Abstract Title: Association between Bioactive Molecules in Breast Milk and Type 1 Diabetes Mellitus. Abstract Source: Sultan Qaboos Univ Med J. 2020 Feb ;20(1):e5-e12. Epub 2020 Mar 9. PMID: 32190364 Abstract Author(s): Tajudeen Yahaya, Ufuoma Shemishere Article Affiliation: Tajudeen Yahaya Abstract: The association between breastfeeding and type 1 diabetes mellitus (T1DM) is controversial. However, several recent studies have established a link between these two factors, necessitating a need to review this subject to raise public awareness. Current research indicates that breast milk contains a variety of bioactive substances including immunoglobulins, oligosaccharides, insulin, lactoferrin, lysozyme, cytokines, epidermal growth factors, leukocytes, nucleotides, beneficial bacteria and vitamins. Such substances strengthen the breastfeeding infant's immune system, both directly, by increasing gut microbiota diversity and attacking harmful bacteria and pro-inflammatory molecules, and indirectly, by increasing thymus performance. Accordingly, a lack of or inadequate breastfeeding may predispose infants to several autoimmune disorders, including T1DM. Nursing mothers and caregivers are therefore advised to follow optimal breastfeeding practices prior to introducing complementary foods. Article Published Date : Jan 31, 2020

Abstract Title: Maternal diet during lactation and breast-feeding practices have synergistic association with child diet at 6 years. Abstract Source: Public Health Nutr. 2019 Jul 10:1-9. Epub 2019 Jul 10. PMID: 31290381 Abstract Author(s): Jacob P Beckerman, Emily Slade, Alison K Ventura Article Affiliation: Jacob P Beckerman Abstract: OBJECTIVE: Children breast-fed during infancy consume more fruits and vegetables than formula-fed children. This pattern is likely due, in part, to infant learning from flavours of the mother's diet transmitted through breast milk, but more research is needed to understand associations between early flavour exposures and later dietary patterns. We examined whether breast-feeding and maternal fruit and vegetable consumption during nursing were synergistically associated with higher child fruit and vegetable consumption. DESIGN: Prospective cohort study of breast-feeding duration, maternal diet postpartum and child diet. Complete breast-feeding and maternal diet data were available for 1396 mother-child dyads; multiple imputation was used for missing data in other variables. In separate multivariable logistic regression models, we estimated the adjusted odds of high child fruit or vegetable consumption at 12 months or 6 years as a function of breast-feeding duration, maternal fruit or vegetable consumption during nursing, and their interaction. SETTING: The Infant Feeding Practices Study II and Year 6 Follow-Up. PARTICIPANTS: Mother-child dyads followed from birth to 6 years during 2005-2012 in the USA. RESULTS: Longer breast-feeding duration was associated with high child fruit and vegetable consumption at 12 months. At 6 years, the interaction between breast-feeding duration and maternal vegetable consumption was associated with high child vegetable consumption. CONCLUSIONS: Higher maternal vegetable consumption and longer breast-feeding duration were synergistically associated with high child vegetable consumption at 6 years, independent of sociodemographic characteristics and fruit and vegetable availability. Exposures to vegetable flavours through breast milk may promote later child vegetable consumption. Article Published Date : Jul 09, 2019

Abstract Title: Human Breast Milk Promotes the Secretion of Potentially Beneficial Metabolites by ProbioticDSM 17938. Abstract Source: Nutrients. 2019 Jul 9 ;11(7). Epub 2019 Jul 9. PMID: 31323989 Abstract Author(s): Tu T Mai, Dat Q Tran, Stefan Roos, J Marc Rhoads, Yuying Liu Article Affiliation: Tu T Mai Abstract: Human breast milk (HBM) may have beneficial effects onDSM 17938 (LR 17938) -mediated immunomodulation. We aimed to determine the effects of HBM on proliferation of LR 17938 in vitro and its associated proteins and metabolites in culture, in order to provide mechanistic insights into the health benefits of LR 17938. LR 17938 was cultured anaerobically in MRS bacterial culture media, HBM (from 6 mothers), and 2 types of cow-milk formula. The colony-forming unit (CFU) was calculated to evaluate LR 17938 growth. Sixteen-hour-fermented supernatants were used for metabolomics, and bacterial lysates were used for proteomics analysis. We found that growth of LR 17938 was 10 times better in HBM than in formula. We detected 261/452 metabolites upregulated when LR 17938 cultured in HBM compared to in formula, mainly participating in the glyoxylate cycle (succinate), urea cycle (citrulline), methionine methylation (N-acetylcysteine), and polyamine synthesis (spermidine). The significantly up-regulated enzymes were also involved in the formation of acetyl-CoA in the glyoxylate cycle and the antioxidant N-acetylcysteine. In conclusion, HBM enhances the growth of LR 17938 compared to formula and promotes LR 17938-associated metabolites that relate to energy and antioxidant status, which may be linked to the physiological effects of. Article Published Date : Jul 08, 2019

Abstract Title: Breastfeeding and Its Relationship to Childhood Respiratory Allergies and Allergic Asthma a Longitudinal Study (P11-104-19). Abstract Source: Curr Dev Nutr. 2019 Jun ;3(Suppl 1). Epub 2019 Jun 13. PMID: 31225254 Abstract Author(s): Galya Bigman Article Affiliation: Galya Bigman Abstract: Objectives: Breastfeeding might be associated with respiratory allergy and asthma subtypes(i.e., allergic asthma), but such relations have never been examined yet in the US. Therefore, the aims of the study were: To examined the association between breastfeeding and respiratory allergy in children aged six years.To examined the association between breastfeeding and asthma including asthma subtypes (allergic) in children aged six yearsOur hypothesis was that exclusively breastfeeding for 3 months would reduce the risk of developing childhood respiratory allergy and allergic asthma. Methods: A longitudinal study was used, utilizing data from mother-infant pairs that participated in the infant Feeding Practices Study-II(IFPS-II) and the Year-6-Follow-Up Study(Y6FU) in the United-States(US). The data included mother-reported breastfeeding practices in IFPS-II, childhood allergies in Y6FU, and covariates as demographic variables, siblings, wheezing, RSV, history of family allergies, maternal smoking status, and introduction to complementary foods. Multiple logistic regressions were used to examine the study aims. Results: Overall, 1,177 questionnaires were completed in IFPS-II and Y6FU. Until 3 months, 35.9%(n = 423) of the children were exclusively breastfed, and 24.6%(n = 290) were exclusively formula-fed. Based on mothers' reports, 20.8%(n = 245) of the children had been diagnosed by a physician as having had a respiratory allergy, and 10.2% (n = 120)with asthma, and of these, 105 cases had allergic asthma(8.7%). The results of the multivariable analyses showed that children who were exclusively breastfed for 3 months were significantly less likely by 37% to have respiratory allergy(AOR = 0.63 CI 95%:0.42-0.93) compared with children who were exclusively formula fed for 3 months afteradjusting for associated covariates. There were no significant differences in the odds of having asthma across the different feeding practices. Allergic asthma, however, was significantly associated with exclusive breastfeeding for 3 months (AOR = 0.54 CI 95%:0.30-0.96), after adjusting for associated covariates. Conclusions: Exclusive breastfeeding for the first 3 months reduce the risk for respiratory allergies and allergic asthma in children. Funding Sources: There is no funding source to declare. Article Published Date : May 31, 2019

Abstract Title: Association of Breastfeeding and Sugar-Sweetened Beverage Consumption with Obesity Prevalence in Offspring Born to Mothers with and Without Gestational Diabetes Mellitus (P11-098-19). Abstract Source: Curr Dev Nutr. 2019 Jun ;3(Suppl 1). Epub 2019 Jun 13. PMID: 31225178 Abstract Author(s): Sarvenaz Vandyousefi, Shannon Whaley, Fiona Asigbee, Matthew Landry, Reem Ghaddar, Jaimie Davis Article Affiliation: Sarvenaz Vandyousefi Abstract: Objectives: Prenatal and early life factors such as Gestational Diabetes Mellitus (GDM), exclusive breastfeeding (EBF), and early exposure to sugar-sweetened beverages (SSBs) may contribute to obesity in children. The relationship of EBF and SSBs with obesity prevalence in children exposed to GDM has rarely been evaluated. This study examined the association of EBF and early SSBs consumption with obesity prevalence in children (1-5y) born to mothers with and without GDM. Methods: This study used data from the 2014 Los Angeles County Women, Infants, and Children(WIC) Survey, which included 3,707 mothers and their children (1-5y). Infants (1-2y) with weight-for-height ≥ 97.7percentile were classified as subjects with high weight-for-length and children (2-5y) were classified as subjects with obesity if their BMI-for-age was ≥ 95percentile. Results: The individual and combination interaction effects of GDM, SSBs intake, and EBF on obesity prevalence were all significant ( < 0.05). Compared to GDM offspring, with low SSBs intake, and who were EBF (referent), those who were GDM, with high SSBs intake and who were EBF had approximately a five-fold increase in odds of obesity (OR = 4.77, 95%CI 1.55-8.60, = 0.03). Compared to the GDM referent group, GDM offspring who were not EBF with low and high SSBs intake had 4.3- and 4.4-times higher odds of obesity, respectively (OR = 4.33, 95%CI 1.42- 8.07, = 0.01; OR = 4.38, 95%CI 1.39- 8.16, = 0.01). Using non-GDM, EBF and low SSBs as referent, those who were not EBF, with either high or low SSBs had approximately a 4-fold increase in odds of obesity (OR = 3.62, 95%CI: 2.16-6.05, < 0.0001; OR = 3.83, 95%CI: 2.26-6.48, < 0.0001).Compared to the non-GDM referent group, those who were EBF and had high SSBs intake had 77% higher odds of obesity (OR = 1.77, 95%CI 0.93-3.37, = 0.001). Conclusions: In non-GDM offspring, EBF was protective against odds of obesity in both high and low SSBs consumers. In GDM offspring, EBF was only protective against obesity when SSBs intake was low. Surprisingly, GDM offspring who were EBF and had high SSBs consumption had a 4- to 5-fold increase in odds of obesity compared to those not EBF with either low or high SSBs intake. These results suggest that interventions should focus on the combined protective effects of EBF and low SSBs intake, particularly in GDM offspring. Funding Sources: First 5 LA. Article Published Date : May 31, 2019

Abstract Title: Clinical Inquiries: Does breastfeeding affect the risk of childhood obesity? Abstract Source: J Fam Pract. 2016 Dec ;65(12):931-932. PMID: 28149981 Abstract Author(s): Lindsay Gunnell, Jon Neher, Sarah Safranek Article Affiliation: Lindsay Gunnell Abstract: Ever having breastfed during the first year of life is associated with a 15% lower risk of overweight or obesity over the next 2 to 14 years compared with never having breastfed. Breastfeeding exclusively for 6 months is associated with a 30% to 50% reduction in risk. Article Published Date : Nov 30, 2016

Abstract Title: Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms. Abstract Source: Int J Environ Res Public Health. 2019 10 29 ;16(21). Epub 2019 Oct 29. PMID: 31671856 Abstract Author(s): Monika A Zielinska, Jadwiga Hamulka Article Affiliation: Monika A Zielinska Abstract: Air pollution is a major social, economic, and health problem around the world. Children are particularly susceptible to the negative effects of air pollution due to their immaturity and excessive growth and development. The aims of this narrative review were to: (1) summarize evidence about the protective effects of breastfeeding on the adverse health effects of air pollution exposure, (2) define and describe the potential mechanisms underlying the protective effects of breastfeeding, and (3) examine the potential effects of air pollution on breastmilk composition and lactation. A literature search was conducted using electronic databases. Existing evidence suggests that breastfeeding has a protective effect on adverse outcomes of indoor and outdoor air pollution exposure in respiratory (infections, lung function, asthma symptoms) and immune (allergic, nervous and cardiovascular) systems, as well as under-five mortality in both developing and developed countries. However, some studies reported no protective effect of breastfeeding or even negative effects of breastfeeding for under-five mortality. Several possible mechanisms of the breastfeeding protective effect were proposed, including the beneficial influence of breastfeeding on immune, respiratory, and nervous systems, which are related to the immunomodulatory, anti-inflammatory, anti-oxidant, and neuroprotective properties of breastmilk. Breastmilk components responsible for its protective effect against air pollutants exposure may be long chain polyunsaturated fatty acids (LC PUFA), antioxidant vitamins, carotenoids, flavonoids, immunoglobins, and cytokines, some of which have concentrations that are diet-dependent. However, maternal exposure to air pollution is related to increased breastmilk concentrations of pollutants (e.g., Polycyclic aromatic hydrocarbons (PAHs) or heavy metals in particulate matter (PM)). Nonetheless, environmental studies have confirmed that breastmilk's protective effects outweigh its potential health risk to the infant. Mothers should be encouraged and supported to breastfeed their infants due to its unique health benefits, as well as its limited ecological footprint, which is associated with decreased waste production and the emission of pollutants. Article Published Date : Jan 28, 2019

Abstract Title: Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: a nationally representative study. Abstract Source: BMC Public Health. 2017 Nov 21 ;17(1):889. Epub 2017 Nov 21. PMID: 29162064 Abstract Author(s): Md Nuruzzaman Khan, M Mofizul Islam Article Affiliation: Md Nuruzzaman Khan Abstract: BACKGROUND: Despite growing evidence in support of exclusive breastfeeding (EBF) among infants in the first 6 months of birth, the debate over the optimal duration of EBF continues. This study examines the effect of termination of EBF during the first 2, 4 and 6 months of birth on a set of adverse health and nutritional outcomes of infants. METHODS: Three waves of Bangladesh Demographic and Health Survey data were analysed using multivariate regression. The adverse health outcomes were: an episode of diarrhea, fever or acute respiratory infection (ARI) during the 2 weeks prior to the survey. Nutritional outcomes were assessed by stunting (height-for-age), wasting (weight-for-height) and underweight (weight-for-age). Population attributable fraction was calculated to estimate percentages of these six outcomes that could have been prevented by supplying EBF. RESULTS: Fifty-six percent of infants were exclusively breastfed during the first 6 months. Lack of EBF increased the odds of diarrhea, fever and ARI. Among the babies aged 6 months or less 27.37% of diarrhea, 13.24% of fever and 8.94% of ARI could have been prevented if EBF was not discontinued. If EBF was terminated during 0-2 months, 2-4 months the odds of becoming underweight were 2.16 and 2.01 times higher, respectively, than babies for whom EBF was not terminated. CONCLUSION: Children who are not offered EBF up to 6 months of their birth may suffer from a range of infectious diseases and under-nutrition. Health promotion and other public health interventions should be enhanced to encourage EBF at least up to six-month of birth. TRAIL REGISTRATION: Data of this study were collected following the guidelines of ICF International and Bangladesh Medical Research Council. The registration number of data collection is 132,989.0.000 and the data-request was registered on September 11, 2016. Article Published Date : Nov 20, 2017

Abstract Title: Breast Milk Transforming Growth Factorβ Is Associated With Neonatal Gut Microbial Composition. Abstract Source: J Pediatr Gastroenterol Nutr. 2017 Sep ;65(3):e60-e67. PMID: 28827481 Abstract Author(s): Alexandra R Sitarik, Kevin R Bobbitt, Suzanne L Havstad, Kei E Fujimura, Albert M Levin, Edward M Zoratti, Haejin Kim, Kimberley J Woodcroft, Ganesa Wegienka, Dennis R Ownby, Christine L M Joseph, Susan V Lynch, Christine C Johnson Article Affiliation: Alexandra R Sitarik Abstract: BACKGROUND AND OBJECTIVES: Breast milk is a complex bioactive fluid that varies across numerous maternal and environmental conditions. Although breast-feeding is known to affect neonatal gut microbiome, the milk components responsible for this effect are not well-characterized. Given the wide range of immunological activity breast milk cytokines engage in, we investigated 3 essential breast milk cytokines and their association with early life gut microbiota. METHODS: A total of 52 maternal-child pairs were drawn from a racially diverse birth cohort based in Detroit, Michigan. Breast milk and neonatal stool specimens were collected at 1-month postpartum. Breast milk transforming growth factor (TGF)β1, TGFβ2, and IL-10 were assayed using enzyme-linked immunosorbent assays, whereas neonatal gut microbiome was profiled using 16S rRNA sequencing. RESULTS: Individually, immunomodulators TGFβ1 and TGFβ2 were significantly associated with neonatal gut microbial composition (R = 0.024, P = 0.041; R = 0.026, P = 0.012, respectively) and increased richness, evenness, and diversity, but IL-10 was not. The effects of TGFβ1 and TGFβ2, however, were not independent of one another, and the effect of TGFβ2 was stronger than that of TGFβ1. Higher levels of TGFβ2 were associated with the increased relative abundance of several bacteria, including members of Streptococcaceae and Ruminococcaceae, and lower relative abundance of distinct Staphylococcaceae taxa. CONCLUSIONS: Breast milk TGFβ concentration explains a portion of variability in gut bacterial microbiota composition among breast-fed neonates. Whether TGFβ acts in isolation or jointly with other bioactive components to alter bacterial composition requires further investigation. These findings contribute to an increased understanding of how breast-feeding affects the gut microbiome-and potentially immune development-in early life. Article Published Date : Aug 31, 2017

Abstract Title: Association between breastfeeding and better preserved cognitive ability in an elderly cohort of Finnish men. Abstract Source: Psychol Med. 2017 Aug 22:1-13. Epub 2017 Aug 22. PMID: 28826414 Abstract Author(s): V Rantalainen, J Lahti, M Henriksson, E Kajantie, M Mikkonen, J G Eriksson, K Raikkonen Article Affiliation: V Rantalainen Abstract: BACKGROUND: Being breastfed in infancy has been shown to benefit neurodevelopment. However, whether the benefits persist to old age remains unclear. METHODS: We examined the associations between breastfeeding and its duration on cognitive ability in young adulthood and old age, and on aging-related cognitive change over five decades. In total, 931 men from the Helsinki Birth Cohort Study born in 1934-1944 in Finland took the Finnish Defence Forces Basic Intellectual Ability Test (total and verbal, arithmetic and visuospatial subtest scores) twice, at ages 20.2 and 67.9 years, and had data on breastfeeding (yes v. no) and its duration ('never breastfed', 'up to 3', '3 to 6' and '6 or more months'). Linear and mixed model regressions tested the associations. RESULTS: At 20.2 years, breastfed men had higher cognitive ability total and visuospatial subtest scores [mean differences (MDs) ranged between 3.0-3.9, p values<0.013], and its longer duration predicted higher cognitive ability total and arithmetic and visuospatial subtest scores (MDs ranged between 3.0 and 4.8, p values<0.039). At 67.9 years, breastfed men had higher total cognitive ability and all subtest scores (MDs ranged between 2.6 and 3.4, p values<0.044) and its longer duration predicted all cognitive ability scores (MDs ranged between 3.1 and 4.7, p values<0.050). Verbal subtest scores decreased over five decades in men who were never breastfed or were breastfed for 3 months or less, and increased in those breastfed for longer than 3 months. CONCLUSIONS: Neurodevelopmental advantages of breastfeeding and its longer duration persist into old age, and longer duration of breastfeeding may benefit aging-related change, particularly in verbal reasoning ability. Article Published Date : Aug 21, 2017

Abstract Title: Impact of Metabolic Hormones Secreted in Human Breast Milk on Nutritional Programming in Childhood Obesity. Abstract Source: J Mammary Gland Biol Neoplasia. 2017 Jun 27. Epub 2017 Jun 27. PMID: 28653126 Abstract Author(s): Pilar Amellali Badillo-Suárez, Maricela Rodríguez-Cruz, Xóchitl Nieves-Morales Article Affiliation: Pilar Amellali Badillo-Suárez Abstract: Obesity is the most common metabolic disease whose prevalence is increasing worldwide. This condition is considered a serious public health problem due to associated comorbidities such as diabetes mellitus and hypertension. Perinatal morbidity related to obesity does not end with birth; this continues affecting the mother/infant binomial and could negatively impact on metabolism during early infant nutrition. Nutrition in early stages of growth may be essential in the development of obesity in adulthood, supporting the concept of"nutritional programming". For this reason, breastfeeding may play an important role in this programming. Breast milk is the most recommended feeding for the newborn due to the provided benefits such as protection against obesity and diabetes. Health benefits are based on milk components such as bioactive molecules, specifically hormones involved in the regulation of food intake. Identification of these molecules has increased in recent years but its action has not been fully clarified. Hormones such as leptin, insulin, ghrelin, adiponectin, resistin, obestatin and insulin-like growth factor-1 copeptin, apelin, and nesfatin, among others, have been identified in the milk of normal-weight women and may influence the energy balance because they can activate orexigenic or anorexigenic pathways depending on energy requirements and body stores. It is important to emphasize that, although the number of biomolecules identified in milk involved in regulating food intake has increased considerably, there is a lack of studies aimed at elucidating the effect these hormones may have on metabolism and development of the newborn. Therefore, we present a state-of-the-art review regarding bioactive compounds such as hormones secreted in breast milk and their possible impact on nutritional programming in the infant, analyzing their functions in appetite regulation. Article Published Date : Jun 26, 2017

Abstract Title: Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium. Abstract Source: Obstet Gynecol. 2017 Jun ;129(6):1059-1067. PMID: 28486362 Abstract Author(s): Susan J Jordan, Renhua Na, Sharon E Johnatty, Lauren A Wise, Hans Olov Adami, Louise A Brinton, Chu Chen, Linda S Cook, Luigino Dal Maso, Immaculata De Vivo, Jo L Freudenheim, Christine M Friedenreich, Carlo La Vecchia, Susan E McCann, Kirsten B Moysich, Lingeng Lu, Sara H Olson, Julie R Palmer, Stacey Petruzella, Malcolm C Pike, Timothy R Rebbeck, Fulvio Ricceri, Harvey A Risch, Carlotta Sacerdote, Veronica Wendy Setiawan, Todd R Sponholtz, Xiao Ou Shu, Amanda B Spurdle, Elisabete Weiderpass, Nicolas Wentzensen, Hannah P Yang, Herbert Yu, Penelope M Webb Article Affiliation: Susan J Jordan Abstract: OBJECTIVE: To investigate the association between breastfeeding and endometrial cancer risk using pooled data from 17 studies participating in the Epidemiology of Endometrial Cancer Consortium. METHODS: We conducted a meta-analysis with individual-level data from three cohort and 14 case-control studies. Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the association between breastfeeding and risk of endometrial cancer using multivariable logistic regression and pooled using random-effects meta-analysis. We investigated between-study heterogeneity with I  and Q statistics and metaregression. RESULTS: After excluding nulliparous women, the analyses included 8,981 women with endometrial cancer and 17,241 women in a control group. Ever breastfeeding was associated with an 11% reduction in risk of endometrial cancer (pooled OR 0.89, 95% CI 0.81-0.98). Longer average duration of breastfeeding per child was associated with lower risk of endometrial cancer, although there appeared to be some leveling of this effect beyond 6-9 months. The association with ever breastfeeding was not explained by greater parity and did not vary notably by body mass index or histologic subtype (grouped as endometrioid and mucinous compared with serous and clear cell). CONCLUSION: Our findings suggest that reducing endometrial cancer risk can be added to the list of maternal benefits associated with breastfeeding. Ongoing promotion, support, and facilitation of this safe and beneficial behavior might therefore contribute to the prevention of this increasingly common cancer. Article Published Date : May 31, 2017

Abstract Title: [Relationship of infant feeding on childhood obesity. A literature review]. Abstract Source: Orv Hetil. 2017 Jun ;158(24):938-943. PMID: 28604078 Abstract Author(s): László Ságodi, Enikő Sólyom, Emőke Kiss-Tóth Article Affiliation: László Ságodi Abstract: The increasing frequency of childhood obesity is a serious public health concern. Today it is recognized that the infant feeding during critical periods of early human development ("the first 1000 days") can be a long-term impact for future health. Authors deal with with the infant period of the first 1000 days of life starting from the conception, based on literature review. Since 2010 a large number of publications have appeared in which the relationship between infant feeding, early weight gain and later obesity are investigated. The majority of studies have demonstrated, that breastfeeding has a marked effect on early growth and reduces the risk of obesity in the long-term. The health benefits of breastfeeding over infant formula feeding are accepted, however, the relationship between infant feeding and later obesity, there is no clear consensus in the literature. The authors investigated this contradiction reviewing the newly published articles over the last few years. In summary they established, that duration of breastfeeding for at least 4 months have an important role in lowering of childhood adiposity risk. The different or ambiguous statements in the relevant publications can be explained by the fact that the development and the prevention of obesity are multifactorial. Orv Hetil. 2017; 158(24): 938-943. Article Published Date : May 31, 2017

Abstract Title: Breastfeeding Mode and Risk of Breast Cancer: A Dose-Response Meta-Analysis. Abstract Source: J Hum Lact. 2017 May ;33(2):422-434. Epub 2017 Feb 14. PMID: 28196329 Abstract Author(s): Mishel Unar-Munguía, Gabriela Torres-Mejía, M Arantxa Colchero, Teresita González de Cosío Article Affiliation: Mishel Unar-Munguía Abstract: BACKGROUND: Breastfeeding reduces women's risk of breast cancer. Since exclusive breastfeeding has a stronger hormonal effect, it could theoretically result in a greater reduction in breast cancer risk than any breastfeeding mode. No meta-analysis has examined breast cancer risk by breastfeeding mode. Research aim: The authors conducted a meta-analysis for breast cancer risk in parous women who breastfed exclusively or in any mode versus parous women who formula fed their infants, and they estimated the summary dose-response association by the accumulated duration of any breastfeeding mode. METHODS: A systematic review of studies published between 2005 and 2015 analyzing breastfeeding and breast cancer risk in women was conducted in PubMed and EBSCOhost. A meta-analysis ( n = 65 studies) with fixed effects (or random effects, if heterogeneity existed) was carried out stratified by breastfeeding mode and menopausal and parity status. A summary dose-response association was estimated using the generalized least-squares method. RESULTS: The summary relative risk (SRR) for breast cancer in parous women who breastfed exclusively was 0.72, 95% confidence interval (CI) [0.58, 0.90], versus parous women who had never breastfed. For parous women who breastfed in any mode, the SRR was lower in both premenopausal women (0.86, 95% CI [0.80, 0.93]) and postmenopausal women (0.89, 95% CI [0.83, 0.95]). There was no heterogeneity or publication bias. There is weak evidence of a difference between exclusive and any breastfeeding mode ( p = .08). The summary dose-response curve was nonlinear ( p<.001). CONCLUSION: Exclusive breastfeeding among parous women reduces the risk of breast cancer compared with parous women who do not breastfeed exclusively. Article Published Date : Apr 30, 2017

Abstract Title: Analgesic Effect of Maternal Human Milk Odor on Premature Neonates: A Randomized Controlled Trial. Abstract Source: J Hum Lact. 2017 May ;33(2):300-308. Epub 2017 Mar 27. PMID: 28346843 Abstract Author(s): Audrey Baudesson de Chanville, Véronique Brevaut-Malaty, Aurélie Garbi, Barthelemy Tosello, Karine Baumstarck, Catherine Gire Article Affiliation: Audrey Baudesson de Chanville Abstract: BACKGROUND: Two studies have demonstrated an analgesic effect of maternal milk odor in preterm neonates, without specifying the method of olfactory stimulation. Research aim: This study aimed to assess the analgesic effect of maternal milk odor in preterm neonates by using a standardized method of olfactory stimulation. METHODS: This trial was prospective, randomized, controlled, double blinded, and centrally administered. The inclusion criteria for breastfed infants included being born between 30 and 36 weeks + 6 days gestational age and being less than 10 days postnatal age. There were two groups: (a) A maternal milk odor group underwent a venipuncture with a diffuser emitting their own mother's milk odor and (2) a control group underwent a venipuncture with an odorless diffuser. The primary outcome was the Premature Infant Pain Profile (PIPP) score, with secondary outcomes being the French scale of neonatal pain-Douleur Aiguë du Nouveau-né (DAN) scale-and crying duration. All neonates were given a dummy. RESULTS: Our study included 16 neonates in the maternal milk odor group and 17 in the control group. Neonates exposed to their own mother's milk odor had a significantly lower median PIPP score during venipuncture compared with the control group (6.3 [interquartile range (IQR) = 5-10] versus 12.0 [IQR = 7-13], p = .03). There was no significant difference between the DAN scores in the two groups ( p = .06). Maternal milk odor significantly reduced crying duration after venipuncture (0 [IQR = 0-0] versus 0 [IQR = 0-18], p = .04). CONCLUSION: Maternal milk odor has an analgesic effect on preterm neonates. Article Published Date : Apr 30, 2017

Abstract Title: Association Between Duration of Breast Feeding and Metabolic Syndrome: The Korean National Health and Nutrition Examination Surveys. Abstract Source: J Womens Health (Larchmt). 2017 Apr ;26(4):361-367. Epub 2017 Jan 10. PMID: 28072915 Abstract Author(s): Se Rin Choi, Yong Min Kim, Min Su Cho, So Hyun Kim, Young Suk Shim Article Affiliation: Se Rin Choi Abstract: BACKGROUND: This study aimed to evaluate the association of the lifelong duration of breast feeding with metabolic syndrome (MetS) and its components in Korean parous women aged 19-50 years. MATERIALS AND METHODS: A total of 4724 participants from the Korean National Health and Nutritional Survey were included. Subjects were divided into four groups according to the duration of breast feeding:≤5, 6-11, 12-23, or ≥24 months groups. The adjusted odds ratios (ORs) of MetS and its components were assessed according to the duration of breast feeding. RESULTS: Women who breastfed for 6-11 months had an OR of 0.67 (95% confidence interval [CI], 0.54-0.86) for elevated blood pressure (BP) compared with those who breastfed for≤5 months after adjustment for possible confounders in a multivariable logistic regression analyses. Women who breastfed for 12-23 months were associated with an OR of 0.68 (95% CI, 0.54-0.86) for elevated BP, an OR of 0.78 (95% CI, 0.62-0.97) for elevated glucose, and an OR of 0.73 (95% CI, 0.56-0.95) for MetS compared with those who breastfed for ≤5 months in a multivariable logistic regression analyses. Women who breastfed for ≥24 months had an OR of 0.62 (95% CI, 0.52-0.84) for elevated glucose, an OR of 0.76 (95% CI, 0.60-0.96) for elevated triglycerides, and an OR of 0.70 (95% CI,0.53-0.92) for MetS compared with those who breastfed for ≤5 months in a multivariable logistic regression analyses. CONCLUSIONS: Our results suggest that lifelong breast feeding for≥12 months may be associated with lower risk for MetS. Article Published Date : Mar 31, 2017

Abstract Title: Prior lactation reduces future diabetic risk through sustained postweaning effects on insulin sensitivity. Abstract Source: Am J Physiol Endocrinol Metab. 2017 Mar 1 ;312(3):E215-E223. Epub 2016 Dec 13. PMID: 27965206 Abstract Author(s): Harpreet Bajaj, Chang Ye, Anthony J Hanley, Philip W Connelly, Mathew Sermer, Bernard Zinman, Ravi Retnakaran Article Affiliation: Harpreet Bajaj Abstract: Breastfeeding for≥12 mo is recommended for optimal infant nutrition but may hold maternal benefits as well. Indeed, lactation has been associated with lower long-term risk of diabetes in the mother, but the mechanism by which it imparts sustained postweaning effects on glucose tolerance remains unclear. In this context, we postulated that lactation could potentially induce postweaning beneficial effects on glucose tolerance by modifying the natural history of insulin sensitivity and/or pancreatic β-cell function over time. Thus, in this study, we evaluated the relationships between duration of lactation [≤3 mo (n = 70), 3-12 mo (n = 140), and ≥12 mo (n = 120)] and trajectories of insulin sensitivity/resistance, β-cell function, and glycemia over the first 3 yr postpartum in a cohort of 330 women comprising the full spectrum of glucose tolerance in pregnancy, who underwent serial metabolic characterization, including oral glucose tolerance tests, at 3 mo, 1 yr, and 3 yr postpartum. The prevalence of dysglycemia (pre-diabetes/diabetes) at 3 yr postpartum was lower in women who breastfed for ≥12 mo (12.5%) than in those who breastfed for ≤3 mo (21.4%) or for 3-12 mo (25.7%)(overall P = 0.028). On logistic regression analysis, lactation for ≥12 mo independently predicted a lower likelihood of prediabetes/diabetes at 3 yr postpartum (OR = 0.37, 95% CI 0.18-0.78, P = 0.009). Notably, lactation for ≥12 mo predicted lesser worsening of insulin sensitivity/resistance (P<0.0001), fasting glucose (P<0.0001), and 2-h glucose (P = 0.011) over 3 yr compared with lactation≤3 mo but no differences in β-cell function (P ≥ 0.37). It has thus emerged that adherence to current breastfeeding recommendations reduces future diabetic risk through sustained postweaning effects on insulin sensitivity/resistance but not β-cell function. Article Published Date : Feb 28, 2017

Abstract Title: [The benefits of breastfeeding and associated risks of replacement with baby formulas]. Abstract Source: Rev Chil Pediatr. 2017 Feb ;88(1):7-14. PMID: 28288222 Abstract Author(s): Paulina Brahm, Verónica Valdés Article Affiliation: Paulina Brahm Abstract: Breastfeeding is the nourishment designed by nature for the newborn and the infant; however its prevalence is nowadays not optimal. The aim of this article is to review the current evidence of the benefits of breastfeeding for children and society, and to elaborate the risks associated with the replacement of lactation with baby formulas. Breastfeeding is a protective factor for several infectious, atopic, and cardiovascular diseases as well as for leukaemia, necrotising enterocolitis, celiac disease, and inflammatory bowel disease. It also has a positive impact on neurodevelopment, improving IQ and reducing the risk of attention deficit disorder, and generalised developmental and behavioural disorders. Lactation can decrease the risk of sudden infant deaths syndrome by 36% and prevent 13% of infant mortality worldwide. Breastfeeding result in direct saving on the use of infant formulas and bottles, and indirectly on associated health costs, premature deaths, and quality-adjusted life years, among others. In addition, breastfeeding is environmentally friendly; it does not leave an ecological footprint in its production and consumption. The use of baby formulas and bottles have inherent risks, because they increase the risk of oral diseases, such as mouth breathing, malocclusion, alteration of bite, and tooth decay. Finally, the intestinal microbiota, oxygenation, and thermoregulation of infants are negatively affected by their use. Article Published Date : Jan 31, 2017

Abstract Title: Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study. Abstract Source: PLoS One. 2017 ;12(2):e0172763. Epub 2017 Feb 23. PMID: 28231310 Abstract Author(s): Ilse Tromp, Jessica Kiefte-de Jong, Hein Raat, Vincent Jaddoe, Oscar Franco, Albert Hofman, Johan de Jongste, Henriëtte Moll Article Affiliation: Ilse Tromp Abstract: BACKGROUND: The protection of breastfeeding against respiratory tract infections in the first year of life has often been suggested. Few studies examined the effect of breastfeeding on respiratory tract infections after infancy. OBJECTIVE: To examine the association between breastfeeding with lower respiratory tract infections (LRTI) and upper respiratory tract infections (URTI) after infancy up to 4 years of age (n = 5322). METHODS: This study was embedded in The Generation R study, a Dutch population-based prospective cohort study from fetal life until young adulthood. Information on breastfeeding duration (never;<3 months; 3-6 months;≥6 months) and dose (never; partially until 4 months; predominantly until 4 months) were collected by questionnaire at 2, 6, and 12 months of age. Information on doctor attendance for LRTI and URTI were obtained by questionnaire at 2, 3, and 4 years of age. RESULTS: Breastfeeding for 6 months or longer was significantly associated with a reduced risk of LRTI up to 4 years of age (aOR: 0.71; 95% CI: 0.51-0.98). Similar ORs for LRTI were found with breastfeeding for less than 3 months and 3-6 months. Although in the same direction, weaker ORs were found for URTI and breastfeeding duration. The same trend was found for partial and predominant breastfeeding until 4 months and LRTI and URTI. CONCLUSION: Breastfeeding duration for 6 months or longer is associated with a reduced risk of LRTI in pre-school children. These findings are compatible with the hypothesis that the protective effect of breastfeeding for respiratory tract infections persist after infancy therefore supporting current recommendations for breastfeeding for at least 6 months. Article Published Date : Dec 31, 2016

Abstract Title: Influence of Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants. Abstract Source: Nurs Res. 2017 Mar/Apr;66(2):123-133. PMID: 28252573 Abstract Author(s): Xiaomei Cong, Michelle Judge, Wanli Xu, Ana Diallo, Susan Janton, Elizabeth A Brownell, Kendra Maas, Joerg Graf Article Affiliation: Xiaomei Cong Abstract: BACKGROUND: Premature infants have a high risk for dysbiosis of the gut microbiome. Mother's own milk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited. OBJECTIVE: The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit. METHODS: Thirty-three stable preterm infants were recruited at birth and followed up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (MOM, human donor milk [HDM], Formula, MOM + HDM, MOM + Formula, and HDM + Formula) during postnatal days 0-10, 11-20, and 21-30. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models. RESULTS: Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily HDM or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight, and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p<.01). DISCUSSION: MOM benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life. Article Published Date : Dec 31, 2016

Abstract Title: Infant Feeding and Risk of Type 1 Diabetes in Two Large Scandinavian Birth Cohorts. Abstract Source: Diabetes Care. 2017 07 ;40(7):920-927. Epub 2017 May 9. PMID: 28487451 Abstract Author(s): Nicolai A Lund-Blix, Stine Dydensborg Sander, Ketil Størdal, Anne-Marie Nybo Andersen, Kjersti S Rønningen, Geir Joner, Torild Skrivarhaug, Pål R Njølstad, Steffen Husby, Lars C Stene Article Affiliation: Nicolai A Lund-Blix Abstract: OBJECTIVE: Our aim was to study the relation between the duration of full and any breastfeeding and risk of type 1 diabetes. RESEARCH DESIGN AND METHODS: We included two population-based cohorts of children followed from birth (1996-2009) to 2014 (Denmark) or 2015 (Norway). We analyzed data from a total of 155,392 children participating in the Norwegian Mother and Child Cohort Study (MoBa) and the Danish National Birth Cohort (DNBC). Parents reported infant dietary practices when their child was 6 and 18 months old. The outcome was clinical type 1 diabetes, ascertained from nationwide childhood diabetes registries. Hazard ratios (HRs) were estimated using Cox regression. RESULTS: Type 1 diabetes was identified in 504 children during follow-up, and the incidence of type 1 diabetes per 100,000 person-years was 30.5 in the Norwegian cohort and 23.5 in the Danish cohort. Children who were never breastfed had a twofold increased risk of type 1 diabetes compared with those who were breastfed (HR 2.29 [95% CI 1.14-4.61] for no breastfeeding vs. any breastfeeding for≥12 months). Among those who were breastfed, however, the incidence of type 1 diabetes was independent of duration of both full breastfeeding (HR per month 0.99 [95% CI 0.97-1.01]) and any breastfeeding (0.97 [0.92-1.03]). CONCLUSIONS: Suggestive evidence supports the contention that breastfeeding reduces the risk of type 1 diabetes. Among those who were breastfed, however, no evidence indicated that prolonging full or any breastfeeding was associated with a reduced risk of type 1 diabetes. Article Published Date : Dec 31, 2016

Abstract Title: Does Breastfeeding Shape Food Preferences? Links to Obesity. Abstract Source: Ann Nutr Metab. 2017 ;70 Suppl 3:8-15. Epub 2017 Sep 14. PMID: 28903109 Abstract Author(s): Alison K Ventura Article Affiliation: Alison K Ventura Abstract: The first 2 years of life have been recognized as a critical window for obesity prevention efforts. This period is characterized by rapid growth and development and, in a relatively short period of time, a child transitions from a purely milk-based diet to a more varied solid-food diet. Much learning about food and eating occurs during this critical window, and it is well-documented that early feeding and dietary exposures predict later food preferences, eating behaviors, and dietary patterns. The focus of this review will be on the earliest feeding experiences - breast- and formula-feeding - and the unique role of breastfeeding in shaping children's food preferences. Epidemiological data illustrate that children who were breastfed have healthier dietary patterns compared to children who were formula-fed, even after controlling for relevant sociodemographic characteristics associated with healthier dietary and lifestyle patterns. These dietary differences are underlined, in part, by early differences in the opportunities for flavor learning and preference development afforded by breast- versus formula-feeding. In particular, the flavors of the mothers' diet are transmitted from mother to child through the amniotic fluid and breastmilk. The flavors experienced in these mediums shape later food preferences and acceptance of the solid foods of the family and culture onto which the infant is weaned. All infants learn from flavor experiences in utero, but only breastfed infants receive the additional reinforcement and flavor learning provided by continued repeated exposure to a wide variety of flavors that occurs during breastfeeding. Given the numerous benefits of breastfeeding, promotion of breastfeeding during early infancy is an important focus for primary prevention efforts and should be combined with efforts to ensure that mothers consume healthy, varied diets during pregnancy and lactation, and expose their infants to a wide array of foods during weaning and solid-food feeding. Article Published Date : Dec 31, 2016

Abstract Title: Breastfeeding, Childhood Asthma, and Allergic Disease. Abstract Source: Ann Nutr Metab. 2017 ;70 Suppl 2:26-36. Epub 2017 May 19. PMID: 28521318 Abstract Author(s): Wendy H Oddy Article Affiliation: Wendy H Oddy Abstract: The worldwide prevalence of childhood asthma has been increasing considerably, and the protection afforded by breastfeeding in its development has been the subject of controversy for more than 80 years. Previous systematic reviews have generally found a protective effect of breastfeeding on allergic outcomes, although many studies have methodological limitations. Although breastfeeding is protective against lower respiratory tract infection during infancy, such protection has not been demonstrated for asthma in all studies. Breastfeeding has health benefits for the mother and child. Exclusive breastfeeding for the first 6 months of an infant's life, with continued breastfeeding for up to 2 years or longer, is recognized as the"gold"standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote a healthy development. There is increasing concern that the practice of delaying complementary foods until 6 months may exacerbate the risk of allergic disease. Breast milk contains immunological components that protect against infections and allergic disease in infancy. The composition of human breast milk is complex, containing factors that interact with the infant immune system and intestinal milieu including allergens, cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines. Transforming growth factorβ is a cytokine in human milk involved in maintaining intestinal homeostasis, inflammation regulation, and oral tolerance development. Modern day society, with increased standards of hygiene, has changed the gut flora of Western infants, potentially impacting the risk of developing immune-mediateddiseases including allergic disease and asthma. Microbial diversity is intrinsic to healthy immune maturation and function. Compared to breastfed infants, formula-fed infants had lower bacterial diversity and an altered intestinal microbiota in the first few weeks of life associated with an increased risk of eczema and asthma. Favorable gut colonization through continued breastfeeding may promote tolerance as well as protection when complementary feeding is initiated. Article Published Date : Dec 31, 2016

Abstract Title: Relationship Between Exclusive Breastfeeding and Lower Risk of Childhood Obesity: A Narrative Review of Published Evidence. Abstract Source: Clin Med Insights Pediatr. 2017 ;11:1179556517690196. Epub 2017 Feb 16. PMID: 28469518 Abstract Author(s): Samuel N Uwaezuoke, Chizoma I Eneh, Ikenna K Ndu Article Affiliation: Samuel N Uwaezuoke Abstract: BACKGROUND: The pattern of infant feeding during the first 1000-day period-from conception to the second birthday-has a significant influence on the child's growth trajectory. The relationship between exclusive breastfeeding and lower risk of childhood obesity has elicited much scientific interest, given the fact that this form of malnutrition is becoming a global epidemic. AIM: This narrative review aims to examine the evidence in the literature linking exclusive breastfeeding with reduction in obesity in children. LITERATURE SEARCH: Using appropriate search terms, PubMed database was searched for relevant articles that met the review objective. RESULTS: Evidence for the protective effect of exclusive breastfeeding against childhood obesity have been provided by studies which explored 5 physiologic mechanisms and those that established the causality between breastfeeding and lower risk of obesity. The few studies that disputed this relationship highlighted the influence of confounding factors. A new insight on molecular mechanisms, however, points to a direct and indirect effect of human milk oligosaccharides on the prevention of overweight and obesity. CONCLUSIONS: The preponderance of current evidence strongly suggests that exclusivity in breastfeeding can prevent the development of obesity in children. Article Published Date : Dec 31, 2016

Abstract Title: Factors Influencing the Infant Gut Microbiome at Age 3-6 months: Findings from the ethnically diverse Vitamin D Antenatal Asthma Reduction Trial (VDAART). Abstract Source: J Allergy Clin Immunol. 2016 Oct 13. Epub 2016 Aug 13. PMID: 27746239 Abstract Author(s): Joanne E Sordillo, Yanjiao Zhou, Michael J McGeachie, John Ziniti, Nancy Lange, Nancy Laranjo, Jessica R Savage, Vincent Carey, George O'Connor, Megan Sandel, Robert Strunk, Leonard Bacharier, Robert Zeiger, Scott T Weiss, George Weinstock, Diane R Gold, Augusto A Litonjua Article Affiliation: Joanne E Sordillo Abstract: BACKGROUND: The gut microbiome in infancy influences immune system maturation, and may have an important impact allergic disease risk. OBJECTIVE: To determine how prenatal and early life factors impact the gut microbiome in a relatively large, ethnically diverse study population of infants at 3-6 months of age, who were enrolled in VDAART, a clinical trial of vitamin D supplementation in pregnancy to prevent asthma and allergies in offspring. METHODS: We performed 16S rRNA gene sequencing on 333 infants' stool samples. Microbial diversity was computed using the Shannon Index. Factor analysis applied to the top 25 most abundant taxa revealed four underlying bacterial co-abundance groups; the first dominated by Firmicutes (Lachnospiraceae/ Clostridiales), the second by Proteobacteria (Klebsiella/Enterobacter), the third by Bacteriodetes, and the fourth by Veillonella. Scores for co-abundance groups were used as outcomes in regression models, with prenatal/birth and demographic characteristics as independent predictors. Multivariate analysis, using all microbial community members, was also conducted. RESULTS: Caucasian race/ethnicity was associated with lower diversity but higher Bacteroidetes co-abundance scores. Caucasian infants had lower Proteobacteria scores as compared to African Americans. C-section birth was associated with higher diversity, but with decreased Bacteroidetes co-abundance scores. Firmicutes and Proteobacteria scores were higher for infants born by C-section. Breastfed infants had lower proportions of Clostridiales. Cord blood vitamin D was linked to increased Lachnobacterium, but decreased Lactococcus. CONCLUSIONS: The findings presented here suggest that race, mode of delivery, breastfeeding and cord blood vitamin D levels are associated with infant gut microbiome composition, with possible long-term implications for immune system modulation and asthma/allergic disease incidence. Article Published Date : Oct 12, 2016

Abstract Title: High-Dose Monthly Maternal Cholecalciferol Supplementation during Breastfeeding Affects Maternal and Infant Vitamin D Status at 5 Months Postpartum: A Randomized Controlled Trial. Abstract Source: J Nutr. 2016 Oct ;146(10):1999-2006. Epub 2016 Aug 24. PMID: 27558577 Abstract Author(s): Benjamin J Wheeler, Barry J Taylor, Peter Herbison, Jillian J Haszard, Adel Mikhail, Shirley Jones, Michelle J Harper, Lisa A Houghton Article Affiliation: Benjamin J Wheeler Abstract: BACKGROUND: Many countries recommend daily infant vitamin D supplementation during breastfeeding, but compliance is often poor. A monthly, high-dose maternal regimen may offer an alternative strategy, but its efficacy is unknown. OBJECTIVE: The objective of the study was to determine the effect of 2 different monthly maternal doses of cholecalciferol on maternal and infant 25-hydroxyvitamin D [25(OH)D] status during the first 5 mo of breastfeeding. METHODS: With the use of a randomized, double-blind, placebo-controlled design, women who were planning to exclusively breastfeed for 6 mo (n = 90; mean age: 32.1 y; 71% exclusively breastfeeding at week 20) were randomly assigned to receive either cholecalciferol (50,000 or 100,000 IU) or a placebo monthly from week 4 to week 20 postpartum. The treatment effects relative to placebo were estimated as changes in maternal and infant serum 25(OH)D from baseline to week 20 postpartum by using a linear fixed-effects regression model. Additional secondary analyses, adjusted for potential confounders such as season of birth, vitamin D-fortified formula intake, and infant or maternal skin color, were also conducted. RESULTS: After 16 wk of supplementation, changes in maternal serum 25(OH)D were significantly higher in the 50,000-IU/mo (12.8 nmol/L; 95% CI: 0.4, 25.2 nmol/L) and 100,000-IU/mo (21.5 nmol/L; 95% CI: 9.2, 33.8 nmol/L) groups than in the placebo group (P = 0.43 and P<0.001, respectively). For infants, the unadjusted mean changes in serum 25(OH)D were 4.5 nmol/L (95% CI: -16.2, 25.0 nmol/L) for the 50,000-IU/mo group and 15.8 nmol/L (95% CI: -4.7, 36.4 nmol/L) for the 100,000-IU/mo group, but the changes did not differ from the placebo reference group. However, after adjustment for season of birth, vitamin D-fortified formula intake, and infant skin color, the mean change effect size for the 100,000-IU/mo group was 19.1 nmol/L (95% CI: 2.5, 35.6 nmol/L; P = 0.025) higher than that in the placebo group. CONCLUSIONS: Maternal cholecalciferol supplementation at a dose of 100,000 IU/mo during the first 5 mo of breastfeeding potentially benefits infant vitamin D status. Further studies are required to determine optimum dose and dosing frequency. This trial was registered at www.anzctr.org.au as ACTRN12611000108910. Article Published Date : Sep 30, 2016

Abstract Title: Maternal Milk T Cells Drive Development of Transgenerational Th1 Immunity in Offspring Thymus. Abstract Source: J Immunol. 2016 Sep 15 ;197(6):2290-6. Epub 2016 Aug 5. PMID: 27496970 Abstract Author(s): Mrinal K Ghosh, Virginia Nguyen, H Konrad Muller, Ameae M Walker Article Affiliation: Mrinal K Ghosh Abstract: Using multiple murine foster-nursing protocols, thereby eliminating placental transfer and allowing a distinction between dam- and pup-derived cells, we show that foster nursing by an immunized dam results in development of CD8(+) T cells in nonimmunized foster pups that are specific for Ags against which the foster dam was immunized (Mycobacterium tuberculosis or Candida albicans). We have dubbed this process"maternal educational immunity"to distinguish it from passive cellular immunity. Of the variety of maternal immune cells present in milk, only T cells were detected in pup tissues. Maternal T cells, a substantial percentage of which were CD4(+)MHC class II(+), accumulated in the pup thymus and spleen during the nursing period. Further analysis of maternal cells in the pup thymus showed that a proportion was positive for maternal immunogen-specific MHC class II tetramers. To determine the outcome of Ag presentation in the thymus, the maternal or foster pup origin of immunogen-responding CD8(+) cells in foster pup spleens was assessed. Whereas∼10% were maternally derived in the first few weeks after weaning, all immunogen-responding CD8(+) T cells were pup derived by 12 wk of age. Pup-derived immunogen-responsive CD8(+) cells persisted until at least 1 y of age. Passive cellular immunity is well accepted and has been demonstrated in the human population. In this study, we show an arguably more important role for transferred immune cells: the direction of offspring T cell development. Harnessing maternal educational immunity through prepregnancy immunization programs has potential for improvement of infant immunity. Article Published Date : Sep 14, 2016

Abstract Title: Breastfeeding for diabetes prevention. Abstract Source: J Pak Med Assoc. 2016 Sep ;66(9 Suppl 1):S88-90. PMID: 27582164 Abstract Author(s): Resham Raj Poudel, Dina Shrestha Article Affiliation: Resham Raj Poudel Abstract: Breastfeeding has been consistently observed to improve metabolism in mothers and their offspring. Apart from mother child bonding and nutritional benefits; it is associated with a decreased risk of acquiring metabolic syndrome and type 2 diabetes mellitus (T2DM) in mothers, obesity and type 1 diabetes mellitus (T1DM) in their children. Early initiation and exclusive breastfeeding should therefore be highly encouraged and strongly supported. Article Published Date : Aug 31, 2016

Abstract Title: The Role of Breastfeeding in Childhood Otitis Media. Abstract Source: Curr Allergy Asthma Rep. 2016 Sep ;16(9):68. PMID: 27595154 Abstract Author(s): Caroline J Lodge, Gayan Bowatte, Melanie C Matheson, Shyamali C Dharmage Article Affiliation: Caroline J Lodge Abstract: PURPOSE OF REVIEW: The purpose of this review is to summarize the recent literature, both systematic reviews and recently published original studies not included within those reviews, on the relationship between breastfeeding and childhood otitis media (OM). RECENT FINDINGS: There is clear evidence that breastfeeding is associated with a reduced risk of OM in childhood with sound biological plausibility to support that the association is likely causal. Any breastfeeding reduces OM risk in early childhood by 40-50 %. Systematic reviews also support a further reduced risk for continued breastfeeding. Recent studies have estimated burden of disease savings if breastfeeding within countries and globally approached WHO guidelines. Cost savings per year for reduced cases of OM by increasing ever and exclusive breastfeeding rates are estimated to be millions of pounds or dollars for UK and Mexico. Breastfeeding reduces OM in children. The burden of disease and economic impact of increasing breastfeeding rates and duration would be substantial. Article Published Date : Aug 31, 2016

Abstract Title: The Association Between Breastfeeding and Length of Hospital Stay Among Infants Diagnosed with Neonatal Abstinence Syndrome: A Population-Based Study of In-Hospital Births. Abstract Source: Breastfeed Med. 2016 Sep ;11:343-9. Epub 2016 Aug 16. PMID: 27529500 Abstract Author(s): Vanessa L Short, Meghan Gannon, Diane J Abatemarco Article Affiliation: Vanessa L Short Abstract: OBJECTIVE: The incidence of neonatal abstinence syndrome (NAS), a drug withdraw syndrome mainly associated with intrauterine opioid exposure, has increased considerably in the United States since 2000. Nonpharmacological options, including breastfeeding, may be effective at improving outcomes in this population. The objective of this population-based study was to examine the association between breastfeeding and length of hospital stay among infants diagnosed with NAS. METHODS: This was a retrospective cohort study of singleton in-hospital births to resident mothers in Pennsylvania. Hospital discharge data from births occurring between 2012 through 2014 were linked with corresponding birth certificate data. International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis codes were used to identify NAS neonates (N = 3,725). Breastfeeding at discharge was used to determine breastfeeding status. Infant and maternal characteristics were compared by breastfeeding status and the association between breastfeeding and infant length of hospitalization was assessed. RESULTS: Less than one-half of infants diagnosed with NAS were breastfed at discharge. Significant differences in infant birth weight and gestational age, and maternal education, marital status, prenatal care, smoking, and insurance status were found by breastfeeding status. A significant inverse relationship existed between breastfeeding and hospital length of stay for infants diagnosed with NAS. Specifically, length of hospitalization was reduced by 9.4% in the breastfed group compared to the nonbreastfed group. CONCLUSION: Breastfeeding may be beneficial for infants diagnosed with NAS by shortening the length of hospital stay. Future prospective studies are warranted to further examine the benefits of breastfeeding and other nonpharmaceutical interventions in NAS populations. Article Published Date : Aug 31, 2016

Abstract Title: Long-term neurodevelopmental benefits of breastfeeding. Abstract Source: Curr Opin Pediatr. 2016 Aug ;28(4):559-66. PMID: 27386975 Abstract Author(s): Sari Bar, Ruth Milanaik, Andrew Adesman Article Affiliation: Sari Bar Abstract: PURPOSE OF REVIEW: The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of an infant#$#apos;s life, with continuation of breastfeeding for at least a year or as mutually desired by mother and child. A robust body of research literature documenting the short-term medical, developmental, and emotional benefits of breastfeeding for infants and toddlers supports this position. This article reviews the neurodevelopmental benefits of breastfeeding as it relates to preschool and school-age children, with particular emphasis on cognitive development, attention-deficit/hyperactivity disorder, and autism spectrum disorder. RECENT FINDINGS: The majority of research studies examining breastfeeding and long-term neurodevelopmental outcomes suggest that children who breastfeed for longer than 6 months have better cognitive outcomes, lower risk of developing attention-deficit/hyperactivity disorder, and lower risk of being diagnosed with autism spectrum disorder. SUMMARY: Pediatricians play a critical role in educating and counseling families about infant nutrition and feeding. Along with the many positive short-term medical effects that breastfeeding confers, physicians should be aware of the growing body of research suggesting that there are also significant long-term neurodevelopmental benefits of breastfeeding. Article Published Date : Jul 31, 2016

Abstract Title: Breast Milk Consumption in Preterm Neonates and Cardiac Shape in Adulthood. Abstract Source: Pediatrics. 2016 Jun 14. Epub 2016 Jun 14. PMID: 27302980 Abstract Author(s): Adam J Lewandowski, Pablo Lamata, Jane M Francis, Stefan K Piechnik, Vanessa M Ferreira, Henry Boardman, Stefan Neubauer, Atul Singhal, Paul Leeson, Alan Lucas Article Affiliation: Adam J Lewandowski Abstract: BACKGROUND AND OBJECTIVES: Preterm birth relates to long-term alterations in cardiac morphology and function. Understanding whether preterm postnatal life is a tractable period of cardiovascular development that can be positively altered by nutrition is relevant to long-term outcomes. We hypothesized that being fed human breast milk during early postnatal life is beneficial to long-term cardiac structure and function in preterm-born individuals compared with infant formulas. METHODS: A total of 926 preterm-born infants originally took part in a randomized controlled trial of postnatal milk-feeding regimens between 1982 and 1985 across 5 different UK centers. Preterm-born individuals were randomly assigned to either breast milk donated by unrelated lactating women or nutrient-enriched formulas. We followed 102 individuals from this cohort: 30 of whom had been randomized to being fed exclusively human milk and 16 to being fed exclusively formula. As a comparison group, we recruited an additional 102 individuals born term to uncomplicated pregnancies. Cardiac morphology and function were assessed by MRI. RESULTS: Preterm-born individuals fed exclusively human milk as infants had increased left and right ventricular end-diastolic volume index (+9.73%, P = .04 and +18.2%, P<.001) and stroke volume index (+9.79%, P = .05 and +22.1%, P = .01) compared with preterm-born individuals who were exclusively formula fed as infants. CONCLUSIONS: This study provides the first evidence of a beneficial association between breast milk and cardiac morphology and function in adult life in those born preterm and supports promotion of human milk for the care of preterm infants to reduce long-term cardiovascular risk. Article Published Date : Jun 13, 2016

Abstract Title: Breastfeeding and Risk of Kawasaki Disease: A Nationwide Longitudinal Survey in Japan. Abstract Source: Pediatrics. 2016 Jun ;137(6). Epub 2016 May 11. PMID: 27244853 Abstract Author(s): Takashi Yorifuji, Hirokazu Tsukahara, Hiroyuki Doi Article Affiliation: Takashi Yorifuji Abstract: BACKGROUND AND OBJECTIVES: Kawasaki disease (KD) is the most common cause of childhood-acquired heart disease in developed countries. However, the etiology of KD is not known. Aberrant immune responses are considered to play key roles in disease initiation and breastfeeding can mature immune system in infants. We thus examined the association between breastfeeding and the development of KD. METHODS: We used a nationwide population-based longitudinal survey ongoing since 2010 and restricted participants to a total of 37 630 children who had data on their feeding during infancy. Infant feeding practice was queried at 6 to 7 months of age, and responses to questions about hospital admission for KD during the period from 6 to 30 months of age were used as outcome. We conducted logistic regression analyses controlling for child and maternal factors with formula feeding without colostrum as our reference group. RESULTS: A total of 232 hospital admissions were observed. Children who were breastfed exclusively or partially were less likely to be hospitalized for KD compared with those who were formula fed without colostrum; odds ratios for hospitalization were 0.26 (95% confidence interval: 0.12-0.55) for exclusive breastfeeding and 0.27 (95% confidence interval: 0.13-0.55) for partial breastfeeding. Although the risk reduction was not statistically significant, feeding colostrum only also provided a protective effect. CONCLUSIONS: We observed protective effects of breastfeeding on the development of KD during the period from 6 to 30 months of age in a nationwide, population-based, longitudinal survey in Japan, the country in which KD is most common. Article Published Date : May 31, 2016

Abstract Title: Bioactive Proteins in Human Milk: Health, Nutrition, and Implications for Infant Formulas. Abstract Source: J Pediatr. 2016 Jun ;173 Suppl:S4-9. PMID: 27234410 Abstract Author(s): Bo Lönnerdal Article Affiliation: Bo Lönnerdal Abstract: Breast milk confers many benefits to the newborn and developing infant. There is substantial support for better long-term outcomes, such as less obesity, diabetes, and cardiovascular disease, in breastfed compared with formula-fed infants. More short-term outcomes, such as incidence and duration of illness, nutrient status, and cognitive development during the first year of life also demonstrate benefits of breastfeeding. Several proteins in breast milk, including lactoferrin,α-lactalbumin, milk fat globule membrane proteins, and osteopontin, have been shown to have bioactivities that range from involvement in the protection against infection to the acquisition of nutrients from breast milk. In some cases, bovine counterparts of these proteins exert similar bioactivities. It is possible by dairy technology to add protein fractions highly enriched in these proteins to infant formula. Article Published Date : May 31, 2016

Abstract Title: Breastfeeding Is Associated with Decreased Hospitalization for Neonatal Fever. Abstract Source: Breastfeed Med. 2016 Jun ;11:218-21. Epub 2016 Aug 12. PMID: 27070106 Abstract Author(s): Hila Netzer-Tomkins, Lisa Rubin, Moshe Ephros Article Affiliation: Hila Netzer-Tomkins Abstract: BACKGROUND: Breastfeeding is the recommended method for feeding newborns and infants. It confers significant health benefits upon both infant and mother and provides developmental, social, and economic advantages. OBJECTIVE: This study explored possible correlations between breastfeeding and neonatal fever (NF). MATERIALS AND METHODS: One hundred and forty infants hospitalized for fever during the first month of life (NF) were identified by retrospective chart review. These were matched with healthy infants born on the same day in the study hospital and who were not hospitalized in the first month of life. A structured telephone interview to determine breastfeeding practice was conducted with the parents of all study participants. RESULTS: The prevalence of children who were formula fed or only partially breastfed was significantly higher among hospitalized children compared to healthy controls (66% versus 34%, respectively, p < 0.001). This association remained after adjusting for exposure to smoke, gender, and household crowding. Exposure to household smoke was also independently associated with hospitalization for NF. CONCLUSION: Increased rates of breastfeeding should result in fewer hospitalizations for NF, fewer laboratory investigations, less intravenous antibiotic therapy and its complications, and lower indirect expenses. This study demonstrates that exclusive or predominant breastfeeding, as opposed to formula or partial breastfeeding, of infants less than 1 month of age reduces the risk of NF-related hospitalization by over two-fold. Our data provide new evidence of the health benefits of breastfeeding. The retrospective nature of the study and possible recall bias are limitations of the study. Article Published Date : May 31, 2016

Abstract Title: The protective effect of longer duration of breastfeeding against pregnancy-associated triple negative breast cancer. Abstract Source: Oncotarget. 2016 May 29. Epub 2016 Aug 29. PMID: 27248476 Abstract Author(s): Wael M ElShamy Article Affiliation: Wael M ElShamy Abstract: Parity associated breast cancer (PABC) often diagnosed within the 2-5 years after a full term pregnancy. PABC is usually present with more advanced, poorly differentiated, high-grade cancers that show shorter time to progression and often of the triple negative breast cancer (TNBC) subtype. Data from around the world show that pregnancy-associated TNBC is independently associated with poor survival, underscoring the impact of the pregnant breast microenvironment on the biology and consequently the prognosis of these tumors. Although it is not yet clear, a link between pregnancy-associated TNBCs and lack or shorter duration of breastfeeding (not pregnancy per se) has been proposed. Here, we present epidemiological and experimental evidence for the protective effect of longer duration of lactation against pregnancy-associated TNBCs, and propose a putative molecular mechanism for this protective effect and its effect in eliminating any potential TNBC precursors from the breast by the end of the natural breast involution. Article Published Date : May 28, 2016

Abstract Title: Human milk feeding protects very low-birth-weight infants from retinopathy of prematurity: a pre-post cohort analysis. Abstract Source: J Matern Fetal Neonatal Med. 2016 Feb 26:1-6. Epub 2016 Feb 26. PMID: 26918740 Abstract Author(s): Gemma Ginovart, Ignasi Gich, Sergio Verd Article Affiliation: Gemma Ginovart Abstract: OBJECTIVES: To examine the effect of early human milk (HM) feeding on the incidence of retinopathy of prematurity (ROP) among very low-birth-weight (VLBW) infants. METHODS: Observational cohort research in a Level III neonatal intensive care unit. A total of 186 infants were enrolled in this pre-post cohort study (114 infants were included in the HM-fed group and 72 in the formula-fed group). ROP, type of feeding (early exclusive HM versus any formula), and potential confounding variables were measured. Differences between groups were explored. RESULTS: The clinical characteristics of the neonates did not differ between the two groups. By bivariate analysis, HM feeding was associated with 75% lower odds of Stage 2 or 3 ROP (OR = 0.25, 95% CI: 0.091 to 0.705; p = 0.009) At multivariate logistic regression, type of milk feeding retained significance, exclusive HM being protective with p = 0.002. CONCLUSIONS: This study found an association between early exposure to formula in VLBW infants and ROP. An initial HM diet, devoid of cow milk-containing products before achieving full enteral feeding, may help prevent ROP. Article Published Date : Feb 25, 2016

Abstract Title: The Long-Term Public Health Benefits of Breastfeeding. Abstract Source: Asia Pac J Public Health. 2016 Jan ;28(1):7-14. PMID: 26792873 Abstract Author(s): Colin Binns, MiKyung Lee, Wah Yun Low Article Affiliation: Colin Binns Abstract: Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer. Article Published Date : Dec 31, 2015

Abstract Title: Patients with ankylosing spondylitis have been breast fed less often than healthy controls: a case-control retrospective study. Abstract Source: Ann Rheum Dis. 2015 Oct 12. Epub 2015 Oct 12. PMID: 26458738 Abstract Author(s): J Montoya, N B Matta, P Suchon, M C Guzian, N C Lambert, J P Mattei, S Guis, M Breban, J Roudier, N Balandraud Article Affiliation: J Montoya Abstract: OBJECTIVE: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the spine and pelvis of young adults. On the HLA-B27 genetic background, the occurrence of AS is influenced by the intestinal microbiota. The goal of our study was to test whether breast feeding, which influences microbiota, can prevent the development of AS. METHODS: First, 203 patients with HLA-B27-positive AS fulfilling the modified New York criteria were recruited in the Department of Rheumatology, Ste Marguerite hospital in Marseilles. A total of 293 healthy siblings were also recruited to make up a control group within the same families. Second, 280 healthy controls, and 100 patients with rheumatoid arthritis and their siblings were recruited. The data collected were age, gender, number of brothers and sisters, age at disease onset, type and duration of feeding (breast or bottle). RESULTS: Patients with AS had been breast fed less often than healthy controls. In families where children were breast fed, the patients with AS were less often breast fed than their healthy siblings (57% vs 72%), giving an OR for AS onset of 0.53 (95% CI (0.36 to 0.77), p value=0.0009). Breast feeding reduced familial prevalence of AS. The frequency of breast feeding was similar in the AS siblings and in the 280 unrelated controls. However, patients with AS were less often breast fed compared with the 280 unrelated controls (OR 0.6, 95% CI (0.42 to 0.89), p<0.01). CONCLUSIONS: Our study suggests a breastfeeding-induced protective effect on the occurrence of AS. To our knowledge, this is the first study of breastfeeding history in patients with AS. Article Published Date : Oct 11, 2015

Abstract Title: Black currant seed oil supplementation of mothers enhances IFN-γ and suppresses IL-4 production in breast milk. Abstract Source: Pediatr Allergy Immunol. 2013 Sep ;24(6):562-6. PMID: 23980846 Abstract Author(s): Pia Linnamaa, Kaisa Nieminen, Leena Koulu, Saska Tuomasjukka, Heikki Kallio, Baoru Yang, Raija Tahvonen, Johannes Savolainen Article Affiliation: Pia Linnamaa Abstract: BACKGROUND: The first year of infancy is crucial for the development of atopic immune response. Inadequate early Th1 and Treg responses and increased production of Th2 cytokines are associated with atopy. Breast milk contains several immunomodulatory cytokines and other factors that might influence the maturation of the infant's immune system. We assessed the cytokines in breast milk of mother of newborn infants and their associations with black currant seed oil (BCSO) supplementation during pregnancy, mother's atopic status and the development of infant's atopic dermatitis. METHODS: Mothers and infants from an intervention study by black currant seed oil (n = 31) or olive oil as placebo (n = 30) were included in the study. Breast milk samples were collected during the first 3 months of breastfeeding. Breast milk levels of IL-4, IL-5, IL-10, IL-12, IFN-γ and TNF were measured by Luminex technology. RESULTS: BCSO intervention group had decreased level of IL-4 (p = 0.044) and elevated level of IFN-γ (p = 0.014) in breast milk as compared to olive oil group. No significant differences were observed in IL-5, IL-10, IL-12 and TNF levels between the BCSO and olive oil groups. Mothers who had atopic dermatitis had significantly decreased levels of IL-10 (p = 0.044) in breast milk. Breast milk ofthe mothers of the children who developed atopic dermatitis had lower levels of IFN-γ (p = 0.039) as compared to the breast milk of the mothers of the children without dermatitis. CONCLUSION: Dietary intervention with BCSO had immunomodulatory effects on breast milk cytokine production towards Th2 to Th1 immunodeviation. Article Published Date : Aug 31, 2013

Abstract Title: Lower prevalence of atopic dermatitis in breast-fed infants whose allergic mothers restrict dairy products. Abstract Author(s): Pipop Jirapinyo, Narumon Densupsoontorn, Channagan Kangwanpornsiri, Tippawan Limlikhit Article Affiliation: Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: To study the prevalence of atopic dermatitis in exclusively breast-fed infants of allergic mothers who were placed either on liberal diets or on dairy-product-restricted diets. MATERIAL AND METHOD: Infants aged 0 to 4 months old, who were exclusively breast-fed and whose mothers had a history of allergic disease, were the subjects of the present study. The mothers were randomized into two groups; mothers in a control group were on liberal diets, while mothers in an intervened group were on dairy product-restricted diets. Infants of both groups were examined for atopic dermatitis at seven days, one month, and four months of age. RESULTS: There were 32 and 30 infants in the control and intervened groups, respectively. Eight infants in the control group and two infants in the intervened group developed atopic dermatitis by the age of four months. The prevalence of atopic dermatitis in the intervened group was significantly lower than that in the control group (6.67% vs. 25%, p<0.05). CONCLUSION: Dairy product restriction in allergic mothers results in decreasing prevalence of atopic dermatitis in 4-month-old infants who were exclusively breast-fed. Article Published Date : Jan 31, 2013

Abstract Title: Digested formula but not digested fresh human milk causes death of intestinal cells in vitro: implications for necrotizing enterocolitis. Abstract Source: Pediatr Res. 2012 Dec ;72(6):560-7. Epub 2012 Sep 24. PMID: 23007028 Abstract Author(s): Alexander H Penn, Angelina E Altshuler, James W Small, Sharon F Taylor, Karen R Dobkins, Geert W Schmid-Schönbein Article Affiliation: Department of Bioengineering, University of California, San Diego, La Jolla, California. Abstract: Background:Premature infants fed formula are more likely to develop necrotizing enterocolitis (NEC) than those who are breastfed, but the mechanisms of intestinal necrosis in NEC and protection by breast milk are unknown. We hypothesized that after lipase digestion, formula, but not fresh breast milk, contains levels of unbound free fatty acids (FFAs) that are cytotoxic to intestinal cells.Methods:We digested multiple term and preterm infant formulas or human milk with pancreatic lipase, proteases (trypsin and chymotrypsin), lipase + proteases, or luminal fluid from a rat small intestine and tested FFA levels and cytotoxicity in vitro on intestinal epithelial cells, endothelial cells, and neutrophils.Results:Lipase digestion of formula, but not milk, caused significant death of neutrophils (ranging from 47 to 99% with formulas vs. 6% with milk) with similar results in endothelial and epithelial cells. FFAs were significantly elevated in digested formula vs. milk and death from formula was significantly decreased with lipase inhibitor pretreatment, or treatments to bind FFAs. Protease digestion significantly increased FFA binding capacity of formula and milk but only enough to decrease cytotoxicity from milk.Conclusion:FFA-induced cytotoxicity may contribute to the pathogenesis of NEC. Article Published Date : Nov 30, 2012

Abstract Title: Immunological programming by breast milk creates an anti-inflammatory cytokine milieu in breast-fed infants compared to formula-fed infants. Abstract Source: Br J Nutr. 2012 Oct 30:1-9. Epub 2012 Oct 30. PMID: 23110822 Abstract Author(s): Essi Kainonen, Samuli Rautava, Erika Isolauri Article Affiliation: Department of Paediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, Turku 20520, Finland. Abstract: Breast milk provides important maturational stimuli to an infant's developing immune system. However, data concerning the role of breast-feeding in reducing the risk of allergic disease remain contradictory. Previous studies have centred on comparative analyses of breast milk and formula compositions. We chose a slightly different angle, whereby we focused on the effects of the chosen diet on the infant himself, comparing the immune development of formula-fed and breast-fed children. The objective of the present study was to determine how the mode of feeding affects infant immunology. Altogether, eighteen formula-fed infants with limited breast-feeding for< 3 months and twenty-nine infants who were exclusively breast-fed for>3 months were included in the study. Concentrations of interferonγ, TNF-α IL-10, IL-5, IL-4 and IL-2 were measured simultaneously from the same serum sample through use of a multiplexed flow cytometric assay at the ages of 1, 3, 6 and 12 months. Transforming growth factor β2 (TGF-β2) was measured using ELISA at the same time points. Serum TNF-α and IL-2 concentrations were significantly higher in formula-fed than in breast-fed infants during the first year of life (ANOVA, P = 0·002). The serum concentrations of TGF-β were significantly lower in formula-fed than in breast-fed infants throughout the first year of life (ANOVA, P ≤ 0·0001). Exclusive breast-feeding promotes an anti-inflammatory cytokine milieu, which is maintained throughout infancy. Such an immunological environment limits hyper-responsiveness and promotes tolerisation, possibly prohibiting the onset of allergic disease. Article Published Date : Oct 29, 2012

Abstract Title: Breastmilk is a novel source of stem cells with multilineage differentiation potential. Abstract Source: Stem Cells. 2012 Oct ;30(10):2164-74. PMID: 22865647 Abstract Author(s): Foteini Hassiotou, Adriana Beltran, Ellen Chetwynd, Alison M Stuebe, Alecia-Jane Twigger, Philipp Metzger, Naomi Trengove, Ching Tat Lai, Luis Filgueira, Pilar Blancafort, Peter E Hartmann Article Affiliation: School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia; School of Anatomy, Physiology and Human Biology, The University of Western Australia, Crawley, Western Australia, Australia. This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: The mammary gland undergoes significant remodeling during pregnancy and lactation, which is fuelled by controlled mammary stem cell (MaSC) proliferation. The scarcity of human lactating breast tissue specimens and the low numbers and quiescent state of MaSCs in the resting breast have hindered understanding of both normal MaSC dynamics and the molecular determinants that drive their aberrant self-renewal in breast cancer. Here, we demonstrate that human breastmilk contains stem cells (hBSCs) with multilineage properties. Breastmilk cells from different donors displayed variable expression of pluripotency genes normally found in human embryonic stem cells (hESCs). These genes included the transcription factors (TFs) OCT4, SOX2, NANOG, known to constitute the core self-renewal circuitry of hESCs. When cultured in the presence of mouse embryonic feeder fibroblasts, a population of hBSCs exhibited an encapsulated ESC-like colony morphology and phenotype and could be passaged in secondary and tertiary clonogenic cultures. While self-renewal TFs were found silenced in the normal resting epithelium, they were dramatically upregulated in breastmilk cells cultured in 3D spheroid conditions. Furthermore, hBSCs differentiated in vitro into cell lineages from all three germ layers. These findings provide evidence that breastmilk represents a novel and noninvasive source of patient-specific stem cells with multilineage potential and establish a method for expansion of these cells in culture. They also highlight the potential of these cells to be used as novel models to understand adult stem cell plasticity and breast cancer, with potential use in bioengineering and tissue regeneration. STEM Cells2012;30:2164-2174. Article Published Date : Sep 30, 2012

Abstract Title: What effect does breastfeeding have on coeliac disease? A systematic review update. Abstract Source: Evid Based Med. 2012 Aug 4. Epub 2012 Aug 4. PMID: 22864373 Abstract Author(s): Camilla Henriksson, Anne-Marie Boström, Ingela E Wiklund Article Affiliation: Department of Biosciences and Nutrition, Karolinska Institutet/Stockholm University, Stockholm, Sweden. Abstract: ObjectiveTo update the evidence published in a previous systematic review and meta-analysis that compared the effect of breastfeeding on risk of coeliac disease (CD).Material and methodsA systematic review of observational studies published between 1966 and May 2004 on the subject was conducted in 2005. This update is a systematic review of observational studies published between June 2004 and April 2011. Pubmed, EMBASE and Cinahl were searched for published studies that examined the association between breastfeeding and CD.ResultsAfter duplicates were removed 90 citations were screened. Four observational studies were included in the review. Two of three studies which had examined the duration of breastfeeding and CD reported significant associations between longer duration of breastfeeding and later onset of CD (OR ranged from 0.18 to 0.665). Breastfeeding during the introduction of gluten to the infant was reported to have a protective effect in two studies.ConclusionsOur findings support previous published findings that breastfeeding seems to offer a protection against the development of CD in predisposed infants. Breastfeeding at time of gluten introduction is the most significant variable in reducing the risk. Timing of gluten introduction may also be a factor in the development of CD. Article Published Date : Aug 03, 2012

Abstract Title: Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children. Abstract Source: Pediatrics. 2010 Jun;125(6):e1433-40. Epub 2010 May 17. PMID: 20478942 Abstract Author(s): Evalotte Decker, Guido Engelmann, Annette Findeisen, Patrick Gerner, Martin Laass, Dietrich Ney, Carsten Posovszky, Ludwig Hoy, Mathias W Hornef Article Affiliation: Department of Pediatrics, Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany. Abstract: OBJECTIVES: The aim of this study was to analyze a possible association between cesarean delivery and enteric inflammatory diseases in children. METHODS: A retrospective, multicenter, case-control study that included 1950 children was performed in cooperation with 26 university and 16 nonacademic children's hospitals. Information on intestinal disease manifestation, together with mode of delivery and gestational age at birth, postnatal complications, and breastfeeding, was collected by the attending physician from children and their parents who were visiting a gastrointestinal outpatient clinic for Crohn disease (CD; 516 cases), ulcerative colitis (250 cases), celiac disease (157 cases), and other gastrointestinal diseases (165 cases) and control subjects who were visiting ophthalmologic, orthodontic, and dental outpatient clinics (862 cases). RESULTS: Whereas the rate of cesarean delivery of children with Crohn disease or ulcerative colitis was similar to that of control subjects, a significantly enhanced likelihood of being born by cesarean delivery was found in children with celiac disease compared with control subjects (odds ratio: 1.8 [95% confidence interval: 1.13-2.88]; P = .014). CONCLUSIONS: The mode of delivery and associated alterations in the development of the enteric homeostasis during the neonatal period might influence the incidence of celiac disease. Article Published Date : Jun 01, 2010

Abstract Title: Marketing breast milk substitutes: problems and perils throughout the world. Abstract Source: Arch Dis Child. 2012 Jun ;97(6):529-32. Epub 2012 Mar 14. PMID: 22419779 Abstract Author(s): June Pauline Brady Article Affiliation: 87 Teralynn Court, Oakland, California 94619, USA; This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: On 21 May 1981 the WHO International Code of Marketing Breast Milk Substitutes (hereafter referred to as the Code) was passed by 118 votes to 1, the US casting the sole negative vote. The Code arose out of concern that the dramatic increase in mortality, malnutrition and diarrhoea in very young infants in the developing world was associated with aggressive marketing of formula. The Code prohibited any advertising of baby formula, bottles or teats and gifts to mothers or 'bribery' of health workers. Despite successes, it has been weakened over the years by the seemingly inexhaustible resources of the global pharmaceutical industry. This article reviews the long and tortuous history of the Code through the Convention on the Rights of the Child, the HIV pandemic and the rare instances when substitute feeding is clearly essential. Currently, suboptimal breastfeeding is associated with over a million deaths each year and 10% of the global disease burden in children. All health workers need to recognise inappropriate advertising of formula, to report violations of the Code and to support efforts to promote breastfeeding: the most effective way of preventing child mortality throughout the world. Article Published Date : Jun 01, 2012

Abstract Title: Breastfed infants metabolize perchlorate. Abstract Source: Environ Sci Technol. 2012 May 1 ;46(9):5151-9. Epub 2012 Apr 20. PMID: 22497505 Abstract Author(s): C Phillip Shelor, Andrea B Kirk, Purnendu K Dasgupta, Martina Kroll, Catrina A Campbell, Pankaj K Choudhary Article Affiliation: Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, USA. Abstract: Bifidobacteria are the dominant intestinal bacteria in breastfed infants. It is known that they can reduce nitrate. Although no direct experiments have been conducted until now, inferred pathways for Bifidobacterium bifidum include perchlorate reduction via perchlorate reductase. We show that when commercially available strains of bifidobacteria are cultured in milk, spiked with perchlorate, perchlorate is consumed. We studied 13 breastfed infant-mother pairs who provided 43 milk samples and 39 infant urine samples, and 5 formula-fed infant-mother pairs who provided 21 formula samples and 21 infant urine samples. Using iodine as a conservative tracer, we determined the average urinary iodine (UI) to milk iodine (MI) concentration ratio to be 2.87 for the breastfed infants. For the same samples, the corresponding perchlorate concentration ratio was 1.37 (difference significant, p<0.001), indicating that perchlorate is lost. For the formula fed infant group the same ratios were 1.20 and 1.58; the difference was not significant (p = 0.68). However, the small number of subjects in the latter group makes it more difficult to conclude definitively whether perchlorate reduction does or does not occur. Article Published Date : Apr 30, 2012

Abstract Title: Total antioxidant concentrations of breastmilk--an eye-opener to the negligent. Abstract Source: J Health Popul Nutr. 2011 Dec ;29(6):605-11. PMID: 22283034 Abstract Author(s): Arun Mamachan Xavier, Kavita Rai, Amitha M Hegde Article Affiliation: Department of Pediatric Dentistry, Amrita School of Dentistry, AIMS Ponekkara PO, Cochin, India. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The balance between free radical production and antioxidant defenses in the body has important systemic and oral health implications. There is convincing evidence that breastmilk containing antioxidants is important in the prevention of diseases in infancy. This study compared the total antioxidant concentration of human breastmilk expressed at different stages of lactation, stored at various temperatures and durations. Expressed breastmilk (EBM) samples of the third, seventh and 30th day were collected from women who had term and preterm deliveries (n = 20). Another cohort of women (n = 20) was also assessed; these women were more than five months postpartum and lactating. The total antioxidant capacity (TAC) of EBM was assessed at zero hours at room temperature, at 48 hours, one week post-refrigeration (4 degrees C), and freezing (-8 degrees C) respectively using the phosphomolybdenum method. The highest antioxidant levels were found in colostrum. The TAC of EBM reduced with time and at post-refrigeration and after freezing (p<0.0005). No significant difference in the mean TAC was observed between the EBM samples obtained from women with either term or preterm deliveries. The progressive loss of antioxidant content of EBM emphasizes the need of awareness and curtailment of the practice of storing and later use of EBM. Article Published Date : Dec 01, 2011

Abstract Title: Breastfeeding and the u.s. Economy. Abstract Source: Breastfeed Med. 2011 Oct ;6:313-8. PMID: 22007819 Abstract Author(s): Melissa Bartick Article Affiliation: Hospitalist and Instructor in Medicine, Department of Medicine, Cambridge Health Alliance and Harvard Medical School , Cambridge and Boston, Massachusetts. Abstract: Abstract Background: A recent study showed that current suboptimal U.S. breastfeeding rates cost the U.S. economy $13 billion per year in 2007 dollars for pediatric health cost and premature death. Cost data of excess maternal disease are not yet published but are thought to be substantial. Little is known about other costs. Methods: The approximate annual costs of many entities that impact breastfeeding or are impacted by breastfeeding were calculated and converted to 2010 dollars. Calculations assumed the United States went from 2007 breastfeeding rates to 90% compliance with medical recommendations. We included pediatric health costs, formula costs, cost of extra food for lactating women, paid leave, and additional factors. Results: If 90% of mothers could comply with current medical recommendations around breastfeeding, our economy could save $3.7 billion in direct and indirect pediatric health costs, with $10.1 billion in premature death from pediatric disease. We would spend $3.9 billion less per year on infant formula. Additional food for nursing mothers would cost up to $1.6-2.1 billion, and more Baby-Friendly(®) (World Health Organization, Geneva, Switzerland/UNICEF, New York, NY) births would cost $0.145 billion. Paid leave would cost $6.2 billion for 12 weeks at 55% pay. Note that current formula company rebates of $2 billion to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are equal to 32% of net WIC expenditures. Conclusions: Even including paid leave, the net cost to our economy of our suboptimal breastfeeding rates would still be at least $8.7 billion. Paid leave would be expected to improve breastfeeding duration and reduce disparities. The WIC budget is dependent on formula company rebates, a conflicting situation. Article Published Date : Oct 01, 2011

Abstract Title: Dietary exposure to brominated flame retardants and abnormal Pap test results. Abstract Source: J Womens Health (Larchmt). 2011 Sep ;20(9):1269-78. Epub 2011 Jul 28. PMID: 21797757 Abstract Author(s): Denise J Jamieson, Metrecia L Terrell, Nnenna N Aguocha, Chanley M Small, Lorraine L Cameron, Michele Marcus Article Affiliation: Denise J Jamieson Abstract: OBJECTIVE: This study examined a possible association of dietary exposure to polybrominated biphenyls (PBBs), a brominated flame retardant, and self-reported abnormal Pap test results and cervical dysplasia as a precursor to cervical cancer. METHODS: Women in Michigan who ingested contaminated poultry, beef, and dairy products in the early 1970s were enrolled in a population-based cohort study in Michigan. Serum PBB and serum polychlorinated biphenyl (PCB) concentrations were measured. Reproductive history and health information, including Pap test results, were self-reported by participants. RESULTS: Of the women, 23% (223 of 956) reported an abnormal Pap test. In unadjusted analyses, self-reporting an abnormal Pap test was associated with younger age, current smoking (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.19-2.17), and longer duration of lifetime use of oral contraceptives (≥10 years; HR 1.92, 95% CI 1.21-3.06). When adjusting for PCB exposure, age at the interview, and smoking history, there was a slightly elevated risk of self-reporting an abnormal Pap test among the highly exposed women compared to women with nondetectable PBB concentrations (PBB≥13 μg/L, HR1.23, 95% CI 0.74-2.06); however, the CI was imprecise. When breastfeeding duration after the initial PBB measurement was taken into account, there was a reduced risk of self-reporting an abnormal Pap test among the highly exposed women who breastfed for ≥12 months (HR 0.41, 95% CI 0.06-3.03; referent group: women with nondetectable PBB concentrations who did not breastfeed). CONCLUSIONS: It remains important to evaluate the potential reproductive health consequences of this class of chemicals as well as other potential predictors of abnormal Pap tests. Article Published Date : Aug 31, 2011

Abstract Title: Breast milk contains relevant neurotrophic factors and cytokines for enteric nervous system development. Abstract Source: Mol Nutr Food Res. 2011 Aug 2. Epub 2011 Aug 2. PMID: 21809438 Abstract Author(s): Michael Fichter, Markus Klotz, David L Hirschberg, Bärbel Waldura, Otto Schofer, Sabrina Ehnert, Lukas K Schwarz, Chris Van Ginneken, Karl-Herbert Schäfer Article Affiliation: Department of Biotechnology, University of Applied Sciences Kaiserslautern, Germany. Abstract: Breast-feeding plays an important role for the development of the newborn. Non-breast fed premature born infants show a significantly higher risk of developing diseases like infantile diarrhoea and necrotizing enterocolitis. In this study, the content of neurotrophic factors and cytokines, which might influence the postnatal development of the enteric nervous system (ENS), was determined in human breast milk. Glial cell-line-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF) as well as a panel of cytokines were analyzed using single factor or multiplex ELISA. In order to link their presence in milk with possible effects on the development of the ENS, rat myenteric neurons were cultured in protein extracts from breast milk. Neurite outgrowth, neuron survival and nestin expression in glial cells were measured. Growth factors and cytokines were found in all breast milk samples at varying concentrations. It could be demonstrated that protein extracts of breast milk increased the amount of surviving enteric neurones as well as neurite outgrowth. Additionally it was shown, that the number of nestin and S100-expressing glial cells increased significantly after incubating in breast milk protein extracts. The data suggest that milk-born proteins support the development of the enteric nervous system. Article Published Date : Aug 02, 2011

Abstract Title: Gestational vitamin D and the risk of multiple sclerosis in offspring. Abstract Source: Ann Neurol. 2011 Jul ;70(1):30-40. PMID: 21786297 Abstract Author(s): Fariba Mirzaei, Karin B Michels, Kassandra Munger, Eilis O'Reilly, Tanuja Chitnis, Michele R Forman, Edward Giovannucci, Bernard Rosner, Alberto Ascherio Article Affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA. This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: OBJECTIVE: Vitamin D may have a protective role in the etiology of multiple sclerosis (MS), but the effect of gestational vitamin D on adult onset MS has not been studied. METHODS: In 2001, 35,794 mothers of participants of the Nurses' Health Study II completed a questionnaire inquiring about their experiences and diet during pregnancy with their nurse daughters. We studied the association of maternal milk intake, maternal dietary vitamin D intake, and predicted maternal serum 25-hydroxyvitamin D (25(OH)D) during pregnancy and their daughters' risk of developing MS. RESULTS: MS was diagnosed in 199 women. The relative risk of MS was lower among women born to mothers with high milk or vitamin D intake during pregnancy. The multivariate adjusted rate ratio (RR) of MS was 0.62 (95% confidence interval [CI], 0.40-0.95; p trend = 0.001) for nurses whose mothers consumed 2 to 3 glasses of milk per day compared with those whose mothers consumed<3 glasses per month, and 0.57 (95% CI, 0.35-0.91; p trend = 0.002) for nurses with mothers in the highest quintile of dietary vitamin D intake compared with those in the lowest. The predicted 25(OH)D level in the pregnant mothers was also inversely associated with the risk of MS in their daughters. Comparing extreme quintiles, the adjusted RR was 0.59; (95% CI, 0.37-0.92; p trend = 0.002). INTERPRETATION: Higher maternal milk and vitamin D intake during pregnancy may be associated with a lower risk of developing MS in offspring. ANN NEUROL 2011; Article Published Date : Jul 01, 2011

Abstract Title: Breastfeeding in HIV Exposed Infants Significantly Improves Child Health: A Prospective Study. Abstract Source: Matern Child Health J. 2011 Apr 20. Epub 2011 Apr 20. PMID: 21505776 Abstract Author(s): Gurpreet Kindra, Anna Coutsoudis, Francesca Esposito, Tonya Esterhuizen Article Affiliation: Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Room 257, DDMRI Building, Congella, Durban, 4013, South Africa, This email address is being protected from spambots. You need JavaScript enabled to view it.. Abstract: Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life. Article Published Date : Apr 20, 2011

Abstract Title: Donated breast milk substitutes and incidence of diarrhoea among infants and young children after the May 2006 earthquake in Yogyakarta and Central Java. Abstract Source: Public Health Nutr. 2011 Mar 23:1-9. Epub 2011 Mar 23. PMID: 21426621 Abstract Author(s): David B Hipgrave, Fitsum Assefa, Anna Winoto, Sri Sukotjo Article Affiliation: 1United Nations Children's Fund China Country Office, 12 Sanlitun Lu, Beijing 100600, People's Republic of China. Abstract: OBJECTIVE: Distribution of breast milk substitutes (BMS) after the 2006 Yogyakarta earthquake was uncontrolled and widespread. We assessed the magnitude of BMS distribution after the earthquake, its impact on feeding practices and the association between consumption of infant formula and diarrhoea among infants and young children. DESIGN: One month after the earthquake, caregivers of 831 children aged 0-23 months were surveyed regarding receipt of unsolicited donations of BMS, and on recent child-feeding practices and diarrhoeal illness. SETTING: Community-level survey in an earthquake-affected district. SUBJECTS: Primary caregivers of surveyed children. RESULTS: In all, 75 % of households with an infant aged 0-5 months and 80 % of all households surveyed received donated infant formula; 76 % of all households received commercial porridge and 49 % received powdered milk. Only 32 % of 0-5-month-old infants had consumed formula before the earthquake, but 43 % had in the 24 h preceding the survey (P<0·001). Consumption of all types of BMS was significantly higher among those who received donated commodities, regardless of age (P<0·01). One-week diarrhoea incidence among those who received donated infant formula (25·4 %) was higher than among those who did not (11·5 %; relative risk = 2·12, 95 % CI = 1·34, 3·35). The rate of diarrhoea among those aged 12-23 months was around five times the pre-earthquake rate. CONCLUSIONS: There were strong associations between receipt of BMS and changes in feeding practices, and between receipt of infant formula and diarrhoea. Uncontrolled distribution of infant formula exacerbates the risk of diarrhoea among infants and young children in emergencies. Article Published Date : Mar 23, 2011

Abstract Title: The effect of galactagogue herbal tea on breast milk production and short-term catch-up of birth weight in the first week of life. Abstract Source: J Altern Complement Med. 2011 Feb ;17(2):139-42. Epub 2011 Jan 24. PMID: 21261516 Abstract Author(s): Canan Turkyılmaz, Esra Onal, Ibrahim Murat Hirfanoglu, Ozden Turan, Esin Koç, Ebru Ergenekon, Yıldız Atalay Article Affiliation: Department of Neonatology, Gazi University, Faculty of Medicine, Ankara, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVES: The aim of this study was to evaluate whether consumption of maternal herbal tea containing fenugreek had any effects on breast milk production and infants' weight gain pattern in the early postnatal period. DESIGN AND SUBJECTS: Sixty-six (66) mother-infant pairs were randomly assigned to 3 groups. Group 1 (n = 22) consisted of mothers who were receiving herbal tea containing fenugreek every day. Group 2 (n = 22) and group 3 (n = 22) were assigned as placebo and controls, respectively. OUTCOME MEASURES: Birth weight, loss of birth weight, time of regain of birth weight, amount of breast milk assessed on the third day after delivery were determined. RESULTS: Maximum weight loss was significantly lower in infants in group 1 compared to both the placebo and control groups (p < 0.05). Infants in group 1 regained their birth weight earlier than those in control and placebo groups (p < 0.05). The mean measured breast milk volume of the mothers who received galactagogue tea was significantly higher than the placebo and control groups (p < 0.05). CONCLUSIONS: Maternal galactagogue herbal tea supplementation seems to be useful for enhancing breast milk production and facilitating infant birth weight regain in early postnatal days. Article Published Date : Feb 01, 2011

Abstract Title: Breast-feeding problems after epidural analgesia for labour: a retrospective cohort study of pain, obstetrical procedures and breast-feeding practices. Abstract Source: Gynecol Obstet Fertil. 2010 Dec;38(12):747-53. PMID: 15321436 Abstract Author(s): P Volmanen, J Valanne, S Alahuhta Article Affiliation: Department of Anaesthesiology, Lapland Central Hospital, Rovaniemi, Finland. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Various clinical practices have been found to be associated with breast-feeding problems. However, little is known about the effect of pain, obstetrical procedures and analgesia on breast-feeding behaviour. We designed a retrospective study with a questionnaire concerning pain, obstetrical procedures and breast-feeding practices mailed to 164 primiparae in Lapland. Altogether 99 mothers (60%) returned completed questionnaires that could be included in the analysis, which was carried out in two steps. Firstly, all accepted questionnaires were grouped according to the success or failure to breast-feed fully during the first 12 weeks of life. Secondly, an ad hoc cohort study was performed on the sub-sample of 64 mothers delivered vaginally. As many as 44% of the 99 mothers reported partial breast feeding or formula feeding during the first 12 weeks. Older age of the mother, use of epidural analgesia and the problem of "not having enough milk" were associated with the failure to breast-feed fully. Caesarean section, other methods of labour analgesia and other breast-feeding problems were not associated with partial breast feeding or formula feeding. In the sub-sample, 67% of the mothers who had laboured with epidural analgesia and 29% of the mothers who laboured without epidural analgesia reported partial breast feeding or formula feeding (P = 0.003). The problem of "not having enough milk" was more often reported by those who had had epidural analgesia. Further studies conducted prospectively are needed to establish whether a causal relationship exists between epidural analgesia and breast-feeding problems. Article Published Date : Dec 01, 2010

Abstract Title: Breastfeeding protects against acute gastroenteritis due to rotavirus in infants. Abstract Source: Eur J Pediatr. 2010 Dec;169(12):1471-6. Epub 2010 Jul 9. PMID: 20617343 Abstract Author(s): Anita Plenge-Bönig, Nelís Soto-Ramírez, Wilfried Karmaus, Gudula Petersen, Susan Davis, Johannes Forster Article Affiliation: Institute for Hygiene and Environment, Hamburg, Germany. Abstract: To assess whether breastfeeding protects against acute gastroenteritis (AGE) due to rotavirus (RV) infection compared to RV-negative AGE (RV-) in children age 0-12 months. Data from a community-based study of children with AGE from 30 pediatric practices in Germany, Switzerland, and Austria were evaluated. A case-control design was conducted with RV-positive AGE (RV+) cases and RV- AGE as controls. Odds ratios and 95% confidence intervals were estimated using log-linear regression models adjusting for child's age, family size, number of siblings, child care attendance, and nationality. A total of 1,256 stool samples were collected from infants with AGE; 315 (25%) were RV+ and 941 RV-. Being breastfed in the period of disease inception reduced the risk of AGE due to RV+ (OR, 0.53; 95% CI, 0.37-0.76). In infants 0-6 months of age, the protective effect was stronger (OR, 0.33; 95% CI, 0.19-0.55) than in 7-12-month-old children. Our study adds to the evidence of a protective concurrent effect of breastfeeding against rotavirus infection in infants, particularly in children 6 months and younger. Breastfeeding is important to diminish rotavirus-related gastroenteritis in infants before vaccination can be introduced. Article Published Date : Dec 01, 2010

Abstract Title: Infants' exposure to aluminum from vaccines and breast milk during the first 6 months. Abstract Source: J Expo Sci Environ Epidemiol. 2010 Nov ;20(7):598-601. Epub 2009 Dec 16. PMID: 20010978 Abstract Author(s): José G Dórea, Rejane C Marques Article Affiliation: José G Dórea Abstract: The success of vaccination programs in reducing and eliminating infectious diseases has contributed to an ever-increasing number of vaccines given at earlier ages (newborns and infants). Exposure to low levels of environmental toxic substances (including metals) at an early age raises plausible concerns over increasingly lower neuro-cognitive rates. Current immunization schedules with vaccines containing aluminum (as adjuvant) are given to infants, but thimerosal (as preservative) is found mostly in vaccines used in non-industrialized countries. Exclusively, breastfed infants (in Brazil) receiving a full recommended schedule of immunizations showed an exceedingly high exposure of Al (225 to 1750μg per dose) when compared with estimated levels absorbed from breast milk (2.0 μg). This study does not dispute the safety of vaccines but reinforces the need to study long-term effects of early exposure to neuro-toxic substances on the developing brain. Pragmatic vaccine safety needs to embraceconventional toxicology, addressing especial characteristics of unborn fetuses, neonates and infants exposed to low levels of aluminum, and ethylmercury traditionally considered innocuous to the central nervous system. Article Published Date : Nov 01, 2010 Study Type : Human Study

Abstract Title: Inhibitory effect of breast milk on infectivity of live oral rotavirus vaccines. Abstract Source: Pediatr Infect Dis J. 2010 Oct;29(10):919-923. PMID: 20442687 Abstract Author(s): Sung-Sil Moon, Yuhuan Wang, Andi L Shane, Trang Nguyen, Pratima Ray, Penelope Dennehy, Luck Ju Baek, Umesh Parashar, Roger I Glass, Baoming Jiang Article Affiliation: From the *National Centers for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA;†Division of Pediatric Infectious Disease, Emory University, Atlanta, GA; ‡The National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; §Department of Pediatrics, All India Institute of Medical Sciences, Delhi, India; ¶Department of Pediatrics, Rhode Island Hospital, Providence, RI; ∥Department of Microbiology, College of Medicine, Abstract: BACKGROUND: Live oral rotavirus vaccines have been less immunogenic and efficacious among children in poor developing countries compared with middle income and industrialized countries for reasons that are not yet completely understood. We assessed whether the neutralizing activity of breast milk could lower the titer of vaccine virus and explain this difference in vitro. METHODS: Breast milk samples were collected from mothers who were breast-feeding infants 4 to 29 weeks of age (ie, vaccine eligible age) in India (N = 40), Vietnam (N = 77), South Korea (N = 34), and the United States (N = 51). We examined breast milk for rotavirus-specific IgA and neutralizing activity against 3 rotavirus vaccine strains-RV1, RV5 G1, and 116E using enzyme immunoassays. The inhibitory effect of breast milk on RV1 was further examined by a plaque reduction assay. FINDINGS: Breast milk from Indian women had the highest IgA and neutralizing titers against all 3 vaccine strains, while lower but comparable median IgA and neutralizing titers were detected in breast milk from Korean and Vietnamese women, and the lowest titers were seen in American women. Neutralizing activity was greatest against the 2 vaccine strains of human origin, RV1 and 116E. This neutralizing activity in one half of the breast milk specimens from Indian women could reduce the effective titer of RV1 by∼2 logs, of 116E by 1.5 logs, and RV5 G1 strain by ∼1 log more than that of breast milk from American women. INTERPRETATION: The lower immunogenicity and efficacy of rotavirus vaccines in poor developing countries could be explained, in part, by higher titers of IgA and neutralizing activity inbreast milk consumed by their infants at the time of immunization that could effectively reduce the potency of the vaccine. Strategies to overcome this negative effect, such as delaying breast-feeding at the time of immunization, should be evaluated. Article Published Date : Oct 01, 2010

Abstract Title: Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Abstract Source: Arch Dis Child. 2010 Sep 27. Epub 2010 Sep 27. PMID: 20876557 Abstract Author(s): Fani Ladomenou, Joanna Moschandreas, Anthony Kafatos, Yiannis Tselentis, Emmanouil Galanakis Article Affiliation: Department of Paediatrics, University of Crete, Heraklion, Greece. Abstract: Objective To prospectively investigate the effects of breastfeeding on the frequency and severity of infections in a well-defined infant population with adequate vaccination coverage and healthcare standards. Study design In a representative sample of 926 infants, successfully followed up for 12 months, feeding mode and all infectious episodes, including acute otitis media (AOM), acute respiratory infection (ARI), gastroenteritis, urinary tract infection, conjunctivitis and thrush, were recorded at 1, 3, 6, 9 and 12 months of life. Results Infants exclusively breastfed for 6 months, as per WHO recommendations, presented with fewer infectious episodes than their partially breastfed or non-breastfed peers and this protective effect persisted after adjustment for potential confounders for ARI (OR 0.58, 95% CI 0.36 to 0.92), AOM (OR 0.37, 95% CI 0.13 to 1.05) and thrush (OR 0.14, 95% CI 0.02 to 1.02). Prolonged exclusive breastfeeding was associated with fewer infectious episodes (r(s)=-0.07, p=0.019) and fewer admissions to hospital for infection (r(s)=-0.06, p=0.037) in the first year of life. Partial breastfeeding was not related to protective effect. Several confounding factors, including parental age and education, ethnicity, presence of other siblings, environmental tobacco smoke exposure and season of birth were demonstrated to have an effect on frequency of infections during infancy. Conclusions Findings from this large-scale prospective study in a well-defined infant population with adequate healthcare standards suggest that exclusive breastfeeding contributes to protection against common infections during infancy regarding and lessens the frequency and severity of infectious episodes. Partial breastfeeding did not seem to provide this protective effect. Article Published Date : Sep 27, 2010

Abstract Title: Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Abstract Source: J Med Food. 2010 Jun;13(3):589-98. PMID: 20566605 Abstract Author(s): Liesbeth Duijts, Vincent W V Jaddoe, Albert Hofman, Henriëtte A Moll Article Affiliation: Generation R Study Group, Rotterdam, Netherlands. Abstract: OBJECTIVE: To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy. METHODS: This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for<4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects. RESULTS: Compared with never-breastfed infants, those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI, LRTI, and GI until the age of 6 months (adjusted odds ratio [aOR]: 0.65 [95% confidence interval (CI): 0.51-0.83]; aOR: 0.50 [CI: 0.32-0.79]; and aOR: 0.41 [CI: 0.26-0.64], respectively) and of LRTI infections between the ages of 7 and 12 months (aOR: 0.46 [CI: 0.31-0.69]). Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer. Partial breastfeeding, even for 6 months, did not result in significantly lower risks of these infections. CONCLUSIONS: Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries. Article Published Date : Jun 01, 2010

Abstract Title: Breastfeeding and risk for fever after immunization. Abstract Source: Pediatrics. 2010 Jun;125(6):e1448-52. Epub 2010 May 17. PMID: 20478932 Abstract Author(s): Alfredo Pisacane, Paola Continisio, Orsola Palma, Stefania Cataldo, Fabiola De Michele, Ugo Vairo Article Affiliation: Dipartimento di Pediatria, Università Federico II, Via S. Pansini 5, Napoli 80131, Italy. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: The objective of this study was to evaluate the effects of breastfeeding on the risk for fever after routine immunizations. METHODS: A prospective cohort study was conducted at a pediatric vaccination center in Naples, Italy. The mothers of the infants scheduled to receive routine immunizations were instructed on how to measure and record infant temperature on the evening of the vaccination and for the subsequent 3 days. The information about the incidence of fever was obtained by telephone on the third day after vaccination. The relative risk for fever in relation to the type of breastfeeding was estimated in multivariate analyses that adjusted for vaccine dose, maternal education and smoking, and number of other children in the household. RESULTS: A total of 460 infants were recruited, and information on the outcome was obtained for 450 (98%). Fever was reported for 30 (25%), 48 (31%), and 94 (53%) of the infants who were being exclusively breastfed, partially breastfed, or not breastfed at all, respectively (P<.01). The relative risk for fever among infants who were exclusively and partially breastfed was 0.46 (95% confidence interval: 0.33-0.66) and 0.58 (95% confidence interval: 0.44-0.77), respectively. The protection conferred by breastfeeding persisted even when considering the role of several potential confounders. CONCLUSIONS: In this study, breastfeeding was associated with a decreased incidence of fever after immunizations. Article Published Date : Jun 01, 2010

Abstract Title: The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Abstract Source: Pediatrics. 2010 May;125(5):e1048-56. Epub 2010 Apr 5. PMID: 20368314 Abstract Author(s): Melissa Bartick, Arnold Reinhold Article Affiliation: Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Boston, Massachusetts, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND AND OBJECTIVE: A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality. STUDY DESIGN: Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars. RESULTS: If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). CONCLUSIONS: Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective. Article Published Date : May 01, 2010

Abstract Title: Breastfeeding and the prevalence of allergic diseases in schoolchildren: Does reverse causation matter? Abstract Source: Pediatr Allergy Immunol. 2010 Feb;21(1 Pt 1):60-6. Epub 2010 Jan 14. PMID: 20088862 Abstract Author(s): Takashi Kusunoki, Takeshi Morimoto, Ryuta Nishikomori, Takahiro Yasumi, Toshio Heike, Kumiko Mukaida, Tatsuya Fujii, Tatsutoshi Nakahata Article Affiliation: Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Shiga, Japan. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Infants at higher risk of allergic diseases might be breastfed for longer periods compared with infants at lower risk in the hope that breastfeeding might reduce the risk of atopic disorders. Therefore, this intention could manifest as an apparent allergy-promoting effect of breastfeeding or reverse causation. To analyze the effect of breast feeding on the prevalence of allergic diseases at school age, a large questionnaire survey was administered to the parents of schoolchildren aged 7-15 yrs. 13,215 parents responded (response rate, 90.1%). Prevalence rates of allergic diseases were compared according to the type of feeding in infancy (either complete breastfeeding, mixed feeding or complete artificial feeding). In both univariate and multivariate analysis, compared with those with complete artificial feeding, those with mixed and complete breastfeeding showed a significantly lower prevalence of bronchial asthma (BA) (p = 0.01 and 0.003, respectively). On the other hand, in univariate analysis, the prevalence of atopic dermatitis (AD) and food allergy (FA) were significantly higher in those with complete breastfeeding (p = 0.04 and 0.01, respectively). There was a significantly higher proportion of complete breastfeeding among those with greater risk of allergic diseases (presence of family history, either eczema or wheeze within 6 months after birth, or FA in infancy). Therefore, our multivariate analysis included these risks as confounding factors, and we found that the promoting effects of breastfeeding on AD and FA disappeared. In conclusion, our data clearly showed the inhibitory effect of breastfeeding on the prevalence of BA at school age. The apparent promoting effect of breastfeeding on the prevalence of AD and FA is most likely because of reverse causation. Article Published Date : Feb 01, 2010

Abstract Title: Breast-feeding is associated with a reduced frequency of acute otitis media and high serum antibody levels against NTHi and outer membrane protein vaccine antigen candidate P6. Abstract Source: Pediatr Res. 2009 Nov;66(5):565-70. PMID: 19581824 Abstract Author(s): Albert Sabirov, Janet R Casey, Timothy F Murphy, Michael E Pichichero Article Affiliation: Department of Microbiology/Immunology, University of Rochester, Rochester, New York 14627, USA. Abstract: Nontypeable Haemophilus influenzae (NTHi) causes acute otitis media (AOM) in infants. Breast-feeding protects against AOM and/or nasopharyngeal (NP) colonization; however, the mechanism of protection is incompletely understood. Children with AOM and healthy children were studied according to feeding status: breastfed,breast/formula fed, or formula fed. Cumulative episodes of AOM, ELISA titers of serum IgG antibodies to whole-cell NTHi and vaccine candidate outer membrane protein P6, bactericidal titers of serum and NP colonization by NTHi were assessed. A lower incidence of AOM was found in breast- versus formula-fed children. Levels of specific serum IgG antibody to NTHi and P6 were highest in breast-fed, intermediate in breast/formula fed, and lowest in formula-fed infants. Serum IgG antibody to P6 correlated with bactericidal activity against NTHi. Among children with AOM, the prevalence of NTHi in the NP was lower in breast- versus nonbreast-fed infants. We conclude that breast-feeding shows an association with higher levels of antibodies to NTHi and P6, suggesting that breast-feeding modulates the serum immune response to NTHi and P6. Higher serum IgG might facilitate protection against AOM and NP colonization in breast-fed children. Article Published Date : Nov 01, 2009

Abstract Title: Protective effect of breastfeeding on diarrhea among children in a rapidly growing newly developed society. Abstract Source: Turk J Pediatr. 2009 Nov-Dec;51(6):527-33. PMID: 20196384 Abstract Author(s): Mohammad S Ehlayel, Abdulbari Bener, Hatim M Abdulrahman Article Affiliation: Unit of Allergy and Immunology, Department of Pediatrics, Hamad Medical Corporation, Qatar. Abstract: In developed communities, the effect of exclusive breastfeeding (EBF) is encouraged since it has been found to be protective against infantile diarrhea. In a newly developing Qatar, modern water supply and sanitation facilities have become available to everyone during the last two decades. The objectives of the current study were to explore the relationships between breastfeeding and diarrhea and to assess the effect of EBF on the risk reduction of diarrhea in children aged 1-5 years. This is a cross-sectional survey conducted in the Well-Baby clinics and pediatric clinics in the 11 Primary Health Care (PHC) Centers and Hamad General Hospital, Hamad Medical Corporation, Qatar. A multistage sampling design was used, and a representative sample of 1500 Qatari infants and pre-school children in the age group of 1-5 years and mothers aged between 18 to 47 years were surveyed during the period from October 2006 to September 2007; 1,278 mothers agreed to participate in this study, with a response rate of 85.2%. The sociodemographic characteristics, feeding modes and diarrhea morbidity were collected from the parents of the children during the interview. Of the 1,278 infants studied, more than half (59.3%) were EBF, followed by those partially breastfed (28.3%), and finally the formula fed (12.4%). The duration of EBF was 11.4 +/- 6.7 months (mean +/- SD) and the duration of partial breastfeeding with bottled milk was 9.2 +/- 4.1 months (mean +/- SD), and the difference was statistically significant (p<0.0010). When compared to the EBF infants, the risk of diarrhea was higher and statistically significant in both the partially breastfed (48.7% vs 32.5%) and in the non-EBF (37.3% vs 32.5%, p<0.001). Upper respiratory tract infection (URTI), short duration of breastfeeding, level of maternal education, and sterilization of bottles were considered as predictors. These results indicate that in Qatar, breastfeeding plays an important role in reducing the incidence and severity of infantile diarrhea. This observation is particularly important given the growing concern that, as an unwanted effect of 'modernization', breastfeeding is on the decline in Qatar and comparable populations elsewhere. Article Published Date : Nov 01, 2009

Abstract Title: A protective effect of breastfeeding on the progression of non-alcoholic fatty liver disease. Abstract Source: Arch Dis Child. 2009 Oct;94(10):801-5. Epub 2009 Jun 24. PMID: 19556219 Abstract Author(s): V Nobili, G Bedogni, A Alisi, A Pietrobattista, A Alterio, C Tiribelli, C Agostoni Abstract: OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease characterised by accumulation of large-droplet fat in hepatocytes with possible progression to inflammation and fibrosis. Breastfeeding has benefits for child health, both during infancy and later in life, reducing the risk of manifestations of the metabolic syndrome. Here we investigated the association between early type of feeding (breastfed versus formula-fed and duration of breastfeeding) and later NAFLD development. STUDY DESIGN: We investigated 191 young Caucasian children (3-18 years old) with NAFLD consecutively enrolled between January 2003 and September 2007 in our centre. 48% of these children (n = 91) had been breastfed for a median (interquartile range) time of 8 (7) months. RESULTS: After correction for age, waist circumference, gestational age and neonatal weight, the odds of non-alcoholic steatohepatitis (NASH) (OR 0.04, 95% CI 0.01 to 0.10) and fibrosis (OR 0.32, 95% CI 0.16 to 0.65) were lower in breastfed versus not breastfed infants. Moreover, the odds of NASH (OR 0.70, exact 95% CI 0.001 to 0.87) and fibrosis (OR 0.86, exact 95% CI 0.75 to 0.98) decreased for every month of breastfeeding. CONCLUSIONS: This observational study suggests that earlier feeding habits might affect the clinical expression of NASH from 3 to 18 years later, with an apparent drug-like preventive effect of breastfeeding. Article Published Date : Oct 01, 2009

Abstract Title: Infantile colic, prolonged crying and maternal postnatal depression. Abstract Source: Acta Paediatr. 2009 Aug;98(8):1344-8. Epub 2009 Apr 28. PMID: 19432839 Abstract Author(s): Torstein Vik, Veit Grote, Joauqín Escribano, Jerzy Socha, Elvira Verduci, Michaela Fritsch, Clotilde Carlier, Rüdiger von Kries, Berthold Koletzko, Abstract: AIM: To study if infant crying is associated with maternal postnatal depression. METHODS: Data from 1015 mothers and their children participating in a prospective European multicentre study were analysed. Infantile colic and prolonged crying were defined as excessive crying as reported by the mothers 2 and 6 months after delivery, and at the same time the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: In cross-sectional analyses, infant crying was associated with high EPDS scores both 2 (OR: 4.4; 95% CI: 2.4-8.2) and 6 months postpartum (OR: 10.8; 95% CI: 4.3-26.9). More than one-third of the others of infants with prolonged crying had high EPDS scores 6 months postpartum. Longitudinal analyses showed that mothers of infants with colic had increased odds of having high EPDS scores 6 months after delivery even if crying had resolved (OR: 3.7; 95% CI: 1.4-10.1). CONCLUSION: Both infantile colic and prolonged crying were associated with high maternal depression scores. Most noteworthy, infantile colic at 2 months of age was associated with high maternal depression scores 4 months later. Article Published Date : Aug 01, 2009    

Abstract Title: Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and meta-analysis of prospective cohort studies. Abstract Source: Br J Dermatol. 2009 Aug;161(2):373-83. Epub 2009 Feb 23. PMID: 19239469 Abstract Author(s): Y W Yang, C L Tsai, C Y Lu Abstract: BACKGROUND: Breastfeeding is undisputedly preferable to formula feeding for infant nutrition because of its nutritional, immunological and psychological benefits. However, studies on the association between breastfeeding and development of atopic dermatitis (AD) have shown inconsistent results. OBJECTIVES: To examine the association between exclusive breastfeeding for at least 3 months after birth and the development of AD in childhood. METHODS: An electronic literature search of MEDLINE (January 1966-May 2008) and EMBASE (1980-May 2008) was conducted. Prospective cohort studies that met the predetermined criteria were independently assessed by three reviewers. The pooled effect estimate was calculated by random effects model. Heterogeneity across the studies was investigated by meta-regression analysis. RESULTS: Twenty-one studies with 27 study populations were included for meta-analysis. The summary odds ratio (OR) for the effect of exclusive breastfeeding on the risk of AD was 0.89 (95% confidence interval, CI 0.76-1.04). Heterogeneity was found across the studies (chi(2) = 83.6, d.f. = 26; P<0.001). Breastfeeding was associated with a decreased risk of AD (OR 0.70; 95% CI 0.50-0.99) when analysis was restricted to the studies comparing breastfeeding with conventional formula feeding. The pooled OR for study populations with atopic heredity was 0.78 (95% CI 0.58-1.05). CONCLUSIONS: There is no strong evidence of a protective effect of exclusive breastfeeding for at least 3 months against AD, even among children with a positive family history. Article Published Date : Aug 01, 2009

Abstract Title: Epidural analgesia: breast-feeding success and related factors. Abstract Source: Midwifery. 2009 Apr;25(2):e31-8. Epub 2007 Nov 5. PMID: 17980469 Abstract Author(s): Ingela Wiklund, Margareta Norman, Kerstin Uvnäs-Moberg, Anna-Berit Ransjö-Arvidson, Ellika Andolf Article Affiliation: Division of Obstetrics and Gynaecology, Danderyd Hospital, Karolinska Institutet, S-182 88 Stockholm, Sweden. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: to compare the early breast-feeding behaviours of full-term newborns whose mothers had received epidural analgesia (EDA) during an uncomplicated labour, with a group of newborns whose mothers had not received EDA. DESIGN AND SETTING: a retrospective comparative study design was used and the study was carried out in a labour ward in Stockholm, Sweden between January 2000 and April 2000. The ward has about 5500 deliveries per year. PARTICIPANTS: all maternity records of women who had received EDA during labour (n=585) were included in the study. For each EDA record, a control record was selected, matched for parity, age and gestational age at birth. Women with emergency caesarean section, vacuum extraction/forceps, twin pregnancy, breech presentation or an intra-uterine death, as well as neonates with an Apgar score<7 at 5 mins were excluded. After exclusion, the study population consisted of 351 healthy women and babies in each group. METHOD: logistic regression was performed. The dependent variables: (1) initiation of breast feeding after birth; (2) artificial milk given during hospital stay; and (3) breast feeding at discharge were studied in response to: (a) parity; (b) gestational age at birth; (c) length of first and second stage of labour; (d) administration of oxytocin; (e) administration of EDA; and (f) neonatal weight, as independent variables. FINDINGS: significantly fewer babies of mothers with EDA during labour suckled the breast within the first 4 hours of life [odds ratio (OR) 3.79]. These babies were also more often given artificial milk during their hospital stay (OR 2.19) and fewer were fully breast fed at discharge (OR 1.79). Delayed initiation of breast feeding was also associated with a prolonged first (OR 2.81) and second stage (OR 2.49) and with the administration of oxytocin (OR 3.28). Fewer newborns of multiparae received artificial milk during their hospital stay (OR 0.58). It was also, but to a lesser extent, associated with oxytocin administration (OR 2.15). Full breast feeding at discharge was also positively associated with multiparity (OR 0.44) and birth weight between 3 and 4 kg (OR 0.42). KEY CONCLUSIONS: the study shows that EDA is associated with impaired spontaneous breast feeding including breast feeding at discharge from the hospital. Further studies are needed on the effects of EDA on short- and long-term breast-feeding outcomes. Article Published Date : Apr 01, 2009

Abstract Title: The role of breast-feeding in the prevention of Helicobacter pylori infection: a systematic review. Abstract Source: Clin Infect Dis. 2009 Feb 15;48(4):430-7. PMID: 19133802 Abstract Author(s): Eric Chak, George W Rutherford, Craig Steinmaus Abstract: BACKGROUND: The benefits of breast-feeding for the prevention of infection in infants and young children have been widely recognized, but epidemiologic studies regarding the role of breast-feeding in protecting against Helicobacter pylori infection have produced conflicting results. METHODS: We performed a systematic review of relevant epidemiologic studies conducted during the period 1984-2007 after abstracting data from articles that met our inclusion criteria. Study quality was assessed using the Newcastle-Ottawa scale. With use of the random effects model, we calculated the summary odds ratios (ORs) and 95% confidence intervals (CIs) for H. pylori infection according to history of breast-feeding. RESULTS: For the 14 studies that met inclusion criteria, the summary OR for H. pylori infection was 0.78 (95% CI, 0.61-0.99; 1-sided P = .002). Nine of the 14 studies reported ORs of<1.0, and 6 of these studies reported statistically significant protective effects. Only 1 study reported a statistically significant OR of>1.0. In studies in which the subjects resided in middle- or low-income nations, the summary OR was 0.55 (95% CI, 0.33-0.93; P = .01), compared with 0.93 (95% CI, 0.73-1.19; P = .28) in studies in which subjects resided in high-income nations. The summary OR for studies that use the (13)C-urea breath test was 0.67 (95% CI, 0.32-1.39), compared with 0.91 (95% CI, 0.74-1.11) for studies that used the H. pylori IgG serologic test. We found no statistically significant dose-dependent protective effect against H. pylori associated with increasing duration of breast-feeding. CONCLUSIONS: Breast-feeding is protective against H. pylori infection, especially in middle- and low-income nations. Article Published Date : Feb 15, 2009

Abstract Title: Infant feeding, solid foods and hospitalisation in the first 8 months after birth. Abstract Source: Arch Dis Child. 2009 Feb ;94(2):148-50. Epub 2008 Oct 1. PMID: 18829618 Abstract Author(s): M A Quigley, Y J Kelly, A Sacker Article Affiliation: National Perinatal Epidemiology Unit, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Most infants in the UK start solids before the recommended age of 6 months. We assessed the independent effects of solids and breast feeding on the risk of hospitalisation for infection in term, singleton infants in the Millennium Cohort Study (n = 15,980). For both diarrhoea and lower respiratory tract infection (LRTI), the monthly risk of hospitalisation was significantly lower in those receiving breast milk compared with those receiving formula. The monthly risk of hospitalisation was not significantly higher in those who had received solids compared with those not on solids (for diarrhoea, adjusted odds ratio 1.39, 95% CI 0.75 to 2.59; for LRTI, adjusted odds ratio 1.14, 95% CI 0.76 to 1.70), and the risk did not vary significantly according to the age of starting solids. Article Published Date : Feb 01, 2009

Abstract Title: Association between Infant Feeding and Early Postpartum Infant Body Composition: A Pilot Prospective Study. Abstract Source: Int J Pediatr. 2009;2009:648091. Epub 2009 Mar 12. PMID: 20041019 Abstract Author(s): Alex Kojo Anderson Abstract: Research studies have produced conflicting results of the impact of breastfeeding on overweight/obesity. This study evaluated the impact of infant feeding on infant body composition. There were two groups of mother-infant pairs (exclusive breastfeeding [EBF; n = 27] and mixed feeding [MF; n = 13]) in this study. At baseline, participants were similar in their demographic characteristics except prepregnancy weight, where MF mothers tended to be heavier than their EBF counterparts (67.3 kg versus 59.9 kg; P = .034). Infant birth weight was slightly higher among the MF group than their EBF counterparts (3.5 kg versus 3.4 kg), although the differences were not statistically significant. At 3 months postpartum, mean infant FMI (4.1 kg/m(2) versus 3.8 kg/m(2)) and percent body fat (24.4% versus 23.1%) were slightly higher among EBF infants than MF infants. In terms of growth velocity, EBF infants gained weight faster than their MF counterparts, although the differences were not statistically significant. The findings from this study suggest that EBF may promote faster weight gain and increase in both fat mass index (FMI) and percent body fat in the early postpartum period in addition to the numerous health benefits enjoyed by the infant and the mother who exclusively breastfeeds her newborn. Article Published Date : Jan 01, 2009

Abstract Title: Effect of pacifier use on exclusive and any breastfeeding: a meta-analysis. Abstract Source: Turk J Pediatr. 2009 Jan-Feb;51(1):35-43. PMID: 19378889 Abstract Author(s): Erdem Karabulut, S Songül Yalçin, Pinar Ozdemir-Geyik, Ergun Karaağaoğlu Abstract: The objective of this meta-analysis was to determine with cross-sectional and cohort trails whether the use of pacifier increases the risk of early weaning from exclusive breastfeeding before six months of age or cessation of breastfeeding from any breastfeeding before 24 months of age. Additionally, the effect of the age for starting pacifier use on breastfeeding duration was analyzed in the cohort trails. The Medline database was searched (1980 to 2006) with "breastfeed, breastfeeding, or breast feed" and "pacifier, dummy, or soother" as individual keywords. Only human studies published in English were included. Unpublished data were not sought. Twelve trials with weaning from exclusive breastfeeding and 19 trials with cessation of any breastfeeding were included in the meta-analysis. The meta-analysis was performed with Stata 6.0 statistical package. Summary risk ratio for early weaning before six months of age in exclusive breastfeeding trails was 2.016 (95% CI: 1.619-2.511) for pacifier users compared with nonusers in studies with univariate analysis and 1.792 (95% CI: 1.452-2.212) in studies with multivariate analysis. Similarly, pacifier usage compared with nonusers reduced the duration of any breastfeeding in both univariate (2.760, 95% CI: 2.083-3.657) and multivariate trials (1.952, 95% CI: 1.662-2.293). The use of pacifiers was associated with shortened duration of exclusive and of any breastfeeding. Given the increase in the benefits with duration of breastfeeding, parents should be informed of the link between pacifier use and shortened breastfeeding duration in order to help them make informed decisions about their children's care. Article Published Date : Jan 01, 2009

Abstract Title: The early origins of atherosclerosis. Abstract Source: Adv Exp Med Biol. 2009;646:51-8. PMID: 19536662 Abstract Author(s): Atul Singhal Abstract: Atherosclerosis has a long pre-clinical phase with development of pathological changes in arteries of children and young adults decades before overt clinical manifestations of disease. Nutritional factors in both infancy and childhood have been shown to be important in this process and affect lifetime cardiovascular disease risk. Breast-feeding in particular is associated with benefits for long-term cardiovascular risk factors possibly as a consequence of a slower pattern of growth in breast-fed compared to formula-fed infants. In fact, the benefits of slower growth for later health and longevity, appears to be a fundamental biological phenomenon conserved across diverse animal species. The nutritional programming of atherosclerosis could therefore be regarded as a specific example of programming of human ageing as seen previously in programming of lifespan and telomere length in animals. The critical window for these effects is unknown, but evidence is accumulating for programming effects of growth from very early in infancy. Article Published Date : Jan 01, 2009

Abstract Title: Breastfeeding reduces postpartum weight retention. Abstract Source: Am J Clin Nutr. 2008 Dec;88(6):1543-51. PMID: 19064514 Abstract Author(s): Jennifer L Baker, Michael Gamborg, Berit L Heitmann, Lauren Lissner, Thorkild I A Sørensen, Kathleen M Rasmussen Abstract: BACKGROUND: Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE: We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding duration is long. DESIGN: We selected women from the Danish National Birth Cohort who ever breastfed (>98%), and we conducted the interviews at 6 (n = 36 030) and 18 (n = 26 846) mo postpartum. We used regression analyses to investigate whether breastfeeding (scored to account for duration and intensity) reduced PPWR at 6 and 18 mo after adjustment for maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). RESULTS: GWG was positively (P<0.0001) associated with PPWR at both 6 and 18 mo postpartum. Breastfeeding was negatively associated with PPWR in all women but those in the heaviest category of prepregnancy BMI at 6 (P<0.0001) and 18 (P<0.05) mo postpartum. When modeled together with adjustment for possible confounding, these associations were marginally attenuated. We calculated that, if women exclusively breastfed for 6 mo as recommended, PPWR could be eliminated by that time in women with GWG values of approximately 12 kg, and that the possibility of major weight gain (>or=5 kg) could be reduced in all but the heaviest women. CONCLUSION: Breastfeeding was associated with lower PPWR in all categories of prepregnancy BMI. These results suggest that, when combined with GWG values of approximately 12 kg, breastfeeding as recommended could eliminate weight retention by 6 mo postpartum in many women. Article Published Date : Dec 01, 2008

Abstract Title: The effect of breastfeeding on breast aesthetics. Abstract Source: Aesthet Surg J. 2008 Sep-Oct;28(5):534-7. PMID: 19083576 Abstract Author(s): Brian Rinker, Melissa Veneracion, Catherine P Walsh Abstract: BACKGROUND: The health benefits of breast milk for infants are well documented, but breastfeeding is avoided by many women because of concerns about a negative effect upon breast appearance. However, there is very little objective data to either support or refute this view. OBJECTIVE: The purpose of this study is to identify risk factors for the development of breast ptosis after pregnancy and to determine whether breastfeeding has an adverse effect on breast shape. METHODS: Charts were reviewed of all patients seeking consultation for aesthetic breast surgery between 1998 and 2006. History of pregnancies, breastfeeding, and weight gain were obtained via telephone interview. Degree of breast ptosis was determined from preoperative photos. Nulliparous women were excluded. Logistic regression analysis was performed to identify independent predictors of postpregnancy breast ptosis. RESULTS: Ninety-three patients met the study criteria. Fifty-four patients (58%) reported a history of breastfeeding. The mean age at surgery in the breastfeeding group was 41 years, compared to 37 years in the nonbreastfeeding group. An adverse change in breast shape following pregnancy was described by 51 respondents (55%). Greater age, higher body mass index, greater number of pregnancies, larger prepregnancy bra size, and smoking were identified as significant independent risk factors for postpregnancy breast ptosis (P<.05). Breastfeeding was not found to be an independent risk factor for ptosis. CONCLUSIONS: The risk of breast ptosis increases with each pregnancy, but breastfeeding does not seem to worsen these effects. Expectant mothers should be reassured that breastfeeding does not appear to have an adverse effect upon breast appearance. Article Published Date : Sep 01, 2008

Abstract Title: Associations of maternal fish intake during pregnancy and breastfeeding duration with attainment of developmental milestones in early childhood: a study from the Danish National Birth Cohort. Abstract Source: Am J Clin Nutr. 2008 Sep;88(3):789-96. PMID: 18779297 Abstract Author(s): Emily Oken, Marie Louise Østerdal, Matthew W Gillman, Vibeke K Knudsen, Thorhallur I Halldorsson, Marin Strøm, David C Bellinger, Mijna Hadders-Algra, Kim Fleischer Michaelsen, Sjurdur F Olsen Abstract: BACKGROUND: Few studies have examined the overall effect of maternal fish intake during pregnancy on child development or examined whether the developmental benefits of maternal fish intake are greater in infants breastfed for a shorter duration. OBJECTIVE: We aimed to study associations of maternal prenatal fish intake and breastfeeding duration with child developmental milestones. DESIGN: We studied 25 446 children born to mothers participating in the Danish National Birth Cohort, a prospective population-based cohort study including pregnant women enrolled between 1997 and 2002. Mothers reported child development by a standardized interview, which we used to generate developmental scores at ages 6 and 18 mo. We used multivariate cumulative ordinal logistic regression to evaluate the odds of higher developmental scores associated with maternal fish intake and breastfeeding, after adjustment for child age, sex, and growth; maternal size and pregnancy characteristics; and parental education and social status. RESULTS: Higher maternal fish intake and greater duration of breastfeeding were associated with higher child developmental scores at 18 mo [odds ratio: 1.29 (95% CI: 1.20, 1.38) for the highest versus the lowest quintile of fish intake, and 1.28 (1.18, 1.38) for breastfeeding for>or =10 mo compared with breastfeeding for Article Published Date : Sep 01, 2008

Abstract Title: Feeding habits as determinants of early childhood caries in a population where prolonged breastfeeding is the norm. Abstract Source: Community Dent Oral Epidemiol. 2008 Aug;36(4):363-9. PMID: 19145723 Abstract Author(s): S Z Mohebbi, J I Virtanen, M Vahid-Golpayegani, M M Vehkalahti Article Affiliation: Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVES: To investigate the impact of feeding habits and daytime sugar intake on the prevalence of early childhood caries in a population where prolonged breastfeeding is a norm. METHODS: A cross-sectional study was carried out at 18 of 102 public health centers in Tehran. During a 4-day period at each center, between 20 and 35 children aged 1-3 years were enrolled, resulting in a sample of 504 children. In structured interviews, mothers were asked to give information about their child's feeding habits, daytime sugar intake, and their family's background. Sugar intake during the night was operationalized as separately calculated burdens of nighttime breastfeeding and bottle-feeding. Clinical dental examinations followed the World Health Organization criteria. Data analysis included chi-square test, t-test, ANOVA, and logistic regression modeling. RESULTS: Of the children, 56% were solely breastfed (mean duration 16.6 months; 95% CI 16.0-17.2), 42% were both breastfed and bottle-fed, and 2% were solely bottle-fed. Mean duration of breastfeeding for the solely breastfed 24- to 36-month olds was 22.8 months (95% CI 21.8-23.9). At bedtime, 69% were breastfed, 11% bottle-fed, and 20% were not fed at all. With respect to feeding during the night, 72% of children were breastfed, 12% were bottle-fed with milk, 1% received a bottle with water, while 15% were not fed. Early childhood caries (ECC) occurred in 3-26% of the children, depending on age group (P<0.001). The burden of milk-bottle feeding at night was a clear determinant for ECC (OR = 5.5) whereas breastfeeding per se, its duration, the burden of breastfeeding at night, and daytime sugar intake were not. CONCLUSION: On account of its association with ECC, milk-bottle feeding at night should be limited, whereas prolonged breastfeeding appears to have no such negative dental consequences. Article Published Date : Aug 01, 2008

Abstract Title: Breastfeeding duration and postpartum psychological adjustment: role of maternal attachment styles. Abstract Source: J Paediatr Child Health. 2008 Jun;44(6):369-73. PMID: 18476931 Abstract Author(s): Ipek Akman, M Kemal Kuscu, Ziya Yurdakul, Nihal Ozdemir, Mine Solakoğlu, Lale Orhon, Aytül Karabekiroğlu, Eren Ozek Abstract: AIM: Depressive and anxiety symptoms are common in new mothers. The aim of this study is to explore the link between postpartum psychological adjustment and feeding preferences of the mothers. METHODS: Sixty mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened by the Edinburgh Postpartum Depression Scale (EPDS), and maternal anxiety level was assessed by the State-Trait Anxiety Inventory at 1 month postpartum. The Multidimensional Scale of Perceived Social Support was used for the assessment of maternal social support. The Adult Attachment Scale was used to determine the attachment style of the mother. Infants were examined and evaluated at 1 and 4 months of life. RESULTS: All mothers started breastfeeding their infants postpartum; 91% and 68.1% continued exclusive breastfeeding at 1 and 4 months, respectively. The first-month median EPDS score of mothers who breastfeed at the fourth month was statistically significantly lower than those who were not breastfeeding (6 and 12, respectively) (P = 0001). The first-month median EPDS score of mothers with secure attachment was lower than the median score of mothers with insecure attachment (5 and 9, respectively) (P<0001). Exclusive breastfeeding rate was not statistically different among mothers with secure and insecure attachment styles. The median state and trait anxiety scores and social support scores of mothers were not different between groups according to breastfeeding status. CONCLUSIONS: This study has shown an association between higher EPDS scores and breastfeeding cessation by 4 months after delivery. Article Published Date : Jun 01, 2008

Abstract Title: Short- and long-term decrease of blood pressure in women during breastfeeding. Abstract Source: Breastfeed Med. 2008 Jun;3(2):103-9. PMID: 18563998 Abstract Author(s): W Jonas, E Nissen, A-B Ransjö-Arvidson, I Wiklund, P Henriksson, K Uvnäs-Moberg Abstract: BACKGROUND AND AIMS: The benefits of breastfeeding for infants are well known. Recently data have started to emerge showing that breastfeeding may also induce positive effects in the mother. This study aimed to investigate the pattern of maternal blood pressure before, during, and after a breastfeed 2 days postpartum. Additionally, blood pressure during the following 25-week breastfeeding period was investigated. METHODS: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at -5, 10, 30, and 60 minutes in connection with a morning breastfeed. Thirty-three women continued to measure blood pressure before and after breastfeeding for 25 weeks. RESULTS: Blood pressure fell significantly in response to breastfeeding 2 days after birth. The fall in systolic and diastolic blood pressure amounted to 8.8 (SD = 11.00) and 7.7 (SD = 9.3) mm Hg, respectively. During the 25-week follow-up period a significant fall of basal blood pressure (systolic, df = 3, F = 7.843, p<0.001; diastolic, df = 3, F = 5.453, p = 0.002) was observed. The total fall in systolic and diastolic blood pressure amounted to a mean of 15 (SD = 10.4) mm Hg and 10 (SD = 9.7) mm Hg, respectively. In addition, blood pressure fell significantly in response to individual breastfeeding sessions during the entire observation period. CONCLUSIONS: In conclusion, both systolic and diastolic blood pressures fall during a breastfeeding session, and pre-breastfeeding blood pressure decreases during at least the first 6 months of a breastfeeding period in a homelike environment. This study lends further support to the health-promoting effects of breastfeeding. Article Published Date : Jun 01, 2008

Abstract Title: Breastfeeding: a potential protective factor against ventriculoperitoneal shunt infection in young infants. Abstract Source: J Neurosurg Pediatr. 2008 Feb;1(2):138-41. PMID: 18352783 Abstract Author(s): Farideh Nejat, Parvin Tajik, Syed Mohammad Ghodsi, Banafsheh Golestan, Reza Majdzadeh, Shahrooz Yazdani, Saeed Ansari, Majid Dadmehr, Sara Ganji, Mehri Najafi, Fatemeh Farahmand, Farzaneh Moatamed Abstract: OBJECT: Previous studies have shown nutritional benefits of breastfeeding for a child's health, especially for protection against infection. Protective factors in human milk locally and systemically prevent infections in the gastrointestinal as well as upper and lower respiratory tracts. It remains unclear whether breastfeeding protects infants against ventriculoperitoneal (VP) shunt infection. METHODS: A cohort study was conducted from December 2003 to December 2006 at Children's Hospital Medical Center in Tehran, Iran. A total of 127 infants with hydrocephalus who were treated using a VP shunt in the first 6 months of life were enrolled. Each infant's breastfeeding method was classified as either exclusively breastfed (EBF), combination feedings of breast milk and formula (CFBF), or exclusively formula-fed (EFF). Infants were followed up to determine the occurrence of shunt infection within 6 months after operation. Statistical analysis was performed using survival methods. RESULTS: Infants ranged in age from 4 to 170 days at the time of shunt insertion (mean 69.6 days), and 57% were males. Regarding the breastfeeding categories, 57.5% were EBF, 25.2% were CFBF, and 17.3% were EFF. During the follow-up, shunt infection occurred in 16 patients, within 15 to 173 days after shunt surgery (median 49 days). The 6-month risk of shunt infection was 8.5% (95% confidence interval [CI] 4-18%) in the EBF group, 16.5% (95% CI 7-35%) in the CFBF group, and 26.0% (95% CI 12-52%) in the EFF group. There was no statistically significant difference between these 3 groups (p=0.11). The trend test showed a significant trend between the extent of breastfeeding and the risk of shunt infection (p=0.035), which persisted even after adjustment for potential confounding variables (hazard ratio=2.01, 95% CI 1.01-4). CONCLUSIONS: This study supports the protective effect of breastfeeding against shunt infection during the first 6 months of life and the presence of a dose-response relationship, such that the higher the proportion of an infant's feeding that comes from human milk, the lower the incidence of shunt infection. Encouraging mothers of infants with VP shunts to breastfeed exclusively in the first 6 months of life is recommended. Article Published Date : Feb 01, 2008

Abstract Title: Effect of infant feeding on maternal body composition. Abstract Source: Int Breastfeed J. 2008;3:18. Epub 2008 Aug 6. PMID: 18684325 Abstract Author(s): Irene E Hatsu, Dawn M McDougald, Alex K Anderson Abstract: BACKGROUND: Women gain total body weight and accrue body fat during pregnancy. Breastfeeding has been suggested as an efficient means of promoting postpartum weight loss due to its high energy cost. We investigated the effect of infant feeding mode on maternal body composition. METHODS: This study evaluated maternal weight and percent body fat changes in exclusively breastfeeding versus mixed feeding mothers during the first 12 weeks postpartum using the BOD POD. Twenty four mothers aged 19 - 42 years were studied. Participants were recruited from Athens-Clarke County and surrounding areas of the State of Georgia, USA. The study was conducted between November 2005 and December 2006. RESULTS: Prepregnancy weight was higher in mixed feeding mothers than in exclusively breastfeeding mothers (68.4 kg vs. 61.4 kg) but the difference was not statistically significant. At 12 weeks postpartum, exclusively breastfeeding mothers had lost more total body weight than mixed feeding mothers (4.41 +/- 4.10 kg versus 2.79 +/- 3.09 kg; p = 0.072). There was no significant difference in fat weight change between the two groups (4.38 +/- 2.06 kg versus 4.17 +/- 2.63 kg). However, mixed feeding mothers lost slightly more percent body fat than exclusively breastfeeding mothers (1.90 +/- 4.18 kg versus 1.71 +/- 3.48 kg), but the difference was not statistically significant. The trend in percent body fat loss was significant among exclusively breastfeeding mothers (p = 0.034) but not mixed feeding mothers (p = 0.081). Exclusively breastfeeding mothers consumed more calories than mixed feeding mothers (1980 +/- 618 kcal versus 1541 +/- 196 kcal p = 0.08). Physical activity levels were, however, higher in mixed feeding mothers than exclusively breastfeeding mothers. CONCLUSION: Our results provide further evidence that exclusive breastfeeding promotes greater weight loss than mixed feeding among mothers even in the early postpartum period. This suggests that there is the need to encourage mothers to exclusively breastfeed as a means of overweight and obesity prevention. Article Published Date : Jan 01, 2008

Abstract Title: Breastfeeding's protection against illness-induced anorexia is mediated partially by docosahexaenoic acid. Abstract Source: Eur J Clin Nutr. 2008 Jan;62(1):32-8. Epub 2007 Feb 21. PMID: 17311056 Abstract Author(s): M López-Alarcón, C Garza, M del Prado, P A García-Zúñiga, L Barbosa Article Affiliation: Unidad de Investigación Médica en Nutrición, Hospital de Pediatría, Centro Médico Nacional Siglo XXI. Mexican Institute of Social Security, Mexico City, Mexico. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: To test whether breastfeeding's protection against anorectic responses to infection is mediated by n-3 fatty acids' attenuation of interleukin (IL)-1beta and tumor necrosis factor (TNF)alpha. DESIGN: Experimental and observational studies. SETTING: A hospital-based study was conducted. SUBJECTS: Five groups of infants were followed; three in the experimental and two in the observational study. METHODS: Breast-fed- (BF-1), DHA-supplemented formula- (SFF-1), and non-DHA-supplemented formula-fed (FF-1) infants were studied before and after immunization against diphtheria, tetanus, pertussis and haemophilus influenzae type b. Pre- and post-immunization energy intakes (EI) and serum IL-1beta and TNFalpha were measured. The two other groups, breast-fed (BF-2) and formula-fed (FF-2) infants with pneumonia were followed throughout hospitalization. EI, IL-1beta and TNFalpha were measured at admission and discharge. Baseline erythrocyte fatty acid contents were determined. RESULTS: Both cytokines increased following immunization in all feeding groups. Post-immunization reductions in EI of SFF-1 infants (-11.8+/-5%, CI(95)=-23.3, 1.4%, P=0.07) were intermediate to those observed in BF-1 (-5.2+/-4.2%, CI(95)=-15.2, 5.9%, P=0.27) and FF-1 infants (-18+/-4.4%, CI(95)=-29%, -5.4%, P=0.02). In the observational study, TNFalpha (17.2+/-8.3 vs 3.4+/-3.0 ng/l, P=0.001) and decreases in EI (-31+/-43 vs -15+/-31%, CI(95)=-34%, 0.001%, P=0.056) were greater in FF-2 than in BF-2 infants at admission. Breastfeeding duration was associated positively with docosahexaenoic acid (DHA) erythrocyte contents, and negatively with admission TNFalpha. Decreases in EIs were associated with IL-1beta and TNFalpha concentrations. CONCLUSION: Reductions in EI following immunologic or infectious stimuli were associated with increases in IL-1beta and TNFalpha. Those reductions were attenuated by breastfeeding, and mediated in part by tissue DHA. Article Published Date : Jan 01, 2008

Abstract Title: Role of breast feeding in primary prevention of asthma and allergic diseases in a traditional society. Abstract Source: Eur Ann Allergy Clin Immunol. 2007 Dec ;39(10):337-43. PMID: 18386435 Abstract Author(s): A Bener, M S Ehlayel, S Alsowaidi, A Sabbah Article Affiliation: Dept. of Medical Statistics&Epidemiology, Hamad Medical Corporation, Qatar. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: The fact that breastfeeding may protect against allergic diseases remains controversial, with hardly any reports from developing countries. Prolonged breastfeeding was shown to reduce the risk of allergic and respiratory diseases. AIM: The aim of this study was to assess the relationship between breastfeeding and the development of childhood asthma and allergic diseases in Qatari children at age 0-5 years. Additionally, this study investigated the effect of prolonged breastfeeding on the allergic diseases in a developing country. DESIGN: This is a cross sectional survey. SETTING: Well baby clinics and Pediatric clinics in the 11 Primary Health Care Centers and Hamad General Hospital, Hamad Medical Corporation, State of Qatar. SUBJECTS: A multistage sampling design was used and a representative sample of 1500 Qatari infants and pre-school children with age range of 0-5 years and mothers aged between 18 to 47 years were surveyed during the period from October 2006 to September 2007 in Qatar. Out of the 1500 mothers of children, 1278 mothers agreed to participate in this study with the response rate of 85.2%. METHODS: A confidential, anonymous questionnaire was completed by the selected subjects assessing breastfeeding and allergic diseases. Questionnaires were administered to women who were attending Primary Health Centers for child immunization. Questionnaire included allergic rhinitis, wheezing, eczema, and additional questions included mode and duration of breastfeeding, tobacco smoke exposure, number of siblings, family income, level of maternal education, parental history of allergies. Univariate and multivariate statistical methods were performed for statistical analysis. RESULTS: More than half of the infants (59.3%) were exclusively breastfed, followed by infants with partial breastfeeding (28.3%) and artificial fed (12.4%). There was a significant difference found across these three categories of infants in terms of their age groups, smoking status of father, socio-economic status and parental consanguinity. Asthma (15.6%), wheezing (12.7%), allergic rhinitis (22.6%), and eczema (19.4%) were less frequent in exclusive breast fed children, compared to infants with partial breast feeding and formula milk. Ear infection (P = 0.0001) and eczema (P = 0.007) were found significant in infants with the history of maternal atopy, while asthma (P = 0.0001) and allergic rhinitis (P = 0.015) were found significant in infants with the history of paternal atopy. The main factors associated with mode of feeding were mothers having first baby, asthmatic mother and parental history of allergic rhinitis. The risk of allergic diseases, eczema, wheeze and ear infection in particular, were lower in children with prolonged breast feeding (>6 months) than in those with short-term breast feeding duration (<6 months). CONCLUSION: The current study indicates that exclusive breast-feeding prevents development of allergic diseases in children. The main factors associated with breastfeeding for allergic diseases were being the first baby, maternal history of asthma, and parental history of allergic rhinitis. The study findings opens a big avenue for interventional role of breastfeeding. Therefore, we recommend breastfeeding is as one possible way to reduce the risk of onset asthma and allergic diseases in developing countries. Article Published Date : Dec 01, 2007

Abstract Title: Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Abstract Source: Pediatrics. 2007 Oct;120(4):e953-9. PMID: 17908750 Abstract Author(s): Betty R Vohr, Brenda B Poindexter, Anna M Dusick, Leslie T McKinley, Rosemary D Higgins, John C Langer, W Kenneth Poole, Abstract: BACKGROUND: We previously reported beneficial effects of breast milk ingestion by infants with extremely low birth weight in the NICU on developmental outcomes at 18 months' corrected age. The objective of this study was to determine whether these effects of breast milk in infants with extremely low birth weight persisted at 30 months' corrected age. METHODS: Nutrition data, including enteral and parenteral feeds, were prospectively collected, and 30 months' corrected age follow-up assessments were completed on 773 infants with extremely low birth weight who participated in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial. A total of 593 ingested some breast milk during the neonatal hospitalization, and 180 ingested none. Neonatal feeding characteristics and morbidities and 30-month interim history, neurodevelopmental outcomes, and growth parameters were analyzed. Children were divided into quintiles of breast milk volume to evaluate the effects of volume of human milk ingested during the NICU hospitalization. RESULTS: At 30 months, increased ingestion of breast milk was associated with higher Bayley Mental Developmental Index scores, higher Bayley behavior score percentiles for emotional regulation, and fewer rehospitalizations between discharge and 30 months. There were no differences in growth parameters or cerebral palsy. For every 10 mL/kg per day increase in breast milk, the Mental Developmental Index increased by 0.59 points, the Psychomotor Developmental Index by 0.56 points, and the total behavior percentile score by 0.99 points, and the risk of rehospitalization between discharge and 30 months decreased by 5%. CONCLUSIONS: Beneficial effects of ingestion of breast milk in the NICU persist at 30 months' corrected age in this vulnerable extremely low birth weight population. Continued efforts must be made to offer breast milk to all extremely low birth weight infants both in the NICU and after discharge. Article Published Date : Oct 01, 2007

Abstract Title: Pasteurization of mother's own milk reduces fat absorption and growth in preterm infants. Abstract Source: Acta Paediatr. 2007 Oct ;96(10):1445-9. Epub 2007 Aug 20. PMID: 17714541 Abstract Author(s): Y Andersson, K Sävman, L Bläckberg, O Hernell Article Affiliation: Department of Clinical Sciences, Pediatrics, Umeå University, S-901 87 Umeå, Sweden. Abstract: AIM: A randomized study was conducted to evaluate whether pasteurized milk (Holder pasteurization 62.5 degrees C, 30 min) reduces fat absorption and growth in preterm infants. METHODS: Preterm infants (825-1325 g) born with gestational age RESULTS: We found, on an average, 17% higher fat absorption with raw as compared to pasteurized milk. Infants gained more weight and linear growth assessed as knee-heel length was also greater during the week they were fed raw milk as compared to the week they were fed pasteurized milk. CONCLUSION: Feeding preterm infants pasteurized as compared to raw own mother's milk reduced fat absorption. When the infants were fed raw milk, they gained more in knee-heel length compared to when they were fed pasteurized milk. Article Published Date : Sep 30, 2007

Abstract Title: Hair mercury in breast-fed infants exposed to thimerosal-preserved vaccines. Abstract Source: Eur J Pediatr. 2007 Sep;166(9):935-41. Epub 2007 Jan 20. PMID: 17237965 Abstract Author(s): Rejane C Marques, José G Dórea, Márlon F Fonseca, Wanderley R Bastos, Olaf Malm Article Affiliation: Fundação Universidade Federal de Rondônia, Porto Velho, RO, Brazil. Abstract: Because of uncertainties associated with a possible rise in neuro-developmental deficits among vaccinated children, thimerosal-preserved vaccines have not been used since 2004 in the USA (with the exception of thimerosal-containing influenza vaccines which are routinely recommended for administration to pregnant women and children), and the EU but are widely produced and used in other countries. We investigated the impact of thimerosal on the total Hg in hair of 82 breast-fed infants during the first 6 months of life. The infants received three doses of the hepatitis-B vaccine (at birth, 1 and 6 months) and three DTP (diphtheria, tetanus, and pertussis) doses at 2, 4 and 6 months, according to the immunization schedule recommended by the Ministry of Health of Brazil. The thimerosal in vaccines provided an ethylmercury (EtHg) exposure of 25 microgHg at birth, 30, 60 and 120 days, and 50 microgHg at 180 days. The exposure to vaccine-EtHg represents 80% of that expected from total breast milk-Hg in the first month but only 40% of the expected exposure integrated in the 6 months of breastfeeding. However, the Hg exposure corrected for body weight at the day of immunization was much higher from thimerosal- EtHg (5.7 to 11.3 microgHg/kg b.w.) than from breastfeeding (0.266 microgHg/kg b.w.). While mothers showed a relative decrease (-57%) in total hair-Hg during the 6 months lactation there was substantial increase in the infant's hair-Hg (446%). We speculate that dose and parenteral mode of thimerosal-EtHg exposure modulated the relative increase in hair-Hg of breast-fed infants at 6 months of age. Article Published Date : Sep 01, 2007

Abstract Title: Benefits of breastfeeding in cystic fibrosis: a single-centre follow-up survey. Abstract Source: Acta Paediatr. 2007 Aug;96(8):1228-32. Epub 2007 Jun 21. PMID: 17590186 Abstract Author(s): Carla Colombo, Diana Costantini, Laura Zazzeron, Nadia Faelli, Maria Chiara Russo, Diana Ghisleni, Italo Gatelli, Marcello Giovannini, Enrica Riva, Rolf Zetterström, Carlo Agostoni Abstract: AIM: To study the effect of breastfeeding (BF) on growth, lung function and number of infections during the first 3 years of life in children with cystic fibrosis (CF). MATERIAL AND METHODS: One hundred forty-six CF patients, 5-18 years old, were recruited at their annual care visit. Information about infant feeding, psychosocial and socioeconomic conditions and smoking exposure was obtained by interviews. Anthropometric parameters at 1 year of age and the number of infections and hospitalisations during the first 3 years of life were obtained from clinical charts. Anthropometrics and pulmonary function parameters were obtained at enrollment. RESULTS: In CF patients, particularly those with pancreatic insufficiency, the prevalence of BF was lower than the general Italian population. After multivariate analysis patients with prolonged BF showed higher values of CED expiratory volume in 1 sec (FEV-1) (p = 0.001) and a lower number of infections during the first 3 years of life (p = 0.098). CONCLUSION: Prolonged BF is beneficial in children with CF and may protect them against decline of pulmonary function. Particular attention should be paid to promote BF in infants with CF. Article Published Date : Aug 01, 2007

Abstract Title: Recurrent neonatal group B streptococcal disease associated with infected breast milk. Abstract Source: Clin Pediatr (Phila). 2007 Jul;46(6):547-9. PMID: 17579109 Abstract Author(s): Lin-Yu Wang, Chun-Ta Chen, Won-Hsiung Liu, Yin-Hsuan Wang Article Affiliation: Department of Pediatrics, Chi-Mei Foundation Medical Center, Tainan, Taiwan. Abstract: Group B streptococcus (GBS) is a major cause of severe systemic infections among the newborn. Both recurrent and maternal mastitis-associated, group B streptococcus diseases are uncommon. Persistence of GBS colonization of infants' mucous membrane is postulated to influence the pathogeneses of recurrent GBS infection. The authors describe a term infant who was treated for GBS sepsis and meningitis and then later developed recurrent GBS sepsis, without meningitis, due to feeding of infected breast milk. Randomly amplified polymorphic DNA polymerase chain reaction assay was performed to demonstrate that the GBS isolates from the first and second episode of infection and the maternal milk are identical. The authors conclude that transmission of GBS through breast milk should be considered in cases of recurrent neonatal GBS infection and bacterial culture of breast milk should be routinely performed in such cases. Article Published Date : Jul 01, 2007

Abstract Title: Identification of nestin-positive putative mammary stem cells in human breastmilk. Abstract Source: Cell Tissue Res. 2007 Jul ;329(1):129-36. Epub 2007 Apr 18. PMID: 17440749 Abstract Author(s): Mark D Cregan, Yiping Fan, Amber Appelbee, Mark L Brown, Borut Klopcic, John Koppen, Leon R Mitoulas, Kristin M E Piper, Mahesh A Choolani, Yap-Seng Chong, Peter E Hartmann Article Affiliation: School of Biomedical, Biomolecular and Chemical Sciences, Faculty of Life and Physical Sciences, M310, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Stem cells in mammary tissue have been well characterised by using the mammary stem cell marker, cytokeratin (CK) 5 and the mature epithelial markers CK14, CK18 and CK19. As these markers have never been reported in cells from breastmilk, the aim of this study has been to determine whether mammary stem cells are present in expressed human breastmilk. Cultured cells from human breastmilk were studied by using immunofluorescent labelling and reverse transcription/polymerase chain reaction (RT-PCR). We found a heterogeneous population of cells with differential expression of CK5, CK14, CK18 and CK19. Further, by using the multipotent stem cell marker, nestin, we identified cells in culture that were positive only for nestin or double-positive for CK5/nestin, whereas no co-staining was observed for CK14, CK18 and CK19 with nestin. When cells isolated from breastmilk were analysed by using RT-PCR prior to culture, only nestin and CK18 were detected, thereby indicating that breastmilk contained differentiated epithelial and putative stem cells. Furthermore, fluorescence-activated cell-sorting analysis demonstrated, in breastmilk, a small side-population of cells that excluded Hoechst 33342 (a key property of multipotent stem cells). When stained for nestin, the cells in the side-population were positive, whereas those not in the side-population were negative. The presence of nestin-positive putative mammary stem cells suggests that human breastmilk is a readily available and non-invasive source of putative mammary stem cells that may be useful for research into both mammary gland biology and more general stem cell biology. Article Published Date : Jun 30, 2007

Abstract Title: The "smellscape" of mother's breast: effects of odor masking and selective unmasking on neonatal arousal, oral, and visual responses. Abstract Source: Dev Psychobiol. 2007 Mar;49(2):129-38. PMID: 17299785 Abstract Author(s): Sébastien Doucet, Robert Soussignan, Paul Sagot, Benoist Schaal Article Affiliation: Equipe d'Ethologie et de Psychobiologie Sensorielle Centre des Sciences du Goût UMR 5170 CNRS, Dijon, France. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Lactating women emit odor cues that release activity in newborns. Such cues may be carried in various substrates, including milk or areolar secretions. The present study aimed to examine the responses of infants facing their mother's breast and to sort out the source(s) of active volatile compounds emitted by the lactating breast. Infants (aged 3-4 days) were presented their mother's breast in two consecutive trials of 90 s each: a scentless condition (breast entirely covered with a transparent film) paired with one of four odorous conditions (fully exposed breast: n = 15; nipple only exposed: 15; areola only exposed: 13; and milk exposed: 12). The infants were more orally activated when facing any of the odorous breast conditions than when facing the scentless breast. They cried earlier and longer, and opened their eyes less, when facing the scentless breast. Nipple, Areola, and Milk odors appeared to be equivalent to the whole breast odor in stimulating oral activity and in delaying crying onset. This study shows that volatile compounds originating in areolar secretions or milk release mouthing, stimulate eye opening, and delay and reduce crying in newborns. Article Published Date : Mar 01, 2007

Abstract Title: Breast-fed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology. Abstract Source: Dev Neuropsychol. 2007;31(3):337-47. PMID: 17559328 Abstract Author(s): Melissa Ferguson, Peter J Molfese Abstract: Numerous studies report positive effects of breast-feeding on infant development. Such effects are apparent early in development as well as in later years. Recently, elements in breast milk, polyunsaturatred fatty acids (PUFAs), have been identified as having great potential for increasing nutritional benefits. PUFAs are long-chain fatty acids containing two or more double bonds. While some scientists are enthusiastic about the long-term benefits of PUFAs on brain and cognitive development, many of the positive pharmacological effects attributed to PUFAs remain unsubstantiated. The present study investigated the differential impact of breast-feeding vs. PUFA-enriched formula in a small but well-matched population of 12 infants tested at 6 months of age. Event-related potential (ERP) and a range of behavior measures were recorded. ERP waveforms identified marked differences between the breast-fed and PUFA-fed infants by 6 months of age. When a range of biological, perinatal, and cognitive factors were equated between the two groups, only the ERPs recorded from breast-fed infants changed throughout their recorded period (700 msec), differentiated between all speech sounds, and generated differences in scalp recordings across all regions recorded across both hemispheres. Such differences in the range of their brain responses could signal an advantage for the breast-fed infants for later linguistic and cognitive development. Article Published Date : Jan 01, 2007

Abstract Title: Parity mediates the association between infant feeding method and maternal depressive symptoms in the postpartum. Abstract Source: Arch Womens Ment Health. 2007;10(6):259-66. Epub 2007 Nov 26. PMID: 18040595 Abstract Author(s): E Sibolboro Mezzacappa, J Endicott Abstract: Maternal depression is the most common complication of the postpartum, having devastating and long lasting effects on mother and infant. Lactation is associated with attenuated stress responses, especially that of cortisol, and the lactogenic hormones, oxytocin and prolactin, are associated with anti-depressant and anxiolytic effects. These associations suggest that breast-feeding may decrease maternal depressive symptoms, yet empirical results have been conflicting. Recent findings have indicated that parity may mediate the association between breast-feeding and stress response. Because a decreased stress response is associated with a decreased risk for depression, parity may also mediate the association between infant feeding method and depressive symptoms. Specifically, the benefits of breast-feeding may appear in multiparous but not primiparous mothers. In the present study, data drawn from a national sample of primiparous and multiparous mothers were examined for possible associations between infant feeding method and depressive symptoms, as assessed by the Center for Epidemiological Survey-Depression scale (CES-D). After controlling for several possible confounding variables, breast-feeding by multiparas was associated with significantly decreased odds of having depression compared with bottle-feeders (OR = 0.41, CI 0.19-0.87, p = 0.02); however, no risk reduction from breast-feeding was evident among primiparas. The results support a parity-mediated association between lactation and maternal depressive symptoms. The results provide a reason for earlier conflicting findings, present new research avenues, and suggest possible clinical approaches. Article Published Date : Jan 01, 2007

Abstract Title: A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. Abstract Source: Int Breastfeed J. 2007;2:6. Epub 2007 Mar 30. PMID: 17397549 Abstract Author(s): Kathleen Kendall-Tackett Abstract: BACKGROUND: Research in the field of psychoneuroimmunology (PNI) has revealed that depression is associated with inflammation manifested by increased levels of proinflammatory cytokines. DISCUSSION: The old paradigm described inflammation as simply one of many risk factors for depression. The new paradigm is based on more recent research that has indicated that physical and psychological stressors increase inflammation. These recent studies constitute an important shift in the depression paradigm: inflammation is not simply a risk factor; it is the risk factor that underlies all the others. Moreover, inflammation explains why psychosocial, behavioral and physical risk factors increase the risk of depression. This is true for depression in general and for postpartum depression in particular. Puerperal women are especially vulnerable to these effects because their levels of proinflammatory cytokines significantly increase during the last trimester of pregnancy--a time when they are also at high risk for depression. Moreover, common experiences of new motherhood, such as sleep disturbance, postpartum pain, and past or current psychological trauma, act as stressors that cause proinflammatory cytokine levels to rise. Breastfeeding has a protective effect on maternal mental health because it attenuates stress and modulates the inflammatory response. However, breastfeeding difficulties, such as nipple pain, can increase the risk of depression and must be addressed promptly. CONCLUSION: PNI research suggests two goals for the prevention and treatment of postpartum depression: reducing maternal stress and reducing inflammation. Breastfeeding and exercise reduce maternal stress and are protective of maternal mood. In addition, most current treatments for depression are anti-inflammatory. These include long-chain omega-3 fatty acids, cognitive therapy, St. John's wort, and conventional antidepressants. Article Published Date : Jan 01, 2007

Abstract Title: Cytokines, infections, stress, and dysphoric moods in breastfeeders and formula feeders. Abstract Source: J Obstet Gynecol Neonatal Nurs. 2006 Sep-Oct;35(5):599-607. PMID: 16958715 Abstract Author(s): Maureen W Groer, Mitzi W Davis Abstract: OBJECTIVE: To analyze relationships between stress, moods, and immunity in breastfeeding compared to formula-feeding mothers. DESIGN: A cross-sectional study of 181 healthy mothers, exclusively breastfeeding or formula feeding, studied at 4 to 6 weeks after childbirth. SETTING: Mothers were recruited in the postpartum unit of the hospital and then visited in their homes once at 4 to 6 weeks after childbirth for data collection. MAIN OUTCOME MEASURES: Stress, mood, infection symptoms, and serum levels of interferon-gamma and interleukin-10 were measured. RESULTS: Formula-feeding mothers had evidence of decreased interferon-gamma and a decreased serum Th1/Th2 ratio (interferon-gamma/interleukin-10) when perceived stress, dysphoric moods, and negative life events were high, an effect consistent with depression of cellular immunity. However, women who were breastfeeding did not show these relationships. CONCLUSIONS: The data suggest that breastfeeding confers some psychoneuroimmunological benefit to mothers, perhaps through prolactin or hypothalamic-hypophyseal-adrenocortical axis stress refractoriness. Article Published Date : Sep 01, 2006

Abstract Title: Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Abstract Source: Pediatrics. 2006 Jul;118(1):e115-23. PMID: 16818526 Abstract Author(s): Betty R Vohr, Brenda B Poindexter, Anna M Dusick, Leslie T McKinley, Linda L Wright, John C Langer, W Kenneth Poole, Abstract: OBJECTIVE: Beneficial effects of breast milk on cognitive skills and behavior ratings have been demonstrated previously in term and very low birth weight infants. Extremely low birth weight infants are known to be at increased risk for developmental and behavior morbidities. The benefits of breast milk that is ingested in the NICU by extremely low birth weight infants on development and behavior have not been evaluated previously. METHODS: Nutrition data including enteral and parenteral feeds were collected prospectively, and follow-up assessments of 1035 extremely low birth weight infants at 18 months' corrected age were completed at 15 sites that were participants in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial between October 14, 1999, and June 25, 2001. Total volume of breast milk feeds (mL/kg per day) during hospitalization was calculated. Neonatal characteristics and morbidities, interim history, and neurodevelopmental and growth outcomes at 18 to 22 months' corrected age were assessed. RESULTS: There were 775 (74.9%) infants in the breast milk and 260 (25.1%) infants in the no breast milk group. Infants in the breast milk group were similar to those in the no breast milk group in every neonatal characteristic and morbidity, including number of days of hospitalization. Mean age of first day of breast milk for the breast milk infants was 9.3 +/- 9 days. Infants in the breast milk group began to ingest non-breast milk formula later (22.8 vs 7.3 days) compared with the non-breast milk group. Age at achieving full enteral feeds was similar between the breast milk and non-breast milk groups (29.0 +/- 18 vs 27.4 +/- 15). Energy intakes of 107.5 kg/day and 105.9 kg/day during the hospitalization did not differ between the breast milk and non-breast milk groups, respectively. At discharge, 30.6% of infants in the breast milk group still were receiving breast milk. Mothers in the breast milk group were significantly more likely to be white (42% vs 27%), be married (50% vs 30%), have a college degree (22% vs 6%), and have private health insurance (34% vs 18%) compared with the no breast milk group. Mothers who were black, had a low household income (or = 85, higher mean Bayley Psychomotor Development Index, and higher Bayley Behavior Rating Scale percentile scores for orientation/engagement, motor regulation, and total score. There were no differences in the rates of moderate to severe cerebral palsy or blindness or hearing impairment between the 2 study groups. There were no differences in the mean weight (10.4 kg vs 10.4 kg), length (80.5 cm vs 80.5 cm), or head circumference (46.8 cm vs 46.6 cm) for the breast milk and no breast milk groups, respectively, at 18 months. Multivariate analyses, adjusting for confounders, confirmed a significant independent association of breast milk on all 4 primary outcomes: the mean Bayley (Mental Development Index, Psychomotor Development Index, Behavior Rating Scale, and incidence of rehospitalization). For every 10-mL/kg per day increase in breast milk ingestion, the Mental Development Index increased by 0.53 points, the Psychomotor Development Index increased by 0.63 points, the Behavior Rating Scale percentile score increased by 0.82 points, and the likelihood of rehospitalization decreased by 6%. In an effort to identify a threshold effect of breast milk on Bayley Mental Development Index and Psychomotor Development Index scores and Behavior Rating Scale percentile scores, the mean volume of breast milk per kilogram per day during the hospitalization was calculated, and infants in the breast milk group were divided into quintiles of breast milk ingestion adjusted for confounders. Overall, the differences across the feeding quintiles of Mental Development Index and Psychomotor Development Index were significant. There was a 14.0% difference in Behavior Rating Scale scores between the lowest and highest quintiles. For the outcomes (Mental Development Index, Psychomotor Development Index, Behavior Rating Scale, and Rehospitalization<1 year), only the values for the>80th percentile quintile of breast milk feeding were significantly different from the no breast milk values. In our adjusted regression analyses, every 10 mL/kg per day breast milk contributed 0.53 points to the Bayley Mental Development Index; therefore, the impact of breast milk ingestion during the hospitalization for infants in the highest quintile (110 mL/kg per day) on the Bayley Mental Development Index would be 10 x 0.53, or 5.3 points. CONCLUSIONS: An increase of 5 points potentially would optimize outcomes and decrease costs by decreasing the number of very low birth weight children who require special education services. The societal implications of a 5-point potential difference (one third of an SD) in IQ are substantial. The potential long-term benefit of receiving breast milk in the NICU for extremely low birth weight infants may be to optimize cognitive potential and reduce the need for early intervention and special education services. Article Published Date : Jul 01, 2006

Abstract Title: Mothers' postpartum psychological adjustment and infantile colic. Abstract Source: Arch Dis Child. 2006 May;91(5):417-9. Epub 2006 Feb 1. PMID: 16452109 Abstract Author(s): I Akman, K Kusçu, N Ozdemir, Z Yurdakul, M Solakoglu, L Orhan, A Karabekiroglu, E Ozek Abstract: BACKGROUND: Infantile colic is a common problem of early infancy. There is limited data on the relation between postpartum maternal psychological problems and colic. AIM: : To investigate whether infantile colic is associated with postpartum mood disorders or insecure adult attachment style of the mother. METHODS: Seventy eight mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened with Edinburgh Postpartum Depression Score (EPDS) and maternal anxiety was assessed with State-Trait Anxiety Inventory (STAI). The Adult Attachment Scale was used to determine the attachment style of the mother. Infantile colic was defined according to Wessel criteria. RESULTS: Infantile colic was present in 17 infants (21.7%); 12.9% of the mothers had an EPDS>or =13. The mean EPDS of the mothers whose infants had infantile colic (10.2+/-6.0) was significantly higher than that of the mothers of infants without colic (6.3+/-4.0). Among infants with infantile colic, 62.5% had mothers who had insecure attachment style, whereas only 31.1% of mothers had insecure attachment when the infant did not have infantile colic. CONCLUSION: Postpartum maternal depressive symptoms and insecure attachment style are associated with infantile colic. Screening and early intervention of postpartum depression might promote the health of both the mother and infant. Article Published Date : May 01, 2006

Abstract Title: Breastfeeding, infant formula supplementation, and Autistic Disorder: the results of a parent survey. Abstract Source: Int Breastfeed J. 2006;1:16. Epub 2006 Sep 15. PMID: 16978397 Abstract Author(s): Stephen T Schultz, Hillary S Klonoff-Cohen, Deborah L Wingard, Natacha A Akshoomoff, Caroline A Macera, Ming Ji, Christopher Bacher Abstract: BACKGROUND: Although Autistic Disorder is associated with several congenital conditions, the cause for most cases is unknown. The present study was undertaken to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. The hypothesis is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are protective for Autistic Disorder. METHODS: This is a case-control study using data from the Autism Internet Research Survey, an online parental survey conducted from February to April 2005 with results for 861 children with Autistic Disorder and 123 control children. The analyses were performed using logistic regression. RESULTS: Absence of breastfeeding when compared to breastfeeding for more than six months was significantly associated with an increase in the odds of having autistic disorder when all cases were considered (OR 2.48, 95% CI 1.42, 4.35) and after limiting cases to children with regression in development (OR 1.95, 95% CI 1.01, 3.78). Use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder when all cases were considered (OR 4.41, 95% CI 1.24, 15.7) and after limiting cases to children with regression in development (OR 12.96, 95% CI 1.27, 132). CONCLUSION: The results of this preliminary study indicate that children who were not breastfed or were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation were significantly more likely to have autistic disorder. Article Published Date : Jan 01, 2006

Abstract Title: Infant-feeding methods and childhood sleep-disordered breathing. Abstract Source: Ostomy Wound Manage. 2005 Aug;51(8):24-39. PMID: 17974740 Abstract Author(s): Hawley Evelyn Montgomery-Downs, Valerie McLaughlin Crabtree, Oscar Sans Capdevila, David Gozal Abstract: OBJECTIVE: Childhood sleep-disordered breathing has an adverse impact on cognitive development, behavior, quality of life, and use of health care resources. Early viral infections and other immune-mediated responses may contribute to development of the chronic inflammation of the upper airway and hypertrophic upper airway lymphadenoid tissues underlying childhood sleep-disordered breathing. Breastfeeding provides immunologic protection against such early exposures. Therefore, we sought to explore whether sleep-disordered breathing severity would differ for children who were breastfed as infants. METHODS: The parents or guardians of 196 habitually snoring children (mean +/- SD: 6.7 +/- 2.9 years old) who were undergoing overnight polysomnography at Kosair Children's Hospital Sleep Medicine and Apnea Center completed a retrospective survey on the method(s) used to feed the child as an infant. RESULTS: Among habitually snoring children, those who were fed breast milk for at least 2 months had significantly reduced sleep-disordered breathing severity on every measure assessed, including apnea-hypopnea index, oxyhemoglobin desaturation nadir, and respiratory arousal index. Breastfeeding for longer than 5 months did not contribute additional benefits. CONCLUSIONS: Our findings support the notion that breastfeeding may provide long-term protection against the severity of childhood sleep-disordered breathing. Future research should explore mechanism(s) whereby infant-feeding methods may affect the pathophysiology of development of childhood sleep-disordered breathing. Article Published Date : Aug 01, 2005

Abstract Title: Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Abstract Source: Bull World Health Organ. 2005 Jun;83(6):418-26. Epub 2005 Jun 17. PMID: 15976892 Abstract Author(s): Rajiv Bahl, Chris Frost, Betty R Kirkwood, Karen Edmond, Jose Martines, Nita Bhandari, Paul Arthur Article Affiliation: Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland. Abstract: OBJECTIVE: To determine the association of different feeding patterns for infants (exclusive breastfeeding, predominant breastfeeding, partial breastfeeding and no breastfeeding) with mortality and hospital admissions during the first half of infancy. METHODS: This paper is based on a secondary analysis of data from a multicentre randomized controlled trial on immunization-linked vitamin A supplementation. Altogether, 9424 infants and their mothers (2919 in Ghana, 4000 in India and 2505 in Peru) were enrolled when infants were 18-42 days old in two urban slums in New Delhi, India, a periurban shanty town in Lima, Peru, and 37 villages in the Kintampo district of Ghana. Mother-infant pairs were visited at home every 4 weeks from the time the infant received the first dose of oral polio vaccine and diphtheria-pertussis-tetanus at the age of 6 weeks in Ghana and India and at the age of 10 weeks in Peru. At each visit, mothers were queried about what they had offered their infant to eat or drink during the past week. Information was also collected on hospital admissions and deaths occurring between the ages of 6 weeks and 6 months. The main outcome measures were all-cause mortality, diarrhoea-specific mortality, mortality caused by acute lower respiratory infections, and hospital admissions. FINDINGS: There was no significant difference in the risk of death between children who were exclusively breastfed and those who were predominantly breastfed (adjusted hazard ratio (HR) = 1.46; 95% confidence interval (CI) = 0.75-2.86). Non-breastfed infants had a higher risk of dying when compared with those who had been predominantly breastfed (HR = 10.5; 95% CI = 5.0-22.0; P<0.001) as did partially breastfed infants (HR = 2.46; 95% CI = 1.44-4.18; P = 0.001). CONCLUSION: There are two major implications of these findings. First, the extremely high risks of infant mortality associated with not being breastfed need to be taken into account when informing HIV-infected mothers about options for feeding their infants. Second, our finding that the risks of death are similar for infants who are predominantly breastfed and those who are exclusively breastfed suggests that in settings where rates of predominant breastfeeding are already high, promotion efforts should focus on sustaining these high rates rather than on attempting to achieve a shift from predominant breastfeeding to exclusive breastfeeding. Article Published Date : Jun 01, 2005

Abstract Title: Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Abstract Source: Pediatrics. 2004 May;113(5):e465-71. PMID: 15121990 Abstract Author(s): Kathleen M Rasmussen, Chris L Kjolhede Abstract: OBJECTIVE: The population subgroups with the highest proportion of overweight and obese women often are characterized by the lowest rates of initiation and shortest durations of breastfeeding. We previously documented that these 2 population-level trends may be related. In a population of white women who lived in a rural area, we observed that prepregnant overweight and obesity were associated with failure to initiate and also to sustain lactation. The means by which being overweight or obese negatively affect lactational performance is unknown and likely to be multifactorial in origin, including the simple mechanical difficulties of latching on and proper positioning of the infant. In addition, we have shown that prepregnant body mass index (BMI) is negatively associated with the timing of lactogenesis II, the onset of copious milk secretion. Although the effects of obesity on the prolactin response to infant suckling have never been studied, we postulated that maternal obesity could compromise this important response. We proposed that this might occur because obesity alters the 24-hour spontaneous release of prolactin and also because prolactin secretion is blunted in response to various stimuli among obese subjects. The fall in progesterone concentration that occurs immediately postpartum is the trigger for the onset of copious milk secretion, but maintenance of prolactin and cortisol concentrations is necessary for this trigger to be effective. Adipose tissue concentrates progesterone. We proposed that this additional source of progesterone would lead to consistently higher progesterone concentrations among obese compared with normal-weight women. This, in turn, would lead to a delay in reaching the appropriate concentration to trigger the onset of lactogenesis II. We tested the hypotheses that a reduced prolactin response to suckling and higher-than-normal progesterone concentration in the first week after delivery might be among the means by which maternal overweight could compromise early lactation. METHODS: We enrolled 40 mothers of term infants from the same population that we studied previously. We measured serum prolactin and progesterone concentrations by radioimmunoassay before and 30 minutes after the beginning of a suckling episode at 48 hours and 7 days after delivery. We used path analysis to develop a parsimonious multivariate prediction of the prolactin response to suckling at 48 hours and 7 days postpartum. RESULTS: As expected, prolactin values decreased from 48 hours to 7 days postpartum. Women who were overweight or obese (using the Institute of Medicine's cutoff for women of a BMI>26 kg/m2) before conception had a lower prolactin response to suckling than normal-weight women at 48 hours but not at day 7. In multivariate analyses, overweight/obesity, primiparity, and birth weight were negatively associated with the prolactin response to suckling at 48 hours. After adjustment for confounding by time since delivery and the duration of the nursing episode, only overweight/obesity remained a significant negative predictor of prolactin response to suckling at day 7. Concentrations of progesterone decreased dramatically from 48 hours to 7 days postpartum but did not differ between normal-weight and overweight/obese women at either time. In addition, the decreases in progesterone concentrations from 48 hours to 7 days postpartum did not differ between the prepregnant BMI groups. CONCLUSION: The unique and important finding from this study is that overweight/obese women had a lower prolactin response to suckling. This would be expected to compromise the ability of overweight/obese women to produce milk and, over time, could lead to premature cessation of lactation. These findings are important because, during our observation period (just before and after lactogenesis II, the time of onset of copious milk secretion), the prolactin response to suckling is more important for milk production than it is later in lactation. We have previously shown that a high proportion of the overweight and obese women in women in this population who give up on breastfeeding do so at this time. This finding thus provides evidence of a biological basis for this association, and additional study of it is likely to be informative. We postulated that there would be consistently higher progesterone concentrations in the early postpartum period among obese compared with normal-weight women because adipose tissue is an extraplacental source of this hormone. This hypothesis was not supported in this study because there were no significant differences between normal-weight and overweight/obese women in progesterone concentrations at either 48 hours or 7 days postpartum. The values that we observed at these times were similar to those reported by others in the early postpartum period. The findings from this study add plausibility to our observation that initiation, not just duration of breastfeeding, is negatively affected by maternal overweight/obesity. Although women should begin pregnancy at a healthy weight and gain reasonably during gestation, not all will. Pediatricians can help overweight/obese women to succeed at breastfeeding by targeting them for contact with a lactation consultant before discharge from the hospital to be sure that they have received optimal advice on breastfeeding techniques. In addition, early contact with the mother after discharge--by calling her at home to offer her support and counseling for breastfeeding, by scheduling the first pediatric visit earlier than for other patients, or by enlisting the assistance of public health nurses for a home visit if this is possible--would help overweight/obese women to continue to breastfeed. Being overweight or obese is negatively associated with the prolactin response to suckling in the first week postpartum and, thus, may contribute to early lactation failure. Article Published Date : May 01, 2004

Abstract Title: Tertiary contact vaccinia in a breastfeeding infant. Abstract Source: JAMA. 2004 Feb 11 ;291(6):725-7. PMID: 14871916 Abstract Author(s): Vinaya Garde, David Harper, Mary P Fairchok Article Affiliation: Vinaya Garde Abstract: On May 4, 2003, a US Army soldier received primary smallpox vaccination and experienced a primary uptake reaction at the inoculation site on days 6 through 8. The vaccinee reported observing all of the standard precautions to avoid household spread. In mid May, his breastfeeding wife developed vesicles on both areolas. On May 29, their infant daughter developed a papule on her philtrum. Contact vaccinia was confirmed by positive polymerase chain reaction and culture for vaccinia of both the maternal and infant lesions. This is the first documented case of inadvertent contact vaccinia transmission from a mother to her infant through direct skin-to-skin and skin-to-mucous membrane contact while breastfeeding. The mechanism of transfer from the vaccinee to the spouse is uncertain. This report demonstrates that breastfeeding infants living in close contact with smallpox vaccinees are at potential risk for contact vaccinia, even if the vaccinee is not the breastfeeding mother, and highlights the need for special precautions to prevent secondary transfer to breastfeeding mothers. Article Published Date : Feb 10, 2004

Abstract Title: Effects of breastfeeding chemosignals on the human menstrual cycle. Abstract Source: Hum Reprod. 2004 Feb ;19(2):422-9. PMID: 14747191 Abstract Author(s): Suma Jacob, Natasha A Spencer, Susan B Bullivant, Sarah A Sellergren, Julie A Mennella, Martha K McClintock Article Affiliation: Suma Jacob Abstract: BACKGROUND: To date, there has not been an investigation to determine whether lactating women and their infants influence the ovarian function of other women with whom they interact. METHODS: In a randomized, double-blind, placebo-controlled study of 47 nulliparous women, we utilized both within- and between-subjects controls to assess the effects of sustained exposure to breastfeeding compounds on menstrual cycle length, as well as characteristics of each phase of the ovarian cycle. RESULTS: Breastfeeding compounds modulated ovarian cycle length in comparison with the carrier control (0.01 CONCLUSIONS: Because compounds from lactating women and their infants modulated the ovarian cycles of women, as is seen in other mammals, they have the potential to function as pheromones, regulating fertility within groups of women. Article Published Date : Jan 31, 2004

Abstract Title: The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. Abstract Source: J Egypt Public Health Assoc. 2004;79(1-2):1-12. PMID: 16916046 Abstract Author(s): Soheir Ibrahim Sobhy, Nabaweya Aly Mohame Abstract: Post partum hemorrhage is a major problem that jeopardizes maternal health. Its prevention can save mothers' life postnatal, through early initiation of breast-feeding. So, the study aimed to explore the effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. A convenient sample of one hundred primiparae was selected from the delivery unit&post partum unit of El-Shatby Maternity University Hospital in Alexandria. The study subjects were divided equally into experimental group (early breast feeding group) and control group (late breast feeding group). Two tools were developed and used for data collection. A specially designed interview questionnaire was used during early first stage of labor to collect data about general characteristics of the study subjects. An observational checklist was used during the fourth stage of labor to collect data about uterine characteristics, number of feeds and the amount of blood loss. The early breast-feeding group started feeding immediately after placental delivery, while late breast feeding group started breast- feeding after the first two hours postnatally. The amounts of blood loss for both groups were calculated. The findings of the study revealed that early initiation&increased frequency of breast-feeding could decrease the amount of blood loss during the fourth stage of labor. Therefore, maternity and pediatric nurses have to encourage mothers to start breast-feeding early. They have to explain how breast-feeding is beneficial for both mother and child. Article Published Date : Jan 01, 2004

Abstract Title: [Vitamin K deficiency bleeding in an infant despite adequate prophylaxis]. Abstract Source: Ned Tijdschr Geneeskd. 2003 Apr 19 ;147(16):737-40. PMID: 12731461 Abstract Author(s): P M van Hasselt, R H J Houwen, A T H van Dijk, T J de Koning Article Affiliation: P M van Hasselt Abstract: Vitamin K deficiency in infants can cause life-threatening haemorrhages. To prevent this, neonates in the Netherlands receive an oral dose of 1 mg vitamin K directly after birth. In addition, because breast milk contains little vitamin K, breast-fed infants receive a daily dose of 25 micrograms the first three months. Of three female infants aged 4 weeks, 5 months and 3 months, respectively, two developed an intracranial haemorrhage, which caused death in one. In two cases there were signs of a bleeding tendency, but no tests were done because the patients appeared healthy otherwise. The underlying resorptive disorders, cholestasis and fat malabsorption, caused few symptoms and were discovered only after a vitamin K deficiency bleeding had occurred. In an infant with a bleeding tendency, one should consider the possibility of vitamin K deficiency, even if adequate prophylaxis has been given. Article Published Date : Apr 18, 2003

Abstract Title: Effect of breastmilk consumption on neurodevelopmental outcomes at 6 and 12 months of age in VLBW infants. Abstract Source: Adv Neonatal Care. 2003 Apr;3(2):76-87. PMID: 12881949 Abstract Author(s): Janet Pinelli, Saroj Saigal, Stephanie A Atkinson Abstract: PURPOSE: To determine the influence of breastmilk consumption, as a dose response, in very low-birth-weight (VLBW) infants (<1,500 g) on neurodevelopmental outcomes at 6 and 12 months corrected age, and to determine the influence of selected sociodemographic and infant variables on neurodevelopmental outcomes. SUBJECTS: VLBW infants (n = 148) who were fed mother's milk or formula by parental choice. DESIGN: Prospective cohort with longitudinal follow-up at 6 and 12 months corrected age. METHODS: Self-administered questionnaires given to mothers at study entry, before discharge, and at 3-, 6-, and 12-month follow-up visits. During hospitalization, mothers recorded the 24-hour volume of expressed milk once per week. At each follow-up visit, the volume of a single feeding was assessed by pre- and postbreastfeeding test weights of infants measured on an electronic scale accurate to 1.0 g. The amount of breastfeeding was also assessed by feeding records and mother's report. MAIN OUTCOME MEASURES: The Bayley Scales of Infant Development (2nd Edition), the Mental Developmental Index (MDI), and the Psychomotor Developmental Index (PDI). PRINCIPAL RESULTS: After controlling for specific sociodemographic and infant variables, this study of VLBW infants showed no statistically significant effect of predominantly breastfeeding compared with predominantly formula feeding on neurodevelopmental outcomes to 12 months corrected age. The most significant predictor of MDI scores at 6 and 12 months corrected age was birth weight, in which higher birth weights predicted higher MDI scores. CONCLUSIONS: Despite the lack of statistically significant differences, the findings suggest a small but consistent advantage in developmental scores in infants who were fed their mother's milk compared with those who were predominantly formula fed. Supporting parents to breastfeed preterm infants may maximize the potential advantages of early nutrition in the neurodevelopmental outcome of VLBW infants. Article Published Date : Apr 01, 2003

Abstract Title: Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Abstract Source: Lancet. 2002 Jul 20 ;360(9328):187-95. PMID: 12133652 Abstract Author(s): Article Affiliation:   Abstract: BACKGROUND: Although childbearing is known to protect against breast cancer, whether or not breastfeeding contributes to this protective effect is unclear. METHODS: Individual data from 47 epidemiological studies in 30 countries that included information on breastfeeding patterns and other aspects of childbearing were collected, checked, and analysed centrally, for 50302 women with invasive breast cancer and 96973 controls. Estimates of the relative risk for breast cancer associated with breastfeeding in parous women were obtained after stratification by fine divisions of age, parity, and women's ages when their first child was born, as well as by study and menopausal status. FINDINGS: Women with breast cancer had, on average, fewer births than did controls (2.2 vs 2.6). Furthermore, fewer parous women with cancer than parous controls had ever breastfed (71% vs 79%), and their average lifetime duration of breastfeeding was shorter (9.8 vs 15.6 months). The relative risk of breast cancer decreased by 4.3% (95% CI 2.9-5.8; p<0.0001) for every 12 months of breastfeeding in addition to a decrease of 7.0% (5.0-9.0; p<0.0001) for each birth. The size of the decline in the relative risk of breast cancer associated with breastfeeding did not differ significantly for women in developed and developing countries, and did not vary significantly by age, menopausal status, ethnic origin, the number of births a woman had, her age when her first child was born, or any of nine other personal characteristics examined. It is estimated that the cumulative incidence of breast cancer in developed countries would be reduced by more than half, from 6.3 to 2.7 per 100 women by age 70, if women had the average number of births and lifetime duration of breastfeeding that had been prevalent in developing countries until recently. Breastfeeding could account for almost two-thirds of this estimated reduction in breast cancer incidence. INTERPRETATION: The longer women breast feed the more they are protected against breast cancer. The lack of or short lifetime duration of breastfeeding typical of women in developed countries makes a major contribution to the high incidence of breast cancer in these countries. Article Published Date : Jul 19, 2002

Abstract Title: Breastfeeding attenuates reductions in energy intake induced by a mild immunologic stimulus represented by DPTH immunization: possible roles of interleukin-1beta, tumor necrosis factor-alpha and leptin. Abstract Source: J Nutr. 2002 Jun;132(6):1293-8. PMID: 12042449 Abstract Author(s): Mardya López-Alarcón, Cutberto Garza, Jean-Pierre Habicht, Lourdes Martínez, Virginia Pegueros, Salvador Villalpando Article Affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA. Abstract: An attenuated severity of infections is among the well-documented benefits of breast-feeding. The degree to which this attenuated severity extends to the amelioration of anorexia is understood incompletely, and possible underlying mechanisms have received limited evaluation. This study was designed to test whether breast-feeding attenuates reductions in energy intake associated with a mild immunologic stimulus and to assess poststimulus relationships among putative reductions in energy intake and serum interleukin (IL)-1beta, tumor necrosis factor (TNF)-alpha and leptin concentrations. A quasi-experimental, hospital-based study was conducted in 23 healthy fully breast- (BF) and formula-fed (FF) infants who received the quadruple diphtheria, pertussis, tetanus and hemophilus influenza (DPTH) immunization as an immunologic challenge. Only FF infants had decreased energy intakes (12 +/- 2%, P = 0.001) after immunization. Leptin concentrations increased after immunization only in FF infants (30 +/- 7%, P = 0.03). Correlations between postimmunization increases in IL-beta and reductions in energy intake were of borderline significance (r = -0.56, P = 0.08). These findings support the view that breast-feeding protects against anorectic responses to mild immunologic stimuli. Increases in leptin are associated with reductions in energy consumption in the postimmunization period in FF infants and postimmunization changes in IL-1beta concentrations likely are related to reductions in energy intake in response to immunologic stimuli. Article Published Date : Jun 01, 2002

Abstract Title: Breast-feeding protects against celiac disease. Abstract Source: Am J Clin Nutr. 2002 May;75(5):914-21. PMID: 11976167 Abstract Author(s): Anneli Ivarsson, Olle Hernell, Hans Stenlund, Lars Ake Persson Abstract: BACKGROUND: Celiac disease, or permanent gluten-sensitive enteropathy, is an immunologic disease strictly dependent on exposure to wheat gluten or related proteins in rye and barley. OBJECTIVE: The aim of this study was to explore whether breast-feeding and the mode of introducing dietary gluten influence the risk of celiac disease in childhood. DESIGN: A population-based incident case-referent study of Swedish children, 627 cases with celiac disease and 1254 referents, was conducted; 78% of the matched sets were included in the final analyses. A questionnaire was used to assess patterns of food introduction to infants. Models were built, based on current epidemiologic and immunologic knowledge of celiac disease, to study the potential influence of dietary patterns on disease risk and were evaluated by conditional logistic regression in multivariate analyses. RESULTS: The risk of celiac disease was reduced in children aged <2 y if they were still being breast-fed when dietary gluten was introduced [adjusted odds ratio (OR): 0.59; 95% CI: 0.42, 0.83]. This effect was even more pronounced in infants who continued to be breast-fed after dietary gluten was introduced (OR: 0.36; 95% CI: 0.26, 0.51). The risk was greater when gluten was introduced in the diet in large amounts (OR: 1.5; 95% CI: 1.1, 2.1) than when introduced in small or medium amounts. In older children, these risk factors were of no or only minor importance. CONCLUSIONS: The gradual introduction of gluten-containing foods into the diet of infants while they are still being breast-fed reduces the risk of celiac disease in early childhood and probably also during the subsequent childhood period.   Article Published Date : May 01, 2002

Abstract Title: Does breastfeeding protect against allergic rhinitis during childhood? A meta-analysis of prospective studies. Abstract Source: Acta Paediatr. 2002;91(3):275-9. PMID: 12022298 Abstract Author(s): A Mimouni Bloch, D Mimouni, M Mimouni, M Gdalevich Abstract: The effect of breastfeeding on the development of allergic rhinitis and other atopic conditions has been assessed in many studies but remains controversial. To elucidate this issue, a systematic review was conducted of prospective studies that evaluated the association between exclusive breastfeeding during the first 3 mo after birth and allergic rhinitis. The 1966-2000 MEDLINE databases were searched and the reference lists of relevant articles were reviewed according to predetermined inclusion criteria. The methodological aspects of each study, duration and exclusivity of breastfeeding, outcome measures, control for potential confounding variables and other factors were assessed, and estimates of the association between breastfeeding and allergic rhinitis were abstracted independently by the investigators using a standardized approach. Six prospective studies met the inclusion criteria. The summary odds ratio for the protective effect of breastfeeding was 0.74 (95% confidence interval 0.54-1.01). The effect estimate in studies of children with a family history of atopy was 0.87 (95% confidence interval 0.48-1.58). CONCLUSION: Exclusive breastfeeding during the first 3 mo after birth protects against allergic rhinitis in children, both with and without a family history of atopy. The protective association, although of borderline statistical significance, was substantial. Larger prospective studies with strict methodology and longer periods of follow-up are needed. Article Published Date : Jan 01, 2002

Abstract Title: Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Abstract Source: Pediatrics. 2001 Oct;108(4):E67. PMID: 11581475 Abstract Author(s): S Arifeen, R E Black, G Antelman, A Baqui, L Caulfield, S Becker Article Affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. Abstract: OBJECTIVES: To describe breastfeeding practices and investigate the influence of exclusive breastfeeding in early infancy on the risk of infant deaths, especially those attributable to respiratory infections (ARI) and diarrhea. METHODS: A prospective observational study was conducted on a birth cohort of 1677 infants who were born in slum areas of Dhaka in Bangladesh and followed from birth to 12 months of age. After enrollment at birth, the infants were visited 5 more times by 12 months of age. Verbal autopsy, based on a structured questionnaire, was used to assign a cause to the 180 reported deaths. Proportional hazards regression models were used to estimate the effect of breastfeeding practices, introduced as a time-varying variable, after accounting for other variables, including birth weight. Overall neonatal, postneonatal and infant mortality, and mortality attributable to ARI and diarrhea were measured. RESULTS: The proportion of infants who were breastfed exclusively was only 6% at enrollment, increasing to 53% at 1 month and then gradually declining to 5% at 6 months of age. Predominant breastfeeding declined from 66% at enrollment to 4% at 12 months of age. Very few infants were not breastfed, whereas the proportion of partially breastfed infants increased with age. Breastfeeding practices did not differ between low and normal birth weight infants at any age. The overall infant mortality rate was 114 deaths per 1000 live births. Compared with exclusive breastfeeding in the first few months of life, partial or no breastfeeding was associated with a 2.23-fold higher risk of infant deaths resulting from all causes and 2.40- and 3.94-fold higher risk of deaths attributable to ARI and diarrhea, respectively. CONCLUSION: The important role of appropriate breastfeeding practices in the survival of infants is clear from this analysis. The reduction of ARI deaths underscores the broad-based beneficial effect of exclusive breastfeeding in prevention of infectious diseases beyond its role in reducing exposure to contaminated food, which may have contributed to the strong protection against diarrhea deaths. Article Published Date : Oct 01, 2001

Abstract Title: Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies. Abstract Source: J Pediatr. 2001 Aug;139(2):261-6. PMID: 11487754 Abstract Author(s): M Gdalevich, D Mimouni, M Mimouni Abstract: BACKGROUND: The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive breast-feeding during the first 3 months after birth and asthma. STUDY DESIGN: We searched the 1966-1999 MEDLINE database and reviewed reference lists of relevant articles to identify 12 prospective studies that met pre-stated inclusion criteria. Methodological aspects of the studies, duration and exclusivity of breast-feeding, and outcomes were assessed. Effect estimates were abstracted by the investigators, using a standardized approach. RESULTS: The summary odds ratio (OR) for the protective effect of breast-feeding was 0.70 (95% CI 0.60 to 0.81). The effect estimate was greater in studies of children with a family history of atopy (OR = 0.52) than in studies of a combined population (OR = 0.73). CONCLUSIONS: Exclusive breast-feeding during the first months after birth is associated with lower asthma rates during childhood. The effect, caused by immunomodulatory qualities of breast milk, avoidance of allergens, or a combination of these and other factors, strengthens the advantage of breast-feeding, especially if a family history of atopy is present. Article Published Date : Aug 01, 2001

Abstract Title: Bovine beta-casein antibodies in breast- and bottle-fed infants: their relevance in Type 1 diabetes. Abstract Source: Diabetes Metab Res Rev. 2001 Jan-Feb;17(1):51-4. PMID: 11241891 Abstract Author(s): L Monetini, M G Cavallo, L Stefanini, F Ferrazzoli, C Bizzarri, G Marietti, V Curro, M Cervoni, P Pozzilli, Article Affiliation: University of Rome Tor Vergata, Rome, Italy. Abstract: BACKGROUND: Bovine beta-casein is a cow's milk protein that targets both humoral and cellular immune responses in patients with Type 1 diabetes and, to a lesser degree, also in normal subjects. In this study we aimed to determine whether the avoidance of cow's milk consumption early in life could prevent the development of antibody response to bovine beta-casein despite the mother being exposed on a daily basis to cow's milk consumption. MATERIALS AND METHODS: We measured the antibody response to bovine beta-casein using an ELISA method in 28 healthy infants under 4 months of age, of whom 16 were exclusively breast-fed and 12 were bottle-fed with cow's milk. In addition, beta-casein antibodies were measured in 37 prepubertal children with Type 1 diabetes and in 31 healthy children who were exposed to cow's milk or dairy products to see whether differences in antibody titers exist in this young age group. Antibodies binding to beta-casein were also evaluated by immunoblotting analysis. RESULTS: Elevated levels of beta-casein antibodies were found in bottle-fed infants compared to breast-fed infants (p<0.0001). Antibody levels to bovine beta-casein were also significantly higher in children with Type 1 diabetes compared to age-matched controls (p=0.03). By western blot analysis we confirmed specific binding to bovine beta-casein in bottle-fed infants, in children with Type 1 diabetes and in controls exposed to cow's milk, but not in infants who were exclusively breast-fed. CONCLUSIONS: The results of this study indicate that breastfeeding within the first 4 months of life prevents the generation of antibody response to bovine beta-casein despite the mothers' consumption of cow's milk during the breastfeeding period. These findings may have relevance for disease prevention. Article Published Date : Jan 01, 2001

Abstract Title: Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro. Abstract Source: J Med Microbiol. 2000 Aug;49(8):719-23. PMID: 10933257 Abstract Author(s): N M Clarke, J T May Abstract: Various antimicrobial factors present in human milk were tested for in-vitro antiviral activity against three rhinoviruses (two clinical isolates and rhinovirus 2) and an isolate of cytomegalovirus (CMV) from human milk. These factors included the gangliosides GM1, 2 and 3, sialyl-lactose, chondroitin sulphates A, B and C, prostaglandins E2 and F2alpha, monolaurin, vitamin A and the protein lactoferrin. All were tested for their ability to inhibit growth of the viruses in cell culture. Human milk was also tested for antiviral activity against these viruses. Only vitamin A, monolaurin and lactoferrin inhibited the growth of CMV, whereas both prostaglandins enhanced the growth of this virus at least four-fold. CMV infects infants from milk but, nevertheless, the milk-borne CMV isolate showed no special resistance to any of the antiviral factors tested. None of the compounds inhibited or enhanced the growth of the rhinoviruses. However, human milk decreased the growth of some of the rhinoviruses and specific secretory immunoglobulin A (sIgA) neutralised the virus. Article Published Date : Aug 01, 2000

Abstract Title: Inhibitory factors in breastmilk, maternal and infant sera against in vitro growth of Plasmodium falciparum malaria parasite. Abstract Source: J Trop Pediatr. 2000 Apr;46(2):92-6. PMID: 10822935 Abstract Author(s): O O Kassim, K A Ako-Anai, S E Torimiro, G P Hollowell, V C Okoye, S K Martin Article Affiliation: Department of Microbiology, Howard University College of Medicine, Washington, D.C. 20059, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Complications from falciparum malaria are responsible for over one million infant deaths annually. There is as yet no clinically protective vaccine that has been developed against human malaria parasites. While several studies have demonstrated the inhibitory properties of human sera against Plasmodium falciparum, there is no reported investigation that has examined the protective effects of human breastmilk against the malaria parasite. This study demonstrates the presence of significant antibody titers to ring, trophozoite, schizont and gametocyte stages of P. falciparum in 144 Nigerian maternal milk samples and also in paired maternal and infant sera. The study also demonstrates significant in vitro growth inhibition of P. falciparum by maternal and infant sera, but most notably by breastmilk samples and breastmilk constituents, such as lactoferrin and sIgA. The results therefore suggest a protective in vivo role for breastmilk in the possible modulation of malaria frequency, severity and complications. Article Published Date : Apr 01, 2000

Abstract Title: Transforming growth factor-beta in breast milk: a potential regulator of atopic disease at an early age. Abstract Source: J Allergy Clin Immunol. 1999 Dec;104(6):1251-7. PMID: 10589009 Abstract Author(s): M Kalliomäki, A Ouwehand, H Arvilommi, P Kero, E Isolauri Article Affiliation: Departments of Paediatrics and Biochemistry and Food Chemistry, University of Turku, Finland. Abstract: BACKGROUND: According to data from animal and in vitro studies, transforming growth factor-beta (TGF-beta) has a crucial effect on 2 essential parts of the mucosal immune system: IgA production and oral tolerance induction. OBJECTIVE: We sought to ascertain whether TGF-beta in breast milk is associated with specific IgA production and atopic disease in human subjects. METHODS: Forty-seven infants with several atopic family members were followed during their first year of life. The concentrations of TGF-beta1 and TGF-beta2 in maternal colostrum, mature milk, and the infants' sera were determined. The enzyme-linked immunospot assay was used to assess the infants' specific IgA production in response to beta-lactoglobulin, casein, gliadin, and ovalbumin. RESULTS: At 12 months, atopic dermatitis was confirmed in 29 of 47 infants; in 11, atopic disease had begun during exclusive breast-feeding (preweaning onset), whereas in 18 the disease manifested itself after weaning (postweaning onset). The concentrations of both TGF-beta1 and TGF-beta2 were higher in maternal colostrum, but not in mature milk and infants' serum, in infants with postweaning-onset atopic disease compared with those with preweaning-onset disease (P =.0008 and P =. 015, respectively). The concentration of TGF-beta2 was, and that of TGF-beta1 tended to be, higher in the colostrum of mothers whose infants had specific IgA-secreting cells at 3 months in response to at least one of the dietary antigens tested compared with those who did not have such cells (P =.048 and P =.076, respectively). CONCLUSION: TGF-beta in colostrum may prevent the development of atopic disease during exclusive breast-feeding and promote specific IgA production in human subjects. Article Published Date : Dec 01, 1999

Abstract Title: Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. Abstract Source: J Ocul Pharmacol Ther. 1999 Jun;15(3):233-40. PMID: 17443195 Abstract Author(s): P M Sisk, C A Lovelady, R G Dillard, K J Gruber, T M O'Shea Abstract: BACKGROUND: Necrotizing enterocolitis (NEC) is a frequent cause of mortality and morbidity in very low birth weight (VLBW) infants. Human milk (HM) feeding has been associated with lower risk of NEC. However, mothers of VLBW infants often experience insufficient milk production, resulting in mixed feedings of HM and formula. Moreover, medical complications often limit the volume of feeding they can be given. OBJECTIVE: To determine if high proportions of (50% or greater) HM enteral feeding within the first 14 days of life are protective against NEC. METHOD: This was a prospective cohort study of VLBW infants who were grouped according to the HM proportion of enteral feeding in the first 14 days:<50% (low human milk, LHM, n=46) and>or =50% (high human milk, HHM, n=156). The outcome of interest was development of NEC (Bell stage 2 or 3). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) and to assess potential confounding due to perinatal risk factors. RESULT: Two hundred and two infants were studied. Confirmed NEC occurred in 5/46 (10.6%) of the LHM group, as compared with 5/156 (3.2%) of the HHM. Gestational age was the only perinatal factor associated with risk of NEC. After adjustment for gestational age, HHM was associated with a lower risk of NEC ((OR=0.17, 95% CI: 0.04 to 0.68), P=0.01). CONCLUSION: Enteral feeding containing at least 50% HM in the first 14 days of life was associated with a sixfold decrease in the odds of NEC. Article Published Date : Jun 01, 1999

Abstract Title: Effect of serum from breast- or formula-fed infants on polymorphonuclear leukocyte function. Abstract Source: Comp Immunol Microbiol Infect Dis. 1997 Jan ;20(1):21-7. PMID: 9023037 Abstract Author(s): C Barriga Ibars, A B Rodríguez, I Pombero, J Durán, J Cardesa, E Ortega Article Affiliation: Department of Animal Physiology, Faculty of Science, University of Extremadura, Badajoz, Spain. Abstract: The aim of the present study was to determine the influence of serum from formula and breast-fed infants on neutrophil function (as measured by the attachment and phagocytosis of Candida albicans) as well as the chemoattractant activity of the serum. The results indicate that: (a) serum from breast-fed infants induces a greater chemoattractant activity in neutrophils than serum from 3-month-old formula-fed infants; (b) the highest values of the attachment capacity were obtained after incubation of neutrophils with serum from 1-month-old breast-fed infants; and (c) serum from breast-fed infants induces a greater phagocytic capacity against C. albicans in neutrophils than serum from formula-fed infants. Article Published Date : Jan 01, 1997

Abstract Title: Measles and atopy in Guinea-Bissau. Abstract Source: Lancet. 1996 Jun 29 ;347(9018):1792-6. PMID: 8667923 Abstract Author(s): S O Shaheen, P Aaby, A J Hall, D J Barker, C B Heyes, A W Shiell, A Goudiaby Article Affiliation: S O Shaheen Abstract: BACKGROUND: Epidemiological studies have led to speculation that infections in early childhood may prevent allergic sensitisation but evidence to support this hypothesis is lacking. We investigated whether measles infection protects against the development of atopy in children of Guinea-Bissau, West Africa. METHODS: We conducted a historical cohort study in Bandim, a semi-rural district of Bissau, the capital of Guinea-Bissau. 395 young adults, first surveyed in 1978-80 aged 0-6 years, were followed up in 1994. Our analyses were restricted to 262 individuals still living in Bandim for whom a measles history, documented in childhood, was judged to be reliable. We defined atopy as skin-prick test positivity (>or = 3 mm weal) to one or more of seven allergens. FINDINGS: 17 (12.8 percent) of 133 participants who had had measles infection were atopic compared with 33 (25.6 percent) of 129 of those who had been vaccinated and not had measles (odds ratio, adjusted for potential confounding variables 0.36 [95 percent CI 0.17-0.78], p=O.O1). Participants who had been breastfed for more than a year were less likely to have a positive skin test to housedust mite. After adjustment for breastfeeding and other variables, measles infection was associated with a large reduction in the risk of skin-prick test positivity to housedust mite (odds ratio for Dermatophagoides pteronyssinus 0.20 [0.05-0.81], p=0.02; D farinae 0.20 [0.06-0.71], p=0.01). INTERPRETATION: Measles infection may prevent the development of atopy in African children. Article Published Date : Jun 28, 1996

Abstract Title: Protective effect of breast feeding against infection. Abstract Source: BMJ. 1990 Jan 6;300(6716):11-6. PMID: 2105113 Abstract Author(s): P W Howie, J S Forsyth, S A Ogston, A Clark, C D Florey Abstract: OBJECTIVE--To assess the relations between breast feeding and infant illness in the first two years of life with particular reference to gastrointestinal disease. DESIGN--Prospective observational study of mothers and babies followed up for 24 months after birth. SETTING--Community setting in Dundee. PATIENTS--750 pairs of mothers and infants, 76 of whom were excluded because the babies were preterm (less than 38 weeks), low birth weight (less than 2500 g), or treated in special care for more than 48 hours. Of the remaining cohort of 674, 618 were followed up for two years. INTERVENTIONS--Detailed observations of infant feeding and illness were made at two weeks, and one, two, three, four, five, six, nine, 12, 15, 18, 21, and 24 months by health visitors. MAIN OUTCOME MEASURE--The prevalence of gastrointestinal disease in infants during follow up. RESULTS--After confounding variables were corrected for babies who were breast fed for 13 weeks or more (227) had significantly less gastrointestinal illness than those who were bottle fed from birth (267) at ages 0-13 weeks (p less than 0.01; 95% confidence interval for reduction in incidence 6.6% to 16.8%), 14-26 weeks (p less than 0.01), 27-39 weeks (p less than 0.05), and 40-52 weeks (p less than 0.05). This reduction in illness was found whether or not supplements were introduced before 13 weeks, was maintained beyond the period of breast feeding itself, and was accompanied by a reduction in the rate of hospital admission. By contrast, babies who were breast fed for less than 13 weeks (180) had rates of gastrointestinal illness similar to those observed in bottle fed babies. Smaller reductions in the rates of respiratory illness were observed at ages 0-13 and 40-52 weeks (p less than 0.05) in babies who were breast fed for more than 13 weeks. There was no consistent protective effect of breast feeding against ear, eye, mouth, or skin infections, infantile colic, eczema, or nappy rash. CONCLUSION--Breast feeding during the first 13 weeks of life confers protection against gastrointestinal illness that persists beyond the period of breast feeding itself. Article Published Date : Jan 06, 1990

Abstract Title: Pooled pasteurized breast milk and untreated own mother's milk in the feeding of very low birth weight babies: a randomized controlled trial. Abstract Source: J Pediatr Gastroenterol Nutr. 1986 Mar-Apr;5(2):242-7. PMID: 3514832 Abstract Author(s): H Stein, D Cohen, A A Herman, J Rissik, U Ellis, K Bolton, J Pettifor, L MacDougall Abstract: It has been shown that milk derived from mothers with term infants is not optimal for premature babies. There is also concern about the effect of heat sterilizing breast milk. At Baragwanath Hospital, the majority of mothers remain with and care for their premature babies. Over many years, pooled pasteurized breast milk has been fed to these babies before direct breast feeding is instituted. A study was done to compare feeding pooled pasteurized breast milk and untreated own mother's milk to very low birth weight babies. There was a significantly more rapid weight gain both in terms of regaining birth weight and, from this point, to reaching a weight of 1,800 g when using untreated own mother's milk. This occurred in spite of the fact that there was little difference, especially in terms of energy content, between the two types of breast milk. This was due to the fact that the pooled pasteurized milk was also largely obtained from mothers of premature babies. It is suggested from our data that slower weight gain in the group receiving the pooled pasteurized milk could be due to the pasteurization, which probably destroys heat-labile milk lipase. Article Published Date : Mar 01, 1986