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Edwards AC, Jacobson SW, Senekal M, Dodge NC, Molteno CD, Meintjes EM, Jacobson JL, Carter RC. Fetal Alcohol-Related Postnatal Growth Restriction Is Independent of Infant Feeding Practices and Postnatal Alcohol Exposure in a Prospective South African Birth Cohort. Nutrients 2023; 15:2018. [PMID: 37432143 DOI: 10.3390/nu15092018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 07/12/2023] Open
Abstract
Prenatal alcohol exposure (PAE) causes growth restriction that worsens in the first year of life. However, the roles of postnatal nutrition in fetal alcohol growth restriction and the impact of postnatal alcohol exposure via breastmilk on growth remain unknown. We aimed to compare infant feeding practices during the first 6.5 months of life between heavy drinkers and abstainers/light drinkers, to examine whether these practices play confounding roles in fetal alcohol growth restriction, and to determine the impact of postnatal alcohol exposure via breastmilk on growth. Eighty-seven heavy-drinking pregnant women and 71 abstainers/light drinkers (controls) were recruited prenatally from antenatal clinics in Cape Town, South Africa. Demographic background and alcohol, cigarette, marijuana, and methamphetamine use during pregnancy were assessed pre- and postnatally. Infant feeding practices were assessed at 6.5 months postpartum using the USDA Infant Feeding Questionnaire. Infant weight, length, and head circumference were measured at 2 weeks, 6.5 and 12 months, and 5 years. Neither prenatal nor postnatal alcohol consumption was related to the duration of breastfeeding, exclusive breastfeeding, exclusive formula, or mixed feeding. Complementary feeding practices were remarkably similar between exposure groups. PAE was related to all postnatal anthropometry measures at all age points, independent of infant feeding practices. Postnatal alcohol exposure via breastmilk was unrelated to any anthropometry outcome after control for PAE. In conclusion, fetal alcohol-related postnatal growth restriction was not attributable to differences in postnatal infant feeding practices or postnatal alcohol exposure and is thus likely a direct teratogenic effect of PAE.
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Affiliation(s)
- Alexia C Edwards
- Departments of Emergency Medicine and Pediatrics, Institute of Human Nutrition, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Adult & Pediatric Intensive Care Units, State University of New York Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Marjanne Senekal
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Neil C Dodge
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Christopher D Molteno
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Ernesta M Meintjes
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Joseph L Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - R Colin Carter
- Departments of Emergency Medicine and Pediatrics, Institute of Human Nutrition, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
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2
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Perez RF, Conner KE, Erickson MA, Nabatanzi M, Huffman KJ. Alcohol and lactation: Developmental deficits in a mouse model. Front Neurosci 2023; 17:1147274. [PMID: 36992847 PMCID: PMC10040541 DOI: 10.3389/fnins.2023.1147274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/21/2023] [Indexed: 03/14/2023] Open
Abstract
It is well documented that prenatal ethanol exposure via maternal consumption of alcohol during pregnancy alters brain and behavioral development in offspring. Thus, the Centers for Disease Control (CDC) advises against maternal alcohol consumption during pregnancy. However, little emphasis has been placed on educating new parents about alcohol consumption while breastfeeding. This is partly due to a paucity of research on lactational ethanol exposure (LEE) effects in children; although, it has been shown that infants exposed to ethanol via breast milk frequently present with reduced body mass, low verbal IQ scores, and altered sleeping patterns. As approximately 36% of breastfeeding mothers in the US consume alcohol, continued research in this area is critical. Our study employed a novel murine LEE model, where offspring were exposed to ethanol via nursing from postnatal day (P) 6 through P20, a period correlated with infancy in humans. Compared to controls, LEE mice had reduced body weights and neocortical lengths at P20 and P30. Brain weights were also reduced in both ages in males, and at P20 for females, however, female brain weights recovered to control levels by P30. We investigated neocortical features and found that frontal cortex thickness was reduced in LEE males compared to controls. Analyses of dendritic spines in the prelimbic subdivision of medial prefrontal cortex revealed a trend of reduced densities in LEE mice. Results of behavioral tests suggest that LEE mice engage in higher risk-taking behavior, show abnormal stress regulation, and exhibit increased hyperactivity. In summary, our data describe potential adverse brain and behavioral developmental outcomes due to LEE. Thus, women should be advised to refrain from consuming alcohol during breastfeeding until additional research can better guide recommendations of safe maternal practices in early infancy.
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Affiliation(s)
- Roberto F. Perez
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Kathleen E. Conner
- Interdepartmental Neuroscience Program, University of California, Riverside, Riverside, CA, United States
| | - Michael A. Erickson
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Mirembe Nabatanzi
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Kelly J. Huffman
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
- Interdepartmental Neuroscience Program, University of California, Riverside, Riverside, CA, United States
- *Correspondence: Kelly J. Huffman,
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Tella intake among pregnant and lactating mothers: may it affect child growth? J Nutr Sci 2022; 11:e42. [PMID: 35720175 PMCID: PMC9171593 DOI: 10.1017/jns.2022.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
Alcohol abuse among women is a public health importance that may impair prenatal and postnatal growth. Tella is among the most common homemade alcoholic beverages in rural Ethiopia, but little is known about the magnitude of tella intake during pregnancy and lactation or its effects on child growth. The present study investigated associations between maternal tella intake and the growth of their children. A cross-sectional mixed-methods study was conducted with mothers (n 228) and their 12–36-month-old children and with key informants (n 12). Tella intake during most recent pregnancy and lactation was estimated retrospectively by glasses per drinking event and frequency of events. Nearly 80 % of mothers had consumed some amount of tella during their most recent pregnancy and lactation. Furthermore, 72 % of children had tasted or drunk tella at some time during their life. Stunting was 42 % and was significantly associated with maternal tella consumption at least every other day during pregnancy (adjusted odds ratio (AOR) 4⋅97, 95 % confidence interval (CI) 2⋅20, 11⋅25), male sex (AOR 2⋅31, 95 % CI 1⋅27, 4⋅19), two or more under-5-year-old children in the household (AOR 3⋅52, 95 % CI 1⋅49, 8⋅33) and family size >5 (AOR 1⋅84, 95 % CI 1⋅01, 3⋅36). Underweight was 24⋅6 % and was associated with the child drinking tella with their mother (AOR 4⋅23, 95 % CI 1⋅99, 8⋅97), being male (AOR 3⋅73, 95 % CI 1⋅73, 7⋅94), having ≥3 diarrhoeal episodes in the last 3 months (AOR 11⋅83, 95 % CI 4⋅22, 33⋅14) and being in the older age group (AOR 2⋅98, 95 % CI 1⋅09, 8⋅13). The associations between tella intake and child growth suggest the need to mitigate the effects of tella on child anthropometry.
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Tamiasso NV, Silva CMO, Reis AMS, Ocarino NM, Serakides R. Ethanol Alters Phenotype and Synthesis Activity of Rat Neonatal Articular Chondrocytes Grown in 2- and 3-Dimensional Culture. Cartilage 2021; 13:839S-846S. [PMID: 31441318 PMCID: PMC8804855 DOI: 10.1177/1947603519870862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We sought to evaluate the effect of different concentrations of ethanol on phenotype and activity of articular chondrocyte synthesis of neonatal rats in 2-dimensional (2D) and 3-dimensional (3D) culture. METHODS Chondrocytes were cultured in chondrogenic medium with different concentrations of ethanol: 0.0% v/v (control); 0.05% v/v (8.6 mM); 0.25% v/v (42.9 mM), and 0.5% v/v (85.7 mM). Chondrocytes under 2D culture were subjected to MTT assay, while chondrocytes under 3D culture were processed for paraffin inclusion and stained by periodic acid Schiff (PAS) to evaluate mean chondrocyte diameter and percentages of cells, nucleus, cytoplasm, well-differentiated matrix, and PAS+ areas. The expression of gene transcripts for aggrecan, Sox9, and type II collagen was evaluated by real-time quantitative polymerase chain reaction. RESULTS There was no difference between groups by the MTT assay. PAS staining revealed that chondrocytes treated with 0.5% v/v ethanol had higher percentages of cytoplasm and nuclear areas, but with a reduction in PAS+ matrix area. The mean diameter of chondrocytes was similar between groups. The expression of aggrecan in the group treated with 0.5% v/v ethanol was lower in comparison to that in the control. In the groups treated with 0.25% v/v and 0.5% v/v ethanol, the percentage of differentiated cartilage was lower in comparison with that in the control. The group treated with 0.05% v/v ethanol was similar to the control in all parameters. CONCLUSIONS Ethanol acted directly on in vitro cultured articular chondrocytes of newborn rats, altering the chondrocyte phenotype and its synthesis activity, and these effects were dose dependent.
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Affiliation(s)
- Natalia Viana Tamiasso
- Núcleo de Células Tronco e Terapia
Celular Animal (NCT-TCA) da Escola de Veterinária da Universidade Federal de Minas
Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Carla Maria Osório Silva
- Núcleo de Células Tronco e Terapia
Celular Animal (NCT-TCA) da Escola de Veterinária da Universidade Federal de Minas
Gerais Belo Horizonte, Minas Gerais, Brazil
| | | | - Natália Melo Ocarino
- Núcleo de Células Tronco e Terapia
Celular Animal (NCT-TCA) da Escola de Veterinária da Universidade Federal de Minas
Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Rogéria Serakides
- Núcleo de Células Tronco e Terapia
Celular Animal (NCT-TCA) da Escola de Veterinária da Universidade Federal de Minas
Gerais Belo Horizonte, Minas Gerais, Brazil,Rogéria Serakides, Núcleo de Células Tronco
e Terapia Celular Animal (NCT-TCA) da Escola de Veterinária da Universidade
Federal de Minas Gerais Belo Horizonte, Av. Antônio Carlos 6627, Caixa Postal
567, campus Pampulha da UFMG, Belo Horizonte, MG CEP 30123-970, Brazil.
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Modjadji P, Pitso M. Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis. CHILDREN-BASEL 2021; 8:children8020133. [PMID: 33670265 PMCID: PMC7918556 DOI: 10.3390/children8020133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.
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Giglia RC, Reibel T. Has a national policy guideline influenced the practice of raising the topic of alcohol and breastfeeding by maternal healthcare practitioners? Aust J Prim Health 2019; 25:275-280. [PMID: 31221244 DOI: 10.1071/py18103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 05/08/2019] [Indexed: 02/28/2024]
Abstract
Globally, the public health recommendation for exclusive breastfeeding to the first 6 months of life is not being achieved by many low- and middle-income countries. Many factors have been determined to affect the early cessation of breastfeeding; however, little attention has been paid to the role of alcohol, an increasingly favoured commodity, particularly in these Westernised nations. Maternal healthcare practitioners play a pivotal role in a woman's breastfeeding journey by providing timely advice that can help support continued breastfeeding. Maternal healthcare practitioners (MHP) from across Australia were invited to take part in a semi-structured telephone interview (n = 19) to elicit their knowledge of a national alcohol policy guideline on alcohol and breastfeeding, their confidence to provide information on this topic, and if they were routinely incorporating conversations on alcohol and breastfeeding into their practice. The results affirmed that the majority of MHP were not aware of the national policy providing direction for safely consuming alcohol during lactation and were not incorporating this information into their practice. This study suggests having a national policy guideline for safe alcohol consumption during lactation has not promoted awareness of this topic among MHP as a potential strategy to support long-term breastfeeding duration.
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Affiliation(s)
- Roslyn Carmel Giglia
- Alcohol, Pregnancy and FASD Research Program, Telethon Kids Institute, University of Western Australia, FASD Research Australia Centre of Research Excellence, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia; and Corresponding author
| | - Tracy Reibel
- Alcohol, Pregnancy and FASD Research Program, Telethon Kids Institute, University of Western Australia, FASD Research Australia Centre of Research Excellence, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
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Brown RA, Dakkak H, Seabrook JA. Is Breast Best? Examining the effects of alcohol and cannabis use during lactation. J Neonatal Perinatal Med 2019; 11:345-356. [PMID: 29843260 DOI: 10.3233/npm-17125] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Maternal drug use during lactation may have adverse effects on the health of their children. Two common drugs used during this period are alcohol and cannabis. A literature search was conducted using PubMed, CINAHL, Nursing and Allied Health, and Google Scholar with the following search terms: marijuana, cannabis, THC, alcohol, ethanol, breastfeeding, lactation, and breastmilk. The search strategy was restricted to papers since the year 2000, and limited to English language journals. Reference lists were also used to capture any articles that were missed from the database searches. In total, 19 articles were found related to alcohol and breastfeeding (n = 17 original research papers; n = 2 systematic reviews), and 4 articles were specific to cannabis (n = 2 original papers; n = 2 systematic reviews). The most common outcomes associated with alcohol consumption and breastfeeding included changes in sleep patterns, reduced milk production and flow, lower milk intake, and impaired immune function. Maternal outcomes related to cannabis consumption included panic attacks, delayed response time, increased heart rate, reduced short-term memory, dizziness, and impaired motor performance; infant outcomes associated with maternal cannabis use and breastfeeding were reduced muscular tonus, poor sucking, and growth delay and restriction. Mothers should be advised to refrain from substance use during the lactation period for the health and safety of their children.
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Affiliation(s)
- R A Brown
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - H Dakkak
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - J A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.,Department of Paediatrics, Western University, London, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.,Children's Health Research Institute, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Human Environments Analysis Laboratory, London, ON, Canada
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Manhire KM, Williams SM, Tipene-Leach D, Baddock SA, Abel S, Tangiora A, Jones R, Taylor BJ. Predictors of breastfeeding duration in a predominantly Māori population in New Zealand. BMC Pediatr 2018; 18:299. [PMID: 30208860 PMCID: PMC6136165 DOI: 10.1186/s12887-018-1274-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although breastfeeding duration in New Zealand’s indigenous Māori is shorter than in non-Māori, we know little about barriers or motivators of breastfeeding in this community. The aim of this analysis was to identify predictors for extended duration of breastfeeding amongst participants drawn from predominantly Māori communities in regional Hawke’s Bay. Methods Mother/baby dyads were recruited from two midwifery practices serving predominantly Māori women in mostly deprived areas, for a randomised controlled trial comparing the risks and benefits of an indigenous sleeping device (wahakura) and a bassinet. Questionnaires were administered at baseline (pregnancy) and at one, three and six months postnatal. Several questions relating to breastfeeding and factors associated with breastfeeding were included. The data from both groups were pooled to examine predictors of breastfeeding duration. Results Māori comprised 70.5% of the 197 participants recruited. The median time infants were fully breastfed was eight weeks and Māori women were more likely to breastfeed for a shorter duration than New Zealand European women with an odds-ratio (OR) of 0.45 (95% CI 0.24, 0.85). The key predictors for extended duration of breastfeeding were the strong support of the mother’s partner (OR = 3.64, 95% CI 1.76, 7.55) or her mother for breastfeeding (OR = 2.47, 95% CI 1.27, 4.82), longer intended duration of maternal breastfeeding (OR = 1.02, 95% CI 1.00, 1.03) and being an older mother (OR = 1.07, 95% CI 1.02, 1.12). The key predictors for shorter duration of breastfeeding were pacifier use (OR = 0.28, 95% CI 0.17, 0.46), daily cigarette smoking (OR = 0.51, 95% CI 0.37, 0.69), alcohol use (OR = 0.54, 95% CI 0.31, 0.93) and living in a more deprived area (OR 0.40, 95% CI 0.22, 0.72). Conclusions Breastfeeding duration in this group of mainly Māori women was shorter than the national average. Increasing the duration of breastfeeding by these mothers could be further facilitated by ante and postnatal education involving their own mothers and their partners in the support of breastfeeding and by addressing pacifier use, smoking and alcohol use.
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Affiliation(s)
- Kathy M Manhire
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. .,Faculty of Education, Humanities and Health Sciences, Eastern Institute of Technology, Hawke's Bay, New Zealand.
| | - Sheila M Williams
- Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David Tipene-Leach
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Faculty of Education, Humanities and Health Sciences, Eastern Institute of Technology, Hawke's Bay, New Zealand
| | - Sally A Baddock
- School of Midwifery, Otago Polytechnic, Dunedin, New Zealand
| | - Sally Abel
- Kaupapa Consulting Ltd, Napier, Napier, New Zealand
| | - Angeline Tangiora
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Raymond Jones
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Barry J Taylor
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Giglia RC, Symons M, Shaw T. The provision of alcohol and breastfeeding information by maternal health practitioners in the Australian setting. Aust N Z J Obstet Gynaecol 2018; 59:258-264. [PMID: 29926916 DOI: 10.1111/ajo.12837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the 2009 National Health and Medical Research Council (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking, a guideline specific to lactating women was included. For the first time the effect of alcohol at this important developmental stage was nationally and internationally acknowledged. AIMS To determine the degree to which maternal health practitioners adopted an Australian national policy guideline (Guideline 4B) on alcohol and breastfeeding into their everyday health practice and the factors associated with adoption. MATERIALS AND METHODS A convenience sample of participants completed an online survey based on the Nursing Practice Questionnaire (NPQ) to elicit measures of knowledge, awareness and practice implementation. RESULTS In total, 240 maternal health practitioners completed the online survey. All statistical analyses clearly indicated a higher adoption of Guideline 4B by the child health nurses, midwives and general practitioners (GPs) than was the case for paediatricians and obstetricians. A mean adoption score (range 0-4) indicative of 'some' practice implementation of 3.13, 3.04 and 2.73 was obtained by child health nurses, midwives and GPs, respectively. Obstetricians and paediatricians scored a mean of 2.0, indicating they remain to be 'persuaded about the practice' of incorporating discussions around alcohol and breastfeeding into their practice. CONCLUSION Despite the existence of a national alcohol guideline for breastfeeding women, maternal health practitioners are not incorporating this advice into their everyday practice with lactating women. Opportunities exist for all maternal practitioners along the reproductive continuum to protect long-term breastfeeding duration using an evidence-based harm minimisation approach to alcohol consumption.
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Affiliation(s)
- Roslyn Carmel Giglia
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Martyn Symons
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Thérèse Shaw
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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De Genna NM, Goldschmidt L, Marshal M, Day NL, Cornelius MD. Maternal Age and Trajectories of Risky Alcohol Use: A Prospective Study. Alcohol Clin Exp Res 2017; 41:1725-1730. [PMID: 28835001 PMCID: PMC5678932 DOI: 10.1111/acer.13451] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/17/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND No prospective study of maternal alcohol use has focused on age at transition to motherhood as a predictor of trajectories of risky drinking. The goal of this study was to examine the impact of maternal age at first birth on trajectories of alcohol use beyond recommended levels over a 17-year span. METHODS Pregnant women (N = 456) were recruited at an urban prenatal clinic. The women (13 to 42 years old; 64% African American, 36% White) were interviewed about alcohol use during pregnancy and at 6, 10, 14, and 16 years postpartum. Growth mixture modeling (GMM) was used to identify trajectories of risky drinking. Maternal age at first birth was then regressed onto trajectory class membership. RESULTS The GMM on maternal alcohol use identified 3 groups of mothers as a function of alcohol use before, during, and after the pregnancy. The majority of mothers (66%) were identified as having low-risk trajectories of alcohol use over the 17-year span. However, 2 groups were in the higher-risk categories, with 23% identified as being in a long-term high-risk trajectory, and 11% in a short-term high-risk trajectory group. Maternal age at first birth predicted membership in a high-risk group: Younger mothers were more likely to be classified into a long-term high-risk alcohol use group. CONCLUSIONS Younger mothers were more likely to engage in risky drinking early in pregnancy, continuing 6 to 14 years postpartum. These results can help physicians target mothers who are likely to exceed current NIAAA guidelines of abstinence during pregnancy, and no more than 7 drinks per week in the postpartum.
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Tearne E, Cox K, Giglia R. Patterns of Alcohol Intake of Pregnant and Lactating Women in Rural Western Australia. Matern Child Health J 2017; 21:2068-2077. [DOI: 10.1007/s10995-017-2318-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Wilson J, Tay RY, McCormack C, Allsop S, Najman J, Burns L, Olsson CA, Elliott E, Jacobs S, Mattick RP, Hutchinson D. Alcohol consumption by breastfeeding mothers: Frequency, correlates and infant outcomes. Drug Alcohol Rev 2017; 36:667-676. [DOI: 10.1111/dar.12473] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Judy Wilson
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Rui Yang Tay
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Clare McCormack
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
- Department of Psychiatry; Columbia University; New York USA
| | - Steve Allsop
- National Drug Research Institute; Curtin University; Perth Australia
| | - Jake Najman
- Queensland Alcohol and Drug Research and Education Centre and Schools of Population Health and Social Science; University of Queensland; Brisbane Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Craig A. Olsson
- School of Psychology, Centre for Social and Early Emotional Development; Deakin University; Geelong Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute; The Royal Children's Hospital; Melbourne Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Australia
| | - Elizabeth Elliott
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead; Sydney Australia
| | - Sue Jacobs
- Department of Obstetrics; Royal Prince Alfred Hospital; Sydney Australia
| | - Richard P. Mattick
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
- School of Psychology, Centre for Social and Early Emotional Development; Deakin University; Geelong Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute; The Royal Children's Hospital; Melbourne Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Australia
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Abstract
National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression may be at high risk for substance use. Understanding postpartum substance use and its relationship to postpartum depression can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999-2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%-49%) and drug use (4.5%-8.5%) were lower than use among not pregnant, not postpartum women (41.5%-57.5%, 7.6%-10.6%, respectively) but higher than use among pregnant women (5.4%-11.6%, 3.7%-4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by blacks and Hispanics, but black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%-46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use.
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Affiliation(s)
- Shawna L Carroll Chapman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Nutrition for the breastfeeding woman. Nutr Diet 2013. [DOI: 10.1111/1747-0080.12067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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