Tag Archives: breastfeeding

Program Addresses Racial Inequities in Breastfeeding in Southern US

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MedicalResearch.com Interview with:

Dr-Anne Merewood

Dr. Merewood

Anne Merewood PhD MPH
Director, Center for Health Equity, Education, and Research
Associate Professor of Pediatrics, Boston University School of Medicine
Associate Professor of Community Health Sciences
Boston University School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: CHAMPS (Communities and Hospitals Advancing Maternity Practices) worked with hospitals and communities across the southern US to implement the Baby-Friendly Hospital Initiative and decrease racial inequities in breastfeeding rates.

We found that indeed this program significantly reduced the gap between Black and White breastfeeding initiation rates in the 31 hospitals studied, by almost 10%. 

MedicalResearch.com: What should readers take away from your report?

Response: Hospitals and communities can work together in areas where racial disparities are extreme and breastfeeding rates are low, to improve hospital practices around the time of birth. These changes will have an impact on racial gaps in breastfeeding, and will bring more humane and evidence-based care to thousands of women, now and in the future, as the changes are solidified. Improved practices level the playing field for underprivileged groups. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should assess the implementation model to see if it can be applied in other settings. Also, future research needs to examine how well these changes can be sustained. 

Citation:

Addressing Racial Inequities in Breastfeeding in the Southern United States

Anne Merewood, Kimarie Bugg, Laura Burnham, Kirsten Krane, Nathan Nickel, Sarah Broom, Roger Edwards, Lori Feldman-Winter
Pediatrics Jan 2019, e20181897; DOI: 10.1542/peds.2018-1897

[last-modified]

 

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Breastfeeding Linked With Right Handedness

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MedicalResearch.com Interview with:

PHILIPPE P. HUJOEL PhD, DDS, MSD, MS Professor, Oral Health Sciences Adjunct Professor, Epidemiology Adjunct Professor, Periodontics Dental Public Health Sciences, School of Dentistry University of Washington

Dr. Hujoel

PHILIPPE P. HUJOEL PhD, DDS, MSD, MS
Professor, Oral Health Sciences
Adjunct Professor, Epidemiology
Adjunct Professor, Periodontics
Dental Public Health Sciences, School of Dentistry
University of Washington

MedicalResearch.com: What is the background for this study?

Response: In 2012, an economist, Kevin Denny, identified an association between breastfeeding and handedness.  The newly published study attempted to refute this association in a larger population, and with more control for potential confounding variables.

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Breastfeeding Linked to Less Belly Fat and Smaller Waist Size

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MedicalResearch.com Interview with:
"Breast feeding... Like its her job." by Jason Lander is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Gabrielle G. Snyder, MPH
Department of Epidemiology
Graduate School of Public Health
University of Pittsburgh

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although previous studies have investigated the association between breastfeeding duration and maternal weight change, we still do not know if there is an optimal duration of breastfeeding for mothers in order to realize potential health benefits. Furthermore, these studies were unable to determine whether health outcomes were due to breastfeeding or other health-promoting behaviors, like better diet and more physical activity.

Our study aims to address both points. To test the association between breastfeeding duration and maternal waist circumference, we used traditional regression models as well as two additional statistical methods that allowed us to control for factors that may influence if a woman would breastfeed and for how long. We found that women who breastfed more than 6 months had smaller waist circumference, as well as lower body mass index, one decade after delivery compared to women who breastfed 6 months or less. These results were consistent across all statistical methods.  Continue reading →

Breastfeeding May Alter Gene That Influences How Children Deal With Stress

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MedicalResearch.com Interview with:

Barry M. Lester, PhD Center for the Study of Children at Risk Warren Alpert Medical School, Brown University Women and Infants Hospital of Rhode Island Providence, Rhode Island;

Dr. Lester

Barry M. Lester, PhD
Center for the Study of Children at Risk
Warren Alpert Medical School, Brown University
Women and Infants Hospital of Rhode Island
Providence, Rhode Island; 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know from rodent studies that maternal care or nurturing behavior can change the rat pups physiologic response to stress. More nurturing behavior makes it easier for rat pups to relax after stress. Not only that, these changes are permanent, they last into adulthood and there is evidence that these changes can be passed on to the next generation. With animal studies you can unlock the mechanism for this in ways that you can’t do with humans and we know from the rodent studies that the mechanism for these changes has to do with changes in gene activity.

Nurturing behavior controls a specific gene that regulates the infant’s physiological response to stress. In other words, we are looking at maternal behavioral programming of a gene that can make, in our case, a human infant less physiologically reactive to stress.

The physiological reactivity to stress that we studied was the production of the stress hormone cortisol. Cortisol is part of the body’s flight or fight reaction, the body’s major response to stress and too much or too little cortisol can be harmful and is related to a wide range of mental and physical health disorders in children and adults. The concerns about separating immigrant children from their parents that we read about every day in the paper are based on this same physiological system, where brain structures that control cortisol production are damaged by the stress of separation. 

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Breast Milk Can Contain THC From Cannabis For Almost a Week

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MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

cannabis

Christina Chambers, PhD, MPH
Principal investigator
Professor in the Department of Pediatrics
UC San Diego School of Medicine
Drector of clinical research at Rady Children’s Hospital
San Diego 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past.

Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample.

Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy.

Our major finding was that low, but measurable levels of THC, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days.  Continue reading →

Probiotics May Help Colic in Breastfed But Not Formula Fed Babies

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MedicalResearch.com Interview with:

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD Department of Paediatrics The University of Melbourne Murdoch Childrens Research Institute Parkville, Australia

Dr. Sung

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD
Department of Paediatrics
The University of Melbourne
Murdoch Childrens Research Institute
Parkville, Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Infant colic is excessive crying in babies less than 3 months old with no underlying medical cause. It affects 1 in 5 newborns, is very distressing, and is associated with maternal depression, Shaken Baby Syndrome, and early cessation of breastfeeding. Up to now, there has been no single effective treatment for colic. The probiotic Lactobacillus reuteri DSM 17938 has recently shown promise but results from trials have been conflicting. In particular, a previous trial from Australia, the largest in the world so far, did not find the probiotic to be effective in both breastfed and formula-fed infants with colic.

This international collaborative study, which collected raw data from 345 infants from existing trials from Italy, Poland, Canada and Australia, confirms Lactobacillus reuteri to be effective in breastfed infants with colic. However, it cannot be recommended for formula-fed infants with colic.

Compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed. The number needed to treat for day 21 success in breastfed infants was 2.6.

In contrast, the formula fed infants in the probiotic group seemed to do worse than the placebo group, but the numbers for this group were limited.

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Should Money Be Used To Encourage Breastfeeding?

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MedicalResearch.com Interview with:
“Breastfeeding welcome here” by Newtown grafitti is licensed under CC BY 2.0Clare Relton, PhD
School of Health and Related Research
University of Sheffield, Sheffield, England

MedicalResearch.com: What are the key findings of your report?

Response: Our five year research project explored whether offering financial incentives (shopping vouchers) for breastfeeding increased breastfeeding. We studied what happened to breastfeeding rates at 6 to 8 weeks post-partum in areas in England with low (<40%) breastfeeding prevalence. Our cluster randomized clinical trial (which included 10 010 mother-infant dyads) showed that areas with the financial incentive had significantly higher rates of breastfeeding at 6 to 8 weeks (37.9% vs 31.7%) compared to usual care.

The financial incentive scheme was widely acceptable to healthcare providers (midwives, health visitors, doctors) and mothers. The financial incentives made it easier for everyone to discuss breastfeeding and mothers reported feeling valued (supported and rewarded) for breastfeeding.

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Affordable Care Act Linked To Increased Duration of BreastFeeding

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MedicalResearch.com Interview with:
“Babies at Brunch!” by TJ DeGroat is licensed under CC BY 2.0Kandice A. Kapinos, Ph.D.
Economist
Professor
RAND Corporation
Pardee RAND Graduate School

MedicalResearch.com: What is the background for this study?

Response: In the U.S., we have relatively high rates of breastfeeding initiation – about 80% of mothers will attempt breastfeeding, but rates drop off precipitously in the first few months of an infant’s life. There are tremendous health benefits for both the mother and child from breastfeeding and estimates of significant cost savings from diseases prevented from breastfeeding. However, breastfeeding can be difficult, especially when you need to return to work or school. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, but only 22% of mothers breastfeed exclusively for 6 months.

My coauthors, Tami Gurley-Calvez and Lindsey Bullinger, and I were interested in evaluating provisions in recent healthcare legislation (the Affordable Care Act) that required private insurers to cover lactation support services, including breast pumps and visits with lactation consultants, without cost-sharing.

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C-Section and Formula-Fed Babies Have Different Microbiome From Breastfed or Vaginal Births

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MedicalResearch.com Interview with:

Anita Kozyrskyj, PhD, Professor Dept Pediatrics Faculty of Medicine & Dentistry, University of Alberta Edmonton, AB   

Dr. Kozyrskyj

Anita Kozyrskyj, PhD, Professor
Dept Pediatrics
Faculty of Medicine & Dentistry, University of Alberta
Edmonton, AB   

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The first year of an infant’s life is a critical time for the development of his or her gut microbiome. Gut microbes not only help infants digest food, but they also “train” their developing immune system. An infant’s environment, from the type of birth and infant diet to use of antibiotics, has a large impact in determining which microbes are present. Frequently these early life exposures occur together. Using data from AllerGen’s CHILD birth cohort and a new analytical approach —called Significance Analysis of Microarrays—we quantified changes to gut microbiota throughout the first year of life according to common combinations of early life exposures.

We found that, compared to vaginally-born and breastfed infants, formula-fed or cesarean-delivered infants had different trajectories of microbial colonization in later infancy, which could have implications for their future health.

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Longer Breastfeeding Linked To Lower Risk of Endometriosis

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MedicalResearch.com Interview with:

Leslie V. Farland, ScD Assistant Director of Epidemiologic Research Center for Infertility and Reproductive Surgery Brigham and Women's Hospital | Harvard Medical School  Instructor | Harvard T.H. Chan School of Public Health

Dr. Farland

Leslie V. Farland, ScD
Assistant Director of Epidemiologic Research
Center for Infertility and Reproductive Surgery
Brigham and Women’s Hospital | Harvard Medical School
Instructor | Harvard T.H. Chan School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Endometriosis is chronic gynecologic condition that affects approximately ten percent of women. Women with endometriosis can experience painful menstrual periods, general chronic pelvic pain, and pain associated with intercourse. Currently we know very few modifiable risk factors for endometriosis.

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Babies Find Nipples To Nurse Because of Higher Areolar Temperature

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MedicalResearch.com Interview with:
Francesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, ItalyFrancesca Volpe Psy.D and
Prof. Vincenzo Zanardo
Division of Perinatal Medicine, Policlinico Abano Terme
Abano Terme, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Newborn infants, placed skin-to-skin on their mother’s chest instinctively have the ability to crawl to their mother’s breast, exploring with their hands and massaging the breast to support the first feed.  Left undisturbed, the infant will make several attempts until it finds and latches onto the nipple and begins to nurse.

What leads mammalian infants who are placed on their mothers’ chests to seek out, without any assistance, the nipple and to attach themselves to it to nurse is not fully understood. When we turned our attention to the thermal properties of the female’s nipple-areolar complex (NAC) in lactating mothers soon after birth, we found that it had a higher temperature and pH value and lower elasticity with respect to the surrounding breast skin. We hypothesised that the higher temperature could help the newborn infant to locate the nipple and to latch onto it, leading to the first sucking experience.  In addition, the diffusion of odorous molecules is presumably enhanced by the relatively high surface temperature of the areola in view of the rich supply of blood capillaries that irrigate the region. There is, in fact, some scientific evidence that show that infants respond to the odours released by the breasts of lactating women; breast odours, which are enhanced by the skin’s greater warmth, are another factor that facilitates breastfeeding by helping the infant to recognize its mother participating in the mother-to-infant bonding.

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Women From High Income Countries Less Likely To Exclusively Breastfeed

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MedicalResearch.com Interview with:

Dr. Alison McFadden, PhD Senior Research Fellow School of Nursing & Health Sciences University of Dundee

Dr. McFadden

Dr. Alison McFadden, PhD
Senior Research Fellow
School of Nursing & Health Sciences
University of Dundee

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The World Health Organization recommends that infants should be breastfed exclusively until six months of age with breastfeeding continuing as an important part of the infant’s diet until he or she is at least two years old. Breastfeeding has an important impact on the short-term and long-term health of both infants and their mothers. There is good evidence that not breastfeeding increases mortality and morbidity due to infectious diseases. Not breastfeeding is also associated with increases in hospitalisation for problems such as gastroenteritis, respiratory disease, and ear infections, as well as higher rates of childhood diabetes, obesity and dental disease.

Breastfeeding is also important for women’s health. It’s been found that not breastfeeding is associated with increased risks of breast and ovarian cancer, and diabetes. Few health behaviours have such a broad-spectrum and long-lasting impact on population health, with the potential to improve life chances, health and well-being. It has been estimated that each year, 823,000 deaths in children under five years and 20,000 deaths from breast cancer could be prevented by near universal breastfeeding.

However, many women stop breastfeeding before they want to as a result of the problems they encounter. Current breastfeeding rates in many countries do not reflect the WHO recommendation. Only around 37% of babies under six months worldwide are exclusively breastfed, and in many high and middle income countries, the rates are much lower. Good care and support may help women solve these problems so that they can continue to breastfeed.

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Which Religious Group Breastfeeds More? Protestants or Catholics?

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MedicalResearch.com Interview with:
Jonathan Y. Bernard, PhD
Inserm UMRS 1153 – Centre for research in Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS)
Team ORCHAD: early Origin of the Child Health And Development
Hôpital Paul Brousse

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the World Health Organization’s recommendations promoting breast feeding, wide variations in breast feeding initiation rates are observed among Western countries: some reach >95%, while others remain <80%. Many individual-level determinants of breast feeding are known, including maternal age, education, ethnicity, smoking and employment status. Less is known regarding cultural determinants, such as religion, which could be underlying and explain rate differences between and within countries.

We aimed at comparing countries’ breast feeding rates with the proportions of Catholics and Protestants. We thus carried out an ecological study by collating publicly available online data for 135 countries. We additionally gathered within-country data for 5 Western nations: France, Ireland, the UK, Canada and the USA.

We found that, in Western countries, the proportion of Catholics was negatively correlated with the rate of breast feeding. This was also observed within countries in France, Ireland, the UK and Canada. In the USA, where breast feeding rates vary hugely between states, race was an important confounder. Interestingly, we also found the correlation in non-Hispanic whites. All our findings hold even when we account for wealth indicators, such as gross domestic product per capita.

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Breastfeeding Important For Mothers’ Health As Well As Babies

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MedicalResearch.com Interview with:

Melissa C. Bartick, MD, MSc Department of Medicine Cambridge Health Alliance Harvard Medical School Cambridge, MA

Dr. Melissa Bartick

Melissa C. Bartick, MD, MSc
Department of Medicine
Cambridge Health Alliance
Harvard Medical School
Cambridge, MA

MedicalResearch.com: What is the background for this study?

Response: This is the first study ever to combine maternal and pediatric health outcomes from breastfeeding into a single model.

We had published a cost analysis of suboptimal breastfeeding for pediatric disease in 2010, which found that suboptimal breastfeeding cost the US $13 billion in costs of premature death costs and medical expenses, and 911 excess deaths. We followed that up with a maternal cost analysis which found about $18 billion in premature death costs and medical expenses.

In both these studies, most of the costs were from premature death. We were unable to combine the results of these two studies because their methodologies were different, and both of them, especially the pediatric portion needed to be updated.

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Comparing Benefits of Donor Breast Milk to Formula For Very Low Birth Weight Babies

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MedicalResearch.com Interview with:
Dr. Sharon Unger BSc, MD, FRCP
Staff Neonatologist at Mount Sinai Hospital
Associate Staff Neonatologist at The Hospital for Sick Children (SickKids)
Associate Professor in the Department of Paediatrics at the University of Toronto.
Medical Director of the Rogers Hixon Ontario Human Milk Bank and
Dr. Deborah L. O’Connor PhD, RD
Senior Associate Scientist in Physiology & Experimental Medicine
SickKids and Professor
Department of Nutritional Sciences at the University of Toronto

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Babies who are born very early (before 32 weeks’ gestation) and/or at very low weights (less than 1,500 grams) are among the most fragile of all paediatric patients, typically facing serious medical issues and requiring care in a Neonatal Intensive Care Unit (NICU). In addition to underdeveloped organs and risk of neurodevelopmental issues, preterm and very low birth weight babies are at risk of a severe bowel emergency called necrotizing enterocolitis, which involves the damage and potential destruction of the intestinal tissue. This disease affects approximately six per cent of very low birth weight infants each year, making it one of the most common causes of death and long-term complications in this population.

As a neonatologist and a PhD-trained dietitian, we have spent our careers working to improve outcomes for babies and supporting breastfeeding. While there is already strong evidence to suggest that breastfeeding is associated with a variety of benefits including reduced risk of childhood infections and may play a role in the prevention of overweight and diabetes, in healthy, full-term infants, we launched a research program a decade ago to figure out how to ensure the same advantage could be provided to vulnerable hospitalized infants, specifically very low birth weight infants.

Breastfeeding initiation rates in Canada are now at all-time high for healthy newborns, but for many reasons related to preterm birth, up to two thirds of mothers of very low birth weight infants are unable to provide a sufficient volume of breast milk to their infant. A variety of factors may limit breast milk production in these cases, including immaturity of the breast cells that make milk, maternal illness, breast pump dependency, and stress. In addition to the health benefits attributed to mother’s milk for full-term, healthy infants, previous studies have shown that use of mother’s milk in very low birth weight infants is associated with a reduction in necrotizing enterocolitis. It is also associated with a reduction in severe infection, improved feeding tolerance and more rapid hospital discharge.

Ten years ago, along with our inter-professional colleagues at 21 NICUs in the Greater Toronto and Hamilton areas, we began to examine whether using donor breast milk as a supplement to mother’s milk would improve health outcomes of very low birth weight infants when mother’s milk was not available.
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US Task Force Recommends Primary Care Interventions to Support Breastfeeding

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MedicalResearch.com Interview with:

Ann Kurth, Ph.D., C.N.M., R.N. USPSTF Task Force member Dean of the Yale School of Nursing

Dr. Ann Kurth

Ann Kurth, Ph.D., C.N.M., R.N.
USPSTF Task Force member
Dean of the Yale School of Nursing

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Breastfeeding is beneficial for both mothers and their babies, with the evidence showing that babies who are breastfed are less likely to get infections such as ear infections, or to develop chronic conditions such as asthma, obesity, and diabetes. For mothers, breastfeeding is associated with a lower risk for breast and ovarian cancer and type 2 diabetes. While breastfeeding rates have been rising in recent decades—with 80 percent of women starting to breastfeed and just over half still doing so at six months—they are still lower than the Healthy People 2020 targets and the Task Force wanted to review the latest evidence around how clinicians can best support breastfeeding.”

After balancing the potential benefits and harms, the Task Force found sufficient evidence to continue to recommend interventions during pregnancy and after birth to support breastfeeding. This recommendation includes the same types of interventions the Task Force recommended in 2008, such as education about the benefits of breastfeeding, guidance and encouragement, and practical help for how to breastfeed.

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Breast Feeding Educates Baby’s Immune System

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MedicalResearch.com Interview with:
Ameae M. Walker
Vice Provost for Academic Personnel
Distinguished Teaching Professor
Biomedical Sciences
School of Medicine
University of California, Riverside

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has previously been some evidence that immune cells in breast milk could pass through the wall of the immature gut, but if active they, like antibodies in milk, were considered likely a form of passive immunity. We now show that in addition to some maternal cells being active in the newborn (i.e. that they do contribute to passive cellular immunity), there are, more importantly, others that go to the thymus where they participate in selection of the neonate’s T cells. In this fashion, the neonate develops cells that recognize antigens against which the mother has been vaccinated – a process we have dubbed maternal educational immunity.

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Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women

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MedicalResearch.com Interview with:

Kenneth K. Mugwanya MBChB, MS Department of Epidemiology andDepartment of Global Health University of Washington, Seattle, Washington, USA Division of Disease Control, School of Public Health Makerere University Kampala, Uganda

Dr. Kenneth K. Mugwanya

Kenneth K. Mugwanya MBChB, MS
Department of Epidemiology andDepartment of Global Health
University of Washington, Seattle, Washington, USA
Division of Disease Control, School of Public Health
Makerere University
Kampala, Uganda

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Women living in regions with high HIV prevalence are at high risk of HIV acquisition in pregnancy and postpartum because they infrequently use condoms, do not know their partner’s HIV status, and have biologic changes or changes in their partner’s sexual partnerships that increase susceptibility. Moreover, acute HIV infection during pregnancy or breastfeeding period is associated with high rates of mother-to child HIV transmission because of high circulating level of HIV virus in blood. Oral antiretroviral pre-exposure prophylaxis (PrEP) is a powerful HIV prevention strategy recommended by both the World Health organization and US Centers for Diseases Control and Prevention. PrEP is an attractive prevention strategy for women as it can be used discreetly and independent of sexual partners. However, there is limited research about the safety of PrEP in HIV-uninfected pregnant or breastfeeding mothers and their infants.

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Maternal High Dose Monthly Vitamin D May Be Useful During Breastfeeding

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MedicalResearch.com Interview with:

Dr-Ben-Wheeler.jpg

Dr. Ben Wheeler

Dr. Ben Wheeler MB ChB(Otago) DCH CCE FRACP
Senior Lecturer / Paediatrician / Paediatric Endocrinologist
Department of Women’s & Children’s Health : Te Tari Hauora Wāhine me te Tamariki
Dunedin School of Medicine

MedicalResearch.com: What is the background for this study?

Response: Vitamin D is essential for calcium and bone metabolism. It is unique among vitamins in that it is mainly derived from synthesis in the
skin after exposure to UV-B radiation. In the absence of fortification, few foods are rich in vitamin D, including human milk, which contains very low amounts. Breastfeeding infants in higher latitude countries such as New Zealand, much of North America and
Central/Northern Europe are at risk of vitamin D deficiency.

The most profound manifestation of vitamin D deficiency in growing children is rickets, characterized by bone deformities, impaired growth, biochemical abnormalities, and depending on the severity of deficiency, seizures. Studies also identified a number of common factors that potentially affect the risk of rickets, including darker pigmented skin, maternal vitamin D deficiency during pregnancy, season of birth, and age.

A potential alternative strategy to improve the vitamin D status of breastfed infants is high-dose vitamin D supplementation to pregnant and lactating women. This would be attractive from a compliance perspective, promote exclusive breastfeeding, and treat both the mother and her infant.

Thus, the primary aim of this randomized, placebo-controlled study was to determine the effect of two different monthly doses of maternal vitamin D supplementation on the vitamin D status of non–vitamin D–supplemented breastfed infants and their mothers.
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Low Birthweight Infants Less Likely To Be Breastfed

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MedicalResearch.com Interview with:

Dr. Kirsten Herrick Ph.D. Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, Maryland

Dr. Kirsten Herrick

Dr. Kirsten Herrick Ph.D.
Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention
Hyattsville, Maryland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The benefits of breastfeeding are well established: for children, it offers protection against infections and increases in intelligence; for nursing women, it protects against breast cancer and improves birth spacing. But there is no nationally representative information about whether there are differences in breastfeeding by birth weight (BW).

Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014, we estimated the proportion of infants ever breastfed (initiated), and those reporting any breastfeeding at 1 month, 4 months, and 6 months by birth weight categories and birth year cohorts. Our sample size was 13,859.

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Hormones in Breast Milk Shape Infant’s Microbiome

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MedicalResearch.com Interview with:

Jacob (Jed) E. Friedman, Professor, Ph.D. Department of Pediatrics, Biochemistry & Molecular Genetics Director, NIH Center for Human Nutrition Research Metabolism Core Laboratory University of Colorado Anschutz

Dr. Jed Friedman

Jacob (Jed) E. Friedman, Professor, Ph.D.
Department of Pediatrics, Biochemistry & Molecular Genetics
Director, NIH Center for Human Nutrition Research Metabolism Core Laboratory
University of Colorado Anschutz

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Scientists have long established that children who are breastfed are less likely to be obese as adults, though they have yet to identify precisely how breastfeeding protects children against obesity. One likely reason is that children who are breastfed have different bacteria in their intestines than those who are formula fed.
The study, published Monday in the American Journal of Clinical Nutrition examines the role of human milk hormones in the development of infants’ microbiome, a bacterial ecosystem in the digestive system that contributes to multiple facets of health.

“This is the first study of its kind to suggest that hormones in human milk may play an important role in shaping a healthy infant microbiome,” said Bridget Young, co-first author and assistant professor of pediatric nutrition at CU Anschutz. “We’ve known for a long time that breast milk contributes to infant intestinal maturation and healthy growth. This study suggests that hormones in milk may be partly responsible for this positive impact through interactions with the infant’s developing microbiome.”

Researchers found that levels of insulin and leptin in the breastmilk were positively associated with greater microbial diversity and families of bacteria in the infants’ stool. Insulin and leptin were associated with bacterial functions that help the intestine develop as a barrier against harmful toxins, which help prevent intestinal inflammation. By promoting a stronger intestinal barrier early in life, these hormones also may protect children from chronic low-grade inflammation, which can lead to a host of additional digestive problems and diseases.

In addition, researchers found significant differences in the intestinal microbiome of breastfed infants who are born to mothers with obesity compared to those born to mothers of normal weight. Infants born to mothers with obesity showed a significant reduction in gammaproteobacteria, a pioneer species that aids in normal intestinal development and microbiome maturation.

Gammaproteobacteria have been shown in mice and newborn infants to cause a healthy amount inflammation in their intestines, protecting them from inflammatory and autoimmune disorders later in life. The 2-week-old infants born to obese mothers in this study had a reduced number of gammaproteobacteria in the infant gut microbiome.

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Gestational Diabetes Raises Risk of Low Milk Supply in Breastfeeding Moms

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MedicalResearch.com Interview with:

Laurie A. Nommsen-Rivers, PhD, RD, IBCLC Assistant Professor, UC Department of Pediatrics Cincinnati Children's Hospital Medical Center

Dr. Laurie Nommsen-Rivers

Laurie A. Nommsen-Rivers, PhD, RD, IBCLC
Assistant Professor, UC Department of Pediatrics
Cincinnati Children’s Hospital Medical Center 

Medical Research: What is the background for this study?

Dr. Nommsen-Rivers: Breastfeeding provides important benefits for mother and infant. Exclusive breastfeeding—that is, without any other food or fluids provided to the infant—is recommended for the first six months of life by multiple public health organizations. Some mothers, despite their best efforts, have difficulty establishing and sustaining sufficient milk production to support exclusive breastfeeding. Our previous research suggested that mothers with less optimal glucose tolerance are at risk for prolonged delays in time between birth and the establishment of copious milk production. We wanted to extend this finding by probing if mothers who had diabetes in pregnancy, as a sign of less optimal glucose tolerance, are at greater risk of sustained low milk production. “Glucose tolerance” refers to the body’s ability to metabolize glucose and maintain a healthy blood sugar level, which is orchestrated by the hormone insulin. For a long time, we did not consider insulin to play a role in milk production, but we are now learning that insulin plays an essential role in milk production.

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Babies’ Microbiome Affected by Cesarean Section and Formula Feeding

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MedicalResearch.com Interview with:
Annie Gatewood Hoen, PhD 
Assistant Professor of Epidemiology and of Biomedical Data Science and
Juliette Madan, MD, MS
Associate Professor of Pediatrics
The Geisel School of Medicine at Dartmouth
Dartmouth-Hitchcock Medical Center
Lebanon, NH 03756

Medical Research: What is the background for this study? What are the main findings?

Response: When newborns are delivered they begin the process of acquiring vast numbers of bacteria that are critical for healthy nutrition and for immune training for a lifetime of health. Diseases such as obesity, heart disease, colitis, autism, and even cancer risk is associated with particular patterns in the gut microbiota; interestingly breast milk exposure is associated with decreased risk of many of these diseases. The intestinal microbiome plays a critical role in development, and delivery mode (cesarean section versus vaginal delivery) and feeding method (breast milk vs. formula) are important determinants of microbiome patterns.  We observed the intestinal microbiome in 6 week old infants and how it relates to delivery type and feeding. We were particularly interested in examining patterns in the microbiome in infants who received combination feeding of both breast milk and formula, an area that has been understudied.

We prospectively studied 102 infants and, with gene sequencing of bacteria, identified important patterns in microbiome composition that differed greatly based upon delivery method and between feeding groups.  Babies who were combination fed (formula and breast milk) had an intestinal microbiome that was more similar to babies who were exclusively formula fed than breast fed babies. We identified individual bacteria that were differentially abundant between delivery mode and feeding groups.

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Breastfeeding May Have Protective Effect Against Triple Negative Breast Cancer

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Dr. Paolo Boffetta, MD, MPH Professor, Medicine, Hematology and Medical Oncology, Oncological Services, Preventive Medicine, Associate Director, Population Sciences Tish Cancer Institute, Chief, Division of Cancer Prevention and Control Icahn School of Medicine at Mount Sinai

Dr. Boffetta

MedicalResearch.com Interview with:
Dr. Paolo Boffetta, MD, MPH
Professor, Medicine, Hematology and Medical Oncology, Oncological Services, Preventive Medicine, Associate Director, Population Sciences
Tish Cancer Institute,
Chief, Division of Cancer Prevention and Control
Icahn School of Medicine at Mount Sinai

Medical Research: What is the background for this study?

Dr. Boffetta: Evidence of a protective effect of breastfeeding on breast cancer risk is becoming stronger; hence the need for a systematic review and meta-analysis.

Medical Research: What are the main findings?

Dr. Boffetta: Breastfeeding appears to be protective against breast cancer, in particular the most aggressive forms (hormone receptor negative and in particular ‘triple negative’).

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Breastfeeding May Not Be Important For Children’s IQ

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Sophie von Stumm BSc MSc PhD Department of Psychology Goldsmiths University of London London, United KingdomMedicalResearch.com Interview with:
Sophie von Stumm BSc MSc PhD
Department of Psychology
Goldsmiths University of London
London, United Kingdom

Medical Research: What is the background for this study?

Dr. von Stumm: At the Hungry Mind Lab (www.hungrymindlab.com), which I direct, we study individual differences in lifespan cognitive development. In particular, I am interested in factors that influence change in cognitive ability and knowledge. One such factor is breastfeeding, which some previous studies suggested to be associated children’s intelligence and IQ gains while others failed to find a relationship.

Medical Research: What are the main findings?

Dr. von Stumm: For this study, which was published last week in PloS One (link:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138676), data were analyzed from more than 11,000 children born in the UK between 1994 and 1996. The children had been repeatedly assessed on IQ: the first time they were tested on intelligence at age 2, and then again repeatedly throughout childhood, overall 9 times, until the age of 16 years. We found that having been breastfed versus not having been breastfed was not meaningfully associated with children’s IQ differences at age 2 and also not with differences in children’s IQ gains until age 16. That is not to say that breastfeeding may not have other benefits for children’s development but our study strongly suggests that breastfeeding is not important for children’s IQ.   Continue reading →

Breastfeeding May Be Linked To Lower Risk of Childhood Leukemia

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Efrat Amitay, PhD, MPH School of Public Health University of Haifa Mount Carmel, Haifa, IsraelMedicalResearch.com Interview with:
Efrat Amitay, PhD, MPH
School of Public Health
University of Haifa
Mount Carmel, Haifa, Israel

Medical Research: What is the background for this study?

Dr. Amitay: Although childhood cancer is still rare, we are seeing an increase of around 0.9% annually in the incidence rate in the western world. In spite of advancements in treatment technologies, childhood cancer is a leading cause of death among children and adolescents in the western world – accounting for about 12.3% of all deaths among children age 1-14 years in the US. Childhood cancer is also emerging as a major cause of death in other parts of the world where death rates from communicable diseases are declining. Leukemia is the most common type of childhood cancer and accounts for about 30% of all childhood and adolescent cancers.

Medical Research: What are the main findings?

Dr. Amitay: The meta-analysis of all 18 studies indicated that compared with no or shorter duration of breastfeeding, breastfeeding for 6 months or longer was associated with a 19% lower risk for childhood leukemia (OR=0.81, 95% CI, 0.73-0.89). A separate analysis of 15 of those studies indicated that ever being breastfed compared with never being breastfed was associated with an 11% lower risk for childhood leukemia (OR=0.89, 95% CI, 0.84-0.94). All meta-analyses of other sub groups of studies have shown similar associations, indicating that 14%-19% of all childhood leukemia cases may be prevented by breastfeeding for 6 months or more.

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Breastfeeding Rates Remain Low Among Minority Women

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Katherine Jones, M.A. Research Associate, Department of Research The American College of Obstetricians and Gynecologists Department of Psychology, American UniversityMedicalResearch.com Interview with:
Katherine Jones, M.A.
Research Associate, Department of Research
The American College of Obstetricians and Gynecologists
Department of Psychology, American University

Medical Research: What is the background for this study? What are the main findings?

Response:  It is well evidenced that breastfeeding is highly advantageous for the mother, child, and society. Benefits to breastfeeding may be significantly larger for minority women as they are disproportionately affected by numerous adverse health outcomes. The benefits of breastfeeding may help mitigate some of these negative health consequences, and thus, also bridge larger gaps in racial and ethnic health disparities. This article aimed to review the literature on racial and ethnic disparities in breastfeeding rates and practices, conduct a systematic review of breastfeeding interventions, address barriers to breastfeeding among minority women, and provide obstetrician-gynecologists (ob-gyns) with recommendations on how they can help improve rates among minority women.

Overall, racial and ethnic minority women continue to have lower breastfeeding rates than white women in the United States, with African American women having the lowest rates of breastfeeding initiation and continuation among to all women. Minority women report several unique barriers to breastfeeding, including lack of access to information that promotes and supports breastfeeding, lack of work and cultural acceptance and support, language and literacy barriers, acculturation, and historical, sociopolitical, and economic challenges. Results from the systematic review of breastfeeding interventions among minority women indicated that breastfeeding-specific clinic appointments, enhanced breastfeeding programs, group prenatal education, peer counseling, and hospital policy changes significantly improve breastfeeding initiation, duration, and exclusivity. Continue reading →

Breastfeeding Linked To Modest Reduction In Childhood Obesity

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MedicalResearch.com Interview with:
Lisa J. Martin PhD
Professor Division of Human Genetics
Jessica G. Woo PhD
Associate Professor Division of Biostatistics and Epidemiology
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH

MedicalResearch: What is the background for this study?

Response: Obesity is a major public health concern. In the past 30 years, more and more children are being considered obese. Because treatment is challenging, researchers are looking toward prevention. The health benefits of breastfeeding over infant formula feeding are well recognized, including evidence that breastfeeding may protect against obesity. But, how much protection it provides and the reasons for protection are unclear. Thus, the purpose of this paper was to examine the relationship between breastfeeding and reduced risk of obesity later in life, with special emphasis on potential mechanisms.

MedicalResearch: What are the main findings?

Response: After reviewing more than 80 studies conducted over a period of 20 years, the authors showed that breastfeeding is associated with a 10 to 20 percent reduction in obesity prevalence in childhood. Mechanisms that connect human milk and infant physiology include maternal obesity, development of a healthy gut environment (microbiome) in the infant, and the development of taste preference and diet quality. Importantly, each of these mechanisms can be influenced by biologic and social factors which may directly and indirectly affect the child’s obesity risk.

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Longer Breastfeeding Not Linked To Higher Childhood IQ

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Sabine Roza MD Ph.D. Department of Child and Adolescent Psychiatry & Psychology Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.

Sabine Roza MD

MedicalResearch.com Interview with:
Sabine Roza MD Ph.D. and
Ayesha Sajjad MD, Phd student
Department of Child and Adolescent Psychiatry & Psychology
Department of Psychiatry, Erasmus MC,
Rotterdam, The Netherlands.

Medical Research: What is the background for this study? What are the main findings?

Dr. Roza: WHO guidelines recommend six months of exclusive breastfeeding followed by partial breastfeeding until two years for overall optimum growth and development of children. However, the role of breastfeeding duration on child cognitive development remains a topic of continual debate. Previous research has shown mixed results on the role of breastfeeding duration and exclusivity on child IQ. Several methodological differences in study design inhibit comparisons of these studies and thus limit their generalizability. Furthermore, the association of breastfeeding with child cognitive development is subject to confounding by various factors especially maternal IQ. Therefore, we aimed to study the association between breastfeeding duration and breastfeeding exclusivity with non-verbal IQ in children. We used data the Generation R Study, which is a prospective cohort study from fetal life until young adulthood. Due to the large variability in ethnic backgrounds in our study participants, we focused on non-verbal IQ. In a large sample of 3761 children aged on average 6 years, we found an initial advantage of 0.32 points in non-verbal IQ for every increasing month of breastfeeding, which strongly attenuated after adjustments were made for child factors, maternal factors, sociodemographic factors, parental lifestyle and maternal IQ. Similar attenuation of effect sizes was observed for breastfeeding duration as a categorical variable and duration of exclusive breastfeeding.

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Formula Fed Babies May Have More Arsenic Exposure From Private Well Water

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Professor Kathy Cottingham PhD Departmental of Biological Sciences Dartmouth University Hanover, NHMedicalResearch.com Interview with:
Professor Kathy Cottingham PhD
Departmental of Biological Sciences
Dartmouth University Hanover, NH

Medical Research: What is the background for this study? What are the main findings?

Professor Cottingham: Arsenic is a naturally occurring element that occurs in high concentrations in groundwater in certain parts of the world, including here in New Hampshire.  Exposure to high concentrations of arsenic in water has a number of potential health consequences, including cancer, cardiovascular disease, diabetes, obesity, adverse birth outcomes, and altered immune systems.  Effects of lower-dose exposures are still under investigation, but emerging evidence suggests similar effects as higher doses.

In the U.S., public drinking water sources are regulated to have arsenic below a maximum contaminant level of 10 micrograms of arsenic per liter of water.  However, private wells are not regulated, and there is no requirement to test water in private wells to ensure that the water is safe to drink.

The New Hampshire Birth Cohort, led by Dr. Margaret Karagas, is an ongoing longitudinal study of pregnant women who drink water from private wells.  This study quantified arsenic exposure in 72 infants born to women in the cohort, using urine samples and exposure modeling.

Our results show that in general, exposure to arsenic during early infancy is quite low, regardless of how the infants were fed (breast milk vs. formula).

However, a few formula-fed infants were highly exposed to arsenic, likely due to high concentrations of arsenic in the drinking water used to mix their powdered formula.

Arsenic concentrations in breast milk – and in the urine of infants fed only with breast milk – were very low.
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