Author Interviews, Pediatrics / 13.03.2015

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. (more…)
Author Interviews, Pediatrics, Toxin Research / 24.02.2015

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. (more…)
Author Interviews, Pediatrics / 12.01.2015

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. (more…)
Author Interviews, BMJ, Cost of Health Care, Pediatrics / 05.12.2014

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 (more…)
Author Interviews, Gastrointestinal Disease, Gluten, Nutrition, Pediatrics / 08.10.2013

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. (more…)
Author Interviews, JAMA, Pediatrics / 25.09.2013

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. (more…)
Author Interviews, JAMA, Weight Research / 17.08.2013

  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. (more…)