Racial capitalism and the US formula shortage: A policy analysis of the formula industry as a neocolonial system

A long-acting prolactin to combat lactation insufficiency

Human infants are born to breastfeed. While 50% of lactating persons struggle to make enough milk, there are no governmentally-approved drugs to enhance lactation1. Here, we engineer a variant of the naturally-occurring driver of lactation, the hormone Prolactin, to increase its serum half-life and produce a viable drug candidate. Our engineered variant, Prolactin-eXtra Long-acting (Prolactin-XL), is comprised of endogenously active human prolactin fused to an engineered human IgG Fc domain designed to overcome the unique drug development challenges specific to the lactating person-infant dyad. Our Prolactin-XL has a serum half-life of 70.9h in mice, 2,625-fold longer than endogenously active prolactin alone (70.9h v. 0.027h). We demonstrate that Prolactin-XL increases milk production and restores growth of pups fed by dams with pharmacologically-ablated lactation. We show that Prolactin-XL-enhanced lactation is accompanied by reversible, lactocyte-driven changes in mammary gland morphology. This work establishes long-acting prolactins as a potentially powerful pharmacologic means to combat insufficient lactation.

Global lessons for strengthening breastfeeding as a key pillar of food security

Breastfeeding is identified as a central pillar of food security by the World Health Organization, however globally significant challenges remain in achieving breastfeeding targets for early initiation, exclusive breastfeeding for 6 months, and continued breastfeeding for 2 years and beyond. Inadequate support in health systems, poor maternity protections and workplace policies, and insufficient regulation of commercial milk formulas, among other barriers, continue to undermine this key pillar across nations. This paper highlights the central importance of breastfeeding for food security across diverse global settings by examining three case studies: Honduras, Pakistan and the USA. The cases highlight the complex layering and intersections of key challenges that threaten breastfeeding in the era of pandemics, the climate crisis, conflict and global inequality. Lessons drawn from these case studies, combined with additional insights, reinforce the importance of multisectorial collaboration to scale up investment in creating equitable, enabling environments for breastfeeding. These structural and systems approaches can successfully strengthen the breastfeeding ecosystem to ensure greater first food system resilience in the face of global crises, which compound maternal and infant vulnerabilities. Additionally, the cases add urgency for greater attention to prioritizing breastfeeding and incorporating IYCF-E protocols into disaster preparedness and management into the policy agenda, as well as ensuring that first food security is considered in energy policy. An integrated approach to policy change is necessary to recognize and strengthen breastfeeding as a pivotal part of ensuring food security across the globe.

Bridging the commercial determinants of Indigenous health and the legacies of colonization: A critical analysis

To date, there has been scarce effort to consider the intertwining of colonization and the commercial determinants of Indigenous health. This is a vital omission, and one that this paper proposes to address. We propose how four losses of tradition borne out of colonialism are intertwined with four respective commercial determinants of Indigenous health: 1) loss of traditional diets and the ultra-processed food industry; 2) loss of traditional ceremony and the tobacco industry; 3) loss of traditional knowledge and the infant formula industry; and 4) loss of traditional support networks and the alcohol industry. Building on Indigenous efforts to decolonize spaces and assert control over their own lives, we argue that analyzing the mechanisms through which industry activities intersect with colonial legacies will improve broader understandings of Indigenous health disparities.

Handbooks and health interpreters: How men are assets for their pregnant partners in Senegal

INTRODUCTION

Global health researchers often approach fatherhood initiatives from a deficit-based perspective, assuming men need sensitization, education, or correction. Senegalese men, which some global health and development organizations have determined to be uninvolved, are part of a team of prenatal and postpartum support called the "entourage" and have a very specific role to play as ad hoc health interpreters.

METHODS

The findings of this article come from 12 months of ethnographic research in Dakar, Senegal in 2018. In addition to participant-observation in three maternity wards across the city, semi-structured interviews were conducted with 32 pregnant women, 27 expectant fathers, and numerous family members, midwives, physicians, and governmental and nongovernmental organization employees. Data were coded and evaluated using thematic analysis.

RESULTS

In Senegal, the Handbook of Mother and Child Health is distributed in state-funded maternity wards. The Handbook outlines what pregnant women should know about pregnancy and how to appropriately engage with clinical services. Male partners of pregnant women commonly read the book for and to their pregnant partners. Men are placed in the unique position of intermediary between pregnant women and the State and as such, they learn a lot about pregnancy and childbirth, as well as prenatal and postpartum care.

CONCLUSIONS

Our ethnographic insights challenge global health rhetoric that frames men as uninvolved in women and children's health and this study demonstrates that future interventions should take an asset-based approach to men's involvement. Senegalese men are uniquely positioned by gendered expectations to act as health interpreters for their pregnant partners. We conclude with specific, actionable recommendations for the Senegalese case.

Protecting, promoting and supporting breastfeeding in all policies: reframing the narrative

Recent research highlights the importance of breastfeeding to health across the lifecourse, yet inadequate investment to facilitate breastfeeding according to World Health Organization recommendations threatens to undermine breastfeeding's protective effects. Western media narratives often fail to convey the significance of breastfeeding, and such narratives can hinder efforts to direct sufficient resources to scaling up effective systems and generating policy change. Delayed action disproportionately harms poor and marginalized communities. The urgency of making these investments in an era of rapidly intensifying climate change and other crises is clear. Reframing the narrative is needed to better appreciate the significance of breastfeeding as well as to recognize and address extensive efforts of undermine it. Evidence-based scientific, health professional and media discussions are necessary to recognize breastfeeding as foundational to food and health security and to enact change so that protecting, promoting and supporting breastfeeding is integrated across all policies.