The “smellscape” of mother's breast: Effects of odor masking and selective unmasking on neonatal arousal, oral, and visual responses

Beliefs, Experiences, and Practices of Lady Health Workers in Facilitating Breastfeeding in Rural Communities in Pakistan

Pakistan has extremely poor breastfeeding indicators: fewer than half of infants under 6 months are exclusively breastfed, only 20% of infants are breastfed within the first hour of life, and nearly half are never fed colostrum. The country's high infant morbidity and mortality is in part due to this suboptimal infant feeding. A network of lady health workers (LHWs) employed by the government facilitate maternal and child health programs, including breastfeeding support in their communities. This study describes LHWs' perspectives and experiences regarding breastfeeding. We conducted semi-structured interviews with 14 LHWs and used thematic qualitative analysis to code and analyze the data. Our research revealed that LHWs use their role as members of the community and involve influential members of the family to build trust. Frequent home visits beginning prenatally help them address misconceptions about infant feeding. While they have strong knowledge about the benefits of breastfeeding and the importance of colostrum, they demonstrate gaps in their knowledge regarding breast conditions, the safe preparation of human milk substitutes, the physiology of milk production, and supporting mothers who are separated from their baby. Future training should address these areas where LHWs lack knowledge to help mothers facilitate early and exclusive breastfeeding. With adequate training, LHWs are uniquely positioned to use their role as trusted members of the community to effectively counsel families on the importance of breastfeeding and support the clinical needs of women during the perinatal time.

Smell throughout the life course

The sense of smell is an important mediator of health and sociality at all stages of life, yet it has received limited attention in our lineage. Olfaction starts in utero and participates in the establishment of social bonds in children, and of romantic and sexual relationships after puberty. Smell further plays a key role in food assessment and danger avoidance; in modern societies, it also guides our consumer behavior. Sensory abilities typically decrease with age and can be impacted by diseases, with repercussions on health and well-being. Here, we critically review our current understanding of human olfactory communication to refute outdated notions that our sense of smell is of low importance. We provide a summary of the biology of olfaction, give a prospective overview of the importance of the sense of smell throughout the life course, and conclude with an outline of the limitations and future directions in this field.

Olfactory-to-visual facilitation in the infant brain declines gradually from 4 to 12 months

During infancy, intersensory facilitation declines gradually as unisensory perception develops. However, this trade-off was mainly investigated using audiovisual stimulations. Here, fifty 4- to 12-month-old infants (26 females, predominately White) were tested in 2017-2020 to determine whether the facilitating effect of their mother's body odor on neural face categorization, as previously observed at 4 months, decreases with age. In a baseline odor context, the results revealed a face-selective electroencephalographic response that increases and changes qualitatively between 4 and 12 months, marking improved face categorization. At the same time, the benefit of adding maternal odor fades with age (R2 = .31), indicating an inverse relation with the amplitude of the visual response, and generalizing to olfactory-visual interactions previous evidence from the audiovisual domain.

Testing detectability, attractivity, hedonic specificity, extractability, and robustness of colostrum odor-Toward an olfactory bioassay for human neonates

Human milk odor is attractive and appetitive for human newborns. Here, we studied behavioral and heart-rate (HR) responses of 2-day-old neonates to the odor of human colostrum. To evaluate detection in two conditions of stimulus delivery, we first presented the odor of total colostrum against water. Second, the hedonic specificity of total colostrum odor was tested against vanilla odor. Third, we delivered only the fresh effluvium of colostrum separated from the colostrum matrix; the stability of this colostrum effluvium was then tested after deep congelation; finally, after sorptive extraction of fresh colostrum headspace, we assessed the activity of colostrum volatiles eluting from the gas chromatograph (GC). Regardless of the stimulus-delivery method, neonates displayed attraction reactions (HR decrease) as well as appetitive oral responses to the odor of total colostrum but not to vanilla odor. The effluvium separated from the fresh colostrum matrix remained appetitive but appeared labile under deep freezing. Finally, volatiles from fresh colostrum effluvium remained behaviorally active after GC elution, although at lower magnitude. In sum, fresh colostrum effluvium and its eluate elicited a consistent increase in newborns' oral activity (relative to water or vanilla), and they induced shallow HR decrease. Newborns' appetitive oral behavior was the most reproducible response criterion to the effluvium of colostrum. In conclusion, a set of unidentified volatile compounds from human colostrum is robust enough after extraction from the original matrix and chromatographic processing to continue eliciting appetitive responses in neonates, thus opening new directions to isolate and assay specific volatile molecules of colostrum.

Intrinsic and extrinsic factors affecting axillary odor variation. A comprehensive review

Humans produce odorous secretions from multiple body sites according to the microbiomic profile of each area and the types of secretory glands present. Because the axilla is an active, odor-producing region that mediates social communication via the sense of smell, this article focuses on the biological mechanisms underlying the creation of axillary odor, as well as the intrinsic and extrinsic factors likely to impact the odor and determine individual differences. The list of intrinsic factors discussed includes sex, age, ethnicity, emotions, and personality, and extrinsic factors include dietary choices, diseases, climate, and hygienic habits. In addition, we also draw attention to gaps in our understanding of each factor, including, for example, topical areas such as the effect of climate on body odor variation. Fundamental challenges and emerging research opportunities are further outlined in the discussion. Finally, we suggest guidelines and best practices based on the factors reviewed herein for preparatory protocols of sweat collection, data analysis, and interpretation.

An integrative review: Human chemosensory communication in the parent-child relationship

Body odors serve as signals of kinship, with parents exhibiting a preference for the scent of their infants, and vice versa. The reciprocal perception of body odors can promote bonding through two mechanisms. Firstly, as an indirect pathway, through associative chemosensory learning, which leads to changes in proximity-seeking behaviors. Secondly, as a direct pathway, by eliciting the display of positive emotions, thereby reinforcing the mutual bond. Both mechanisms weaken as the child undergoes development due to changes in body odor expression and perception. This comprehensive review provides an overview of the current literature on chemosignals in the parent-child relationship, highlighting their significance in facilitating dyadic communication throughout the developmental span. Furthermore, future research perspectives are outlined to gain a better understanding of these benefits and, on the long run, derive potential interventions to strengthen parent child attachment.

Why human olfaction should not be modeled on theories and tasks of vision

In this paper we analyze some key concepts and problems in olfaction and argue that many concepts borrowed from vision are not helpful in elucidating the functions of human olfaction. This is illustrated with several examples. Olfaction is rarely in the focus of human attention. Olfaction is, compared to vision, a 'hidden sense', but still guides many important behaviors by way of unattended unconscious olfactory perception and implicit memory. Not all olfactory processing, however, is of an unconscious nature. Flavors, and the pleasures gained from them, are most often consciously perceived. These are experiences mostly determined by olfaction, taste, touch and chemesthesis. Our analyses lead us to conclude that olfaction should not be modeled on vision, neither conceptually nor with respect to the problems solved by the two senses. A critical examination of the ecological and physical constraints of olfaction and the other senses should be given priority. Such analyses will further our understanding of which problems are solved by the different senses and how they collaborate to guide us through the world.

Infant factors that impact the ecology of human milk secretion and composition-a report from "Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)" Working Group 3

Infants drive many lactation processes and contribute to the changing composition of human milk through multiple mechanisms. This review addresses the major topics of milk removal; chemosensory ecology for the parent-infant dyad; the infant's inputs into the composition of the human milk microbiome; and the impact of disruptions in gestation on the ecology of fetal and infant phenotypes, milk composition, and lactation. Milk removal, which is essential for adequate infant intake and continued milk synthesis through multiple hormonal and autocrine/paracrine mechanisms, should be effective, efficient, and comfortable for both the lactating parent and the infant. All 3 components should be included in the evaluation of milk removal. Breastmilk "bridges" flavor experiences in utero with postweaning foods, and the flavors become familiar and preferred. Infants can detect flavor changes in human milk resulting from parental lifestyle choices, including recreational drug use, and early experiences with the sensory properties of these recreational drugs impact subsequent behavioral responses. Interactions between the infant's own developing microbiome, that of the milk, and the multiple environmental factors that are drivers-both modifiable and nonmodifiable-in the microbial ecology of human milk are explored. Disruptions in gestation, especially preterm birth and fetal growth restriction or excess, impact the milk composition and lactation processes such as the timing of secretory activation, adequacy of milk volume and milk removal, and duration of lactation. Research gaps are identified in each of these areas. To assure a sustained and robust breastfeeding ecology, these myriad infant inputs must be systematically considered.

Incarcerated mothers' views of their children's experience: A qualitative study in French nurseries

CONTEXT

In France, young children of incarcerated women live with their mothers in prison in specific units called nurseries, up to the age of 18 months. Only a few studies have examined the impact of this environment on these children. This study sought to explore through mothers' narratives how they perceive their children to experience this environment and how it affects their development.

METHOD

We used semistructured interviews to collect the perceptions of 25 mothers about their children's experience of daily life in 12 different prison nurseries in France. Interpretative phenomenological analysis was used to explore the data.

RESULTS

According to mothers, prison is a sensorially aggressive environment for children that may impair the children's sensory abilities. The children's and mothers' emotional perceptions of anger, sadness, insecurity and imprisonment intertwine. Prison is home for these children, which leads them to establish strong bonds with this inside world-prison staff, other inmates-but to develop reluctances and concern about exploring the outside world.

CONCLUSION

The prison's sensorial environment may overlay the sensorial environment created by the mother, interfering with early mother-child interactions and leading to emotional misattunement. The gap between what the mother and the child each feel to be their home, and the social group they feel they belong to, causes pain to the mothers. This could alter their mandate of being a protective shield that could reduce the traumatic potential of the carceral environment on their babies. These mothers' sentences must be reconsidered for the sake of their children.

Olfactory sensory and perceptual evaluation in newborn infants: A systematic review

Fetuses are able to process olfactory stimuli present in the womb and continue to show a preference for these odors for months after birth. Despite the accumulated knowledge about their early ability to perceive odors, there is a lack of validated scales for odor response in newborns. The evaluation of reactions of the olfactory system to environmental stimuli in infants has been defined by methodological theoretical approaches of experimental and clinical assessment tools. These approaches are mainly based on psychophysical approaches and predominantly use behavioral and physiological measures. Examples can be found in studies describing early abilities of newborn babies for behaviors or heart rate variability showing memory of maternal food preferences or mother's breast milk. This systematic review aimed to determine whether validated odor assessment tools can be feasibly used in studies. Particularly in light of the current COVID-19 pandemic and evidence of associated olfactory impairment resulting from SARS-COV-2 infection, the study is also motivated by the need for tools to assess olfactory function in neonates.

Olfaction in the Multisensory Processing of Faces: A Narrative Review of the Influence of Human Body Odors

A recent body of research has emerged regarding the interactions between olfaction and other sensory channels to process social information. The current review examines the influence of body odors on face perception, a core component of human social cognition. First, we review studies reporting how body odors interact with the perception of invariant facial information (i.e., identity, sex, attractiveness, trustworthiness, and dominance). Although we mainly focus on the influence of body odors based on axillary odor, we also review findings about specific steroids present in axillary sweat (i.e., androstenone, androstenol, androstadienone, and estratetraenol). We next survey the literature showing body odor influences on the perception of transient face properties, notably in discussing the role of body odors in facilitating or hindering the perception of emotional facial expression, in relation to competing frameworks of emotions. Finally, we discuss the developmental origins of these olfaction-to-vision influences, as an emerging literature indicates that odor cues strongly influence face perception in infants. Body odors with a high social relevance such as the odor emanating from the mother have a widespread influence on various aspects of face perception in infancy, including categorization of faces among other objects, face scanning behavior, or facial expression perception. We conclude by suggesting that the weight of olfaction might be especially strong in infancy, shaping social perception, especially in slow-maturing senses such as vision, and that this early tutoring function of olfaction spans all developmental stages to disambiguate a complex social environment by conveying key information for social interactions until adulthood.

Olfactory impairment and close social relationships. A narrative review

Olfactory impairment is one of the more unique symptoms of COVID-19 infection and has therefore enjoyed increased public attention in recent months. Olfactory impairment has various implications and consequences ranging from difficulty detecting dangerous pathogens to hindering social functioning and social behaviors. We provide an overview of how olfactory impairment can impact 3 types of close social relationships: family relationships, friendships, and romantic relationships. Evidence is divided into several categories representing potential mechanisms by which olfactory impairment can impact close social relationships: bonding disruptions, decreased social support, missed group-eating experiences, hygiene concerns, and altered sexual behaviors. We conclude with a discussion of emerging future research questions.

Body Odours Sampled at Different Body Sites in Infants and Mothers-A Comparison of Olfactory Perception

Body odours and their importance for human chemical communication, e.g., in the mother-child relationship, are an increasing focus of recent research. Precise examination of sampling methods considering physiology and feasibility aspects in order to obtain robust and informative odour samples is therefore necessary. Studies comparing body odour sampling at different body sites are still pending. Therefore, we sampled axilla, breast, and head odour from 28 mother-infant dyads and examined whether odour perception differs with regard to the body site. The participating mothers were asked to evaluate their own and their infant's body odour samples, as well as odours of two unfamiliar mother-infant dyads. We tested whether maternal pleasantness and intensity evaluation, as well as recognition ability of the odours differed between the body sites. In infants, the head odour exhibited slightly lower pleasantness ratings than axilla and breast, and intensity ratings did not differ between body sites. In mothers, body site affected intensity ratings but not pleasantness ratings, as the breast odour was rated as less intense compared with head and axilla. Across all body sites, mothers rated the own and their infant's odour as less intense when compared with unfamiliar samples. Recognition ability did not differ between body sites, and in line with previous studies, mothers were able to recognize their own and their own infant's odour above chance. In sum, our study extends the previous methodological repertoire of body odour sampling and indicates that the axilla, breast, and head of adults as well as infants serve as informative odour sources.

Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants: A Randomized Clinical Trial

IMPORTANCE

Approximately 1 in 5 women in low- and middle-income countries experience postpartum depression, and the risk is higher among mothers of low-birth-weight (LBW) infants. Kangaroo mother care (KMC) is effective in improving survival among LBW infants, but the benefits of KMC for mothers are not well described.

OBJECTIVE

To estimate the effects of community-initiated KMC (ciKMC) on maternal risk of moderate-to-severe postpartum depressive symptoms and on salivary cortisol concentration, a biomarker of stress.

DESIGN, SETTING, AND PARTICIPANTS

This was an unmasked, parallel-group, individually randomized clinical trial. Participants included 1950 mothers of stable LBW infants (weighing 1500-2250 g) in rural and semiurban low-income populations in North India enrolled between April 2017 and March 2018. Data analysis was performed from January to July 2020.

INTERVENTIONS

Eligible participants were randomly assigned to the intervention or control group by block randomization. The mothers in the intervention group were supported to practice ciKMC until 28 days after birth or until the infant wriggled out of the KMC position (ie, was no longer staying in the KMC position). The intervention included promotion and support of skin-to-skin contact and exclusive breastfeeding through home visits.

MAIN OUTCOMES AND MEASURES

Postpartum depressive symptoms at the end of the neonatal period were measured using the Patient Health Questionnaire-9, with a score of 10 or higher used to identify moderate-to-severe depressive symptoms. Salivary cortisol concentration was measured in a subsample of 550 mothers before and after breastfeeding on day 28 after birth.

RESULTS

Of the 1950 participants (mean [SD] age, 23 [3.5] years), outcome assessment was completed for 974 of 1047 participants (93%) in the intervention group and 852 of 903 participants (94%) in the control group. Sixty-four percent of participants (1175 of 1826 participants) belonged to the lowest 3 wealth quintiles. The proportion of mothers with moderate-to-severe postpartum depressive symptoms was 10.8% (95% CI, 8.9%-12.9%; 105 of 974 mothers) in the intervention group vs 13.6% (95% CI, 11.4%-16.1%; 116 of 852 mothers) in the control group. The adjusted relative risk of moderate-to-severe maternal postpartum depressive symptoms was 0.75 (95% CI, 0.59-0.96), or an efficacy of 25%. There was no difference in day-28 salivary cortisol concentration between the ciKMC and control group mothers before or after breastfeeding. The analysis estimated that supporting 36 mothers to perform KMC at home would prevent 1 mother from experiencing moderate-to-severe postpartum depressive symptoms.

CONCLUSIONS AND RELEVANCE

These findings suggest that ciKMC practice may substantially reduce the risk of moderate-to-severe maternal postpartum depressive symptoms. This evidence supports KMC as an intervention to be incorporated in essential newborn care programs in low- and middle-income settings.

TRIAL REGISTRATION

Clinical Trials Registry-India Identifier: CTRI/2017/04/008430.

A Randomized Controlled Trial: The Effect of Own Mother's Breast Milk Odor and Another Mother's Breast Milk Odor on Pain Level of Newborn Infants

Objective: Our research was conducted empirically to determine whether another mother's breast milk could be used to reduce the pain of newborns who were not able to access their own mother's milk for any reason. Materials and Methods: The sample group of the research included 90 newborns [smell of own mother's milk (30), smell of another mother's milk (30), and the control group (30)] hospitalized in the unit. A neonatal information form was used as the data collection tool, the Neonatal Pain, Agitation, and Sedation Scale (N-PASS) was used to assess the newborn's pain, and an evaluation form prepared by the researcher was used to record the findings. Results: The group which was exposed to their own mother's milk had a significantly lower N-PASS mean score compared to other groups and the group which was exposed to another mother's milk was observed to have a significantly lower N-PASS mean score compared to the control group (p < 0.05). While the median values for the total time spent crying of the "own mother's milk" group and the "another mother's milk" group were similar; the total time spent crying of the control group had a significantly higher median value. Conclusion: Our research determined that, while the most effective method for reducing pain in newborns was the smell of their own mother's breast milk, for newborns who were not able to access their own mother's breast milk, the smell of breast milk from a different mother could also be used.

Newborn crawling and rooting in response to maternal breast odor

A growing literature shows that perception and action are already tightly coupled in the newborn. The current study aimed to examine the nature of the coupling between olfactory stimuli from the mother and the newborn's crawling and rooting (exploratory movements of the head). To examine the coupling, the crawling and rooting behavior of 28 2-day-old newborns were studied while they were supported prone on a mobility device shaped like a mini skateboard, the Crawliskate®, their head positioned directly on top of a pad infused with either their mother's breast odor (Maternal) or the odor of water (Control). Video and 3D kinematic analyses of the number and types of limb movements and quantification of displacement across the surface revealed that newborns are significantly more efficient crawlers when they smell the maternal odor, moving greater distances although performing fewer locomotor movements. In addition, the newborns made significantly more head rooting movements in the presence of the maternal odor. These findings suggest that the circuitry underlying quadrupedal locomotion and exploratory movements of the head is already adaptable to olfactory information via higher brain processing. Moreover, the coupling between olfaction and the two action systems, locomotion and rooting, is already differentiated. As crawling enables the newborn to move toward the mother's breast immediately after birth and facilitates mother-infant interaction, the results of this study highlight the potential value of using maternal odors to stimulate mobility in infants at risk of motor delay and/or deprived of this odor when born prematurely.

Human neonates prefer colostrum to mature milk: Evidence for an olfactory bias toward the "initial milk"?

OBJECTIVES

Colostrum is the initial milk secretion which ingestion by neonates warrants their adaptive start in life. Colostrum is accordingly expected to be attractive to newborns. The present study aims to assess whether colostrum is olfactorily attractive for 2-day-old newborns when presented against mature milk or a control.

METHODS

The head-orientation of waking newborns was videotaped in three experiments pairing the odors of: (a) colostrum (sampled on postpartum day 2, not from own mother) and mature milk (sampled on average on postpartum day 32, not from own mother) (n tested newborns = 15); (b) Colostrum and control (water; n = 9); and (c) Mature milk and control (n = 13).

RESULTS

When facing the odors of colostrum and mature milk, the infants turned their nose significantly longer toward former (32.8 vs 17.7% of a 120-s test). When exposed to colostrum against the control, they responded in favor of colostrum (32.9 vs 16.6%). Finally, when the odor of mature milk was presented against the control, their response appeared undifferentiated (26.7 vs 28.6%).

CONCLUSIONS

These results indicate that human newborns can olfactorily differentiate conspecific lacteal fluids sampled at different lactation stages. They prefer the odor of the mammary secretion - colostrum - collected at the lactation stage that best matches the postpartum age of their own mother. These results are discussed in the context of the earliest mother-infant chemo-communication. Coinciding maternal emission and offspring reception of chemosignals conveyed in colostrum may be part of the sensory precursors of attunement between mothers and infants.

Maternal odor reduces the neural response to fearful faces in human infants

Maternal odor is known to play an important role in mother-infant-interaction in many altricial species such as rodents. However, we only know very little about its role in early human development. The present study therefore investigated the impact of maternal odor on infant brain responses to emotional expression. We recorded the electroencephalographic (EEG) signal of seven-month-old infants watching happy and fearful faces. Infants in two control groups exposed to no specific odor (control 1) or the odor of a different infant’s mother (control 2) showed the expected EEG fear response. Crucially, this response was markedly absent in the experimental group exposed to their mother’s odor. Thus, infants respond differently to fear signals in the presence of maternal odor. Our data therefore suggest that maternal odor can be a strong modulator of social perception in human infants.

Olfaction scaffolds the developing human from neonate to adolescent and beyond

The impact of the olfactory sense is regularly apparent across development. The fetus is bathed in amniotic fluid (AF) that conveys the mother's chemical ecology. Transnatal olfactory continuity between the odours of AF and milk assists in the transition to nursing. At the same time, odours emanating from the mammary areas provoke appetitive responses in newborns. Odours experienced from the mother's diet during breastfeeding, and from practices such as pre-mastication, may assist in the dietary transition at weaning. In parallel, infants are attracted to and recognize their mother's odours; later, children are able to recognize other kin and peers based on their odours. Familiar odours, such as those of the mother, regulate the child's emotions, and scaffold perception and learning through non-olfactory senses. During juvenility and adolescence, individuals become more sensitive to some bodily odours, while the timing of adolescence itself has been speculated to draw from the chemical ecology of the family unit. Odours learnt early in life and within the family niche continue to influence preferences as mate choice becomes relevant. Olfaction thus appears significant in turning on, sustaining and, in cases when mother odour is altered, disturbing adaptive reciprocity between offspring and carer during the multiple transitions of development between birth and adolescence. This article is part of the Theo Murphy meeting issue 'Olfactory communication in humans'.

Impact of the odors of vanilla extract and breast milk on the frequency of apnea in preterm neonates

AIM

We developed this study using an experimental design to determine the impact of the odors of vanilla extract and breast milk on apnea frequency in preterm neonates.

MATERIALS AND METHODS

We obtained the study data from 42 preterm neonates (16 vanilla, 13 breast milk, 13 control group) who had been admitted to the Neonatal Intensive Care Unit of Istanbul University meeting the case selection criteria. All groups were monitored on the first day without any intervention. On the second and third days, breast milk was placed in the incubators of the babies in the breast milk group and the sterile gauze that was vanilla-impregnated was placed in the incubators of the babies in the vanilla group. On the fourth day, the babies were watched without any interference.

RESULTS

On the second, third and fourth days of the study, we determined that apnea frequency in the vanilla group neonates was significantly lower (P < .00) as compared to the breast milk and control groups.

CONCLUSION

Using vanilla extract in neonates suffering from apnea to reduce its frequency is an effective method.

Optimal Timing to Utilize Olfactory Stimulation with Maternal Breast Milk to Improve Oral Feeding Skills in the Premature Newborn

Background: Olfactory maturation is essential for successful oral feeding. Previous studies have suggested that olfactory stimulation with maternal breast milk may expedite oral feeding skills in the premature infant; however, the optimal developmental window to utilize this intervention and sex-specific responses to stimuli are largely unknown. Objectives: To determine individual responses to olfactory stimulation with mother's own milk (MOM) on feeding outcomes in premature newborns. Materials and Methods: Infants born between 28 0/7 and 33 6/7 weeks' gestation (n = 36) were randomized to receive either MOM or water (sham) stimulus during the learning process of oral feeding. Clinical and feeding outcomes were recorded. Statistical analyses examined the effect of stimulation with MOM on feeding outcomes stratified for age and sex. Results: Overall, there was no significant difference between sham infants compared with MOM infants in mean postmenstrual age of full oral feeds (sham: 35 5/7 versus MOM 36 0/7; p = 0.37). However, when stratified by gestational age (GA), infants born <31 weeks' gestation who received MOM stimulation learned to feed sooner than controls (p = 0.06), whereas infants born ≥31 weeks' gestation learned to feed later than controls (p = 0.20) with a significant interaction (p = 0.02) between the stimulus (MOM versus sham) and dichotomized GA (<31 versus ≥31 weeks). There were no sex differences in response to olfactory stimulus. Conclusions: Infants born <31 weeks' GA who received MOM stimulation learned to feed sooner than control infants and the impact of MOM is significantly different between infants born before or after 31 weeks GA. These data suggest there may be an optimal time in development to utilize maternal breast milk to expedite oral feeding maturation in the premature newborn.

Social visual stimuli increase infants suck response: A preliminary study

This study investigated whether visual stimuli (FACES vs. CARS) combined with the presence of maternal scent can influence suck patterning in healthy infants. Fifteen healthy full-term infants (six months and younger) were exposed to their mother’s scent during a visual preference paradigm consisting of FACES vs. CARS stimuli while sucking on a custom research pacifier. Infants looked significantly longer to the FACES compared to CARS, p = .041. Repeated Measures ANOVA revealed a significant main effect for non-nutritive suck (NNS) bursts and visual stimuli (p = .001) with the largest differences evident between FACES and when the infant looked away from the visual stimuli (p = 0.008) as well as between FACES and CARS (p = 0.026). These preliminary findings suggest that infants have more suck attempts when looking at FACES in the presence of maternal scent thereby indicating potent links between visual preference and suck behavior.

Female Chemical Signalling Underlying Reproduction in Mammals

Chemical communication plays many key roles in mammalian reproduction, although attention has focused particularly on male scent signalling. Here, we review evidence that female chemical signals also play important roles in sexual attraction, in mediating reproductive competition and cooperation between females, and in maternal care, all central to female reproductive success. Female odours function not only to advertise sexual receptivity and location, they can also have important physiological priming effects on male development and sperm production. However, the extent to which female scents are used to assess the quality of females as potential mates has received little attention. Female investment in scent signalling is strongly influenced by the social structure and breeding system of the species. Although investment is typically male-biased, high competition between females can lead to a reversed pattern of female- biased investment. As among males, scent marking and counter-marking are often used to advertise territory defence and high social rank. Female odours have been implicated in the reproductive suppression of young or subordinate females across a range of social systems, with females of lower competitive ability potentially benefiting by delaying reproduction until conditions are more favourable. Further, the ability to recognise individuals, group members and kin through scent underpins group cohesion and cooperation in many social species, as well as playing an important role in mother-offspring recognition. However, despite the diversity of female scent signals, chemical communication in female mammals remains relatively understudied and poorly understood. We highlight several key areas of future research that are worthy of further investigation.

Responses of Human Neonates to Highly Diluted Odorants from Sweat

Conjugated forms of odorants contributing to sweat odor occur not only in human sweat but also in amniotic fluid, colostrum, and milk. However, it is unclear whether the released odorants are detected and hedonically discriminated by human newborns. To investigate this issue, we administered highly diluted solutions of (R)/(S)-3-methyl-3-sulfanylhexan-1-ol (MSH), (R)/(S)-3-sulfanylhexan-1-ol (SH), (E)/(Z)-3-methylhex-2-enoic acid (3M2H), and (R)/(S)-3-hydroxy-3-methylhexanoic acid (HMHA) to 3-d-old infants while their respiratory rate and oro-facial movements were recorded. Adult sensitivity to these odorants was assessed via triangle tests. Whereas no neonatal stimulus-specific response was found for respiratory rate, oro-facial reactivity indicated orthonasal detection of MSH and SH by male neonates, and of HMHA by the whole group of neonates. Dependent on the dilution of odorants, newborns evinced neutral responses or longer negative oro-facial expressions compared with the reference stimuli. Finally, newborns appeared to be more sensitive to the target odorants than did adults.

Developmental Changes in Adolescents' Olfactory Performance and Significance of Olfaction

Aim of the current work was to examine developmental changes in adolescents' olfactory performance and personal significance of olfaction. In the first study olfactory identification abilities of 76 participants (31 males and 45 females aged between 10 and 18 years; M = 13.8, SD = 2.3) was evaluated with the Sniffin Stick identification test, presented in a cued and in an uncued manner. Verbal fluency was additionally examined for control purpose. In the second study 131 participants (46 males and 85 females aged between 10 and 18 years; (M = 14.4, SD = 2.2) filled in the importance of olfaction questionnaire. Odor identification abilities increased significantly with age and were significantly higher in girls as compared to boys. These effects were especially pronounced in the uncued task and partly related to verbal fluency. In line, the personal significance of olfaction increased with age and was generally higher among female compared to male participants.

So close yet so far: Motor anomalies impacting on social functioning in autism spectrum disorder

Difficulties in the social domain and motor anomalies have been widely investigated in Autism Spectrum Disorder (ASD). However, they have been generally considered as independent, and therefore tackled separately. Recent advances in neuroscience have hypothesized that the cortical motor system can play a role not only as a controller of elementary physical features of movement, but also in a complex domain as social cognition. Here, going beyond previous studies on ASD that described difficulties in the motor and in the social domain separately, we focus on the impact of motor mechanisms anomalies on social functioning. We consider behavioral, electrophysiological and neuroimaging findings supporting the idea that motor cognition is a critical "intermediate phenotype" for ASD. Motor cognition anomalies in ASD affect the processes of extraction, codification and subsequent translation of "external" social information into the motor system. Intriguingly, this alternative "motor" approach to the social domain difficulties in ASD may be promising to bridge the gap between recent experimental findings and clinical practice, potentially leading to refined preventive approaches and successful treatments.

The neurobiology of mammalian parenting and the biosocial context of human caregiving

This article is part of a Special Issue "Parental Care". Research on the neurobiology of attachment, pioneered by scholars in the generation that followed the discovery of social bonding, examined the biological basis of mammalian parenting through systematic experiments in animal models and their application to theories on human attachment. This paper argues for the need to construct a theory on the neurobiology of human attachment that integrates findings in animal models with human neuroscience research to formulate concepts based on experimental, not only extrapolative data. Rosenblatt's (2003) three characteristics of mammalian parenting - rapid formation of attachment, behavioral synchrony, and mother-offspring attachment as basis of social organization - are used to guide discussion on mammalian-general versus human-specific attributes of parental care. These highlight specific components of attachment in rodents, primates, and humans that chart the evolution from promiscuous, nest-bound, olfactory-based bonds to exclusive, multi-sensory, and representation-based attachments. Following, three continua are outlined in parental behavior, hormones, and brain, each detailing the evolution from rodents to humans. Parental behavior is defined as a process of trophallaxis - the reciprocal multisensory exchange that supports approach orientation and enables collaboration in social species - and includes human-specific features that enable behavioral synchrony independent of tactile contact. The oxytocin system incorporates conserved and human-specific components and is marked by pulsatile activity and dendritic release that reorganize neural networks on the basis of species-specific attachment experiences. Finally, the subcortical limbic circuit underpinning mammalian mothering extends in humans to include multiple cortical networks implicated in empathy, mentalizing, and emotion regulation that enable flexible, goal-directed caregiving. I conclude by presenting a philosophical continuum from Hobbes to Lorenz, which illustrates how research on the neurobiology of attachment can put in the forefront the social-collaborative elements in human nature and afford a new perspective on the mind-brain polarity.

Responsiveness of human neonates to the odor of 5α-androst-16-en-3-one: a behavioral paradox?

The odorous steroid 5α-androst-16-en-3-one (AND) occurs in numerous biological fluids in mammals, including man, where it is believed to play a chemocommunicative role. As AND was recently detected in milk and amniotic fluid, sensitivity and hedonic responses to this substance were assessed in human neonates. To this aim, respiration and facial expressions were recorded in 3-day-old newborns in response to aqueous solutions of AND, ranging from 500ng/mL to 0.5 fg/mL. Although analyses of respiratory rate did not lead to clear-cut results, the newborns changed their facial expressions at concentrations not detected by adults in a triangle test. Newborns displayed negative facial actions of longer duration to AND relative to an odorless control. Thus, AND may be considered to be offensive to newborns, which is a counterintuitive outcome as they are exposed to this compound in the womb (and it should therefore be familiar), in milk, and on the mother's skin surface (and it should therefore be conditioned as positive). Multiple reasons for this perceptual-behavioral paradox are discussed.

Affective matching of odors and facial expressions in infants: shifting patterns between 3 and 7 months

Recognition of emotional facial expressions is a crucial skill for adaptive behavior. Past research suggests that at 5 to 7 months of age, infants look longer to an unfamiliar dynamic angry/happy face which emotionally matches a vocal expression. This suggests that they can match stimulations of distinct modalities on their emotional content. In the present study, olfaction-vision matching abilities were assessed across different age groups (3, 5 and 7 months) using dynamic expressive faces (happy vs. disgusted) and distinct hedonic odor contexts (pleasant, unpleasant and control) in a visual-preference paradigm. At all ages the infants were biased toward the disgust faces. This visual bias reversed into a bias for smiling faces in the context of the pleasant odor context in the 3-month-old infants. In infants aged 5 and 7 months, no effect of the odor context appeared in the present conditions. This study highlights the role of the olfactory context in the modulation of visual behavior toward expressive faces in infants. The influence of olfaction took the form of a contingency effect in 3-month-old infants, but later evolved to vanish or to take another form that could not be evidenced in the present study.

Neuroendocrinology of childbirth and mother-child attachment: the basis of an etiopathogenic model of perinatal neurobiological disorders

This review focuses on the neuroendocrine mechanisms in the mother and the newborn that are involved in the generation and consolidation of mother-child attachment. The role that different hormones and neurotransmitters play on the regulation of these mechanisms during parturition, the immediate postpartum period and lactation is discussed. Interferences in the initiation of mother-child attachment may have potential long-term effects for the behavior and affection of the newborn. Therefore, the possible consequences of alterations in the physiological neuroendocrine mechanisms of attachment, caused by elective Cesarean section, intrapartum hormonal manipulations, preterm delivery, mother-infant postpartum separation and bottle-feeding instead of breastfeeding are also discussed.

Adding odor: Less distress and enhanced attention for 6-month-olds

The effect of odor on cognitive and emotional processes has been studied in adults and children, but less so in infants. In this study twenty-seven six-month-olds were presented with a video while in either an odor (pine or baby-powder) or a no odor control condition. The video was a 92-s audiovisual presentation of a woman expressing happiness and sadness, with the order of emotion counterbalanced. Infant attention (looking time) and emotional expression (smiling, crying, mouthing) were coded. Infants looked longer in the presence of odor and expressed less crying and mouthing but more smiling behavior. Presence of odor markedly reduced infant emotional distress and increased attention, suggesting that the olfactory sensory system provides cues to infants that support mood regulation and maintain attention. These results have implications for optimizing infant environments for emotional health and cognitive development.

Eye-catching odors: olfaction elicits sustained gazing to faces and eyes in 4-month-old infants

This study investigated whether an odor can affect infants' attention to visually presented objects and whether it can selectively direct visual gaze at visual targets as a function of their meaning. Four-month-old infants (n = 48) were exposed to their mother's body odors while their visual exploration was recorded with an eye-movement tracking system. Two groups of infants, who were assigned to either an odor condition or a control condition, looked at a scene composed of still pictures of faces and cars. As expected, infants looked longer at the faces than at the cars but this spontaneous preference for faces was significantly enhanced in presence of the odor. As expected also, when looking at the face, the infants looked longer at the eyes than at any other facial regions, but, again, they looked at the eyes significantly longer in the presence of the odor. Thus, 4-month-old infants are sensitive to the contextual effects of odors while looking at faces. This suggests that early social attention to faces is mediated by visual as well as non-visual cues.

Body odors promote automatic imitation in autism

BACKGROUND

Autism spectrum disorders comprise a range of neurodevelopmental pathologies characterized, among other symptoms, by impaired social interactions. Individuals with this diagnosis are reported to often identify people by repetitively sniffing pieces of clothing or the body odor of family members. Since body odors are known to initiate and mediate many different social behaviors, smelling the body odor of a family member might constitute a sensory-based action promoting social contact. In light of this, we hypothesized that the body odor of a family member would facilitate the appearance of automatic imitation, an essential social skill known to be impaired in autism.

METHODS

We recruited 20 autistic and 20 typically developing children. Body odors were collected from the children's mothers' axillae. A child observed a model (their mother or a stranger mother) execute (or not) a reach-to-grasp action toward an object. Subsequently, she performed the same action. The object was imbued with the child's mother's odor, a stranger mother's odor, or no odor. The actions were videotaped, and movement time was calculated post hoc via a digitalization technique.

RESULTS

Automatic imitation effects-expressed in terms of total movement time reduction-appear in autistic children only when exposed to objects paired with their own mother's odor.

CONCLUSIONS

The maternal odor, which conveys a social message otherwise neglected, helps autistic children to covertly imitate the actions of others. Our results represent a starting point holding theoretical and practical relevance for the development of new strategies to enhance communication and social behavior among autistic individuals.

A hit map-based statistical method to predict best ligands for orphan olfactory receptors: natural key odorants versus "lock picks"

Smell is a multidimensional chemical sense. It creates a perception of our odorous environment by integrating the information of a plethora of volatile chemicals with other sensory inputs, emotions and memories. We are almost always exposed to odorant mixtures, not just single chemicals. Olfactory processing of complex odorant mixtures, such as coffee or wine, first is decoded at the site of perception by the hundreds of different olfactory receptor types, each residing in the cilia of their olfactory sensory neurons in the nose. Often, only a few odorants from many are essential to determine complex olfactory perception. But merely using the chemical structure of odorants is insufficient to identify and predict characteristic odor qualities and low odor thresholds. An understanding of odorant coding critically depends on knowledge about the interaction of key odorants of biologically relevant odor bouquets with their best cognate receptors. Here, we describe a hit map-based method of correlating the information content of all bioassay-tested odorants with their cognate odorant-receptor frequency in four phylogenetic subsets of human olfactory/chemosensory receptors.

How does a newly born mouse get to the nipple? Odor substrates eliciting first nipple grasping and sucking responses

It is a mammalian female strategy to emit odor cues and signals that direct their inexperienced newborns to the nipple, and optimize their initial sucking success and, hence, viability. Here, natural odorous substrates that contribute to nipple grasping were investigated in mice, a species that has not been much scrutinized on this topic. The response of pups toward the nipples of lactating females (LF) versus nonlactating females (NLF) were first assessed right after watched birth, before and after the first suckling experience, and at 1 day old, after more extended suckling experience. It appeared that only nipples of LF induced grasping at these early ages, leading to take NLF as the baseline setting to present various odor substrates sampled from LF, viz. amniotic fluid, murine milk, LF saliva, pup saliva, LF urine, and an odorless control stimulus (water). Results indicate that: (1) only amniotic fluid and fresh milk induced nipple grasping before the first suckling experience; (2) LF saliva started inducing grasping after the first suckling experience; (3) pup saliva released grasping after 24-36 hr of suckling experience; finally (4) neither LF urine, nor water induced any nipple grasping. In conclusion, the activity of amniotic fluid and murine milk on neonatal pup behavior before any postnatal suckling experience suggests that either prenatal learning and/or predisposed olfactory mechanisms do operate, while the behavioral activation due to maternal and infantile salivas clearly depends on postnatal exposure.

An overlooked aspect of the human breast: areolar glands in relation with breastfeeding pattern, neonatal weight gain, and the dynamics of lactation

The early nursing-sucking relationship is not to be taken for granted in humans. A number of factors can either facilitate or mitigate its optimal establishment on the mother's or newborn's sides. Among these factors, a morphological feature of human mothers' breasts--the areolar glands (AG)--has been identified as potentially important. Three day-old infants display attraction during the presentation of the native secretions of the AG, suggesting that they could influence the newborn's behaviour during breastfeeding. The present study assessed this topic in a sample of 121 Caucasian mother-infant dyads. The areolae of these women were screened during the first 3 postnatal days in parallel with the infant's sucking performance, body weight fluctuations and time to lactation onset. On average, 97% of the women bore AG, 80.2% having 1-20 units per areola and 33% showing AG excreting a visible fluid. The endowment in AG appeared positively linked with neonatal growth after birth and with the speed of lactation onset: infants of primiparous women with lower AG numbers had a lower weight gain than those of mothers with higher AG numbers. Further, it took longer to primiparae with lower AG counts to set on lactation. This study confirms and extends the fact that AG, in interaction with maternal experience, might influence the initiation of the breastfeeding relationship.

Orientation of newborn mice to lactating females: identifying biological substrates of semiochemical interest

Among mammals, odor-based communication between females and infants is decisive for neonatal survival. So far, the nature of odor substrates involved in the localization of the mother and their nipples is unknown in mice. The present study aims: (1) to evaluate the specific attractive value of lactating females to newborn mice, (2) to localize the abdominal region that is most attractive to pups, and (3) to identify odor substrates that support such attraction. Results showed that 5-6-day-old mice roam preferentially over the abdomen of lactating females than the abdomen of non-lactating females. In lactating females, pups are more attracted to abdominal areas comprising nipples. The blend of odor substrates from nipples, as well as separate sources presumed to compose it, viz. milk, maternal saliva and pup saliva, were detectable and equivalently attractive to pups. The equivalent attraction of these different odor substrates may derive either from overlap in chemical constituents, or from associative learning during nursing.

Onset of vocal interaction between parents and newborns in skin-to-skin contact immediately after elective cesarean section

BACKGROUND

Cesarean section is associated with delayed mother-infant interaction because neither the mother nor the father routinely maintains skin-to-skin contact with the infant after birth. The aim of the study was to explore and compare parent-newborn vocal interaction when the infant is placed in skin-to-skin contact either with the mother or the father immediately after a planned cesarean section.

METHODS

A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin-to-skin contact either with fathers or mothers after an initial 5 minutes of skin-to-skin contact with the mothers after birth. The newborns' and parents' vocal interaction were recorded on a videotape and audiotape. The following variables were explored: newborns' and parents' soliciting, newborns' crying and whining, and parental speech directed to the other parent and to the newborn.

RESULTS

Newborns' soliciting increased over time (p=0.032). Both fathers and mothers in skin-to-skin contact communicated more vocally with the newborn than did fathers (p=0.003) and mothers (p=0.009) without skin-to-skin contact. Fathers in skin-to-skin contact also communicated more with the mother (p=0.046) and performed more soliciting responses than the control fathers (p=0.010). Infants in skin-to-skin contact with their fathers cried significantly less than those in skin-to-skin contact with their mothers (p=0.002) and shifted to a relaxed state earlier than in skin-to-skin contact with mothers (p=0.029).

CONCLUSIONS

Skin-to-skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin-to-skin contact and exposed to the parents' speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication.

Family scents: developmental changes in the perception of kin body odor?

There is increasing evidence that human body odors are involved in adaptive behaviors, such as parental attachment in infants or partner choice in adults. The aim of the present study was to investigate changes in body-odor perception around puberty, a period largely ignored for odor-mediated behavioral changes, despite major changes in social needs and in odor emission and perception. Nine families with two children (8 pre-pubertal, aged 7-10, and 10 pubertal, aged 11-18) evaluated body odors of family members and unfamiliar individuals for pleasantness, intensity, and masculinity, and performed a recognition task. The hypothesized emergence of a parent-child mutual aversion for the odor of opposite-sex family members at puberty was not found, contradicting one of the few studies on the topic (Weisfeld et al., J. Exp. Child Psychol. 85:279-295, 2003). However, some developmental changes were observed, including reduced aversion for odor of the same-sex parent, and increased ability of adults, compared to children, to recognize odor of family members. Sex and personality (depressive and aggressive traits) also significantly influenced odor judgments. Further research with larger samples is needed to investigate the poorly explored issue of how olfactory perception of self and family members develops, and how it could correlate with normal reorganizations in social interactions at adolescence.