Longer Breastfeeding Linked To Lower Risk of Endometriosis

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

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

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?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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Hospitalizations Reduced in Breastfed Infants

MedicalResearch.com Interview with:
Tomi  Ajetunmobi MSc and Bruce Whyte MSc

Bespoke Specialist Services
Information Services Division
NHS National Services Scotland
Edinburgh

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

Response: In developing countries, breast milk is considered the best source of nutrition for human infants, vital for child health and development. In developed counties, however, the message that ‘breast is best’ though widely accepted, is not practiced, particularly in the UK; debate continues on the role played by infant feeding in ensuring child health.

The benefits of breastfeeding in terms of child health have been difficult to prove methodologically for ethical reasons. Moreover, most studies that have shown an association are often limited by the sample size, scope of the data and adjustment for a wide range of confounders particularly socioeconomic factors, which influence both infant feeding and child health outcomes.

Using a range of linked administrative records comprising 502,948 singletons born in Scotland between 1997 and 2013 (representing approximately 70% of all Scottish births) , the study aimed to quantify the association between infant feeding patterns reported at a routine check-up 6 to 8 weeks after birth and hospital admission for childhood common illnesses. These included gastrointestinal, respiratory and urinary tract infections, otitis media, fever, asthma, eczema, diabetes and dental caries. The linkage made it possible to adjust for a wide range of confounders.

Our findings were consistent with other studies and showed a greater risk of hospital admission amongst infants who were not breastfed particularly within six months of birth, even after adjustment for parental, delivery and infant health factors and features of the health care system. At least one in five hospitalisations for gastrointestinal and lower respiratory tract infections within six months of birth may have been averted (all other factors remaining constant) had all children in the cohort been exclusively breastfed 6 to 8 weeks after birth. The association was also evident beyond six months of birth.

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Increased Breastfeeding Would Reduce Morbidities and Costs

MedicalResearch.com Interview with
Rosemary Dodds
Senior Policy Adviser
NCT (formerly National Childbirth Trust), London, UK

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

Response: The study, which was commissioned by UNICEF UK, was designed to take an in-depth look at how raising breastfeeding rates might save money for the health service through reducing illness. It found that low breastfeeding rates in the UK are costing the health service millions of pounds.  We calculated that from reducing rates of illnesses, where the evidence is strongest, moderate increases in breastfeeding could see potential annual savings to the health service of around £40m per year.

It should be noted however, that this figure is likely to be only the tip of the iceberg when the full range of conditions affected by breastfeeding are taken into account.

Economic models around five illnesses (breast cancer in the mother, and gastroenteritis, respiratory infections, middle ear infections and necrotising enterocolitis (NEC) in the baby), show that moderate increases in breastfeeding would translate into the following cost savings for the NHS:

  •  If half those mothers who currently do not breastfeed were to do so for up to 18 months over their life, there would be:

–      865 fewer cases of breast cancer

–      With cost savings to the NHS of over £21million

–      Improved quality of life equating to more than £10million[1]

Over the lifetime of each annual cohort of first-time mothers.

  • If 45% of babies were exclusively breastfed for four months, and if 75% of babies in neonatal units were breastfeeding at discharge, each year there would be:

–      3,285 fewer babies hospitalised with gastroenteritis and 10,637 fewer GP consultations, saving more than £3.6million

–      5,916 fewer babies hospitalised with respiratory illness, and 22,248 fewer GP consultations, saving around £6.7million

–      21,045 fewer GP visits for ear infection, saving £750,000

–      361 fewer cases of the potentially fatal disease necrotising enterocolitis, saving more than £6million

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Celiac Disease: When Should Gluten Be Introduced to Infants?

Ketil Stordal Researcher/consultant paediatrician National Institute of Public Health NorwayMedicalResearch.com Interview with:
Ketil Stordal
Researcher/consultant paediatrician
National Institute of Public Health
Norway


MedicalResearch.com:
What are the main findings of the study?

Answer: The study identified 324 children with celiac disease from a cohort of 82 000. Start of gluten in the diet later than 6 months was associated with a 27% increased risk of celiac disease compared to those starting during the 5th or 6th month of life. Breastfeeding was not protective; the duration of breastfeeding was slightly longer among children with celiac disease (10.4 vs 9.9 months) and breastfeeding at the time of gluten introduction was not associated with the later risk of celiac disease. The participating mothers had submitted detailed data since pregnancy including infant feeding practices, and these were collected before onset of the disease.

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Breastfeeding Duration and Bedsharing Activity Influence

Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine Director, International Family Medicine Clinic Department of Family Medicine University of Virginia, PO Box 800729 Charlottesville, VA  22908-072MedicalResearch.com Interview with:
Fern R. Hauck, MD, MS
Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine
Director, International Family Medicine Clinic
Department of Family Medicine
University of Virginia, PO Box 800729
Charlottesville, VA  22908-072

Co-author of “14 Ways to Protect Your Baby from SIDS”
(www.parentingpress.com/sids.html)

MedicalResearch.com: What are the main findings of the study?

Dr. Hauck: We looked at data from the Infant Feeding Practices Study II, which followed mother from pregnancy through the first year of infant life. Mothers received several surveys that asked about infant feeding and bedsharing (sleeping with their infant in the same bed or other sleep surface). We found that mothers who bedshared for the longest time had the longest duration of breastfeeding compared with mothers who did not bedshare or bedshared for shorter times. Breastfeeding duration was also longer among mothers who were better educated, were white, had previously breastfed another child, had planned to breastfeed this baby, and had not returned to work in the first year after the baby was born.
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Obesity Among Schoolchildren and Breastfeeding

 

MedicalResearch.com Interview with:
Michiyo Yamakawa MHSc

Department of Epidemiology
Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences,
Okayama, Japan

MedicalResearch.com: What are the main findings of the study?

Answer: We found that breastfeeding was associated with decreased risk of  overweight and obesity at the age of 7 and 8 years compared with formula feeding. Moreover, the protective associations for obesity were greater than those for overweight.
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