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Kivlighan KT, Schneider SS, Browne EP, Pentecost BT, Anderton DL, Arcaro KF. Mammary epithelium permeability during established lactation: associations with cytokine levels in human milk. Front Nutr 2024; 11:1258905. [PMID: 38419845 PMCID: PMC10900798 DOI: 10.3389/fnut.2024.1258905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Objective The cytokine profile of human milk may be a key indicator of mammary gland health and has been linked to infant nutrition, growth, and immune system development. The current study examines the extent to which mammary epithelium permeability (MEP) is associated with cytokine profiles during established lactation within a sample of US mothers. Methods Participants were drawn from a previous study of human milk cytokines. The present analysis includes 162 participants (98 Black, 64 White) with infants ranging from 1 to 18 months of age. Levels of cytokines were determined previously. Here we measure milk sodium (Na) and potassium (K) levels with ion-selective probes. Two approaches were used to define elevated MEP: Na levels ≥10 mmol/L and Na/K ratios greater than 0.6. Associations between maternal-infant characteristics, elevated MEP, and twelve analytes (IL-6, IL-8, TNFα, IL-1β, FASL, VEGFD, FLT1, bFGF, PLGF, EGF, leptin, adiponectin) were examined using bivariate associations, principal components analysis, and multivariable logistic regression models. Results Elevated MEP was observed in 12 and 15% of milk samples as defined by Na and Na/K cutoffs, respectively. The odds of experiencing elevated MEP (defined by Na ≥ 10 mmol/L) were higher among Black participants and declined with older infant age. All cytokines, except leptin, were positively correlated with either Na or the Na/K ratio. A pro-inflammatory factor (IL-6, IL-8, TNFα, IL-1β, EGF) and a tissue remodeling factor (FASL, VEGFD, FLT1, bFGF, PLGF, adiponectin) each contributed uniquely to raising the odds of elevated MEP as defined by either Na or the Na/K ratio. Conclusion This exploratory analysis of MEP and cytokine levels during established lactation indicates that elevated MEP may be more common in US populations than previously appreciated and that individuals identifying as Black may have increased odds of experiencing elevated MEP based on current definitions. Research aimed at understanding the role of MEP in mammary gland health or infant growth and development should be prioritized.
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Affiliation(s)
- Katie T. Kivlighan
- College of Nursing, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sallie S. Schneider
- Pioneer Valley Life Sciences Institute, Baystate Medical Center, Springfield, MA, United States
| | - Eva P. Browne
- Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Brian T. Pentecost
- Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Douglas L. Anderton
- Department of Sociology, University of South Carolina, Columbia, SC, United States
| | - Kathleen F. Arcaro
- Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA, United States
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Walker RE, Harvatine KJ, Ross AC, Wagner EA, Riddle SW, Gernand AD, Nommsen-Rivers LA. Fatty Acid Transfer from Blood to Milk Is Disrupted in Mothers with Low Milk Production, Obesity, and Inflammation. J Nutr 2023; 152:2716-2726. [PMID: 36208911 PMCID: PMC9840005 DOI: 10.1093/jn/nxac220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/26/2022] [Accepted: 09/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated suppression of LPL could inhibit mammary uptake of long-chain fatty acids (LCFAs; >16 carbons). OBJECTIVES In an ancillary case-control analysis, we investigated whether women with low milk production despite regular breast emptying have elevated inflammation and disrupted transfer of LCFAs from plasma into milk. METHODS Data and specimens from a low milk supply study and an exclusively breastfeeding control group were analyzed, with milk production measured by 24-h test-weighing at 2-10 wk postpartum. Low milk supply groups were defined as very low (VL; <300 mL/d; n = 23) or moderate (MOD; ≥300 mL/d; n = 20) milk production, and compared with controls (≥699 mL/d; n = 18). Serum and milk fatty acids (weight% of total) were measured by GC, serum and milk TNF-α by ELISA, and serum high-sensitivity C-reactive protein (hsCRP) by clinical analyzer. Group differences were assessed by linear regression models, chi-square exact tests, and Kruskal-Wallis nonparametric tests. RESULTS VL cases, as compared with MOD cases and controls, had higher prevalence of elevated serum hsCRP (>5 mg/L; 57%, 15%, and 22%, respectively; P = 0.004), detectable milk TNF-α (67%, 32%, and 33%, respectively; P = 0.04), and obesity (78%, 40%, and 22%, respectively; P = 0.003). VL cases had lower mean ± SD LCFAs in milk (60% ± 3%) than MOD cases (65% ± 4%) and controls (66% ± 5%) (P < 0.001). Milk and serum LCFAs were strongly correlated in controls (r = 0.82, P < 0.001), but not in the MOD (r = 0.25, P = 0.30) or VL (r = 0.20, P = 0.41) groups (Pint < 0.001). CONCLUSIONS Mothers with very low milk production have significantly higher obesity and inflammatory biomarkers, lower LCFAs in milk, and disrupted association between plasma and milk LCFAs. These data support the hypothesis that inflammation disrupts normal mammary gland fatty acid uptake. Further research should address impacts of inflammation and obesity on mammary fatty acid uptake for milk production.
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Affiliation(s)
- Rachel E Walker
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Kevin J Harvatine
- Department of Animal Science, The Pennsylvania State University, University Park, PA, USA
| | - A Catharine Ross
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Erin A Wagner
- College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Sarah W Riddle
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
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3
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Fatty acid transfer from blood to milk is disrupted in mothers with low milk production, obesity, and inflammation. J Nutr 2022. [DOI: 10.1016/j.tjnut.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Oxylipins as Potential Regulators of Inflammatory Conditions of Human Lactation. Metabolites 2022; 12:metabo12100994. [PMID: 36295896 PMCID: PMC9610648 DOI: 10.3390/metabo12100994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2022] Open
Abstract
Chronic low-grade inflammation can be associated with obesity or subclinical mastitis (SCM), which is associated with poor infant growth in low- to middle-income country settings. It is unknown what physiological mechanisms are involved in low milk supply, but our research group has shown that mothers with low milk supply have higher inflammatory markers. Studies investigating oxylipin signaling have the potential to help explain mechanisms that mediate the impacts of inflammation on milk production. Animal studies have reported various elevated oxylipins during postpartum inflammation, mastitis, and mammary involution in ruminant models. Several investigations have quantified oxylipins in human milk, but very few studies have reported circulating oxylipin concentrations during lactation. In addition, there are technical considerations that must be addressed when reporting oxylipin concentrations in human milk. First, the majority of milk oxylipins are esterified in the triglyceride pool, which is not routinely measured. Second, total milk fat should be considered as a covariate when using milk oxylipins to predict outcomes. Finally, storage and handling conditions of milk samples must be carefully controlled to ensure accurate milk oxylipin quantitation, which may be affected by highly active lipases in human milk.
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Hasianna S, Gunadi J, Rohmawaty E, Lesmana R. Potential role of β‑carotene‑modulated autophagy in puerperal breast inflammation (Review). Biomed Rep 2022; 17:75. [DOI: 10.3892/br.2022.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/17/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Stella Hasianna
- Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java 45363, Indonesia
| | - Julia Gunadi
- Department of Physiology, Faculty of Medicine, Universitas Kristen Maranatha, Bandung, West Java 40164, Indonesia
| | - Enny Rohmawaty
- Pharmacology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java 45363, Indonesia
| | - Ronny Lesmana
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java 45363, Indonesia
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Rutagwera DG, Molès JP, Kankasa C, Mwiya M, Tuaillon E, Peries M, Nagot N, Van de Perre P, Tylleskär T. Recurrent Severe Subclinical Mastitis and the Risk of HIV Transmission Through Breastfeeding. Front Immunol 2022; 13:822076. [PMID: 35309352 PMCID: PMC8931278 DOI: 10.3389/fimmu.2022.822076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/08/2022] [Indexed: 11/15/2022] Open
Abstract
Subclinical mastitis (SCM) is an important risk factor of postnatal HIV-1 transmission that is still poorly understood. A longitudinal sub-study of the ANRS12174 trial including 270 breastfeeding mothers in Lusaka, Zambia measured sodium (Na+) and potassium (K+) in archived paired breast milk samples collected at week 14, 26 and 38 postpartum to determine cumulative incidence of SCM and the effects of recurrent severe SCM on HIV-1 shedding in breast milk. A nested retrospective cohort study including 112 mothers was also done to determine longitudinal effects of SCM on four pro-inflammatory cytokines; IL6, IL8, IP10 and RANTES. The cumulative incidence for any SCM (Na+/K+ ratio > 0.6) and severe SCM (Na+/K+ ratio > 1) were 58.6% (95%CI: 52.7 – 64.5) and 27.8% (95%CI: 22.5 – 33.1), respectively. In majority of affected mothers (51.4%) severe SCM was recurrent. Both breasts were involved in 11.1%, 33.3% and 70% of the mothers with a single episode, 2 and 3 episodes respectively. In affected breasts, an episode of severe SCM resulted in steep upregulation of the four cytokines considered (IL8, IP10, RANTES and IL6) compared to: before and after the episode; contralateral unaffected breasts; and SCM negative control mothers. Recurrent severe SCM significantly increased the odds of shedding cell-free HIV-1 in breast milk (OR: 5.2; 95%CI: 1.7 – 15.6) whereas single episode of severe SCM did not (OR: 1.8; 95%CI: 0.8 – 4.2). A Na+/K+ ratio > 1 indicative of severe SCM is an excellent indicator of breast inflammation characterized by a steep, localized and temporal upregulation of several pro-inflammatory cytokines that favor HIV-1 shedding in mature breast milk and may facilitate postnatal HIV-1 transmission through breastfeeding.
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Affiliation(s)
- David Gatsinzi Rutagwera
- Centre for International Health, University of Bergen, Bergen, Norway
- Children's Hospital, University Teaching Hospitals, School of Medicine, University of Zambia, Lusaka, Zambia
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
| | - Jean-Pierre Molès
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
| | - Chipepo Kankasa
- Children's Hospital, University Teaching Hospitals, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Mwiya Mwiya
- Children's Hospital, University Teaching Hospitals, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
| | - Marianne Peries
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, INSERM, Université des Antilles, Etablissement français du Sang, Montpellier, France
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Castro I, Arroyo R, Aparicio M, Martínez MÁ, Rovira J, Ares S, Cunha SC, Casal S, Oliveira Fernandes J, Schuhmacher M, Nadal M, Rodríguez JM, Fernández L. Dietary Habits and Relationship with the Presence of Main and Trace Elements, Bisphenol A, Tetrabromobisphenol A, and the Lipid, Microbiological and Immunological Profiles of Breast Milk. Nutrients 2021; 13:nu13124346. [PMID: 34959899 PMCID: PMC8708081 DOI: 10.3390/nu13124346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
Breastfeeding is the best way to feed an infant, although it can also be a source of abiotic contaminants such as heavy metals or bisphenol A (BPA). The early life exposure to these compounds can lead to serious toxic effects in both the short and long-term. These substances can reach breast milk through the mother’s habits, diet being one of the main routes of exposure. The aim of the present work was to analyse possible associations between the dietary habits of women and the content of major trace elements, BPA, fatty acids and lipids, and the microbiological and immunological profiles of human milk. Possible associations between major trace elements and BPA and the lipid, microbiological and immunological profiles were also analysed. The results of this study support that the microbiological composition of human milk is associated with the dietary habits of the women, and that the consumption of canned drinks is related to the presence of BPA in human milk. Furthermore, some relationships were found between the amount of major trace elements and the microbiological and immunological profile of the milk samples. Finally, the presence of BPA was associated with changes in the immunological profile of human milk.
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Affiliation(s)
- Irma Castro
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Rebeca Arroyo
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Marina Aparicio
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - María Ángeles Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain;
- Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, 43204 Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43007 Reus, Spain
| | - Joaquim Rovira
- Environmental Engineering Laboratory, Departament d’Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (J.R.); (M.S.)
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain;
| | - Susana Ares
- Department of Neonatology, Universitary Hospital La Paz, P° de la Castellana, 261, 28046 Madrid, Spain;
| | - Sara Cristina Cunha
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Susana Casal
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Jose Oliveira Fernandes
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Marta Schuhmacher
- Environmental Engineering Laboratory, Departament d’Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (J.R.); (M.S.)
| | - Martí Nadal
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain;
| | - Juan Miguel Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Leónides Fernández
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913943745
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Danchuk V, Ushkalov V, Midyk S, Vigovska L, Danchuk O, Korniyenko V. MILK LIPIDS AND SUBCLINICAL MASTITIS. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.15673/fst.v15i2.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article deals with the process of obtaining quality raw milk by analyzing its lipid composition. The lipid composition of raw milk depends on many factors, among which, first of all, is the species, the composition of the diet and the physiological state of the breast. In recent years, a large amount of data has accumulated on the fluctuations of certain lipid parameters of milk depending on the type, age, lactation, diet, time of year, exercise, animal husbandry technology, physiological state of the lactating organism in general and breast status in particular. Factors of regulation of fatty acid composition of raw milk: genetically determined parameters of quality and safety; fatty acid composition of the diet; synthesis of fatty acids by microorganisms of the digestive tract; synthesis of fatty acids in the breast; physiological state of the breast. The milk of each species of productive animals has its own specific lipid profile and is used in the formulation of certain dairy products to obtain the planned technological and nutritional parameters. Diagnosis of productive animals for subclinical mastitis involves the use of auxiliary (thermometry, thermography, electrical conductivity) and laboratory research methods: counting the number of somatic cells; use of specialized tests; microbiological studies of milk; biochemical studies of milk. The biochemical component in the diagnosis of subclinical forms of mastitis is underestimated. An increase in body temperature implies an increase in the intensity of heat release during the oxidation of substrates, sometimes due to a decrease in the intensity of synthesis of energy-intensive compounds. There are simply no other sources of energy in the body. The situation is the same with certain parts of the metabolism, which are aimed at the development of protective reactions to the etiological factor aimed at the defeat of the breast. That is why the biochemical composition of breast secretions in the absence of clinical signs of mastitis undergoes biochemical changes and the task of scientists is to develop mechanisms for clear tracking of such changes, identification of animals with subclinical forms of mastitis and effective treatment.
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Wren-Atilola HM, Solomons NW, Scott ME, Koski KG. Infant Anthropometry and Growth Velocity Before 6 Months are Associated with Breastfeeding Practices and the Presence of Subclinical Mastitis and Maternal Intestinal Protozoa in Indigenous Communities in Guatemala. Curr Dev Nutr 2021; 5:nzab086. [PMID: 34585057 PMCID: PMC8460162 DOI: 10.1093/cdn/nzab086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The possibility that maternal health status and breastfeeding practices contribute to growth faltering before 6 mo is underexplored. OBJECTIVES This longitudinal study investigated whether indicators of subclinical mastitis (SCM) and breast inflammation, maternal fecal-oral contamination, and/or breastfeeding practices were associated with infant anthropometry or growth velocity before 6 mo. METHODS Indigenous Mam-Mayan mother-infant dyads (n = 140) were recruited. Breast milk was collected at early (<6 wk) and established (4-6 mo) lactation when maternal and infant anthropometry were measured. Milk Na:K ratio as an indicator of SCM and concentrations of 4 proinflammatory cytokines were measured. Maternal stool samples were examined for the presence of intestinal parasites including nonpathogenic protozoa (Endolimax nana, Iodamoeba bütschlii, Entamoeba coli, Blastocystis hominis). Questionnaires characterized breastfeeding and hygiene practices. Multiple linear regression identified factors associated with infant growth attainment [weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and head circumference-for-age z-score (HCAZ)] and growth velocity (expressed as change per day from early to established lactation). Multiple logistic regression identified factors associated with increased odds of underweight, stunting, and low head circumference at both lactation stages. RESULTS A higher Na:K ratio, individual nonpathogenic protozoa, and specific breastfeeding and hygiene practices were associated with impaired growth before 6 wk and at 4-6 mo in exclusively breastfed infants. Growth velocity for weight was inversely associated with Entamoeba coli but cranial growth was associated positively with Iodamoeba bütschlii whereas feeding colostrum in early lactation was protective and decreased the odds of an HCAZ < -2 SD. Finally, the presence of SCM in early lactation increased the likelihood of both WAZ < -2 SD and LAZ < -2 SD by 6 wk. CONCLUSIONS Prevention of SCM can improve early infant weight, but measures that promote the feeding of colostrum and reduce exposure to fecal-oral contamination might be required to minimize infant growth faltering in breastfed infants.
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Affiliation(s)
- Hilary M Wren-Atilola
- School of Human Nutrition, McGill University (Macdonald Campus), Ste-Anne de Bellevue, Quebec, Canada
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Marilyn E Scott
- Institute of Parasitology, McGill University (Macdonald Campus), Ste-Anne de Bellevue, Quebec, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University (Macdonald Campus), Ste-Anne de Bellevue, Quebec, Canada
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10
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Bogin B. Fear, violence, inequality, and stunting in Guatemala. Am J Hum Biol 2021; 34:e23627. [PMID: 34125987 DOI: 10.1002/ajhb.23627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Stunting is defined by the public health community as a length- or height-for-age <-2 SD of a growth standard or reference and is claimed to be caused by poor nutrition, repeated infection, and inadequate psychosocial stimulation. MATERIAL AND METHODS Stunting is common at all income levels in middle- and low-income countries. At the higher income levels, stunting is unlikely to be caused by nutrient deficiency or infectious disease. RESULTS In Guatemala, 17% of <5-year-olds in the highest family income quintile are stunted. Guatemala has a history of violence from armed conflict, current-day social and economic inequalities, government corruption, and threat of kidnapping for the wealthiest families. DISCUSSION AND CONCLUSION The high level of persistent violence creates an ecology of fear, an extreme range of inequalities in Social-Economic-Political-Emotional resources, and biosocial stress that inhibits skeletal growth and causes stunting for people of all income levels.
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Affiliation(s)
- Barry Bogin
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK.,UCSD/Salk Center for Academic Research and Training in Anthropogeny (CARTA), University of California San Diego, USA
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Lopez Leyva L, Gonzalez E, Li C, Ajeeb T, Solomons NW, Agellon LB, Scott ME, Koski KG. Human Milk Microbiota in an Indigenous Population Is Associated with Maternal Factors, Stage of Lactation, and Breastfeeding Practices. Curr Dev Nutr 2021; 5:nzab013. [PMID: 33898919 PMCID: PMC8053399 DOI: 10.1093/cdn/nzab013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/29/2021] [Accepted: 02/17/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Human milk contains a diverse community of bacteria that are modified by maternal factors, but whether these or other factors are similar in developing countries has not been explored. Our objective was to determine whether the milk microbiota was modified by maternal age, BMI, parity, lactation stage, subclinical mastitis (SCM), and breastfeeding practices in the first 6 mo of lactation in an indigenous population from Guatemala. METHODS For this cross-sectional study, Mam-Mayan indigenous mothers nursing infants aged <6 mo were recruited. Unilateral human milk samples were collected (n = 86) and processed for 16S rRNA sequencing at the genus level. Microbial diversity and relative abundance were compared with maternal factors [age, BMI, parity, stage of lactation, SCM, and 3 breastfeeding practices (exclusive, predominant, mixed)] obtained through questionnaires. RESULTS Streptococcus was the most abundant genus (33.8%), followed by Pseudomonas (18.7%) and Sphingobium (10.7%) but relative abundance was associated with maternal factors. First, Lactobacillus and Streptococcus were more abundant in early lactation whereas the common oral (Leptotrichia) and environmental (Comamonas) bacteria were more abundant in established lactation. Second, Streptococcus,Lactobacillus,Lactococcus,Leuconostoc, and Micrococcus had a higher abundance in multiparous mothers compared with primiparous mothers. Third, a more diverse microbiota characterized by a higher abundance of lactic acid bacteria (Lactobacillus,Leuconostoc, and Lactococcus), Leucobacter, and Micrococcus was found in mothers with a healthy BMI. Finally, distinct microbial communities differed by stage of lactation and by exclusive, predominant, or mixed breastfeeding practices. CONCLUSION Milk bacterial communities in an indigenous community were associated with maternal factors. Higher microbial diversity was supported by having a healthy BMI, the absence of SCM, and by breastfeeding. Interestingly, breastfeeding practices when assessed by lactation stage were associated with distinct microbiota profiles.
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Affiliation(s)
- Lilian Lopez Leyva
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Emmanuel Gonzalez
- Canadian Centre for Computational Genomics (C3G), Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montréal, QC, Canada
- Microbiome Research Platform, McGill Interdisciplinary Initiative in Infection and Immunity (MI4), Genome Centre, McGill University, Montréal, QC, Canada
| | - Chen Li
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Tamara Ajeeb
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Luis B Agellon
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Marilyn E Scott
- Institute of Parasitology, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC, Canada
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Pace RM, Williams JE, Järvinen KM, Belfort MB, Pace CDW, Lackey KA, Gogel AC, Nguyen-Contant P, Kanagaiah P, Fitzgerald T, Ferri R, Young B, Rosen-Carole C, Diaz N, Meehan CL, Caffé B, Sangster MY, Topham D, McGuire MA, Seppo A, McGuire MK. Characterization of SARS-CoV-2 RNA, Antibodies, and Neutralizing Capacity in Milk Produced by Women with COVID-19. mBio 2021; 12:e03192-20. [PMID: 33563823 PMCID: PMC7885115 DOI: 10.1128/mbio.03192-20] [Citation(s) in RCA: 164] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/09/2021] [Indexed: 12/28/2022] Open
Abstract
Whether mother-to-infant SARS-CoV-2 transmission can occur during breastfeeding and, if so, whether the benefits of breastfeeding outweigh this risk during maternal COVID-19 illness remain important questions. Using RT-qPCR, we did not detect SARS-CoV-2 RNA in any milk sample (n = 37) collected from 18 women following COVID-19 diagnosis. Although we detected evidence of viral RNA on 8 out of 70 breast skin swabs, only one was considered a conclusive positive result. In contrast, 76% of the milk samples collected from women with COVID-19 contained SARS-CoV-2-specific IgA, and 80% had SARS-CoV-2-specific IgG. In addition, 62% of the milk samples were able to neutralize SARS-CoV-2 infectivity in vitro, whereas milk samples collected prior to the COVID-19 pandemic were unable to do so. Taken together, our data do not support mother-to-infant transmission of SARS-CoV-2 via milk. Importantly, milk produced by infected mothers is a beneficial source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.IMPORTANCE Results from prior studies assaying human milk for the presence of SARS-CoV-2, the causative virus of COVID-19, have suggested milk may act as a potential vehicle for mother-to-child transmission. Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed. As such, considerable uncertainty remains regarding whether human milk is capable of transmitting SARS-CoV-2 from mother to child. Here, we report that repeated milk samples collected from 18 women following COVID-19 diagnosis did not contain SARS-CoV-2 RNA; however, risk of transmission via breast skin should be further evaluated. Importantly, we found that milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness as milk likely provides specific immunologic benefits to infants.
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Affiliation(s)
- Ryan M Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Janet E Williams
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, Idaho, USA
| | - Kirsi M Järvinen
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Christina D W Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Kimberly A Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Alexandra C Gogel
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Phuong Nguyen-Contant
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - Preshetha Kanagaiah
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - Theresa Fitzgerald
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - Rita Ferri
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Bridget Young
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Casey Rosen-Carole
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Nichole Diaz
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Courtney L Meehan
- Department of Anthropology, Washington State University, Pullman, Washington, USA
| | - Beatrice Caffé
- Department of Anthropology, Washington State University, Pullman, Washington, USA
| | - Mark Y Sangster
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - David Topham
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - Mark A McGuire
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, Idaho, USA
| | - Antti Seppo
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
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13
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Pace RM, Williams JE, Järvinen KM, Belfort MB, Pace CD, Lackey KA, Gogel AC, Nguyen-Contant P, Kanagaiah P, Fitzgerald T, Ferri R, Young B, Rosen-Carole C, Diaz N, Meehan CL, Caffe B, Sangster MY, Topham D, McGuire MA, Seppo A, McGuire MK. COVID-19 and human milk: SARS-CoV-2, antibodies, and neutralizing capacity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.09.16.20196071. [PMID: 32995804 PMCID: PMC7523143 DOI: 10.1101/2020.09.16.20196071] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background It is not known whether SARS-CoV-2 can be transmitted from mother to infant during breastfeeding, and if so whether the benefits of breastfeeding outweigh this risk. This study was designed to evaluate 1) if SARS-CoV-2 RNA can be detected in milk and on the breast of infected women, 2) concentrations of milk-borne anti-SARS-CoV-2 antibodies, and 3) the capacity of milk to neutralize SARS-CoV-2 infectivity. Methods We collected 37 milk samples and 70 breast swabs (before and after breast washing) from 18 women recently diagnosed with COVID-19. Samples were analyzed for SARS-CoV-2 RNA using RT-qPCR. Milk was also analyzed for IgA and IgG specific for the nucleocapsid protein, receptor binding domain (RBD), S2 subunit of the spike protein of SARS-CoV-2, as well as 2 seasonal coronaviruses using ELISA; and for its ability to neutralize SARS-CoV-2. Results We did not detect SARS-CoV-2 RNA in any milk sample. In contrast, SARS-CoV-2 RNA was detected on several breast swabs, although only one was considered conclusive. All milk contained SARS-CoV-2-specific IgA and IgG, and levels of anti-RBD IgA correlated with SARS-CoV-2 neutralization. Strong correlations between levels of IgA and IgG to SARS-CoV-2 and seasonal coronaviruses were noted. Conclusions Our data do not support maternal-to-child transmission of SARS-CoV-2 via milk; however, risk of transmission via breast skin should be further evaluated. Importantly, milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.
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Affiliation(s)
- Ryan M. Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844
| | - Janet E. Williams
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, ID 83844
| | - Kirsi M. Järvinen
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Mandy B. Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115
| | - Christina D.W. Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844
| | - Kimberly A. Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844
| | - Alexandra C. Gogel
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844
| | - Phuong Nguyen-Contant
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
| | - Preshetha Kanagaiah
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
| | - Theresa Fitzgerald
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
| | - Rita Ferri
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Bridget Young
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Casey Rosen-Carole
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Nichole Diaz
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Courtney L. Meehan
- Department of Anthropology, Washington State University, Pullman, WA 99164
| | - Beatrice Caffe
- Department of Anthropology, Washington State University, Pullman, WA 99164
| | - Mark Y. Sangster
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
| | - David Topham
- David H. Smith Center for Vaccine Biology and Immunology, Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
| | - Mark A. McGuire
- Department of Animal, Veterinary, and Food Sciences, University of Idaho, Moscow, ID 83844
| | - Antti Seppo
- Department of Pediatrics, Division of Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Michelle K. McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844
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Samuel TM, De Castro CA, Dubascoux S, Affolter M, Giuffrida F, Billeaud C, Picaud JC, Agosti M, Al-Jashi I, Pereira AB, Costeira MJ, Silva MG, Marchini G, Rakza T, Haaland K, Stiris T, Stoicescu SM, Martínez-Costa C, Vanpee M, Domellöf M, Castañeda-Gutiérrez E, Thakkar SK, Silva-Zolezzi I. Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth. Nutrients 2019; 12:nu12010105. [PMID: 31905959 PMCID: PMC7019749 DOI: 10.3390/nu12010105] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 02/01/2023] Open
Abstract
Background: Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland. We examined the effects of SCM on human milk (HM) composition, infant growth, and HM intake in a mother–infant cohort from seven European countries. Methods: HM samples were obtained from 305 mothers at 2, 17, 30, 60, 90, and 120 days postpartum. SCM status was assessed using HM Sodium (Na): Potassium (K) ratio >0.6. Levels of different macro- and micronutrients were analyzed in HM. Results: SCM prevalence in the first month of lactation was 35.4%. Mean gestational age at delivery was lower and birth by C-section higher in SCM mothers (p ≤ 0.001). HM concentrations of lactose, DHA, linolenic acid, calcium, and phosphorous (p < 0.05 for all) was lower, while total protein, alpha-lactalbumin, lactoferrin, albumin, arachidonic acid to DHA ratio, n-6 to n-3 ratio and minerals (iron, selenium, manganese, zinc, and copper) were higher (p < 0.001 for all) in mothers with SCM. There were no differences in infant growth and HM intake between non-SCM and SCM groups. Conclusion: We document, for the first time, in a large European standardized and longitudinal study, a high prevalence of SCM in early lactation and demonstrate that SCM is associated with significant changes in the macro- and micronutrient composition of HM. Future studies exploring the relation of SCM with breastfeeding behaviors and developmental outcomes are warranted.
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Affiliation(s)
- Tinu Mary Samuel
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
- Correspondence:
| | | | - Stephane Dubascoux
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Michael Affolter
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Francesca Giuffrida
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | | | - Jean-Charles Picaud
- Hospices Civils de Lyon, Neonatal intensive care unit, Hôpital Croix Rousse, 69004 Lyon, France;
- Univ. Lyon, CarMeN Laboratory, INSERM U1060, INRA U1397, INSA Lyon, Universite Claude Bernard, 69221 Lyon 1, France
| | | | - Isam Al-Jashi
- Medical School, Department of Obstetrics and Gynecology, Titu Maiorescu Medicine University, 031593 Bucharest, Romania;
| | | | - Maria Jose Costeira
- Instituto de Investigação em Ciências da Vida e Saúde, 4720-011 Braga, Portugal;
| | | | - Giovanna Marchini
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Thameur Rakza
- Centre d’Investigation Clinique de Lille, Hôpital Jeanne de Flandre, 59777 Lille, France;
| | - Kirsti Haaland
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | - Tom Stiris
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | | | | | - Mireilla Vanpee
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umea University, 901 87 Umeå, Sweden;
| | - Eurídice Castañeda-Gutiérrez
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Sagar Kiran Thakkar
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
| | - Irma Silva-Zolezzi
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
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15
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Li C, Solomons NW, Scott ME, Koski KG. Anthropometry before Day 46 and Growth Velocity before 6 Months of Guatemalan Breastfed Infants Are Associated with Subclinical Mastitis and Milk Cytokines, Minerals, and Trace Elements. J Nutr 2019; 149:1651-1659. [PMID: 31187864 DOI: 10.1093/jn/nxz109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/10/2019] [Accepted: 04/30/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland, but its association with human milk composition and infant growth is not well described. OBJECTIVES We investigated whether SCM, milk cytokines, and/or estimated intakes of milk minerals and trace elements were associated with infant anthropometry or growth velocity before 6 mo. METHODS Breast milk was collected from Mam-Mayan mothers (n = 114) at both early (2-46 d) and established (4-6 mo) lactation. Concentrations of 9 elements (sodium, potassium, calcium, magnesium, copper, iron, manganese, selenium, zinc) analyzed by inductively-coupled plasma mass spectrometry were used to estimate infants' daily intakes. Concentrations of 4 cytokines were measured. Milk concentrations and infants' estimated elemental intakes and anthropometric measurements during early and established lactation were compared by SCM status. Multiple regression was used to identify factors associated with infant growth attainment (<46 d) for infant weight- (WAZ), length- (LAZ), and head circumference-for-age (HCAZ) and weight-for-length (WLZ) z scores and with growth velocity (expressed as Δ/d) from early to established lactation. RESULTS SCM prevalence was higher in early (30%) than established (10%) lactation. Breast milk of SCM mothers had higher cytokine concentrations and higher magnesium in early and higher selenium concentrations in both early and established lactation (Padj < 0.0121). At day 46, regression models showed inverse associations of SCM with WLZ and IL-1β with LAZ (Padj < 0.0150). In contrast, linear growth velocity was positively associated with IL-1β measured in early lactation (Padj < 0.0124), whereas cranial growth velocity was positively associated with IL-8 measured during established lactation ( Padj < 0.0124). CONCLUSIONS Despite a high prevalence of inadequate intakes, only infants' intake of milk magnesium during early lactation was associated with linear growth velocity in breastfed infants <6 mo. Evidence shows that SCM, breast-milk cytokines, and infants' estimated intakes of select elements are independently associated with growth attainment and growth velocity during lactation.
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Affiliation(s)
- Chen Li
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging, and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Marilyn E Scott
- Institute of Parasitology, McGill University, Montreal, Quebec, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
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16
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Pajewska-Szmyt M, Sinkiewicz-Darol E, Gadzała-Kopciuch R. The impact of environmental pollution on the quality of mother's milk. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:7405-7427. [PMID: 30687894 PMCID: PMC6447517 DOI: 10.1007/s11356-019-04141-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/02/2019] [Indexed: 05/18/2023]
Abstract
Breastfeeding is a gold standard of neonate nutrition because human milk contains a lot of essential compounds crucial for proper development of a child. However, milk is also a biofluid which can contain environmental pollution, which can have effects on immune system and consequently on the various body organs. Polychlorinated biphenyls are organic pollutants which have been detected in human milk. They have lipophilic properties, so they can penetrate to fatty milk and ultimately to neonate digestive track. Another problem of interest is the presence in milk of heavy metals-arsenic, lead, cadmium, and mercury-as these compounds can lead to disorders in production of cytokines, which are important immunomodulators. The toxicants cause stimulation or suppression of this compounds. This can lead to health problems in children as allergy, disorders in the endocrine system, end even neurodevelopment delay and disorder. Consequently, correlations between pollutants and bioactive components in milk should be investigated. This article provides an overview of environmental pollutants found in human milk as well as of the consequences of cytokine disorder correlated with presence of heavy metals. Graphical abstract.
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Affiliation(s)
- Martyna Pajewska-Szmyt
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, 7 Gagarin St, 87-100, Toruń, Poland
- Interdisciplinary Centre for Modern Technologies, Nicolaus Copernicus University, 4 Wileńska St, PL-87100, Toruń, Poland
| | - Elena Sinkiewicz-Darol
- Ludwik Rydygier Provincial Polyclinic Hospital in Toruń, Human Milk Bank, Św. Józefa 53-59, 87-100, Toruń, Poland
- Human Milk Bank Foundation, 128J Podkowy St, 04-937, Warsaw, Poland
| | - Renata Gadzała-Kopciuch
- Department of Environmental Chemistry and Bioanalytics, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, 7 Gagarin St, 87-100, Toruń, Poland.
- Interdisciplinary Centre for Modern Technologies, Nicolaus Copernicus University, 4 Wileńska St, PL-87100, Toruń, Poland.
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17
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Sun H, Han S, Cheng R, Hei M, Kakulas F, Lee SK. Testing the feasibility and safety of feeding preterm infants fresh mother's own milk in the NICU: A pilot study. Sci Rep 2019; 9:941. [PMID: 30700726 PMCID: PMC6353969 DOI: 10.1038/s41598-018-37111-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022] Open
Abstract
Necrotizing enterocolitis (NEC) is the leading cause of death among infants born at <30 weeks’ gestation, but donor human milk can reduce the incidence of NEC. Unfortunately, freezing or pasteurizing human milk deactivates beneficial bioactive components. We evaluated the feasibility, safety, and impact of feeding very preterm infants fresh (unprocessed) mother’s own milk within 4 hours of expression. In our multicentre prospective cohort analytic study, we fed 109 control and 98 intervention infants previously frozen donor or mother’s own milk; only the intervention group was fed fresh mother’s own milk once daily from enrollment until 32 weeks’ corrected age. Control group mothers could not commit to provide fresh milk daily and were less likely receive antenatal corticosteroids than mothers in the intervention group. In the intervention group, 87.5% (98/112) of mothers were able to provide at least one feed of fresh milk a day. No critical incidents or non-compliance with the protocol were reported. The duration of mechanical ventilation and total parenteral nutrition use were shorter in the intervention group than controls (P < 0.01) but the length of hospital stay was similar (P = 0.57). Although the study might be underpowered, the intervention group had lower unadjusted rates of the composite outcome NEC ≥ stage 2 or mortality (8% vs 20%, P = 0.04), sepsis (22% vs 38%, P = 0.02), retinopathy of prematurity (17% vs 39%, P < 0.01) and bronchopulmonary dysplasia (32% vs 47%, P < 0.01) than the control. These results indicated that feeding fresh mother’s own milk once daily was safe, feasible, and may reduce morbidity.
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Affiliation(s)
- Huiqing Sun
- Department of Neonatology, Children's Hospital of Zhengzhou University, Zhengzhou, China.,Department of Neonatology, Henan Children's Hospital, Zhengzhou, China.,Department of Neonatology, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Shuping Han
- Department of Pediatrics, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Rui Cheng
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mingyan Hei
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China.,Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Foteini Kakulas
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shoo K Lee
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. .,Department of Paediatrics, Department of Obstetrics & Gynecology, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. .,Department of Paediatrics, Sinai Health System, Toronto, Ontario, Canada.
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18
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Wren-Atilola HM, Solomons NW, Scott ME, Koski KG. Infant growth faltering linked to subclinical mastitis, maternal faecal-oral contamination, and breastfeeding. MATERNAL AND CHILD NUTRITION 2019; 15:e12756. [PMID: 30472802 DOI: 10.1111/mcn.12756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 12/26/2022]
Abstract
Infant growth faltering occurs in breastfed infants <6 months of age. The possibility that maternal health status contributes to this growth faltering is underexplored. We investigated whether (a) subclinical mastitis (SCM), an asymptomatic inflammation of the breast, (b) maternal intestinal nematode and protozoan infections, indicators of faecal-oral contamination, or (c) poor breastfeeding practices increased the odds of stunting (length-for-age z-score < -2SD), underweight (weight-for-age z-score < -2SD), or low head circumference (head circumference-for-age z-score < -2SD) in breastfed infants in rural indigenous communities in Guatemala. Mother-infant dyads (n = 105) were subdivided into those with and without SCM (milk Na:K ratio > 0.6). Maternal and infant anthropometry were measured at the time of breast milk collection. Maternal stool samples were examined for the presence of intestinal nematodes and protozoa. Questionnaires were used to characterize breastfeeding practices (exclusivity and frequency) and support, hygiene (latrine use and household faucet), and infant diarrhoea. SCM occurred in 14% of women and was associated with increased odds of infant stunting (odds ratio [OR] = 4.3; confidence interval [CI] [1.1, 15.8]), underweight (OR = 9.2; CI [1.8, 48.0]), and low head circumference (OR = 15.9; CI [2.6, 96.9]). Maternal pathogenic protozoa and nematodes were uncommon (<4%), but nonpathogenic protozoa were common (e.g., Entamoeba coli [39%]). Entamoeba coli increased the likelihood (OR = 3.3; CI [1.02, 10.6]) of low head circumference, whereas higher breastfeeding frequency lowered its odds (OR = 0.74, CI [0.56, 0.97]). Prevention of SCM may improve early infant growth, but public health measures that increase breastfeeding frequency and reduce faecal-oral contamination may be required to minimize low head circumference.
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Affiliation(s)
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Marilyn E Scott
- Institute of Parasitology, McGill University, Montreal, Quebec, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
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19
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Towards appropriate feeding to prevent malnutrition in infants and toddlers. Eur J Clin Nutr 2018; 72:1274-1281. [PMID: 30185846 DOI: 10.1038/s41430-018-0266-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 11/09/2022]
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20
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Gustafsson A, Granström E, Stecksén-Blicks C, West CE, Silfverdal SA. The Antisecretory Factor in Plasma and Breast Milk in Breastfeeding Mothers-A Prospective Cohort Study in Sweden. Nutrients 2018; 10:E1227. [PMID: 30181494 PMCID: PMC6164404 DOI: 10.3390/nu10091227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/29/2018] [Accepted: 09/03/2018] [Indexed: 12/25/2022] Open
Abstract
Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and inflammation. The objective of the study was to describe AF-levels in plasma and breast milk, and in relation to breast complications. Breastfeeding mothers (n = 95) were consecutively recruited at a Well Baby Clinic in Umeå, Sweden. At inclusion four weeks postpartum, samples of venous blood (10 mL) and breast milk (10 mL) were collected. Active AF was analyzed with ELISA using a monoclonal antibody mAb43, and was detected in all samples of plasma and breast milk with a positive correlation (Spearman coefficient = 0.40, p < 0.001; Pearson correlation = 0.34, p < 0.01). High AF-levels in plasma correlated with high AF-levels in breast milk. The results suggest a co-regulation between active AF in plasma and breastmilk, and/or a local regulation of AF in the breast. Further studies are needed to determine the pathways for the activation of AF-levels in breast milk and plasma.
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Affiliation(s)
- Anna Gustafsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE 141 86 Stockholm, Sweden.
- Department of Neonatology, Karolinska University Hospital, SE 171 76 Stockholm, Sweden.
| | - Elisabeth Granström
- Department of Odontology, Pediatric dentistry, Umeå university, SE 901 87 Umeå, Sweden.
| | | | - Christina E West
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 87 Umeå, Sweden.
| | - Sven-Arne Silfverdal
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 87 Umeå, Sweden.
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