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Rahmartani LD, Quigley MA, Carson C. Do various types of prelacteal feeding (PLF) have different associations with breastfeeding duration in Indonesia? A cross-sectional study using Indonesia Demographic and Health Survey datasets. BMJ Glob Health 2024; 9:e014223. [PMID: 38857945 PMCID: PMC11168184 DOI: 10.1136/bmjgh-2023-014223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/16/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Prelacteal feeding (PLF) is anything other than breastmilk given to newborns in the first few days of birth and/or before breastfeeding is established. PLF comes in many forms and is known as a challenge to optimal breastfeeding. Interestingly, both breastfeeding and PLF are common in Indonesia. This study investigated the association between PLF (any PLF, formula, honey, water and other milk) and breastfeeding duration. METHODS This study used Indonesia Demographic and Health Surveys data from 2002, 2007 and 2017. Sample sizes were 5558 (2007), 6268 (2007) and 6227 (2017) mothers whose last child was aged 0-23 months. We used Cox regression survival analysis to assess the association between PLF and breastfeeding duration, estimating hazard ratios (HR) for stopping earlier. RESULTS Overall PLF was prevalent (59%, 67% and 45% in 2002, 2007 and 2017, respectively), with formula being the most common (38%, 50% and 25%). No association between any PLF and breastfeeding duration in 2002 (HR 0.90 (95% CI 0.70 to 1.16)), but in 2007 and 2017, mothers who gave any PLF were more likely to stop breastfeeding earlier than those who did not (HR 1.33 (95% CI 1.11 to 1.61) and 1.47 (95% CI 1.28 to 1.69), respectively), especially in the first 6 months (HR 2.13 (95% CI 1.55 to 2.92) and 2.07 (95% CI 1.74 to 2.47), respectively). This association was more consistent for milk-based PLF. For example, HR in 2017 was 2.13 (95% CI 1.78 to 2.53) for prelacteal formula and 1.73 (95% CI 1.39 to 2.15) for other milk. The associations were inconsistent for the other PLF types. Prelacteal water showed no association while prelacteal honey showed some association with a longer breastfeeding duration in 2002 and 2007. CONCLUSION The impact of PLF on breastfeeding duration varied by type. While this study supports current recommendations to avoid PLF unless medically indicated, the potential consequences of different PLF types on breastfeeding outcomes should be clearly communicated to healthcare providers and mothers. Further research should explore the reasons for the high PLF prevalence in this setting.
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Affiliation(s)
- Lhuri D Rahmartani
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maria A Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claire Carson
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Thatrimontrichai A, Surachat K, Singkhamanan K, Thongsuksai P. Long Duration of Oral Care Using Mother's Own Milk Influences Oral Microbiota and Clinical Outcomes in Very-low-birthweight Infants: Randomized Controlled Trial. Pediatr Infect Dis J 2023; 42:804-810. [PMID: 37343216 DOI: 10.1097/inf.0000000000004002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Several studies have focused on the clinical outcomes of oral care using colostrum for a limited time (2-5 days) in very-low-birthweight (VLBW) infants. However, the effect of long-term mother's own milk (MOM) on the clinical outcomes and oral microbiota of VLBW infants remains unknown. METHODS In this randomized controlled trial, VLBW neonates were randomly assigned to oral care by MOM or sterile water (SW) groups until they started oral feeding. The primary outcome was oral microbiota composition including alpha and beta diversity, relative abundance, and linear discriminant analysis effect size (LEfSe). The secondary outcomes were various morbidities and mortality. RESULTS The baseline characteristics of the two groups did not differ (63 neonates, MOM group, n = 30, oral care 22 days; SW group, n = 33, oral care 27 days). There was no significant difference in alpha and beta diversities between the groups before and after the intervention. The MOM group had a significantly lower rate of clinical sepsis than the SW group (47% vs. 76%, risk ratio = 0.62, 95% CI: 0.40-0.97). The relative abundance of Bifidobacterium bifidum and Faecalibacterium were maintained after MOM care, especially in neonates without clinical sepsis, but decreased after SW care. LEfSe showed that neonates in the MOM and SW groups with clinical sepsis had the highest abundance of Pseudomonas and Gammaproteobacteria, respectively, compared with neonates without sepsis. CONCLUSIONS A longer duration of oral care using MOM in VLBW infants sustains healthy bacteria and decreases the risk of clinical sepsis.
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Affiliation(s)
- Anucha Thatrimontrichai
- From the Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Komwit Surachat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Molecular Evolution and Computational Biology Research Unit, Prince of Songkla University, Songkhla, Thailand
| | - Kamonnut Singkhamanan
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJD, Bégin F, Chapman DJ, Grummer-Strawn LM, McCoy D, Menon P, Ribeiro Neves PA, Piwoz E, Rollins N, Victora CG, Richter L. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet 2023; 401:472-485. [PMID: 36764313 DOI: 10.1016/s0140-6736(22)01932-8] [Citation(s) in RCA: 128] [Impact Index Per Article: 128.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/10/2023]
Abstract
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Cecília Tomori
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Sonia Hernández-Cordero
- Research Center for Equitable Development (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Purnima Menon
- International Food Policy Research Institute, New Delhi, India
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva, Switzerland
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda Richter
- Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Early-Life Gut Health Indicators and Reported Prevalence of Infant Functional Constipation by Healthcare Professionals. Nutrients 2023; 15:nu15020298. [PMID: 36678169 PMCID: PMC9862041 DOI: 10.3390/nu15020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023] Open
Abstract
A healthy gut during early childhood is important. However, it seems that there are no standard indicators used to assess it. Healthcare professionals (HCPs) were asked via an electronic survey question about gut health indicators (GHIs) for infants and toddlers, in addition to an estimated prevalence of infant's functional constipation (FC) and its management. HCPs from eight countries participated in the survey (Russia (66.0%, 1449), Indonesia (11.0%, 242), Malaysia (6.0%, 132), Mexico (5.7%, 125), KSA (5.1%, 113), Turkey (3.0%, 66), Hong Kong (2.2%, 49), and Singapore (1.0%, 23)). The 2199 participating respondents were further classified into three continents (Asia (20.2%), Europe (68.8%), and others (11.0%)). Most of them were pediatricians (80.3%), followed by pediatric gastroenterologists (7.0%), general practitioners (6.4%), and others (6.3%). The top three preferred GHIs were similar for infants and toddlers: an absence of gastrointestinal (GI) symptoms, effective digestion/absorption as assessed by normal growth, and a general feeling of well-being. The absence of GI-related infection was the least preferred indicator. Most of the respondents reported the prevalence of FC among infants was less than 5%, with the peak incidence between the ages of 3 and 6 months. The reported choices of intervention to manage FC in infants were a change to a specific nutritional solution from a standard formula (40.2%), parental reassurance (31.7%), and lactulose (17.0%). Conclusion: The HCPs in the eight countries preferred the absence of GI symptoms, normal growth for effective digestion and absorption, and general well-being as the gut health indicators in infants and toddlers. The reported prevalence of FC in infants was less than 5%.
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Hernández-Caravaca I, Cabañas A, López-Úbeda R, González-Brusi L, Guillén-Martínez A, Izquierdo-Rico MJ, Muñoz-Rodríguez MN, Avilés M, Ruiz García MJ. Analysis of Minor Proteins Present in Breast Milk by Using WGA Lectin. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1084. [PMID: 35884068 PMCID: PMC9318462 DOI: 10.3390/children9071084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022]
Abstract
Breast milk is a complex and dynamic biological fluid and considered an essential source of nutrition in early life. In its composition, the proteins have a relevant biological activity and are related to the multiple benefits demonstrated when compared with artificial milks derived from cow's milk. Understanding human milk composition provides an important tool for health care providers toward the management of infant feeding and the establishment of breastfeeding. In this work, a new technique was developed to increase the knowledge of human milk, because many of the components remain unknown. To isolate minor proteins present in breast milk by using WGA lectin, breast milk was centrifuged to remove cells and separate the fat phase from the serum phase. The serum obtained was separated into two groups: control (n = 3; whole serum sample from mature milk) and WGA lectin (n = 3; sample processed with WGA lectin to isolate glycosylated proteins). The samples were analyzed by high-performance liquid chromatography coupled to mass spectrometry (HPLC/MS). A total of 84 different proteins were identified from all of the samples. In the WGA lectin group, 55 different proteins were isolated, 77% of which had biological functions related to the immune response. Of these proteins, there were eight WGA lectin group exclusives, and two had not previously been described in breast milk (polyubiquitin-B and POTE ankyrin domain family member F). Isolation by WGA lectin is a useful technique to detect minor proteins in breast milk and to identify proteins that could not be observed in whole serum.
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Affiliation(s)
- Iván Hernández-Caravaca
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Sant Vicent del Raspeig, 03690 Alicante, Spain
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
| | - Andrés Cabañas
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Rebeca López-Úbeda
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Leopoldo González-Brusi
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Ascensión Guillén-Martínez
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Mª José Izquierdo-Rico
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Mª Nieves Muñoz-Rodríguez
- Coordinación Sociosanitaria Dirección General de Planificación, Investigación, Farmacia y Atención al Ciudadano (CARM), 30071 Murcia, Spain;
| | - Manuel Avilés
- IMIB-Arrixaca (Instituto Murciano de Investigación Biosanitaria), 30120 Murcia, Spain; (R.L.-Ú.); (L.G.-B.); (A.G.-M.); (M.J.I.-R.); (M.A.)
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
| | - Mª Jesús Ruiz García
- Department of Nursing, Faculty of Nursing, University of Murcia, Campus Mare Nostrum, 30100 Murcia, Spain;
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Gleeson JP, Chaudhary N, Fein KC, Doerfler R, Hredzak-Showalter P, Whitehead KA. Profiling of mature-stage human breast milk cells identifies six unique lactocyte subpopulations. SCIENCE ADVANCES 2022; 8:eabm6865. [PMID: 35767604 PMCID: PMC9242445 DOI: 10.1126/sciadv.abm6865] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Breast milk is chock-full of nutrients, immunological factors, and cells that aid infant development. Maternal cells are the least studied breast milk component, and their unique properties are difficult to identify using traditional techniques. Here, we characterized the cells in mature-stage breast milk from healthy donors at the protein, gene, and transcriptome levels. Holistic analysis of flow cytometry, quantitative polymerase chain reaction, and single-cell RNA sequencing data identified the predominant cell population as epithelial with smaller populations of macrophages and T cells. Two percent of epithelial cells expressed four stem cell markers: SOX2, TRA-1-60, NANOG, and SSEA4. Furthermore, milk contained six distinct epithelial lactocyte subpopulations, including three previously unidentified subpopulations programmed toward mucosal defense and intestinal development. Pseudotime analysis delineated the differentiation pathways of epithelial progenitors. Together, these data define healthy human maternal breast milk cells and provide a basis for their application in maternal and infant medicine.
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Affiliation(s)
- John P. Gleeson
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Namit Chaudhary
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Katherine C. Fein
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Rose Doerfler
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | | | - Kathryn A. Whitehead
- Department of Chemical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
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Guo J, Tan M, Zhu J, Tian Y, Liu H, Luo F, Wang J, Huang Y, Zhang Y, Yang Y, Wang G. Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19. Nutrients 2022; 14:nu14122513. [PMID: 35745243 PMCID: PMC9227629 DOI: 10.3390/nu14122513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/05/2023] Open
Abstract
Despite the well-known benefits of breastfeeding and the World Health Organization’s breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk’s protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.
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Affiliation(s)
- Juanjuan Guo
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Minjie Tan
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Jing Zhu
- Institute of Biotechnology and Health, Beijing Academy of Science and Technology, Beijing 100089, China
- Correspondence: (J.Z.); (G.W.)
| | - Ye Tian
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Huanyu Liu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Fan Luo
- State Key Laboratory of Virology, Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China;
| | - Jianbin Wang
- School of Life Sciences, Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing 100084, China;
| | - Yanyi Huang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
| | - Yuanzhen Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Yuexin Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
| | - Guanbo Wang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
- Correspondence: (J.Z.); (G.W.)
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Ahmed F, Malik NI, Shahzad M, Ahmad M, Shahid M, Feng XL, Guo J. Determinants of Infant Young Child Feeding Among Mothers of Malnourished Children in South Punjab, Pakistan: A Qualitative Study. Front Public Health 2022; 10:834089. [PMID: 35664102 PMCID: PMC9160796 DOI: 10.3389/fpubh.2022.834089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 01/13/2023] Open
Abstract
Inadequate feeding is one of the most critical underlying determinants of child malnutrition. In this study, we explore infant young child feeding (IYCF) and deconstruct breastfeeding barriers in mothers of severely malnourished children in one of the most marginalized districts of Punjab province of Pakistan. Using purposive sampling, 20 lactating mothers are recruited for open-ended semi-structured interviews. Results reveal that barriers to immediate and exclusive breastfeeding include the introduction of pre-lacteal, butter, and cow or formula milk by mothers and grandmothers. Birthing difficulties and ritualizing prelacteal to transfer religion and culture cause the delay of early initiation of breastmilk. The colostrum is also discarded based on its weird physical look. Moreover, household circumstances, limited diet, extra workload, and mental stress associated with marital relationships are other significant barriers. Mothers perceive their breastmilk as thin, impotent, and of bad quality and often complain against breastmilk insufficiency due to general weakness. Furthermore, poor mothers reduce breastfeeding when the fertility burden is high, especially if a female baby is in their womb. Alternatively, outer milk is recommended but washing bottles with detergents often becomes frequent. In conclusion, immediacy, exclusivity, frequency, and duration of breastfeeding are circumscribed owing to multiple social, cultural, and economic causes. Therefore, a holistic approach combining cultural and structural causes might be more relevant for successful IYCF practices in marginalized communities of Pakistan.
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Affiliation(s)
- Farooq Ahmed
- Department of Anthropology, Quaid-i-Azam University, Islamabad, Pakistan
- Department of Anthropology, University of Washington, Seattle, WA, United States
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Muhammad Shahzad
- Department of Anthropology, Bahauddin Zakariya University, Multan, Pakistan
| | - Manal Ahmad
- Mather Hospital Northwell, New York, NY, United States
| | - Muhammad Shahid
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- *Correspondence: Xing Lin Feng
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Jing Guo
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Sinkiewicz-Darol E, Martysiak-Żurowska D, Puta M, Adamczyk I, Barbarska O, Wesołowska A, Bernatowicz-Łojko U. Nutrients and Bioactive Components of Human Milk After One Year of Lactation: Implication for Human Milk Banks. J Pediatr Gastroenterol Nutr 2022; 74:284-291. [PMID: 34520401 DOI: 10.1097/mpg.0000000000003298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Specifying the nutrient content and bioactive compounds in milk from long-term lactation for the purpose of finding additional sources of donors' milk for human milk banks. METHOD Human milk samples were collected from 43 mothers of term infants (term infant human milk, TIHM) (3-6 weeks of lactation) and 50 mothers who have breastfed for over a year (long-nursing human milk, LNHM). The milk collection time was 24 hours. The analyses of fat, protein, carbohydrate and energy content were performed with human milk analyzer MIRIS (Miris HMA™ ); lactoferrin and vitamin C content using high performance liquid chromatography in reversed phase (RP-HPLC); total antioxidant activity (TAC) and lysozyme by enzyme-linked immunosorbent assay (ELISA); and the activity of glutathione peroxidase (GPx) and catalase (CAT) via spectrophotometric methods. Sociodemographic characteristics of both groups of mothers have been compiled. RESULTS Higher fat content and energy value was found in LNHM than in TIHM. Protein content in LNHM and TIHM did not differ. Carbohydrate content was lower in LNHM than in TIHM. TAC, CAT and GPx activity were higher in LNHM compared to TIHM. No significant differences in the content of lysozyme, lactoferrin and vitamin C between the studied groups were found. CONCLUSIONS The findings suggest that after 12 months of lactation, human milk still has significant nutritional value, does not lose bioactive components and can be considered for use in human milk banks.
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Affiliation(s)
- Elena Sinkiewicz-Darol
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Bydgoszcz
| | - Dorota Martysiak-Żurowska
- Department of Chemistry, Technology and Biotechnology of Food, Chemical Faculty, Gdansk University of Technology, Gdansk
| | - Małgorzata Puta
- Department of Chemistry, Technology and Biotechnology of Food, Chemical Faculty, Gdansk University of Technology, Gdansk
| | - Iwona Adamczyk
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Bydgoszcz
| | - Olga Barbarska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital; Medical University of Warsaw, The Faculty of Health Sciences, Department of Medical Biology, Warsaw
| | - Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital; Medical University of Warsaw, The Faculty of Health Sciences, Department of Medical Biology, Warsaw
| | - Urszula Bernatowicz-Łojko
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Midwifery, Centre of Postgraduate Medical Education, St. Sophia's Hospital, Warsaw, Poland
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Ayalew DD, Kassie BA, Hunegnaw MT, Gelaye KA, Belew AK. Determinants of Early Initiation of Breastfeeding in West Belessa District, Northwest Ethiopia. Nutr Metab Insights 2022; 15:11786388211065221. [PMID: 35023927 PMCID: PMC8744188 DOI: 10.1177/11786388211065221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The world is now suffering from malnutrition and remains one of the leading causes of death for under 5 children. Children from developing countries, including Ethiopia also suffer from undernutrition due to suboptimal breastfeeding practice. Therefore, the aim of this study was to assess the EIBF practices and determinants among children aged less than 24 months in West Belessa district, Northwest Ethiopia, 2019. METHODS A community-based cross-sectional study was conducted from January 2 to February 28, 2019 in the West Belessa district. A total of 569 mother-children pairs were participated in the study. Study particnapants were selected by using simple random sampling technique. The data were collected by an interviewer-administered structured questionnaire. Data were entered and analyzed by using Epi-Info version 7 and SPPS version 20, respectively. Bi-variable and Multivariable logistic regression analysis were done. Odds ratio with 95% confidence was done to determine the level of significance value less than .05 considered as significant with the outcome variable. RESULT The prevalence of early initiation of breastfeeding (EIBF) was found to be 77.7 % (95%CI, 74.3-81.0). Age of the mother (AOR = 2.76, 95%CI [1.21, 6.27]), antenatal care (ANC) (AOR = 3.79, 95%CI [2.58, 9.94]), and number of antenatal care visit (AOR = 1.85, 95%CI [1.03, 3.85]) were significantly associated with early initiation of breastfeeding. CONCLUSION AND RECOMMENDATION In this study, more than three fourth of children were received early initiation of breastfeeding within 1 hour after delivery. Age of the mother, antenatal, and number of antenatal care were associated with EIBF. Therefore, during this contact period, improve antenatal services by increasing accessibility and providing counseling is important to improve EIBF utilization.
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Affiliation(s)
- Desalew Degu Ayalew
- Department of Human Nutrition,
Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Belayneh Ayanaw Kassie
- Department of Midwifery, College of
Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition,
Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and
Biostatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Aysheshim Kassahun Belew
- Department of Human Nutrition,
Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Reyes SM, Patra B, Elliott MJ. The Impact of Homogenization on Donor Human Milk and Human Milk-Based Fortifiers and Implications for Preterm Infant Health. Curr Dev Nutr 2022; 6:nzab147. [PMID: 35059551 PMCID: PMC8764228 DOI: 10.1093/cdn/nzab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 12/30/2022] Open
Abstract
An exclusive human milk diet (EHMD) has been shown to reduce health complications of prematurity in infants born weighing ≤1250 g compared with cow milk-based diets. Accordingly, the number of available human milk (HM)-based nutritional products continues to increase. Newly available products, and those reportedly soon to enter the market, include homogenized donor HM and homogenized HM-based fortifiers. Existing literature demonstrating the benefits of an EHMD, however, is limited to non-homogenized HM-based products. Herein, we summarize existing evidence on the impact of homogenization on HM, with a particular focus on changes to the macromolecular structure of the milk fat globule and the subsequent impact on digestion kinetics. We use these published data to create a conceptual framework for the potential implications of homogenized HM-based nutritional products on preterm infant health. Importantly, we underscore that the safety and efficacy of homogenized HM-based products warrant investigation.
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Affiliation(s)
| | | | - Melinda J Elliott
- Prolacta Bioscience®, Duarte, CA, USA
- Pediatrix Medical Group of Maryland, Rockville, MD, USA
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12
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Amaje E, Gebremeskel F, Tufa G, Gelchu M, Wayessa ZJ. Colostrum Avoidance Practices and Its Associated Factors among Mothers of Children Aged Less Than 12 Months in Jinka Town, South Ethiopia, 2020. A Community Based Cross Sectional Study. Health Serv Res Manag Epidemiol 2022; 9:23333928221106056. [PMID: 35693462 PMCID: PMC9184999 DOI: 10.1177/23333928221106056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background Even though colostrum discarding hurts child health, little is known about the extent of the problem and its contributing factors in Southern Ethiopia. This study aimed to determine the prevalence of colostrum avoidance practices and associated factors among mothers of children aged less than 12 months in Jinka town, South Ethiopia. Methods A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2020. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer-administered and semi-structured questionnaires. The data was entered using EPI DATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, binary and multivariable logistic regression analysis were done. Adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9-12.5)]. Delayed initiation of breastfeeding [AOR = 9.08(95% CI 4.16-19.83)], lack of breastfeeding counseling [AOR = 2.33(95% CI 1.11-4.87)], home delivery of index child [AOR = 2.48 (95% CI 1.16-5.27)] and poor knowledge on breastfeeding [AOR = 4.55(95% CI 1.95-10.63)] were factors associated with colostrum avoidance practices. Conclusion Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of breastfeeding, lack of breastfeeding counseling, home delivery, and knowledge of breastfeeding practice were factors associated with colostrum avoidance practice.
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Affiliation(s)
- Elias Amaje
- School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Feleke Gebremeskel
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Tufa
- Department of Midwifery, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Miesa Gelchu
- School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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13
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Wang Y, Wang X, Long Q, Liu Y, Yin T, Sirota I, Ren F, Gu Z, Luo J. Reducing embryonic mtDNA copy number alters epigenetic profile of key hepatic lipolytic genes and causes abnormal lipid accumulation in adult mice. FEBS J 2021; 288:6828-6843. [PMID: 34258867 DOI: 10.1111/febs.16121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022]
Abstract
Adverse fetal environment, in particular a shortage or excess of nutrients, is associated with increased risks of metabolic diseases later in life. However, the molecular mechanisms underlying this developmental origin of adult diseases remain unclear. Here, we directly tested the role of mitochondrial stress in mediating fetal programming in mice by enzymatically depleting mtDNA in zygotes. mtDNA-targeted plasmid microinjection is used to reduce embryonic mtDNA copy number directly, followed by embryo transfer. Mice with reduced zygote mtDNA copy number were born morphologically normal and showed no accelerated body weight gain. However, at 5 months of age these mice showed markedly increased hepatic lipidosis and became glucose-intolerant. Hepatic mRNA and protein expressions of peroxisome proliferator-activated receptor α (Pparα), a key transcriptional regulator of lipid metabolism, were significantly decreased as a result of increased DNA methylation in its proximal regulatory region. These results indicate that perturbation of mitochondrial function around the periconceptional period causes hypermethylation and thus suppressed expression of PPARα in fetal liver, leading to impaired hepatic lipid metabolism. Our findings provide the first direct evidence that mitochondrial stress mediates epigenetic changes associated with fetal programming of adult diseases in a mammalian system.
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Affiliation(s)
- Yakun Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Xuan Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Qiaoming Long
- Cam-Su Mouse Genomic Resource Center, Soochow University, China
| | - Yuanwu Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Tao Yin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Inna Sirota
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Fazheng Ren
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Zhenglong Gu
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Junjie Luo
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, China
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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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15
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Ahmad SM, Bhat B, Bhat SA, Yaseen M, Mir S, Raza M, Iquebal MA, Shah RA, Ganai NA. SNPs in Mammary Gland Epithelial Cells Unraveling Potential Difference in Milk Production Between Jersey and Kashmiri Cattle Using RNA Sequencing. Front Genet 2021; 12:666015. [PMID: 34413874 PMCID: PMC8369411 DOI: 10.3389/fgene.2021.666015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Deep RNA sequencing experiment was employed to detect putative single nucleotide polymorphisms (SNP) in mammary epithelial cells between two diverse cattle breeds (Jersey and Kashmiri) to understand the variations in the coding regions that reflect differences in milk production traits. The low milk-producing Kashmiri cattle are being replaced by crossbreeding practices with Jersey cattle with the aim of improving milk production. However, crossbred animals are prone to infections and various other diseases resulting in unsustainable milk production. In this study, we tend to identify high-impact SNPs from Jersey and Kashmiri cows (utilizing RNA-Seq data) to delineate key pathways mediating milk production traits in both breeds. A total of 607 (442 SNPs and 169 INDELs) and 684 (464 SNPs and 220 INDELs) high-impact variants were found specific to Jersey and Kashmir cattle, respectively. Based on our results, we conclude that in Jersey cattle, genes with high-impact SNPs were enriched in nucleotide excision repair pathway, ABC transporter, and metabolic pathways like glycerolipid metabolism, pyrimidine metabolism, and amino acid synthesis (glycine, serine, and threonine). Whereas, in Kashmiri cattle, the most enriched pathways include endocytosis pathway, innate immunity pathway, antigen processing pathway, insulin resistance pathway, and signaling pathways like TGF beta and AMPK which could be a possible defense mechanism against mammary gland infections. A varied set of SNPs in both breeds, suggests a clear differentiation at the genomic level; further analysis of high-impact SNPs are required to delineate their effect on these pathways.
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Affiliation(s)
- Syed Mudasir Ahmad
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Basharat Bhat
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Shakil Ahmad Bhat
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Mifftha Yaseen
- Division of Food Science, Faculty of Horticulture, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Shabir Mir
- Division of Animal Genetics and Breeding, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Mustafa Raza
- Centre for Agricultural Bioinformatics (CABin), ICAR-Indian Agricultural Statistics Research Institute, New Delhi, India
| | - Mir Asif Iquebal
- Centre for Agricultural Bioinformatics (CABin), ICAR-Indian Agricultural Statistics Research Institute, New Delhi, India
| | - Riaz Ahmad Shah
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
| | - Nazir Ahmad Ganai
- Directorate Planning and Monitoring, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
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Raihana S, Alam A, Chad N, Huda TM, Dibley MJ. Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012-2017). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115976. [PMID: 34199564 PMCID: PMC8199672 DOI: 10.3390/ijerph18115976] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 11/24/2022]
Abstract
Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. Methods: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study sample comprised all women who had a live birth in the 24 months preceding the survey. ‘Delayed’ initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as “vaginal birth at a facility (VBF)”, “caesarean section birth (CSB) “, and “vaginal birth at home (VBH)”. We used respondent-level sampling weights to account for individual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. Results: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births; however, there was no direct association with each country’s national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from −28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. Discussion: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth.
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Affiliation(s)
- Shahreen Raihana
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
- Correspondence: or ; Tel.: +61-406-890-170
| | - Ashraful Alam
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Nina Chad
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Tanvir M. Huda
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Michael J. Dibley
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
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Dietary Patterns of Breastfeeding Mothers and Human Milk Composition: Data from the Italian MEDIDIET Study. Nutrients 2021; 13:nu13051722. [PMID: 34069630 PMCID: PMC8160768 DOI: 10.3390/nu13051722] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Several studies have reported associations between maternal diet in terms of single foods or nutrients and human milk compounds, while the overall role of maternal diet and related dietary patterns has rarely been investigated. (2) Methods: Between 2012 and 2014, we enrolled 300 healthy Italian mothers, who exclusively breastfed their infant. During a hospital visit at 6 weeks postpartum, a sample of freshly expressed foremilk was collected and information on maternal dietary habits in the postpartum period was obtained through an interviewer-administered food frequency questionnaire. We applied principal component factor analysis to selected nutrients in order to identify maternal dietary patterns, and assessed correlations in human milk macronutrients and fatty acids across levels of dietary patterns. (3) Results: Five dietary patterns were identified, named “Vitamins, minerals and fibre”, “Proteins and fatty acids with legs”, “Fatty acids with fins”, “Fatty acids with leaves”, “Starch and vegetable proteins”. These dietary patterns were correlated with some milk components, namely fatty acids, and in particular ω-3 and its subcomponents. (4) Conclusions: This study showed that overall maternal dietary habits during breastfeeding may influence human milk composition, suggesting the importance of adequate maternal nutrition during lactation not only for the mother herself but also to provide the infant with milk containing adequate amount and quality of nutrients for a balanced nutrition.
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Teshale AB, Tesema GA. Timely initiation of breastfeeding and associated factors among mothers having children less than two years of age in sub-Saharan Africa: A multilevel analysis using recent Demographic and Health Surveys data. PLoS One 2021; 16:e0248976. [PMID: 33755702 PMCID: PMC7987153 DOI: 10.1371/journal.pone.0248976] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the significant advantages of timely initiation of breastfeeding (TIBF), many countries particularly low- and middle-income countries have failed to initiate breastfeeding on time for their newborns. Optimal breastfeeding is one of the key components of the SDG that may help to achieve reduction of under-five mortality to 25 deaths per 1000 live births. OBJECTIVE To assess the pooled prevalence and associated factors of timely initiation of breastfeeding among mothers having children less than two years of age in sub-Saharan Africa. METHODS We used pooled data from the 35 sub-Saharan Africa (SSA) Demographic and Health Surveys (DHS). We used a total weighted sample of 101,815 women who ever breastfeed and who had living children under 2 years of age. We conducted the multilevel logistic regression and variables with p<0.05, in the multivariable analysis, were declared significantly associated with TIBF. RESULTS The pooled prevalence of TIBF in SSA was 58.3% [95%CI; 58.0-58.6%] with huge variation between countries, ranging from 24% in Chad to 86% in Burundi. Both individual and community level variables were associated with TIBF. Among individual-level factors; being older-aged mothers, having primary education, being from wealthier households, exposure to mass media, being multiparous, intended pregnancy, delivery at a health facility, vaginal delivery, single birth, and average size of the child at birth were associated with higher odds of TIBF. Of community-level factors, rural place of residence, higher community level of ANC utilization, and health facility delivery were associated with higher odds of TIBF. CONCLUSION In this study, the prevalence of TIBF in SSA was low. Both individual and community-level factors were associated with TIBF. The authors recommend interventions at both individual and community levels to increase ANC utilization as well as health facility delivery that are crucial for advertising optimal breastfeeding practices such as TIBF.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Human milk immunomodulatory proteins are related to development of infant body composition during the first year of lactation. Pediatr Res 2021; 89:911-921. [PMID: 32438370 DOI: 10.1038/s41390-020-0961-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND To investigate relationships between infant body composition (BC) and human milk (HM) immunomodulatory proteins (IMPs) during the first 12 months of lactation. METHODS BC of breastfeeding dyads (n = 20) was measured with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers) at 2, 5, 9, and/or 12 months post partum. Breastfeeding frequency, 24-h milk intake, and IMP concentrations (lactoferrin, lysozyme, secretory immunoglobulin A (sIgA)) were measured, and calculated daily intakes (CDIs) were determined. We used linear regression/mixed-effects models and adjusted results for multiple comparisons. RESULTS No associations were seen between maternal characteristics and IMP concentrations/CDIs or between IMP concentrations and infant BC. Lactoferrin CDI was negatively associated with infant fat-free mass index (P = 0.002); lysozyme CDI was positively associated with infant fat mass (P = 0.004) and fat mass index (P = 0.004) measured with ultrasound skinfolds. CONCLUSION In this small cohort of infants breastfed on demand during first year of life, we report differential associations of HM IMPs with infant BC, showing that in addition to their critical role in shaping infant immunity, lactoferrin, and lysozyme also influence development of infant BC, highlighting the importance of breastfeeding for 12 months and beyond. IMPACT HM IMPs (concentrations and, most importantly, daily intakes) time-dependently and differentially associate with development of infant lean mass and adiposity during first 12 months of lactation. There is no information on how intakes and concentrations of these components affect development of infant BC. HM contains IMPs-lactoferrin, lysozyme, and sIgA, which not only play a critical role in shaping infant's immunity, but also influence infant growth and development of BC, highlighting the importance of breastfeeding for 12 months and beyond and warranting careful consideration of the dose effects of supplemented formula.
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Duran MC, Bosire R, Beima-Sofie KM, Igonya EK, Aluisio AR, Gatuguta A, Mbori-Ngacha D, Farquhar C, Stewart GJ, Roxby AC. Women's Autonomy in Infant Feeding Decision-Making: A Qualitative Study in Nairobi, Kenya. Matern Child Health J 2021; 25:724-730. [PMID: 33544286 DOI: 10.1007/s10995-021-03119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is the optimal way to feed young infants. Guidelines recommend that women living with HIV on antiretroviral therapy should EBF for 6 months and continue breastfeeding for up to 24 months or longer. Parents may face social or logistical barriers creating challenges to EBF. OBJECTIVES To explore barriers, facilitators and community norms influencing EBF practices in Kenya. METHODS This qualitative research was nested within a longitudinal study of intensive maternal counseling to increase EBF among HIV-positive mothers. HIV-negative and HIV-positive mothers were recruited from four public clinics in Nairobi. Women participated in focus group discussions (FGDs) that explored beliefs about and experiences with infant feeding. Conventional content analysis was used to describe and compare barriers and facilitators influencing HIV-positive and HIV-negative women's EBF experiences. RESULTS We conducted 17 FGDs with 80 HIV-positive and 53 HIV-negative women between 2009 and 2012. Overall, women agreed that breastmilk is good for infants. However, early mixed feeding was a common cultural practice. HIV-positive women perceived that infant feeding methods and durations were their decision. In contrast, HIV-negative women reported less autonomy and more mixed feeding, citing peer pressure and lack of HIV transmission concerns. Autonomy in decision-making was facilitated by receiving EBF counseling and family support, especially from male partners. Low milk production was a barrier to EBF, regardless of HIV status, and perceived to represent poor maternal nutrition. CONCLUSIONS Despite challenges, counseling empowered women living with HIV to advocate for EBF with spouses and family.
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Affiliation(s)
- Miriana C Duran
- Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA.
| | - Rose Bosire
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kristin M Beima-Sofie
- Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA
| | - Emmy Kageha Igonya
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands.,African Population and Health Research Center, Nairobi, Kenya
| | - Adam R Aluisio
- Division of Global Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA
| | - Anne Gatuguta
- Global Health and Infection Department, Brighton and Sussex Medical School, Brighton, UK
| | | | - Carey Farquhar
- Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA.,Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Grace John Stewart
- Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
| | - Alison C Roxby
- Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
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21
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Łubiech K, Twarużek M. Lactobacillus Bacteria in Breast Milk. Nutrients 2020; 12:E3783. [PMID: 33321792 PMCID: PMC7764098 DOI: 10.3390/nu12123783] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 02/07/2023] Open
Abstract
Breast milk is an optimal food for infants and toddlers. The composition of breast milk adapts to the needs of the developing organism, satisfying nutritional needs at an early stage of growth and development. The results of research to date have shown that breast milk is the best food for a child, containing not only nutrients but also biologically active substances that aid in the optimal, proper growth and development of infants. Among the many components of breast milk, an important element is the probiotic microflora, including bacteria of the genus Lactobacillus spp. These organisms exert a multidirectional, health-promoting effect on the body of children who consume breast milk. The number of lactic acid bacteria, including Lactobacillus, colonizing the breast milk environment and their species diversity varies and depends on many factors, both maternal and environmental. Breast milk, as a recommended food for infants, is an important source of probiotic microflora. The aim of this study was to present the current understanding of probiotic bacteria of the genus Lactobacillus present in breast milk.
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Affiliation(s)
- Katarzyna Łubiech
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland;
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Pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town, South Ethiopia, 2018/19. PLoS One 2020; 15:e0240583. [PMID: 33048981 PMCID: PMC7553318 DOI: 10.1371/journal.pone.0240583] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 09/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background Pre-lacteal feeding is one of the major harmful practices being faced while feeding the newborns. Although it affects child health, little is known about the extent of the problem and its contributing factors in the study area. Therefore, this study aimed to figure the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town. Methods A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 430 mothers, having children less than 12 months of age, were selected by systematic sampling technique. The data were collected by using pretested and interviewer- administered structured questionnaires. The data were entered using epidata 4.2.1 and exported to SPSS version 23 for analysis. Adjusted odds ratios, 95% confidence intervals and p-values were reported. Results The prevalence of pre-lacteal feeding practice was 12.6% [95% CI (9.5–15.7)]. Having no maternal education [AOR = 4.82(95%CI 1.60–14.24)], colostrum avoidance [AOR = 4.09(95% CI 1.62–7.67)], lack of breast feeding counseling [AOR: = 2.51(95% CI 1.20–5.25)], home delivery [AOR = 3.34 (95% CI 1.52–7.33)], lack of knowledge about risks of pre-lacteal feeding [AOR = 2.86 (95% CI 1.30–6.29] and poor knowledge on breast feeding practices [AOR = 3.63(95% CI 1.62–8.11)] were factors associated with pre-lacteal feeding practices. Conclusion Pre-lacteal feeding practice among mothers of children aged less than 12 months in Jinka town was found to be higher than the national prevalence. Illiterate, colostrum avoidance, lack of breastfeeding counseling, home delivery, lack of knowledge on the risk of pre-lacteal feeding, and poor knowledge on breastfeeding practice were factors associated with pre-lacteal feeding practices.
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23
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Abdel-Rahman ME, El-Heneidy A, Benova L, Oakley L. Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey. Int Breastfeed J 2020; 15:41. [PMID: 32410678 PMCID: PMC7227029 DOI: 10.1186/s13006-020-00288-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/06/2020] [Indexed: 11/24/2022] Open
Abstract
Background In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan. Methods This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes. Results Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age. Conclusions Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions.
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Affiliation(s)
- Manar E Abdel-Rahman
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | - Asmaa El-Heneidy
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Laura Oakley
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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24
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Demmelmair H, Jiménez E, Collado MC, Salminen S, McGuire MK. Maternal and Perinatal Factors Associated with the Human Milk Microbiome. Curr Dev Nutr 2020; 4:nzaa027. [PMID: 32270132 PMCID: PMC7127925 DOI: 10.1093/cdn/nzaa027] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/12/2020] [Accepted: 02/26/2020] [Indexed: 12/13/2022] Open
Abstract
Microbes are present in human milk regardless of the mother's health. The origins of the milk microbiota likely include the mother's skin, infant's mouth, and transfer from the maternal gastrointestinal (GI) tract. Prominent bacterial taxa in human milk are Staphylococcus and Streptococcus, but many other genera are also found including anaerobic Lactobacillus, Bifidobacterium, and Bacteroides. The milk microbiome is highly variable and potentially influenced by geographic location, delivery mode, time postpartum, feeding mode, social networks, environment, maternal diet, and milk composition. Mastitis alters the milk microbiome, and the intake of Lactobacilli has shown potential for mastitis treatment and prevention. Although milk and infant fecal microbiomes are different, their variations appear to be related - suggesting that milk is an important contributor of early GI colonization. Nonetheless, nothing is known regarding whether the milk microbiome influences infant health. Further research and clinical interventions are needed to determine if changes in the microbiomes of human milk and infant formula/food impact health.
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Affiliation(s)
- Hans Demmelmair
- Dr. von Hauner Children´s Hospital, University of Munich Medical Center, Munich, Germany
| | - Esther Jiménez
- ProbiSearch SLU, Madrid, Spain
- Department of Nutrition, Food Science, and Technology, University Complutense, Madrid, Spain
| | - Maria Carmen Collado
- Institute of Agrochemistry and Food Technology, Spanish National Research Council, Valencia, Spain
- Functional Foods Forum, University of Turku, Turku, Finland
| | - Seppo Salminen
- Functional Foods Forum, University of Turku, Turku, Finland
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, USA
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Burge K, Bergner E, Gunasekaran A, Eckert J, Chaaban H. The Role of Glycosaminoglycans in Protection from Neonatal Necrotizing Enterocolitis: A Narrative Review. Nutrients 2020; 12:nu12020546. [PMID: 32093194 PMCID: PMC7071410 DOI: 10.3390/nu12020546] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/14/2020] [Accepted: 02/16/2020] [Indexed: 12/22/2022] Open
Abstract
Necrotizing enterocolitis, a potentially fatal intestinal inflammatory disorder affecting primarily premature infants, is a significant cause of morbidity and mortality in neonates. While the etiology of the disease is, as yet, unknown, a number of risk factors for the development of necrotizing enterocolitis have been identified. One such risk factor, formula feeding, has been shown to contribute to both increased incidence and severity of the disease. The protective influences afforded by breastfeeding are likely attributable to the unique composition of human milk, an extremely potent, biologically active fluid. This review brings together knowledge on the pathogenesis of necrotizing enterocolitis and current thinking on the instrumental role of one of the more prominent classes of bioactive components in human breast milk, glycosaminoglycans.
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MESH Headings
- Breast Feeding
- Enterocolitis, Necrotizing/etiology
- Enterocolitis, Necrotizing/pathology
- Enterocolitis, Necrotizing/prevention & control
- Female
- Glycosaminoglycans/pharmacology
- Humans
- Infant Formula/adverse effects
- Infant, Newborn
- Infant, Premature, Diseases/etiology
- Infant, Premature, Diseases/pathology
- Infant, Premature, Diseases/prevention & control
- Male
- Milk, Human/chemistry
- Protective Agents/pharmacology
- Risk Factors
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Priputnevich T, Isaeva E, Muravieva V, Gordeev A, Zubkov V, Timofeeva L, Mesyan M, Shubina J, Makarov V, Yudin S. Gut microbiota of healthy newborns: new diagnostic technologies — new outlook on the development process. ACTA ACUST UNITED AC 2019. [DOI: 10.24075/brsmu.2019.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Currently, there are no criteria allowing to adequately assess composition and volume of the newborns' gut microbiota, which prevents early detection of the pathological processes and appropriate intervention. This study aimed to apply the methods of culturomics, proteomics and molecular genetic technologies to investigate the development of gut microbiota in healthy newborns delivered in the city of Moscow both vaginally and through a cesarean section. We examined 66 children, 33 of them delivered vaginally and 33 by cesarean section. The luminal bacterial flora samples were collected on the 1st, 7th and 30th days of life. There were 136 species of microorganisms belonging to 40 genera identified. We established that cesarean section slows down normal development of the gut microflora: through the follow-up period (1 month of life), gut microbiocenosis in such children did not yield the results on par with those registered in children born vaginally. Bifidobacteria were significantly more common in the vaginal delivery group: 84% of 109–1012 CFU/g versus 33% of 105–1012 CFU/g in the cesarean section group. At the same time, the former group had significantly less clostridia (33.3% and 65.4%, respectively) and lactose-negative Escherichia coli strains (2.4 and 19.4%, respectively) than the latter group.
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Affiliation(s)
- T.V. Priputnevich
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
| | - E.L. Isaeva
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
| | - V.V. Muravieva
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
| | - A.B. Gordeev
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
| | - V.V. Zubkov
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
| | - L.A. Timofeeva
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow
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27
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The Impact of Lactoferrin on the Growth of Intestinal Inhabitant Bacteria. Int J Mol Sci 2019; 20:ijms20194707. [PMID: 31547574 PMCID: PMC6801499 DOI: 10.3390/ijms20194707] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
Lactoferrin (Lf) is an iron-binding milk glycoprotein that promotes the growth of selected probiotic strains. The effect of Lf on the growth and diversification of intestinal microbiota may have an impact on several issues, including (i) strengthening the permeability of the epithelial cell monolayer, (ii) favoring the microbial antagonism that discourages the colonization and proliferation of enteric pathogens, (iii) enhancing the growth and maturation of cell-monolayer components and gut nerve fibers, and (iv) providing signals to balance the anti- and pro-inflammatory responses resulting in gut homeostasis. Given the beneficial role of probiotics, this contribution aims to review the current properties of bovine and human Lf and their derivatives in in vitro probiotic growth and Lf interplay with microbiota described in the piglet model. By using Lf as a component in pharmacological products, we may enable novel strategies that promote probiotic growth while conferring antimicrobial activity against multidrug-resistant microorganisms that cause life-threatening diseases, especially in neonates.
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Bhandari S, Thorne-Lyman AL, Shrestha B, Neupane S, Nonyane BAS, Manohar S, Klemm RDW, West KP. Determinants of infant breastfeeding practices in Nepal: a national study. Int Breastfeed J 2019; 14:14. [PMID: 30988689 PMCID: PMC6448244 DOI: 10.1186/s13006-019-0208-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background Optimal breastfeeding practices, reflected by early initiation and feeding of colostrum, avoidance of prelacteal feeds, and continued exclusivity or predominance of breastfeeding, are critical for assuring proper infant nutrition, growth and development. Methods We used data from a nationally representative survey in 21 district sites across the Mountains, Hills and Terai (southern plains) of Nepal in 2013. Determinants of early initiation of breastfeeding, feeding of colostrum, prelacteal feeding and predominant breastfeeding were explored in 1015 infants < 12 months of age. Prelacteal feeds were defined as food/drink other than breast milk given to newborns in first 3 days. Predominant breastfeeding was defined as a child < 6 months of age is mainly breastfed, not fed solid/semi-solid foods, infant formula or non-human milk, in the past 7 days. Adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated, using log Poisson regression models with robust variance for clustering. Results The prevalence of breastfeeding within an hour of birth, colostrum feeding, prelacteal feeding and predominant breastfeeding was 41.8, 83.5, 32.7 and 57.2% respectively. Compared to infants not fed prelacteal feeds, infants given prelacteal feeds were 51% less likely to be breastfed within the first hour of birth (APR 0.49; 95% CI 0.36, 0.66) and 55% less likely to be predominantly breastfed (APR 0.45; 95% CI 0.32, 0.62). Infants reported to have received colostrum were more likely to have begun breastfeeding within an hour of birth (APR 1.26; 95% CI 1.04, 1.54) compared to those who did not receive colostrum. Infants born to mothers ≥ 20 years of age were less likely than adolescent mothers to initiate breastfeeding within 1 hour of birth. Infants in the Terai were 10% less likely to have received colostrum (APR 0.90; 95% CI 0.83, 0.97) and 2.72 times more likely to have received prelacteal feeds (APR 2.72; 95% CI 1.67, 4.45) than those in the Mountains. Conclusions Most infants in Nepal receive colostrum but less than half initiate breastfeeding within an hour of birth and one-third are fed prelacteal feeds, which may negatively affect breastfeeding and health throughout early infancy. Electronic supplementary material The online version of this article (10.1186/s13006-019-0208-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shiva Bhandari
- PoSHAN Study Team, Lalitpur, Nepal.,2Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Andrew L Thorne-Lyman
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | | | - Bareng Aletta Sanny Nonyane
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Swetha Manohar
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Rolf D W Klemm
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.,4Helen Keller International, New York, NY USA
| | - Keith P West
- 3Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Tian M, Han J, Ye A, Liu W, Xu X, Yao Y, Li K, Kong Y, Wei F, Zhou W. Structural characterization and biological fate of lactoferrin-loaded liposomes during simulated infant digestion. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2019; 99:2677-2684. [PMID: 30338536 DOI: 10.1002/jsfa.9435] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 09/15/2018] [Accepted: 10/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Limited information is concerned on the structure changes of liposomal delivery system under infant conditions. Positively charged lactoferrin (LF)-loaded liposomes, with the entrapment efficiency (EE) of 52.3 ± 6.3%, were prepared from soybean-derived phospholipids using a thin-layer dispersion method. The structure changes and digestibility of LF-loaded liposomes under infant conditions, including simulated gastric fluid (SGF) and simulated small intestinal fluid (SIF), were characterized in terms of the average particle size, zeta potential, turbidity, fourier transform infrared, transmission electron microscopy, lipolysis and protein hydrolysis. RESULTS This study showed that the functional groups, favorable membrane structure and the EE of liposomes were slightly changed as a function of time when the liposome digested under SGF conditions. However, the intact bilayer structures were damaged and the EE of LF-loaded liposomes decreased to 28.5% after digestion in infant SIF. CONCLUSION These results suggested that liposomal membrane could prevent the gastric degradation and the structure of liposomes was not completely destroyed with a low concentration of pancreatin and bile salts under infant conditions. Present study provided information on the insight into the characteristics of liposomes during infant gastrointestinal digestion, which was useful for the development of microcapsule systems in infant diet. © 2018 Society of Chemical Industry.
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Affiliation(s)
- Mengmeng Tian
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Jianzhong Han
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Aiqian Ye
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Weilin Liu
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Xiankang Xu
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Yixin Yao
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Kexuan Li
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Youyu Kong
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Fuqiang Wei
- Department of Food Quality and Safety, School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Wei Zhou
- Agricultural Products Processing Research Institute, Chinese Academy of Tropical Agricultural Sciences, Zhanjiang, China
- Key Laboratory of Tropical Crop Products Processing of Ministry of Agriculture, Zhanjiang, China
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30
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Vass RA, Kemeny A, Dergez T, Ertl T, Reglodi D, Jungling A, Tamas A. Distribution of bioactive factors in human milk samples. Int Breastfeed J 2019; 14:9. [PMID: 30792750 PMCID: PMC6371541 DOI: 10.1186/s13006-019-0203-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background Breast milk provides nutrition for infants and also contains a variety of bioactive factors that influence the development of the newborn. Human milk is a complex biological fluid that can be separated into different layers (water phase and lipid phase with its component water and lipid fractions). It can affect the developing human body along the whole length of the gastrointestinal tract, and through the circulation, its factors may reach every organ. Methods In the present study, we analyzed milk samples collected monthly for 6 months from 16 mothers from the 4th week postpartum between 2014 and 2016 in Baranya County, Hungary. The 96 samples provided us information about the fluctuation of certain bioactive factors during the first 6 months of lactation. We investigated with Luminex technology the concentrations of several cytokines (CD40, Flt-3L), chemokines (MCP-1, RANTES, GRO, MIP-1ß, MDC, eotaxin, fractalkine), and epidermal growth factor (EGF). Paired t-tests and one-way ANOVA followed by Bonferroni post-hoc tests were used to compare the data. Results We detected the presence of each bioactive factor in every layer of the milk samples during the first 6 months of breastfeeding in widespread concentration ranges. In the case of GRO, MIP-1ß, MDC, Flt-3L, fractalkine, and eotaxin, the concentrations were constant during the first 6 months of lactation. The water phase of human milk contained higher factor concentrations compared to both fractions of the lipid phase for most factors (except eotaxin and MIP-1ß). The concentrations of CD40, EGF, MCP-1, and RANTES in the first 3 months were significantly different compared to the values detected between 4th and 6th months. In the water phase, the level of MCP-1 was significantly decreased, while all of the other factors increased during the 4th through 6th months. We found significantly higher EGF, GRO, and RANTES levels in the water fraction compared to the lipid fraction of the lipid phase. Conclusions The novel findings of this investigation were the presence of Flt-3L and MDC in all layers of breast milk, and nearly all bioactive factors in the lipid phase. Due to their widespread physiological effects these factors may have an essential role in organogenesis.
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Affiliation(s)
- Reka A Vass
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Agnes Kemeny
- 2Department of Pharmacology and Pharmacotherapy; Medical School, University of Pécs, Pécs, Hungary.,3Department of Medical Biology and Central Electron Microscope Laboratory, Medical School, University of Pécs, Pécs, Hungary
| | - Timea Dergez
- 4Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Ertl
- 5Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
| | - Dora Reglodi
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Adel Jungling
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Tamas
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
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Bhat SA, Ahmad SM, Ibeagha-Awemu EM, Bhat BA, Dar MA, Mumtaz PT, Shah RA, Ganai NA. Comparative transcriptome analysis of mammary epithelial cells at different stages of lactation reveals wide differences in gene expression and pathways regulating milk synthesis between Jersey and Kashmiri cattle. PLoS One 2019; 14:e0211773. [PMID: 30721247 PMCID: PMC6363229 DOI: 10.1371/journal.pone.0211773] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022] Open
Abstract
Jersey and Kashmiri cattle are important dairy breeds that contribute significantly to the total milk production of the Indian northern state of Jammu and Kashmir. The Kashmiri cattle germplasm has been extensively diluted through crossbreeding with Jersey cattle with the goal of enhancing its milk production ability. However, crossbred animals are prone to diseases resulting to unsustainable milk production. This study aimed to provide a comprehensive transcriptome profile of mammary gland epithelial cells at different stages of lactation and to find key differences in genes and pathways regulating milk traits between Jersey and Kashmiri cattle. Mammary epithelial cells (MEC) isolated from milk obtained from six lactating cows (three Jersey and three Kashmiri cattle) on day 15 (D15), D90 and D250 in milk, representing early, mid and late lactation, respectively were used. RNA isolated from MEC was subjected to next-generation RNA sequencing and bioinformatics processing. Casein and whey protein genes were found to be highly expressed throughout the lactation stages in both breeds. Largest differences in differentially expressed genes (DEG) were between D15 vs D90 (1,805 genes) in Kashmiri cattle and, D15 vs D250 (3,392 genes) in Jersey cattle. A total of 1,103, 1,356 and 1,397 genes were differentially expressed between Kashmiri and Jersey cattle on D15, D90 and D250, respectively. Antioxidant genes like RPLPO and RPS28 were highly expressed in Kashmiri cattle. Differentially expressed genes in both Kashmiri and Jersey were enriched for multicellular organismal process, receptor activity, catalytic activity, signal transducer activity, macromolecular complex and developmental process gene ontology terms. Whereas, biological regulation, endopeptidase activity and response to stimulus were enriched in Kashmiri cattle and, reproduction and immune system process were enriched in Jersey cattle. Most of the pathways responsible for regulation of milk production like JAK-STAT, p38 MAPK pathway, PI3 kinase pathway were enriched by DEG in Jersey cattle only. Although Kashmiri has poor milk production efficiency, the present study suggests possible physicochemical and antioxidant properties of Kashmiri cattle milk that needs to be further explored.
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Affiliation(s)
- Shakil Ahmad Bhat
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
| | - Syed Mudasir Ahmad
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
- * E-mail:
| | - Eveline M. Ibeagha-Awemu
- Agriculture and Agri-Food Canada, Sherbrooke Research and Development Centre, Sherbrooke, Quebec, Canada
| | - Basharat A. Bhat
- Department of Life Science, Shiv Nadar University, Greater Noida, Uttar Pradesh, India
| | - Mashooq Ahmad Dar
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
| | - Peerzada Tajamul Mumtaz
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
| | - Riaz A. Shah
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
| | - Nazir A. Ganai
- Division of Animal Genetics and Breeding, Faculty of Veterinary Sciences and Animal Husbandry, SKUAST-Kashmir, India
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Mukora-Mutseyekwa F, Gunguwo H, Mandigo RG, Mundagowa P. Predictors of early initiation of breastfeeding among Zimbabwean women: secondary analysis of ZDHS 2015. Matern Health Neonatol Perinatol 2019; 5:2. [PMID: 30675366 PMCID: PMC6332660 DOI: 10.1186/s40748-018-0097-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/19/2018] [Indexed: 02/03/2023] Open
Abstract
Background The World Health Organization recommends initiation of breastfeeding within the first hour of delivery. Early initiation is beneficial for both mother and baby. Previous Zimbabwe Demographic and Health Surveys (ZDHS) have shown reduction in early initiation of breast feeding from 68% (2005/06) to 58% (2015). This study sought to investigate factors associated with early initiation of breast feeding among women aged 15–49 years in Zimbabwe. Methodology Secondary analysis of ZDHS 2015 data was done to investigate the association between early initiation of breast feeding and maternal, provider and neonatal factors using multivariate logistic regression (n = 2192). Results The majority of the study sample (78%) reported having practised early initiation of breastfeeding during their most recent delivery (preceding 24 months).Children who were put on skin to skin contact (AOR = 1.51, 95% CI 1.13–2.02) and those delivered by skilled attendants (AOR = 4.36, 95% CI 1.07–17.77) had greater odds of early initiation compared to those who were not. Other factors associated with early initiation were multiparity (AOR 1.82 95% CI 1.33–2.49) and rural residence (AOR 2.10 95% 1.12–3.93). However, having an abnormal birth weight, i.e. low birth weight (AOR 0.60 95% CI 0.36–0.99) and macrosomia (AOR = 0.42, CI 0.22–0.79) as well as delivery by caesarean section (AOR 0.1195% CI 0.06–0.19) were associated with reduced odds of early initiation. Conclusion Early initiation of breast feeding in Zimbabwe is mainly associated with residing in the rural areas and multiparity. The 78% rate of early initiation of breastfeeding was contrary to the 58% reported in the ZDHS findings. Interventions targeting an improvement in early initiation of breastfeeding must aim at women who deliver by caesarean section, women with babies of abnormal birth weight, primi-parous women and women residing in rural areas.
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Affiliation(s)
- Fadzai Mukora-Mutseyekwa
- 1Lifestyle & Prevention Medicine Unit, Africa University Clinical Research Centre, Mutare, Zimbabwe.,JSI Research & Training Institute, MCHIP Project, Harare, Zimbabwe
| | - Hilary Gunguwo
- 3National University of Science & Technology, Bulawayo, Zimbabwe
| | | | - Paddington Mundagowa
- 1Lifestyle & Prevention Medicine Unit, Africa University Clinical Research Centre, Mutare, Zimbabwe
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Breast Milk Macronutrient Components in Prolonged Lactation. Nutrients 2018; 10:nu10121893. [PMID: 30513944 PMCID: PMC6316538 DOI: 10.3390/nu10121893] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 12/21/2022] Open
Abstract
Human milk (HM) is the first dietary exposure in infancy and the best nutritional option for growth and healthy development of the newborn and infant. The concentrations of macronutrients, namely proteins, carbohydrates and lipids, change during lactation stages. HM has been studied extensively in the first 6 months of lactation, but there are limited data regarding milk composition beyond 1 or 2 years postpartum. The aim of our study was to describe longitudinal changes in HM macronutrient concentrations during the prolonged lactation of healthy mothers from the 1st to the 48th month. For the macronutrient content of milk of mothers breastfeeding for longer than 18 months, fat and protein increased and carbohydrates decreased significantly, compared with milk expressed by women breastfeeding up to 12 months. Moreover, the concentration of fat, protein and carbohydrates in HM over 2 years of lactation from the 24th to the 48th month remained at a stable level. However, analyzed macronutrients were positively (carbohydrate, r = 0.51) or negatively (fat, r = -0.36 and protein, r = -0.58) correlated with the amount of feeding. Our results create a greater potential for understanding the nutritional contribution of HM over 2 years of lactation and showed that the source of calories in breast milk for older children is mainly fat, while carbohydrates play a greater role in infant nutrition in the early stage. The observed changes of macronutrient concentrations from the 1st to the 48th month of lactation are probably related to the adaptation of milk composition to the increased energy demand of the intensively growing child.
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34
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Boyer K. Breastmilk as Agentic Matter and the Distributed Agencies of Infant Feeding. STUDIES IN THE MATERNAL 2018. [DOI: 10.16995/sim.257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Vaidya H, Cheema SK. Breastmilk with a high omega-6 to omega-3 fatty acid ratio induced cellular events similar to insulin resistance and obesity in 3T3-L1 adipocytes. Pediatr Obes 2018; 13:285-291. [PMID: 28335075 DOI: 10.1111/ijpo.12215] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 01/28/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND An imbalance of omega (n)-3 and n-6 polyunsaturated fatty acids (PUFA) during critical periods of development may have adverse effects on the health of the newborn in later life. OBJECTIVES We hypothesized that breastmilk with higher n-6 to n-3 PUFA ratio will have higher inflammatory cytokines and initiate cellular events similar to insulin resistance and obesity. METHODS Breastmilk was collected from healthy women who gave natural birth at full term. Breastmilk fatty acids were measured using gas chromatography; samples were pooled based on the n-6 to n-3 PUFA ratio (high, medium and low), and soluble cytokines were measured. Pooled samples were used to treat 3T3-L1 cells; mRNA expression of diacylglycerol acyltransferase2, stearoyl-CoA desaturase-1, leptin and RPLPO was measured. RESULTS Breastmilk with a higher ratio of n-6 to n-3 PUFA showed higher pro-inflammatory cytokines; there was a direct correlation between n-6 PUFA and pro-inflammatory cytokines. Breastmilk with a higher ratio of n-6 to n-3 PUFA increased the expression of genes involved in lipogenesis. CONCLUSIONS Pro-inflammatory cytokines in breastmilk are associated with higher levels of n-6 PUFA in breastmilk and has the capacity to alter adipose tissue metabolism to likely predispose the newborn to a higher risk of obesity in later life.
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Affiliation(s)
- H Vaidya
- Department of Biochemistry, Memorial University, St. John's, NL, Canada
| | - S K Cheema
- Department of Biochemistry, Memorial University, St. John's, NL, Canada
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36
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Khan SM, Speizer IS, Singh K, Angeles G, Twum-Danso NA, Barker P. Does postnatal care have a role in improving newborn feeding? A study in 15 sub-Saharan African countries. J Glob Health 2018; 7:020506. [PMID: 29423183 PMCID: PMC5785869 DOI: 10.7189/jogh.07.020506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Breastfeeding is known as a key intervention to improve newborn health and survival while prelacteal feeds (liquids other than breastmilk within 3 days of birth) represents a departure from optimal feeding practices. Recent programmatic guidelines from the WHO and UNICEF outline the need to improve newborn feeding and points to postnatal care (PNC) as a potential mechanism to do so. This study examines if PNC and type of PNC provider are associated with key newborn feeding practices: breastfeeding within 1 day and prelacteal feeds. Methods We use data from the Demographic and Health Surveys for 15 sub-Saharan African countries to estimate 4 separate pooled, multilevel, logistic regression models to predict the newborn feeding outcomes. Findings PNC is significantly associated with increased breastfeeding within 1day (OR = 1.35, P < 0.001) but is not associated with PLFs (OR = 1.04, P = 0.195). PNC provided by nurses, midwives and untrained health workers is also associated with higher odds of breastfeeding within 1 day of birth (OR = 1.39, P < 0.001, (OR = 1.95, P < 0.001) while PNC provided by untrained health workers is associated with increased odds of PLFs (OR = 1.20, P = 0.017). Conclusions PNC delivered through customary care may be an effective strategy to improve the breastfeeding within 1 day but not to discourage PLFs. Further analysis should be done to examine how these variables operate at the country level to produce finer programmatic insight.
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Affiliation(s)
- Shane M Khan
- Data and Analytics, Division of Data, Research and Policy, United Nations Children's Fund (UNICEF), New York, New York, USA
| | - Ilene S Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kavita Singh
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gustavo Angeles
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nana Ay Twum-Danso
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Pierre Barker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Velasquez DE, Parashar U, Jiang B. Decreased performance of live attenuated, oral rotavirus vaccines in low-income settings: causes and contributing factors. Expert Rev Vaccines 2017; 17:145-161. [PMID: 29252042 DOI: 10.1080/14760584.2018.1418665] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Numerous studies have shown that the oral rotavirus vaccines are less effective in infants born in low income countries compared to those born in developed countries. Identifying the specific factors in developing countries that decrease and/or compromise the protection that rotavirus vaccines offer, could lead to a path for designing new strategies for the vaccines' improvement. AREAS COVERED We accessed PubMed to identify rotavirus vaccine performance studies (i.e., efficacy, effectiveness and immunogenicity) and correlated performance with several risk factors. Here, we review the factors that might contribute to the low vaccine efficacy, including passive transfer of maternal rotavirus antibodies, rotavirus seasonality, oral polio vaccine (OPV) administered concurrently, microbiome composition and concomitant enteric pathogens, malnutrition, environmental enteropathy, HIV, and histo blood group antigens. EXPERT COMMENTARY We highlight two major factors that compromise rotavirus vaccines' efficacy: the passive transfer of rotavirus IgG antibodies to infants and the co-administration of rotavirus vaccines with OPV. We also identify other potential risk factors that require further research because the data about their interference with the efficacy of rotavirus vaccines are inconclusive and at times conflicting.
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Affiliation(s)
- Daniel E Velasquez
- a Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Umesh Parashar
- a Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Baoming Jiang
- a Division of Viral Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
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Jama NA, Wilford A, Masango Z, Haskins L, Coutsoudis A, Spies L, Horwood C. Enablers and barriers to success among mothers planning to exclusively breastfeed for six months: a qualitative prospective cohort study in KwaZulu-Natal, South Africa. Int Breastfeed J 2017; 12:43. [PMID: 29026431 PMCID: PMC5627494 DOI: 10.1186/s13006-017-0135-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) for the first six months of life is the most important determinant of child health and development, and is the recommended feeding practice for all mothers. However, EBF rates remain low in South Africa. This study aimed to prospectively explore enablers or barriers to success among mothers who planned to exclusively breastfeed their infants for the first six months of life, in KwaZulu-Natal, South Africa. METHODS A qualitative, longitudinal cohort design was adopted. Women were recruited during pregnancy from the catchment area of two hospitals (one urban and one rural) and purposively sampled to include working women, teenagers, and HIV positive pregnant women. This analysis relates to 22 women, from 30 women recruited, who planned antenatally to exclusively breastfeed for six months. These mothers were interviewed monthly for six months postpartum. Infant feeding practices were explored at each visit using in-depth interviews and 24 h feeding recall assessment. Framework analysis was conducted for qualitative data, and quantitative data analyzed using descriptive statistics. RESULTS A total of 125 interviews were conducted between November 2015 and October 2016. Among 22 mothers who planned to exclusively breastfeed for six months, 17 reported adding other food or fluids before six months, and five reported exclusively breastfeeding successfully for the first six months. Key themes showed that all mothers relied strongly on health workers' infant feeding advice and support. All mothers experienced challenges regardless of whether they succeeded in EBF, including inappropriate advice from health workers, maternal-baby issues, pressure from family members and returning to school and work. However, those who were successful at EBF for six months reported that high breastfeeding self-efficacy, HIV status and cultural meaning attached to breastfeeding were underlying factors for success. CONCLUSION Health workers are key players in providing infant feeding information and support, yet some health workers give mothers infant feeding advice that is not supportive of EBF. Strategies to improve health workers' competency in infant feeding counselling are needed to better prepare pregnant women to overcome common breastfeeding challenges and build mothers' confidence and self-efficacy, thus increasing EBF rates.
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Affiliation(s)
| | - Aurene Wilford
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Zandile Masango
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Lyn Haskins
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Coutsoudis
- Department of Pediatrics & Child Health School of Clinical Medicine Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Lenore Spies
- Department of Health, Pietermaritzburg, KwaZulu-Natal South Africa
| | - Christiane Horwood
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
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Immune Components in Human Milk Are Associated with Early Infant Immunological Health Outcomes: A Prospective Three-Country Analysis. Nutrients 2017; 9:nu9060532. [PMID: 28538696 PMCID: PMC5490511 DOI: 10.3390/nu9060532] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 01/22/2023] Open
Abstract
The role of breastfeeding in improving allergy outcomes in early childhood is still unclear. Evidence suggests that immune mediators in human milk (HM) play a critical role in infant immune maturation as well as protection against atopy/allergy development. We investigated relationships between levels of immune mediators in colostrum and mature milk and infant outcomes in the first year of life. In a large prospective study of 398 pregnant/lactating women in the United Kingdom, Russia and Italy, colostrum and mature human milk (HM) samples were analysed for immune active molecules. Statistical analyses used models adjusting for the site of collection, colostrum collection time, parity and maternal atopic status. Preliminary univariate analysis showed detectable interleukin (IL) 2 and IL13 in HM to be associated with less eczema. This finding was further confirmed in multivariate analysis, with detectable HM IL13 showing protective effect OR 0.18 (95% CI 0.04-0.92). In contrast, a higher risk of eczema was associated with higher HM concentrations of transforming growth factor β (TGFβ) 2 OR 1.04 (95% CI 1.01-1.06) per ng/mL. Parental-reported food allergy was reported less often when IL13 was detectable in colostrum OR 0.10 (95% CI 0.01-0.83). HM hepatocyte growth factor (HGF) was protective for common cold incidence at 12 months OR 0.19 (95% CI 0.04-0.92) per ng/mL. Data from this study suggests that differences in the individual immune composition of HM may have an influence on early life infant health outcomes. Increased TGFβ2 levels in HM are associated with a higher incidence of reported eczema, with detectable IL13 in colostrum showing protective effects for food allergy and sensitization. HGF shows some protective effect on common cold incidence at one year of age. Future studies should be focused on maternal genotype, human milk microbiome and diet influence on human milk immune composition and both short- and long-term health outcomes in the infant.
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Takahashi K, Ganchimeg T, Ota E, Vogel JP, Souza JP, Laopaiboon M, Castro CP, Jayaratne K, Ortiz-Panozo E, Lumbiganon P, Mori R. Prevalence of early initiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the WHO Global Survey. Sci Rep 2017; 7:44868. [PMID: 28322265 PMCID: PMC5359598 DOI: 10.1038/srep44868] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 02/15/2017] [Indexed: 11/09/2022] Open
Abstract
Early initiation of breastfeeding (EIBF) within 1 hour of birth can decrease neonatal death. However, the prevalence of EIBF is approximately 50% in many developing countries, and data remains unavailable for some countries. We conducted a secondary analysis using the WHO Global Survey on Maternal and Perinatal Health to identify factors hampering EIBF. We described the coverage of EIBF among 373 health facilities for singleton neonates for whom breastfeeding was initiated after birth. Maternal and facility characteristics of EIBF were compared to those of breastfeeding >1 hour after birth, and multiple logistic regression analysis was performed. In total, 244,569 singleton live births without severe adverse outcomes were analysed. The EIBF prevalence varied widely among countries and ranged from 17.7% to 98.4% (average, 57.6%). There was less intra-country variation for BFI <24 hours. After adjustment, EIBF was significantly lower among women with complications during pregnancy and caesarean delivery. Globally, EIBF varied considerably across countries. Maternal complications during pregnancy, caesarean delivery and absence of postnatal/neonatal care guidelines at hospitals may affect EIBF. Our findings suggest that to better promote EIBF, special support for breastfeeding promotion is needed for women with complications during pregnancy and those who deliver by caesarean section.
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Affiliation(s)
- Kenzo Takahashi
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Togoobaatar Ganchimeg
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
- Department of Global Health Nursing, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
| | - Joshua P. Vogel
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland
| | - João Paulo Souza
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland
| | - Malinee Laopaiboon
- Faculty of Public Health, Department of Biostatistics & Demography, Khon Kaen University, 123 Moo 16 Mittapap Rd., Nai-Muang, Muang District, Khon Kaen 40002, Thailand
| | - Cynthia Pileggi Castro
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Brazil
| | - Kapila Jayaratne
- Family Health Bureau, Ministry of Health, 231 De Saram Place, Colombo 10, Sri Lanka
| | - Eduardo Ortiz-Panozo
- National Institute of Public Health, Center for Population Health Research, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, México
| | - Pisake Lumbiganon
- Department of Obstetrics & Gynaecology, Faculty of Medicine, Khon Kaen University, 123 Moo 16 Mittapap Rd., Nai-Muang, Muang District, Khon Kaen 40002, Thailand
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
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Abstract
Necrotizing enterocolitis (NEC) is a devastating disease in premature infants with high case fatality and significant morbidity among survivors. Immaturity of intestinal host defenses predisposes the premature infant gut to injury. An abnormal bacterial colonization pattern with a deficiency of commensal bacteria may lead to a further breakdown of these host defense mechanisms, predisposing the infant to NEC. Here, we review the role of the innate and adaptive immune system in the pathophysiology of NEC.
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MESH Headings
- Adaptive Immunity
- Enterocolitis, Necrotizing/immunology
- Enterocolitis, Necrotizing/microbiology
- Enterocolitis, Necrotizing/physiopathology
- Evidence-Based Medicine
- Humans
- Immunity, Innate
- Infant, Premature
- Infant, Premature, Diseases/immunology
- Infant, Premature, Diseases/microbiology
- Infant, Premature, Diseases/physiopathology
- Intestinal Mucosa/immunology
- Intestinal Mucosa/microbiology
- Intestinal Mucosa/physiopathology
- Intestines/blood supply
- Intestines/immunology
- Intestines/physiopathology
- Milk, Human/immunology
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Affiliation(s)
- Timothy L Denning
- Institute for Biomedical Sciences, Georgia State University, Atlanta, GA
| | - Amina M Bhatia
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Andrea F Kane
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Ravi M Patel
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Patricia W Denning
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
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42
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Abstract
OBJECTIVES Human milk oligosaccharides (HMOs) are reported to promote epithelial cell differentiation in vitro. The aim of the present study was to assess induction of epithelial cell differentiation by individual and combined administration of 3 HMOs. METHODS An in vitro epithelial model of the crypt-villus axis consisting of preconfluent HT-29, preconfluent Caco-2Bbe, and postconfluent Caco-2Bbe cells was used. Cultures were randomized to 17 treatments for 72 hours of incubation: low- and high-dose HMOs (3'sialyllactose [3'SL] at 0.2 and 1.0 g/L, 6'siallylactose [6'SL] at 0.4 and 1.0 g/L, and 2'fucosyllactose at 0.2 and 2.0 g/L), HMO combinations at both low and high doses, and controls (culture medium, 4 g/L pooled HMO, and lipopolysaccharide). RESULTS High doses of individual HMOs (P < 0.05), combined HMOs (P < 0.05), and pooled HMO decreased (P < 0.001) proliferation in preconfluent HT-29 cultures. Pooled means of individual low and high treatments with 3'SL and 6'SL, combinations of 2 or 3 high-dose HMOs, and total HMO significantly reduced (P < 0.05) proliferation in preconfluent Caco-2Bbe cells. HMOs increased differentiation in preconfluent HT-29 and Caco-2Bbe cells. 3'SL and 6'SL increased alkaline phosphatase activity but did not affect disaccharidase activity in postconfluent Caco-2Bbe cells. Apoptosis and necrosis were both decreased (P < 0.001) in postconfluent Caco-2Bbe cells treated with pooled HMO. CONCLUSIONS HMO treatments inhibited proliferation with some associated enhancement of epithelial differentiation. Effects of HMOs were additive but no specific combinations of HMOs were especially potent. These results suggest that commercially viable individual HMOs and specific combinations may promote intestinal epithelial cell maturation.
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43
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Gridneva Z, Kugananthan S, Hepworth AR, Tie WJ, Lai CT, Ward LC, Hartmann PE, Geddes DT. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants. Nutrients 2016; 9:nu9010015. [PMID: 28036041 PMCID: PMC5295059 DOI: 10.3390/nu9010015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/16/2016] [Accepted: 12/22/2016] [Indexed: 12/17/2022] Open
Abstract
Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.
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Affiliation(s)
- Zoya Gridneva
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Sambavi Kugananthan
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
- School of Anatomy, Physiology and Human Biology, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Anna R Hepworth
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Wan J Tie
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Ching T Lai
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Queensland 4072, Australia.
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Donna T Geddes
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
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44
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Holder pasteurization impacts the proteolysis, lipolysis and disintegration of human milk under in vitro dynamic term newborn digestion. Food Res Int 2016. [DOI: 10.1016/j.foodres.2015.11.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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45
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Palmer DJ. Timing of Introduction of Solids and Early-Onset Allergic Disease. CURRENT PEDIATRICS REPORTS 2016. [DOI: 10.1007/s40124-016-0106-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Dritsakou K, Liosis G, Valsami G, Polychronopoulos E, Skouroliakou M. The impact of maternal- and neonatal-associated factors on human milk's macronutrients and energy. J Matern Fetal Neonatal Med 2016; 30:1302-1308. [PMID: 27405688 DOI: 10.1080/14767058.2016.1212329] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To test the impact of specific maternal- and neonatal-associated factors on human milk's macronutrients and energy. METHODS This study was conducted with the use of a human milk analyzer (HMA, MIRIS, Uppsala, Sweden). Six hundred and thirty samples of raw milk and 95 samples of donor pasteurized milk were delivered from a total of 305 mothers. RESULTS A significant inverse correlation of fat, protein and energy content with gestational age and birth weight was established. Fat and energy were lower in colostrum, increased in transitional milk and decreased on the 30th day's mature milk compared to transitional. The rate of protein decline from colostrum to mature milk was lower in premature deliveries compared to that of full-terms, resulting in greater contents of protein in preterm mature milk. The upmost amounts of carbohydrates were found in mature milk of preterm deliveries. A positive correlation was found between maternal age and fat contents. In women with higher post-pregnancy BMI levels greater analogies of fat and energy were presented. In women suffering diet-controlled gestational diabetes (GD), lower protein and higher fat and energy levels were found. CONCLUSIONS Prematurity, maternal age, diet-controlled GD and high post-pregnancy BMI levels were found to impose statistical significant effect on milk's macronutrients and energy.
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Affiliation(s)
- Kalliopi Dritsakou
- a Department of Quality Control , Research and Continuing Education, Elena Venizelou Maternity Hospital , Athens , Greece
| | - Georgios Liosis
- b Human Donor Milk Bank, NICU, Elena Venizelou Maternity Hospital , Athens , Greece
| | - Georgia Valsami
- c School of Pharmacy, University of Athens , Athens , Greece
| | - Evangelos Polychronopoulos
- d Department of Science of Dietetics - Nutrition , Harokopeion University of Athens , Athens , Greece , and
| | - Maria Skouroliakou
- e Department of Science of Dietetics- Nutrition , Harokopeion University of Athens , Athens , Greece
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47
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Undernutrition and associated factors among children aged 6-59 months in East Belesa District, northwest Ethiopia: a community based cross-sectional study. BMC Public Health 2016; 16:506. [PMID: 27297078 PMCID: PMC4906918 DOI: 10.1186/s12889-016-3180-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/05/2016] [Indexed: 12/31/2022] Open
Abstract
Background Undernutrition remains the major public health concern in Ethiopia and continues as the underlying cause of child mortality. However, there is a scarcity of information on the magnitude and determinant factors of undernutrition. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors among children aged 6–59 months in East Belesa District, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from April to May, 2014. A multistage stratified sampling technique was used to select 633 study participants. A structured interviewer-administered questionnaire was used to collect data. In order to identify factors associated with undernutrition (stunting and wasting) a multivariate logistic regression analysis was employed. The Adjusted Odds Ratio (AOR) with a 95 % Confidence Interval (CI) was computed to show the strength of the association. In the multivariate analysis, variables with a p-value of <0.05 were considered as statistically significant. Results In this study, about 57.7 and 16 % of the children were stunted and wasted, respectively. The odds of stunting were higher in children born to mothers who gave their first birth before 15 years of age (AOR = 2.4; 95 % CI: 1.19, 5.09) and gave prelacteal feeding to their child (AOR = 1.83; 95 % CI: 1.28, 2.61). However, lower odds of stunting were observed among children aged 36–47 months (AOR = 0.41; 95 % CI: 0.22, 0.78) and had higher family monthly income, Et. Br. 750–1000, (AOR = 0.61; 95 % CI: 0.39, 0.92). Moreover, the odds of wasting were higher among children who received butter as prelacteal food (AOR = 2.32; 95 % CI:1.82, 5.31). Conclusion Child undernutrition is a critical public health problem in the study area. Advanced age of children (36–47 months) and higher family monthly income were inversely associated with stunting. However, higher odds of stunting were observed among children whose mothers delivered their first child before 15 years of age, and gave their children prelacteal feeding. Thus, delaying the first pregnancy and reducing prelacteal feeding is of a paramount significance in reducing the burden of undernutrition.
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48
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Abstract
To discuss the potential clinical benefits of lactoferrin in preterm and term infants, as well as in young children and to review information on the burden of neonatal sepsis. Current evidence on the mechanisms that explain the role of human milk in the neonatal and infant anti-infective responses will be briefly reviewed and preclinical research data on the potential mechanisms of action by which lactoferrin may impact infant gut health, gut immune development and functions, including the lactoferrin effects on the neonatal microbiome, will be examined. Finally, updated translational research on lactoferrin will be presented and discussed and the current evidence from prospective randomized controlled trials in neonates, infants, and toddlers will be analyzed. These randomized controlled trials demonstrate that lactoferrin has a clinically significant impact on feeding, the microbiome, and clinical outcomes in neonates and infants.
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Affiliation(s)
- Paolo Manzoni
- Neonatology and Neonatal Intensive Care Unit, S. Anna Hospital, AO Città della Salute e della Scienza, Torino, Italy; Charity and Scientific Foundation "Crescere insieme al S.Anna-ONLUS", Torino, Italy.
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49
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Donovan SM. The Role of Lactoferrin in Gastrointestinal and Immune Development and Function: A Preclinical Perspective. J Pediatr 2016; 173 Suppl:S16-28. [PMID: 27234407 DOI: 10.1016/j.jpeds.2016.02.072] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The early postnatal period is a critical time for gastrointestinal (GI) and immune development. Neonates fed mother's milk have more rapid GI and immune development than fed-formula infants. In addition, clinical and epidemiologic data provide strong evidence that breastfeeding reduces the incidence and/or severity of infectious diseases. Lactoferrin is a 77 kDa, iron-binding glycoprotein that is present at high concentration in human milk compared with bovine milk and infant formula. It is a multifunctional protein that mediates many of the physiological processes in which breastfed infants have advantages over their formula-fed peers, including promoting GI and immune development, protection from infections, and improved cognitive development. Feeding bovine lactoferrin or recombinant human lactoferrin was well tolerated and stimulated intestinal cell proliferation and increased villus length and crypt depth in piglets. Lactoferrin also influenced both systemic and GI immune development by stimulating a balanced T-helper-1/T-helper-2 cytokine immune response. Further, there was a tendency for immune cells to secrete more anti-inflammatory cytokines in an unstimulated state, while being primed for a robust pro-inflammatory response when presented with a bacterial trigger in piglets fed lactoferrin. These findings support clinical studies demonstrating benefits of dietary lactoferrin in the prevention of infections, late onset sepsis, and necrotizing enterocolitis.
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Affiliation(s)
- Sharon M Donovan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL.
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50
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Tariku A, Biks GA, Wassie MM, Gebeyehu A, Getie AA. Factors associated with prelacteal feeding in the rural population of northwest Ethiopia: a community cross-sectional study. Int Breastfeed J 2016; 11:14. [PMID: 27231482 PMCID: PMC4880979 DOI: 10.1186/s13006-016-0074-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Prelacteal feeding has continued as a deep-rooted nutritional malpractice in developing countries. Prelacteal feeding is a barrier for implementation of optimal breastfeeding practices, and increases the risk of neonatal illness and mortality. However, its determinants are not well studied, which are essential to design intervention. This study aimed to assess the prevalence and determinants of prelacteal feeding among mothers with children aged 6–24 months in the rural population of northwest Ethiopia. Methods A community based cross-sectional study was conducted in Dabat Health and Demographic Surveillance System site, Dabat district, northwest Ethiopia from May 01 to June 29, 2015. Eight hundred and twenty-two mother-child pairs were included in the study. A pretested and structured questionnaire was used to collect data. Multivariable logistic regression analysis was carried out to identify the determinants of prelacteal feeding. Results In this community, about 26.8 % of children were given prelacteal feeds. The odds of prelacteal feeding was higher among mothers with a poor knowledge of Infant and Young Child Feeding (IYCF) (Adjusted Odds Ratio [AOR] = 3.82; 95 % Confidence Interval [CI] 2.42, 6.04), who gave birth at home (AOR = 3.74; 95 % CI 2.12, 6.60), and who were in the lowest wealth status (AOR = 2.11; 95 % CI 1.35, 3.31). Conclusions Prelacteal feeding was common in the study area, and significantly associated with a poor household wealth status, poor maternal knowledge of IYCF, and giving birth at home. Thus, emphasis should be given to improve mothers IYCF knowledge and utilization of institutional delivery. Moreover, special attention should be given to mothers with poor socio-economic status to reduce the practice of prelacteal feeding.
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Affiliation(s)
- Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Service Management and Heath Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Mesele Wassie
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebaw Gebeyehu
- Department of Reproductive and Child Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azeb Atinafu Getie
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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