in human milk (HM). Recent studies show FAA in HM could be influenced by infants’ gender and could have an important role in their growth and development. We studied the concentrations of FAA in HM and potential associations with infants’ gender and their patterns of growth in a cohort of Ecuadorian women. Methods: Human milk samples were collected after approximately eight hours of overnight fast within one week (colostrum), 2 weeks (transition milk), and 2 and/or 4 months (mature milk) after parturition. Free AA were determined by cation-exchange chromatography separation. Results: We observed significantly higher concentrations of Glu 14.40 (1.35, 27.44), Gly 1.82 (0.24, 3.4), Cys 0.36 (0.03, 0.68), and Tyr 0.24 (0.02, 0.46) in HM intended for boys. Free Glu, Gly, Cys, and Tyr concentrations increased with time of lactation. In addition, there were higher concentrations of Glu 28.62 (1.78, 55.46) and Ala 7.16 (1.26, 13.06) in HM for children that presented faster weight gain than for those with slower gain. Conclusions: The present results showed that there are differences in FAA levels in HM intended for male and fast-growing children.
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163
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Mazzocchi A, Giannì ML, Morniroli D, Leone L, Roggero P, Agostoni C, De Cosmi V, Mosca F. Hormones in Breast Milk and Effect on Infants' Growth: A Systematic Review. Nutrients 2019; 11:E1845. [PMID: 31395844 PMCID: PMC6724322 DOI: 10.3390/nu11081845] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 01/13/2023] Open
Abstract
Breast milk is characterized by a dynamic and complex composition which includes hormones and other bioactive components that could influence infant growth, development, and optimize health. Among the several beneficial effects associated with prolonged breastfeeding, a 13% decrease in the risk of overweight and obesity has been reported. Recent research has focused on breast milk hormones contributing to the appetite and energy balance regulation and adiposity. Accordingly, we conducted a literature systematic review with the aim to provide an update on the effect of leptin, ghrelin, Insulin Growth Factor 1, adiponectin, and insulin on infants' and children's growth and body composition. The revised literature reveals contrasting findings concerning the potential role of all these hormones on modeling growth and fat mass apposition and health outcomes later in life. Further studies are needed to gain further insight into the specific role of these bioactive components in metabolic pathways related to body composition. This could help gain a further insight on infants' growth, both in physiological and pathological settings.
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Affiliation(s)
- Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy
| | - Ludovica Leone
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Paola Roggero
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, 20122 Milan, Italy.
| | - Valentina De Cosmi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, 20122 Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy
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