1
|
Sorce LR, Asaro LA, Curley MAQ. Infant feeding and criticality in children. Nurs Crit Care 2024. [PMID: 38923099 DOI: 10.1111/nicc.13103] [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: 02/13/2024] [Revised: 04/02/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Data support the protective effects of human breast milk (HBM) feeding in acute illness but little is known about the impact of HBM feeding on the criticality of infants. AIM To explore the relationship between early HBM feeding and severity of illness and recovery in critically ill children requiring intubation and mechanical ventilation for acute respiratory failure (ARF). STUDY DESIGN Prospective cohort study of mothers of patients aged 1-36 months who participated in the acute and follow-up phases of the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial. Participants completed a survey describing HBM dose fed during their infant's first month of life. RESULTS Of 138 patients, 70 (51%) received exclusive HBM feedings (90%-100% total feeds) and 68 (49%) did not. We found no group differences in severity of illness on paediatric intensive care unit (PICU) admission or severity of paediatric acute respiratory distress syndrome (PARDS) within the first 24-48 h of intubation/mechanical ventilation (Pediatric Risk of Mortality [PRISM] III-12 score median: 5 vs. 5, p = .88; moderate/severe PARDS: 53% vs. 54%, p = .63). While median time to recovery from ARF was reduced by 1 day in patients who received exclusive HBM feedings, the difference between groups was not statistically significant (median 1.5 vs. 2.6 days, hazard ratio 1.40 [95% confidence interval, 0.99-1.97], p = .06). CONCLUSIONS Human breast milk dose was not associated with severity of illness on PICU admission in children requiring mechanical ventilation for ARF. RELEVANCE TO CLINICAL PRACTICE Data support the protective effects of HBM during acute illness and data from this study support a clinically important reduction in time to recovery of ARF. Paediatric nurses should continue to champion HBM feeding to advance improvements in infant health.
Collapse
Affiliation(s)
- Lauren R Sorce
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lisa A Asaro
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - Martha A Q Curley
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
Tenenbaum Weiss Y, Ovnat Tamir S, Globus O, Marom T. Protective Characteristics of Human Breast Milk on Early Childhood Otitis Media: A Narrative Review. Breastfeed Med 2024; 19:73-80. [PMID: 38386988 DOI: 10.1089/bfm.2023.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Introduction: Human breast milk (HBM) contains a complex and dynamically changing variety of factors that contribute to the infant's developing immune system's ability to fight upper respiratory tract infections, including otitis media (OM). We sought to summarize the current evidence on the protective characteristics of HBM, through direct or donated feeding, toward early childhood OM. Methods: For this narrative review, we performed a literature search on OM in the context of HBM feeding in the PubMed, Embase, and Google Scholar databases, between January 1, 2008, and July 1, 2023. Results: Immunoglobulin A (IgA) provides a short-term immunity of 2-3 days against otopathogens causing OM. IgA-mediated immunity is effective against OM up to 7 months of age if breastfeeding continues. The role of transferred IgM and IgG in HBM is unclear. Although there is a potential protective value of microRNA, hormones, oligosaccharides, stem cells, and interleukins present in HBM, their role is unclear. Any duration of breastfeeding is superior to no breastfeeding in OM risk reduction, with a big variability among studies (odds ratio 0.23-0.81, depending on the duration). Duration of breastfeeding ≥6 months was found to be the most effective in OM risk reduction, but there was no evidence of continued benefits after 2 years of age. Expressed breastfeeding was not shown to be more beneficial. The protective values of donor HBM against OM are still undetermined. Conclusion: HBM has numerous components that contribute to protection against early childhood OM.
Collapse
Affiliation(s)
- Yarden Tenenbaum Weiss
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Omer Globus
- Neonatal Intensive Care Unit, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| |
Collapse
|
3
|
Tesfaye SH, Seboka BT, Sisay D. Spatial patterns and spatially-varying factors associated with childhood acute respiratory infection: data from Ethiopian demographic and health surveys (2005, 2011, and 2016). BMC Infect Dis 2023; 23:293. [PMID: 37147575 PMCID: PMC10163815 DOI: 10.1186/s12879-023-08273-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND In Ethiopia, acute respiratory infections (ARIs) are a leading cause of morbidity and mortality among children under five years. Geographically linked data analysis using nationally representative data is crucial to map spatial patterns of ARIs and identify spatially-varying factors of ARI. Therefore, this study aimed to investigate spatial patterns and spatially-varying factors of ARI in Ethiopia. METHODS Secondary data from the Ethiopian Demographic Health Survey (EDHS) of 2005, 2011, and 2016 were used. Kuldorff's spatial scan statistic using the Bernoulli model was used to identify spatial clusters with high or low ARI. Hot spot analysis was conducted using Getis-OrdGi statistics. Eigenvector spatial filtering regression model was carried out to identify spatial predictors of ARI. RESULTS Acute respiratory infection spatially clustered in 2011 and 2016 surveys year (Moran's I:-0.011621-0.334486). The magnitude of ARI decreased from 12.6% (95%, CI: 0.113-0.138) in 2005 to 6.6% (95% CI: 0.055-0.077) in 2016. Across the three surveys, clusters with a high prevalence of ARI were observed in the North part of Ethiopia. The spatial regression analysis revealed that the spatial patterns of ARI was significantly associated with using biomass fuel for cooking and children not initiating breastfeeding within 1-hour of birth. This correlation is strong in the Northern and some areas in the Western part of the country. CONCLUSION Overall there has been a considerable decrease in ARI, but this decline in ARI varied in some regions and districts between surveys. Biomass fuel and early initiation of breastfeeding were independent predictors of ARI. There is a need to prioritize children living in regions and districts with high ARI.
Collapse
Affiliation(s)
| | - Binyam Tariku Seboka
- School of Public Health, college of health sciences and medicine, Dilla University, Dilla, Ethiopia
| | - Daniel Sisay
- School of Public Health, college of health sciences and medicine, Dilla University, Dilla, Ethiopia
| |
Collapse
|
4
|
Lechosa-Muñiz C, Paz-Zulueta M, Irure-Ventura J, Mendez-Legaza JM, Cuesta González R, Gómez-Acebo I, López-Hoyos M, Llorca J, Cabero-Pérez MJ. Development of SARS-CoV-2 specific IgG and IgA antibodies in serum and milk with different SARS-COV-2 vaccines in lactating women. Int Breastfeed J 2023; 18:3. [PMID: 36627706 PMCID: PMC9831888 DOI: 10.1186/s13006-022-00536-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Our main objective was to determine the evolution of IgG and IgA antibodies directed against SARS-CoV-2 protein S in the blood of lactating women and in breast milk. METHODS A cohort of 110 uninfected and vaccinated breastfeeding women was followed-up for 6 months at the Marqués de Valdecilla University Hospital, Spain, in 2020. An additional group of 23 breastfeeding mothers who had no previously documented infection and had not been vaccinated against SARS-CoV-2 were included as a control group. The antibodies in blood and breast milk and their evolution at 6 months post-vaccination were analysed. RESULTS One hundred ten breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) received two doses of mRNA-1273, and 20 women (18.2%) received a single dose of ChAdOx1-S. No evidence of differences between concentrations of antibodies was found according to the type of vaccine, with the exception of serum IgA antibodies, which was higher in women vaccinated with mRNA-1273: mean [95%CI]: 0.05 AU/mL [0.03,0.06] with mRNA-1273, 0.02 AU/mL [0.01,0.03] with BNT162b2 and 0.01 AU/mL [0.00,0.03] with ChAdOx1-S, ANOVA p value = 0.03. The lack of difference between vaccines was also found when anti-S1 specific IgG in serum and breast milk were measured. CONCLUSIONS In lactating women vaccinated against COVID-19, anti-SARS-CoV-2 antibodies can be detected in both serum and breastmilk 6 months after receiving the second dose, although their concentrations decreased when compared with concentrations reached immediately after vaccination.
Collapse
Affiliation(s)
- Carolina Lechosa-Muñiz
- grid.7821.c0000 0004 1770 272XDepartamento de Enfermería, Universidad de Cantabria, Santander, Spain ,grid.411325.00000 0001 0627 4262Breastfeeding Coordinator, IBCLC, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - María Paz-Zulueta
- Departamento de Enfermería, Universidad de Cantabria, Santander, Spain. .,IDIVAL- Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, Cantabria, Spain.
| | - Juan Irure-Ventura
- grid.411325.00000 0001 0627 4262Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jose Manuel Mendez-Legaza
- grid.411325.00000 0001 0627 4262Department of Microbiology, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - Rocío Cuesta González
- grid.411325.00000 0001 0627 4262Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - Inés Gómez-Acebo
- grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.466571.70000 0004 1756 6246CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marcos López-Hoyos
- grid.411325.00000 0001 0627 4262Department of Immunology, Hospital Universitario Marqués de Valdecilla, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.7821.c0000 0004 1770 272XLaboratory, Molecular Biology Department, University of Cantabria, Santander, Spain
| | - Javier Llorca
- grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.466571.70000 0004 1756 6246CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María Jesús Cabero-Pérez
- grid.411325.00000 0001 0627 4262Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain ,grid.7821.c0000 0004 1770 272XDepartamento de Ciencias Médicas y Quirúrgicas. Universidad de Cantabria, Santander, Spain ,grid.484299.a0000 0004 9288 8771IDIVAL, Cantabria, Spain ,grid.413448.e0000 0000 9314 1427Red de Salud Materno Infantil y del Desarrollo – SAMID. Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
5
|
Esteve-Palau E, Gonzalez-Cuevas A, Eugenia Guerrero M, Garcia-Terol C, Carmen Alvarez M, Garcia G, Moreno E, Medina F, Casadevall D, Diaz-Brito V. Quantification and progress over time of specific antibodies against SARS-CoV-2 in breast milk of lactating women vaccinated with BNT162b2 Pfizer-BioNTech COVID-19 vaccine (LacCOVID). Open Forum Infect Dis 2022; 9:ofac239. [PMID: 35783685 PMCID: PMC9129184 DOI: 10.1093/ofid/ofac239] [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: 01/03/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Several observational studies demonstrated the passage of postvaccine antibodies through breast milk in women vaccinated against coronavirus disease 2019 (COVID-19), mostly with messenger RNA (mRNA)–based vaccines, but lacked long-term data. Methods A 6-month prospective cohort study was performed to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine–induced antibody levels in the breast milk of 33 lactating healthcare workers at different timepoints after mRNA BNT162b2 Pfizer-BioNTech COVID-19 vaccination. Moreover, we examined the correlation of SARS-CoV-2 antibody levels between serum and breast milk, adverse events related to vaccination, and rate of SARS-CoV-2 infections. Results Mothers’ median age was 38 (interquartile range [IQR], 36–39) years and 15 (IQR, 10–22) months for infants. Median (IQR) SARS-CoV-2 immunoglobulin G (IgG) spike protein subunit S1 (S1) vaccine–induced levels at different timepoints for serum–milk pairs were 519 (234–937) to 1 (0–2.9) arbitrary units (AU)/mL at 2 weeks after first dose and 18 644 (9923–29 264) to 78 (33.7–128), 12 478 (6870–20 801) to 50.4 (24.3–104), 4094 (2413–8480) to 19.9 (10.8–51.9), 1350 (831–2298) to 8.9 (7.8–31.5) AU/mL at 2, 4, 12 and 24 weeks after second dose, respectively. We observed a positive correlation of antibody levels between serum and breast milk, no serious adverse events related to vaccination, and 2 (6%) COVID-19 vaccine breakthrough infections. Conclusions Women vaccinated with Pfizer-BioNTech transmit antibodies into breast milk with a positive correlation with serum levels. Both decreased over time in a 6-month follow-up.
Collapse
Affiliation(s)
- Erika Esteve-Palau
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | | | - M. Eugenia Guerrero
- Department of Microbiology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Clara Garcia-Terol
- Department of Obstetrics and Gynecology, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - M. Carmen Alvarez
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Geneva Garcia
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Encarna Moreno
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - Francisco Medina
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| | - David Casadevall
- Cancer Research Program, Hospital del Mar Research Institute, Barcelona, Spain
| | - Vicens Diaz-Brito
- Department of Infectious Diseases, Parc Sanitari Sant Joan de Deu (Sant Boi, Barcelona, Spain)
| |
Collapse
|
6
|
Domenici R, Vierucci F. Exclusive Breastfeeding and Vitamin D Supplementation: A Positive Synergistic Effect on Prevention of Childhood Infections? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052973. [PMID: 35270666 PMCID: PMC8910000 DOI: 10.3390/ijerph19052973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health.
Collapse
|
7
|
Allergic diseases in infancy: I - Epidemiology and current interpretation. World Allergy Organ J 2021; 14:100591. [PMID: 34820047 PMCID: PMC8593659 DOI: 10.1016/j.waojou.2021.100591] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Among non-communicable diseases, the prevalence of allergic diseases has increased significantly in the new millennium. The increase of allergic diseases is linked to the changing environment of infants. Methods This narrative review summarizes the discussions and conclusions from the 8th Human Milk Workshop. Information from the fields of pediatrics, epidemiology, biology, microbiology, and immunology are summarized to establish a framework describing potential avenues for the prevention of allergic diseases in the future. Results Several environmental circumstances are linked to the development of allergic diseases. While cesarean section is increasing the risk of allergies, early childhood exposure to a farm environment has a protective effect. From their analysis, nutritive and non-nutritive factors influencing the allergy risk in later life have been identified. The effect of breastfeeding on food allergy development is non-univocal. Human milk components including immunoglobulins, cytokines, and prebiotics have been indicated as important for allergy prevention. Conclusion Many factors linked to the western lifestyle have been associated with the development of allergic diseases. This suggests several theories that may serve as a basis for new protective interventions. While it is indubitable that mother's milk protects from infectious diseases, its role in the prevention of allergic diseases is to be elucidated.
Collapse
|
8
|
Perikleous E, Fouzas S, Karageorgiou A, Steiropoulos P, Nena E, Chatzimichael A, Tsalkidis A, Paraskakis E. Association of breastfeeding with tidal breathing analysis in infants with bronchiolitis. World J Clin Pediatr 2021; 10:168-176. [PMID: 34868893 PMCID: PMC8603642 DOI: 10.5409/wjcp.v10.i6.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/30/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tidal breathing flow-volume (TBFV) analysis provides important information about lung mechanics in infants.
AIM To assess the effects of breastfeeding on the TBFV measurements of infants who recover from acute bronchiolitis.
METHODS In this cross-sectional study, TBFV analysis was performed in infants with bronchiolitis prior to hospital discharge. The ratio of time to peak expiratory flow to total expiratory time (tPEF/tE) at baseline and after the administration of 400 mcg salbutamol was evaluated.
RESULTS A total of 56 infants (35 boys), aged 7.4 ± 2.8 mo, were included. Of them, 12.5% were exposed to tobacco smoke and 41.1% were breastfed less than 2 mo. There were no differences in baseline TBFV measurements between the breastfeeding groups; however, those who breastfed longer than 2 mo had a greater change in tPEF/tE after bronchodilation (12% ± 10.4% vs 0.9% ± 7.1%; P < 0.001). Moreover, there was a clear dose-response relationship between tPEF/tE reversibility and duration of breastfeeding (P < 0.001). In multivariate regression analysis, infants who breastfed less (regression coefficient -0.335, P = 0.010) or were exposed to cigarette smoke (regression coefficient 0.353, P = 0.007) showed a greater change in tPEF/tE after bronchodilation, independent of sex, prematurity, and family history of asthma or atopy.
CONCLUSION Infants who recover from bronchiolitis and have a shorter duration of breastfeeding or are exposed to cigarette smoke, have TBFV measurements indicative of obstructive lung disease.
Collapse
Affiliation(s)
- Evanthia Perikleous
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Sotirios Fouzas
- Department of Paediatrics, University Hospital of Patras, University of Patras, Patra 26504, Greece
| | - Athina Karageorgiou
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Paschalis Steiropoulos
- Department of Pneumonology, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Athanasios Chatzimichael
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Aggelos Tsalkidis
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupoli 68100, Greece
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, Heraklion 71500, Greece
| |
Collapse
|
9
|
Lechosa-Muñiz C, Paz-Zulueta M, Mendez-Legaza JM, Irure-Ventura J, Cuesta González R, Calvo Montes J, López-Hoyos M, Llorca J, Cabero-Pérez MJ. Induction of SARS-CoV-2-Specific IgG and IgA in Serum and Milk with Different SARS-CoV-2 Vaccines in Breastfeeding Women: A Cross-Sectional Study in Northern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168831. [PMID: 34444579 PMCID: PMC8393848 DOI: 10.3390/ijerph18168831] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/11/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
Breastfeeding mothers were excluded from the clinical trials conducted for vaccines against SARS-CoV-2. Since the start of the vaccination, some doubts have arisen regarding its compatibility with breastfeeding. The aim of this study was to analyse the presence of anti-SARS-CoV-2 antibodies in breast milk and serum (IgG and IgA) of vaccinated breastfeeding women. The main variables of the observational study were: adverse related events after vaccination and determination of the presence of IgG and IgA isotypes antibodies in serum and in breast milk of vaccinated women against the SARS-CoV-2 antigens. Results: 110 breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) with two doses of mRNA-1273, and 20 women (18.2%) with a single dose of ChAdOx1-S. Regarding adverse reactions and vaccine safety, 38 women had no adverse reactions; 20 (18.2%) had general malaise or adenopathies; 10 (9.1%) had a headache; and 7 (6.4%) had fever. When analysing IgG antibodies, significantly higher levels of antibodies were found in serum and breast milk from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (p < 0.001 and p = 0.001, respectively). Analysing IgA antibodies, significant differences were found when comparing mean values in serum from mothers vaccinated with BNT162b2 or mRNA-1273 vs. ChAdOx1-S (0.12, 0.16, and 0.02, respectively; p < 0.001) and breast milk of mothers vaccinated when comparing BNT16b2 vs. ChAdOx1-S. All vaccinated breastfeeding mothers had serum anti-S1 IgG antibodies in response to vaccination against SARS-CoV-2, regardless of the commercial vaccine administered. Conclusions: the anti-SARS-CoV-2 vaccines were well tolerated by the mothers and the breastfed infant. In addition, breastfeeding mothers offer their infants IgA and IgG isotype antibodies directed against SARS-CoV-2 protein S in breast milk.
Collapse
Affiliation(s)
- Carolina Lechosa-Muñiz
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Cantabria, Spain;
- Breastfeeding Coordinator, IBCLC, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain
| | - María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Cantabria, Spain;
- Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, IDIVAL, C/ Cardenal Herrera Oria s/n. C.P., 39011 Santander, Cantabria, Spain
- Correspondence:
| | - Jose Manuel Mendez-Legaza
- Department of Microbiology, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain; (J.M.M.-L.); (J.C.M.)
| | - Juan Irure-Ventura
- Department of Immunology, Hospital Universitario Marqués de Valdecilla, IDIVAL, C.P., 39008 Santander, Cantabria, Spain; (J.I.-V.); (M.L.-H.)
| | - Rocío Cuesta González
- Department of Pediatrics, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain;
| | - Jorge Calvo Montes
- Department of Microbiology, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain; (J.M.M.-L.); (J.C.M.)
| | - Marcos López-Hoyos
- Department of Immunology, Hospital Universitario Marqués de Valdecilla, IDIVAL, C.P., 39008 Santander, Cantabria, Spain; (J.I.-V.); (M.L.-H.)
- Laboratory, Molecular Biology Department, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain
| | - Javier Llorca
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain; (J.L.); (M.J.C.-P.)
- CIBER Epidemiology and Public Health (CIBERESP), C.P., 28029 Madrid, Spain
| | - María Jesús Cabero-Pérez
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Cantabria, Spain; (J.L.); (M.J.C.-P.)
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, C.P., 39008 Santander, Cantabria, Spain
- IDIVAL, C/ Cardenal Herrera Oria s/n. C.P., 39011 Santander, Cantabria, Spain
| |
Collapse
|
10
|
Health Care Costs Associated to Type of Feeding in the First Year of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134719. [PMID: 32630048 PMCID: PMC7369965 DOI: 10.3390/ijerph17134719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. METHODS A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined-Diagnosis Related Groups (APR-DRG) classification. RESULTS Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5€, 95% confidence interval (CI): 903.0-1775.0 for artificially fed vs. 443.5€, 95% CI: 193.7-694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7€ for formula fed children vs. 197.9€ for breastfed children), emergency room consultations (260.1€ for artificially fed children vs. 196.2€ for breastfed children) and hospital admissions (791.6€ for artificially fed children vs. 86.9€ for breastfed children). CONCLUSIONS Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumption.
Collapse
|
11
|
Davisse-Paturet C, Adel-Patient K, Forhan A, Lioret S, Annesi-Maesano I, Heude B, Charles MA, de Lauzon-Guillain B. Breastfeeding initiation or duration and longitudinal patterns of infections up to 2 years and skin rash and respiratory symptoms up to 8 years in the EDEN mother-child cohort. MATERNAL AND CHILD NUTRITION 2020; 16:e12935. [PMID: 31970921 PMCID: PMC7296801 DOI: 10.1111/mcn.12935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 12/25/2022]
Abstract
This paper aimed to examine the effect of breastfeeding on longitudinal patterns of common infections up to 2 years and respiratory symptoms up to 8 years. To assess the incidence and reoccurrence of infections and allergic symptoms in the first years of life among 1,603 children from the EDEN mother–child cohort, distinct longitudinal patterns of infectious diseases as well as skin rash and respiratory symptoms were identified by group‐based trajectory modelling. To characterize infections, we considered the parent‐reported number of cold/nasopharyngitis and diarrhoea from birth to 12 months and otitis and bronchitis/bronchiolitis from birth to 2 years. To characterize allergy‐related symptoms, we considered the parent‐reported occurrence of wheezing and skin rash from 8 months to 8 years and asthma from 2 to 8 years. Then associations between breastfeeding and these longitudinal patterns were assessed through adjusted multinomial logistic regression. Compared with never‐breastfed infants, ever‐breastfed infants were at a lower risk of diarrhoea events in early infancy as well as infrequent events of bronchitis/bronchiolitis throughout infancy. Only predominant breastfeeding duration was related to frequent events of bronchitis/bronchiolitis and infrequent events of otitis. We found no significant protective effect of breastfeeding on longitudinal patterns of cold/nasopharyngitis, skin rash, or respiratory symptoms. For an infant population with a short breastfeeding duration, on average, our study confirmed a protective effect of breastfeeding on diarrhoea events in early infancy, infrequent bronchitis/bronchiolitis and, to a lesser extent, infrequent otitis events up to 2 years but not on other infections, skin rash, or respiratory symptoms4. In an infant population with a short breastfeeding duration and using longitudinal patterns of infection, skin rash and respiratory symptoms, on average, our study confirmed a protective effect of breastfeeding on diarrhea events in early infancy, infrequent bronchitis/bronchiolitis and, to a lesser extent,infrequent otitis events up to 2 years but not on cold/ nasopharyngitis, skin rash or respiratory symptoms.
Collapse
Affiliation(s)
| | - Karine Adel-Patient
- UMR Service de Pharmacologie et Immunoanalyse, CEA, INRA, Université Paris-Saclay, Paris, France
| | - Anne Forhan
- Université de Paris, CRESS, INSERM, INRA, Paris, France
| | | | - Isabella Annesi-Maesano
- EPAR (Epidemiology of Allergic and Respiratory Diseases Department), Institute Pierre Louis of Epidemiology and Public Health, UMR-S 1136 INSERM and Sorbonne Université, Medical School Saint-Antoine, Paris, France
| | - Barbara Heude
- Université de Paris, CRESS, INSERM, INRA, Paris, France
| | - Marie Aline Charles
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Ined, INSERM, Joint Unit Elfe, Paris, France
| | | |
Collapse
|