Relationship between exclusive breastfeeding and cardiorespiratory fitness in children and adolescents: A meta‐analysis

The impact of exclusive breastfeeding on breastfeeding duration

BACKGROUND

While breastfeeding is globally recommended, its duration still represents a public health issue.

AIM

To examine the association between the period of exclusive breastfeeding (EBF) and the duration of overall human milk nutrition, and to identify determinants associated with the duration of EBF and overall human milk nutrition length.

STUDY DESIGN

The presented study is a cross-sectional study. A total of 209 healthy Polish women of Caucasian origin, aged 19-42 years, who were the mother of a child aged 3-12 months, were enrolled in the study. Data were collected from 2018 to 2020 using an anonymous questionnaire. Statistical analyses included one way ANOVA and liner regression.

RESULTS

After birth almost all newborns were exclusively breastfed (96.7 %), but the supply of mother's milk declined as the children's ages increased. The duration of breastfeeding is strongly associated with EBF, especially until the child is six months old (p < 0.001). Mother's breastfeeding self-efficiency and her will for breastfeeding, comfortable latch, younger infant age, avoiding of a pacifier and excluding additional food may explain 36 % of variation of EBF duration (p < 0.001) and could be useful information for exclusive breastfeeding support.

CONCLUSIONS

The practice of exclusive breastfeeding strongly affects overall breastfeeding duration. The promotion of exclusive breastfeeding, rather than of overall breast milk supply, is crucial.

P-Wave Axis of Schoolchildren Who Were Once Breastfed

BACKGROUND

It has been known for decades that breastfeeding leads to a lower risk of asthma, respiratory infections, or metabolic syndrome at school age. In addition, evidence is now accumulating on the influence of breast milk on the shape, volume, or function of the heart and lungs. Within this field of research into the effects of breast milk on the structure of the heart and lungs, we have set out to analyze the differential electrocardiographic characteristics of schoolchildren who were once breastfed.

METHOD

This was an observational cross-sectional study, including 138 children aged 6 or 12 consecutively presenting to a well-child clinic between May and December 2022.

INCLUSION CRITERIA

The ability to perform reproducible ECG records, the feasibility of weighing and measuring patient, and breastfeeding data collected from birth were used as the inclusion criteria.

RESULTS

Using the 40° cut-off value for the mean P-wave axis among schoolchildren, 76% of never-breastfed children in our sample have a P-wave axis in a more vertical position than the mean as compared to 58% of ever-breastfed children (OR: 2.25; 95% CI: 3.13-1.36); there was no other significant difference between infant feeding groups in somatometric characteristics or ECG parameters.

CONCLUSION

We found a significant difference of the mean values of the P-wave axis between never- and ever-breastfed children. Although this report should be approached cautiously, these findings add to the renewed interest in discerning developmental interventions to improve cardiovascular health.

Role of breastfeeding on maternal and childhood cancers: An umbrella review of meta-analyses

Background

Multiple studies and meta-analyses have claimed that breastfeeding is inversely correlated with maternal and childhood cancers. These results could either be causal or confounded by shared risk factors. By conducting an umbrella review, we aimed to consolidate the relationship between breastfeeding and maternal and childhood cancers.

Methods

We searched PubMed, Embase, Web of Science, Elsevier ScienceDirect, and Cochrane Library databases from inception to December 2022. Two reviewers independently extracted the data and assessed the quality of the studies using standardised forms. We considered two types of breastfeeding comparisons ("ever" vs "never" breastfeeding; and "longest" vs "shortest" duration). We estimated the pooled risk and 95% confidence interval (CI) for each meta-analysis.

Results

We included seventeen meta-analyses with 55 comparisons. There was an inverse correlation between breastfeeding and childhood leukaemia (pooled risk = 0.90, 95% CI = 0.81-0.99), neuroblastoma (pooled risk = 0.81, 95% CI = 0.71-0.93), maternal ovarian cancer (pooled risk = 0.76, CI = 0.71-0.81), breast cancer (pooled risk = 0.85, 95% CI = 0.82-0.88), and oesophageal cancer (pooled risk = 0.67, 95% CI = 0.54-0.81) for "ever" vs "never" breastfeeding; and with childhood leukaemia (pooled risk = 0.94, 95% CI = 0.89-0.98), and maternal ovarian cancer (pooled risk = 0.84, 95% CI = 0.78-0.90) and breast cancer (pooled risk = 0.92, 95% CI = 0.89-0.96) for "longest" vs "shortest" breastfeeding duration.

Conclusions

We found evidence that breastfeeding may reduce the risk of maternal breast cancer, ovarian cancers, and childhood leukaemia, suggesting positive implications for influencing women's decision in breastfeeding.

Registration

PROSPERO (CRD42021255608).

The role of human milk feeds on inotrope use in newborn infants with sepsis

Background

Regarding neonatal hypotension, there is no certainty as to whether inotrope properties are beneficial or whether they may be harmful. However, given that the antioxidant content of human milk plays a compensatory role in neonatal sepsis and that human milk feeding has direct effects in modulating the cardiovascular function of sick neonates, this research hypothesized that human milk feeds might predict lower requirements of vasopressors in the management of neonatal septic shock.

Method

Between January 2002 and December 2017, all late preterm and full-term infants attending a neonatal intensive care unit, with clinical and laboratory findings of bacterial or viral sepsis, were identified in a retrospective study. During their first month of life, data on feeding type and early clinical characteristics were collected. A multivariable logistic regression model was constructed to determine the impact of human milk on the use of vasoactive drugs in septic newborns.

Results

322 newborn infants were eligible to participate in this analysis. Exclusively formula-fed infants were more likely to be delivered via C-section, to have a lower birth weight and a lower 1-minute Apgar score than their counterparts. Human milk-fed newborns had 77% (adjusted OR = 0.231; 95% CI: 0.07-0.75) lower odds of receiving vasopressors than exclusively formula-fed newborns.

Conclusion

We report that any human milk feeding is associated with a decrease in the need for vasoactive medications in sepsis-affected newborns. This observation encourages us to undertake further research to determine whether human milk feeds mitigate the use of vasopressors in neonates with sepsis.

Factors Influencing Muslim Women’s Decisions about Induced Lactation: A Qualitative Study

The induction of lactation occurs when breast milk is produced in a woman, without going through the process of pregnancy and delivery. Induced lactation is a method of strengthening the bond between the adopted child and the adoptive mother. This study aimed to explore the factors influencing Muslim women’s decisions about induced lactation in Malaysia. This qualitative study used in-depth interviews with women who had induced lactation in five states based on five regions in Malaysia (Central Region (Selangor), Northern Region (Penang), Southern Region (Johor), East Coast Region (Kelantan), and Malaysia Borneo (Sabah)). All interviews were consented, audio-recorded, and transcribed verbatim, followed by identification of emerging themes. After interviewing 23 induced lactation women, data saturation was achieved. Data synthesized using thematic analysis revealed three themes describing the main factors in determining women’s decisions on induced lactation: (1) mahram relationship, (2) experiencing motherhood, and (3) the perceived superiority of breastfeeding. It is hoped that by identifying the various factors that influence the decision to induce lactation, health care professionals and the community will be empowered to support breastfeeding in terms of facilitating motherhood, providing breastfeeding aid equipment, and assisting with daily necessities. By expanding efforts and programs, the government and other stakeholders can assist adoptive mothers in breastfeeding their children and feeling more accomplished as women and mothers.

Kusrin Z, Abdul Majid L, Saidon R, Illias MZ. A quantitative study on Muslim milk mother’s understanding of the Islamic concept of wet nursing

Background

The practice of wet nursing or breastfeeding another woman’s child in Malaysia, especially among Muslim mothers, is on the rise. This is due to the emergence of public awareness of the benefits of breast milk to children. However, it is claimed that some mothers do not have a clear understanding of the Islamic rulings concerning wet nursing, especially those related to mahram (prohibition to marry), nasab (lineage) and inheritance. Hence, the purpose of this study is to examine the level of understanding of the legal implications of wet nursing and the factors influencing the practice among Muslim mothers who have practiced breastfeeding.

Methods

This was a cross-sectional descriptive study that was conducted between January and July 2019. This study was conducted with 100 Muslim mothers who had breastfed others’ child(ren) in Selangor. Data were obtained using a validated questionnaire (Cronbach’s alpha = 0.8) and processed using the Statistical Package for the Social Sciences (SPSS) software.

Results

The results show that the majority of the respondents understand the basic Islamic rulings on wet nursing, especially on the persons prohibited to marry, conditions and feeding method. However, the respondents need to further understand the rulings related to nasab (lineage), guardianship and inheritance involving the milk child. Various factors that have influenced wet nursing in society were also found.

Conclusions

This study has significant implications for the need to have more activities to create awareness and enhance the understanding related to wet nursing among Muslim women in society. Therefore, more research studies related to wet nursing and the impact of the practice should be conducted to offer better solutions to society.

Relationship between exclusive breastfeeding and brain-derived neurotrophic factor in children

Objective

A positive relationship between breastfeeding and brain-derived neurotrophic factor (BDNF) in infants has been suggested due to the presence of BDNF in human milk. This study aimed to determine the relationship between exclusive breastfeeding and BDNF serum levels in Spanish schoolchildren.

Methods

A cross-sectional analysis including 202 schoolchildren, aged eight to 11 years, from Cuenca, Spain, was conducted. Information on sociodemographic and anthropometric variables, sexual maturation, birth weight and exclusive breastfeeding (‘no exclusive breastfeeding’, and exclusive breastfeeding for ≤6 and >6 months), and BDNF serum levels using an ELISA method were obtained. Covariance analyses (ANCOVA) were conducted to examine the relationship between serological BDNF and exclusive breastfeeding after controlling for potential confounders.

Results

ANCOVA models showed no significant differences in BDNF levels between children who were exclusively breastfed for more than six months versus those who were not (p > 0.05). No significant differences were observed by age group (eight to nine years versus 10 to 11 years; p > 0.05). Additionally, no clear negative trend in BDNF serum levels according to sexual maturation categories was found (p > 0.05).

Conclusion

These findings suggest that exclusive breastfeeding does not have a significant positive association on BDNF from eight to 11 years, since children who were exclusively breastfed did not have significantly higher BDNF levels than those who were not exclusively breastfed. Likewise, BDNF levels were not found to be negatively affected by hormonal development. Future research should examine the influence of exclusive breastfeeding on BDNF over the different developmental stages.

Current Resources for Evidence-Based Practice, November 2020

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of diversity in the maternity care workforce and commentaries on reviews focused on burnout in midwifery and a cross-national comparison of guidelines for uncomplicated childbirth.