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Breast Milk and Infant Well-Being

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 29294

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Dr. Magdalena Orczyk-Pawiłowicz

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Department of Chemistry and Immunochemistry, Wroclaw Medical University, 50-369 Wrocław, Poland
Interests: maternal-child health; perinatal period; breastfeeding and lactation; biochemistry of amniotic fluid and human milk; immunological status of human milk; metabolic syndrome
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Dear Colleagues,

The recommendation of breast milk as the best food for newborns and infants is related to its unique composition. Apart from basic nutrients, such as proteins, fats, and sugars, mother’s milk is rich in bioactive molecules, which exhibit a wide range of biological functions. Dietary bioactive components delivered with mother’s milk benefit newborns and infants in various ways, and they are an important element of the innate immunity passed through breast milk. Bioactive milk molecules provide protection against pathogens, modulate the infant’s microbiome, and support the development and maturation of the immature immune, digestive, and nervous systems. All of these aspects play significant roles in ensuring the well-being of newborns and infants. Additionally, it should be pointed out that breastfeeding provides mental and physical benefits for the mother.

The rapidly rising incidence and burden of metabolic disorders worldwide is suggestive of widespread behavioural change. During infancy, there has been a shift in breastfeeding pattern due to the increased implementation of artificial milk for feeding newborns/infants, despite of the overwhelming evidence-based data concerning the adverse developmental and health consequences of insufficient breastfeeding. The quality of the infant diet, namely breast milk, trains the immune system, has significant impacts on short- and long-term healthy development, and is an important element in so-called "metabolic programming". Nevertheless, the role of breast milk in the prevention of civilization-related diseases such as obesity, diabetes, hypertension (metabolic syndrome), and allergies in later life has not been given enough attention.

Taking into account the above, there is a need to increase public awareness of the beneficial effects of breast milk on the proper physical and emotional development and well-being of infants. Therefore, the promotion of breastfeeding should be an overarching goal in public health domain.

The listed keywords suggest a few of the many related areas that are of interest for this Special Issue of IJERPH. We look forward to receiving your valuable contribution and creating a Special Issue that provides readers with the latest information concerning the impact of breast milk on infant well-being.

Dr. Magdalena Orczyk-Pawiłowicz
Guest Editor

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Keywords

bioactive milk molecules
breastfeeding
breast milk
healthy development and well-being
immunological protection
infant nutrition
innate immunity
metabolic programming
protection against pathogens

Related Special Issue

2nd Edition of Breast Milk and Infant Well-Being in International Journal of Environmental Research and Public Health (1 article)

Published Papers (9 papers)

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Research

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9 pages, 333 KiB

Open AccessArticle

Management of Breast Abscess during Breastfeeding

by Paola Pileri, Alessandra Sartani, Martina Ilaria Mazzocco, Sofia Giani, Sara Rimoldi, Gaia Pietropaolo, Anna Pertusati, Adriana Vella, Luca Bazzi and Irene Cetin

Int. J. Environ. Res. Public Health 2022, 19(9), 5762; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095762 - 09 May 2022

Cited by 3 | Viewed by 3716

Abstract

(1) Background: Breast abscess (BA) is a condition leading in the majority of cases to breastfeeding interruption. Abscesses are commonly treated with antibiotics, needle aspiration or incision and drainage (I&D), but there is still no consensus on the optimal treatment. Since there are no well-defined clinical guidelines for abscess management, we conducted a retrospective, observational study with the aim of assessing ultrasound (US)-guided management of BA without surgery, regardless of the BA size. The secondary objective was the microbiologic characterization and, in particular, the S. aureus methicillin resistance identification. (2) Methods: our population included 64 breastfeeding mothers with diagnosis of BA. For every patient, data about maternal, perinatal and breastfeeding features were collected. All patients underwent office US scans and 40 out of 64 required a more detailed breast diagnostic ultrasound performed by a radiologist. In all cases, samples of milk or abscess material were microbiologically tested. All patients received oral antibiotic treatment. We performed needle aspiration, when feasible, even on abscesses greater than 5 cm. (3) Results: most of the women developed BA during the first 100 days (68.8% during the first 60 days) after delivery and 13 needed hospitalization. Four abscesses were bilateral and 16 had a US major diameter greater than 5 cm. All patients were treated with antibiotic therapy according to our clinical protocol and 71.9% (46/64) underwent fine needle aspiration. None of them required I&D. The average duration of breastfeeding was 5 months (IR 2; 9.5) and 40.6% of women with BA continued to breastfeed for more than 6 months. Only 21 mothers interrupted breastfeeding before 3 months. (4) Conclusions: our observational data suggest, regardless of the size and the clinical features of the BA, a conservative approach with antibiotic therapy targeted at the Methicillin-Resistant Staphilococcus aureus (MRSA) identified and needle aspiration, if feasible. In our experience, treatment with needle aspiration is a cost- effective method. Unlike drainage, it is an outpatient procedure, easily repeatable, with no cosmetic damage. In addition, it has lower risk of recurrences since, differently from surgical incision, it does not cause interruption of the ducts. Moreover, needle aspiration is less painful, does not require the separation of the mother-child dyad and allows for a quicker, if not immediate, return to breastfeeding. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

11 pages, 926 KiB

Open AccessArticle

Antenatal Classes in the Context of Prenatal Anxiety and Depression during the COVID-19 Pandemic

by Aleksandra Ciochoń, Anna Apanasewicz, Dariusz P. Danel, Andrzej Galbarczyk, Magdalena Klimek, Anna Ziomkiewicz and Urszula M. Marcinkowska

Int. J. Environ. Res. Public Health 2022, 19(9), 5073; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095073 - 21 Apr 2022

Cited by 8 | Viewed by 2887

Abstract

Perinatal maternal anxiety and depression negatively affect intrauterine fetal development, birth outcome, breastfeeding initiation, duration, and milk composition. Antenatal classes potentially reduce the anxiety of pregnant women and may thus contribute to healthy infant development. The study investigates the relationship between participation in online or in-person antenatal classes and levels of anxiety and depression in Polish women during the COVID-19 pandemic. The study group included 1774 adult, non-smoking pregnant women. We compared the state anxiety (STAI-State) and depression levels (EPDS) in women who (i) attended antenatal classes in-person, (ii) attended online classes, and (iii) did not attend any of them. The statistical analyses included a GLM model and trend analysis, while controlling for maternal trait anxiety, age, pregnancy complications, trimester of pregnancy, previous pregnancies, and COVID-19 infections. We observed statistically significant differences in the level of anxiety (and depression). Women who did attend antenatal classes in person had the lowest levels of anxiety and depression. Considering the importance of maternal mental well-being on fetal development, birth outcome, and breastfeeding, in-person participation in antenatal classes should be recommended to pregnant women. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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15 pages, 1450 KiB

Open AccessArticle

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

by Chiao-Hsuan Lin, Jen-Jiuan Liaw, Yu-Ting Chen, Ti Yin, Luke Yang and Hsiang-Yun Lan

Int. J. Environ. Res. Public Health 2022, 19(3), 1240; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031240 - 22 Jan 2022

Cited by 5 | Viewed by 2541

Abstract

This study aimed to evaluate the efficacy of breast milk odor either alone or in combination with breast milk taste (via syringe-feeding) to alleviate neonates’ biobehavioral responses to pain during heel-prick procedures. This prospective randomized controlled trial recruited 114 neonates by convenience sampling from a newborn unit of a medical center in Taiwan. Neonates were randomly assigned to three groups: control (gentle touch + human voice), control + breast milk odor, and control + breast milk odor + breast milk taste. Heart rate, oxygen saturation, and voice recordings of crying were measured across heel-prick procedures: baseline, no stimuli (stage 0); during heel prick (Stages 1–4); and recovery (Stages 5–10). Generalized estimating equations and Kaplan–Meier survival analysis compared differences in changes between groups for heart rate, oxygen saturation, and time to crying cessation. Changes in mean heart rate and oxygen saturation in neonates receiving breast milk odor or breast milk odor + breast milk taste were significantly less than those at the corresponding stage for the control group. Among neonates receiving breast milk odor or breast milk odor + breast milk taste, hazard rate ratios for crying cessation were 3.016 and 6.466, respectively. Mother’s breast milk olfactory and gustatory interventions could stabilize the biobehavioral responses to pain during heel prick procedures in neonates. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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10 pages, 656 KiB

Open AccessArticle

Breastmilk as a Multisensory Intervention for Relieving Pain during Newborn Screening Procedures: A Randomized Control Trial

by Hsiang-Yun Lan, Luke Yang, Chiao-Hsuan Lin, Kao-Hsian Hsieh, Yue-Cune Chang and Ti Yin

Int. J. Environ. Res. Public Health 2021, 18(24), 13023; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413023 - 10 Dec 2021

Cited by 6 | Viewed by 3597

Abstract

The study aim was to explore the effects of multisensory breastmilk interventions on short-term pain of infants during newborn screening. This is a randomized controlled trial. A total of 120 newborns were recruited and assigned by randomization to one of three treatment conditions: Condition 1 = routine care (gentle touch + verbal comfort); Condition 2 = breastmilk odor + routine care; or Condition 3 = breastmilk odor + taste + routine care. Pain was scored with the Neonatal Infant Pain Scale (NIPS). Data were collected from video recordings at 1 min intervals over the 11 phases of heel sticks: phase 1, 5 min before heel stick without stimuli (baseline); phase 2 to phase 6 (during heel stick); and phase 7 to phase 11 (recovery). Generalized estimating equations compared differences in pain scores for newborns over phases among the three conditions. Compared with the routine care, provision of the odor and taste of breastmilk reduce NIPS scores during heel sticks (B = −4.36, SE = 0.45, p < 0.001 [phase₆]), and during recovery (B = −3.29, SE = 0.42, p < 0.001 [phase₇]). Our findings provide new data, which supports the use of multisensory interventions that include breastmilk odor and taste in combination with gentle touch and verbal comfort to relieve pain in infants undergoing newborn screening. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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25 pages, 959 KiB

Open AccessArticle

Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits

by Jolanta Lis-Kuberka and Magdalena Orczyk-Pawiłowicz

Int. J. Environ. Res. Public Health 2021, 18(19), 10409; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910409 - 03 Oct 2021

Cited by 12 | Viewed by 3152

Abstract

Gestational diabetes mellitus (GDM) is a multifaceted disease and is associated with complications for newborns and mothers. The aim of the study was to assess Polish women’s knowledge concerning GDM and their attitude to breastfeeding. As a research tool, an anonymous online survey that included 33 questions, grouped into three main sections—sociodemographic and obstetric variables, risk factors for GDM and neonatal adverse outcomes, and knowledge about breastfeeding—was used and administered online. A total of 410 women aged from 18 to 45 participated in this study. Based on the survey, it was demonstrated that the women had moderate knowledge concerning the maternal risk factors and adverse neonatal outcomes associated with GDM and, additionally, the short- and long-term effects of breastfeeding. Significantly deeper knowledge about GDM, including breastfeeding by GDM mothers, was observed among hyperglycemic mothers in comparison to normoglycemic mothers. However, knowledge concerning the health benefits of breastfeeding was not related to the mothers’ glycemic status. In conclusion, educational programs must include pre-pregnancy education of women and place emphasis on explaining the mechanism of development of GDM and the transformation of GDM to type 2 diabetes. This is crucial for changing the public’s perception of GDM as a temporary, reversible clinical entity. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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12 pages, 1642 KiB

Open AccessArticle

Factors Associated with the Maintenance of Breastfeeding at One Year among Women in Chiang Mai, Thailand

by Krongporn Ongprasert and Penprapa Siviroj

Int. J. Environ. Res. Public Health 2021, 18(17), 9224; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179224 - 01 Sep 2021

Cited by 2 | Viewed by 1966

Abstract

This study aimed to investigate factors associated with breastfeeding for at least one year among women in Chiang Mai, Thailand. We conducted a cross-sectional study of 451 mothers with children aged between 12 and 24 months who visited the well-baby clinic among women who visited the well-baby clinic in secondary and tertiary hospitals. The data collected included maternal sociodemographic information, employment status, reasons contributing to continued breastfeeding, primary sources of information, and influential people affecting continued breastfeeding. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding at one year. Reporting “easier to bond with baby” as a reason to continue breastfeeding (AOR 3.118, 95% CI: 2.022, 4.809) and multiparous status (AOR 1.588, 95% CI: 1.042, 2.420) were positive predictors of mothers who had breastfeeding at least one year postpartum while mothers with undergraduate education level (AOR 0.635, 95% CI: 0.404, 0.997) were more likely to discontinue breastfeeding. Our study highlighted that working mothers have lower odds of continued breastfeeding than stay-at-home mothers (SAHMs), which was found for work with day shifts (AOR 0.437, 95% CI: 0.261, 0.731), work with rotational shifts (AOR 0.481, 95% CI: 0.247, 0.934), and work from home jobs with a flexible schedule (AOR 0.439, 95% CI: 0.229, 0.838). These findings showed that both employment outside home and work from home were strong risk factors for discontinuing breastfeeding before 12 months. We suggest that a breastfeeding-friendly workplace policy is essential to enhance the continuance of breastfeeding. Additionally, working at home requires more research to explore breastfeeding barriers and establish more support strategies. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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14 pages, 346 KiB

Open AccessArticle

How Knowledge about Stem Cells Influences Attitudes towards Breastfeeding: Case Study of Polish Women

by Malgorzata Witkowska-Zimny and Dorota Majczyna

Int. J. Environ. Res. Public Health 2021, 18(5), 2382; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052382 - 01 Mar 2021

Cited by 1 | Viewed by 2435

Abstract

Maternal breastfeeding is associated with multiple health benefits, both for the child and the mother. Since breastfeeding rates are declining, finding new, future-oriented strategies to strengthen and support mothers’ positive attitudes towards breastfeeding need to be developed. In this paper, we describe how information about the presence of stem cells in breast milk can influence the willingness to breastfeed in the population of Polish pregnant women. A cross-sectional study involving a group of 150 pregnant women was conducted to assess the correlation between their knowledge about stem cells and their attitude towards breastfeeding. Among the respondents, only 6% claimed that they did not know anything about stem cells, but general knowledge about stem cells in the research group was poor. The survey results indicated that city residence, university degree, maternal experience and advanced pregnancy correlated with higher general knowledge regarding stem cells. Most respondents (77.3%) had no knowledge regarding the presence of stem cells in breast milk. Approximately two-thirds of mothers with earlier negative breastfeeding experience declared that information about the presence of stem cells in breast milk could have influenced the decision to continue and extend the time of breastfeeding. Hence highlighting the presence of stem cells in breast milk can be used to encourage breastfeeding as a unique activity. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

Review

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26 pages, 2790 KiB

Open AccessReview

Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being

by Aleksandra Wesołowska, Magdalena Orczyk-Pawiłowicz, Agnieszka Bzikowska-Jura, Małgorzata Gawrońska and Bartłomiej Walczak

Int. J. Environ. Res. Public Health 2022, 19(6), 3347; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063347 - 11 Mar 2022

Cited by 7 | Viewed by 3578

Abstract

The objective of this scoping review is to determine to what extent the recommendations on perinatal care protect breastfeeding during the COVID-19 pandemic. The review follows the PRISMA ScR Extension guidelines. The research was conducted in Scopus, Medline via Pubmed, and Web of Science databases from 1 March 2020 to 31 May 2021, using 392 combinations of keywords. We searched for reviews and original papers published in English providing recommendations on delivery mode, companion during labor, the possibility of skin-to-skin contact (SSC), breastfeeding, and visitors policy. After screening, 86 out of 8416 publications qualified for data extraction. The majority of them indicated that COVID-19 infection is not a sufficient reason for a cesarean section; however, on a national level, cesarean births in severely ill patients were overrepresented. A significant number of recommendations deprived mothers of the necessary support during their labor and stay in the maternity ward. A shared decision-making model was hardly visible. Only the earliest COVID-19 recommendations suspended direct breastfeeding; in later publications, decisions were related to the mother’s health, but other options of natural feeding were rarely discussed. Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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19 pages, 354 KiB

Open AccessReview

Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers

by Flaminia Bardanzellu, Melania Puddu and Vassilios Fanos

Int. J. Environ. Res. Public Health 2021, 18(11), 5668; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115668 - 25 May 2021

Cited by 9 | Viewed by 3717

Abstract

In this context of COVID-19 pandemic, great interest has been aroused by the potential maternal transmission of SARS-CoV-2 by transplacental route, during delivery, and, subsequently, through breastfeeding. Some open questions still remain, especially regarding the possibility of finding viable SARS-CoV-2 in breast milk (BM), although this is not considered a worrying route of transmission. However, in BM, it was pointed out the presence of antibodies against SARS-CoV-2 and other bioactive components that could protect the infant from infection. The aim of our narrative review is to report and discuss the available literature on the detection of anti-SARS-CoV-2 antibodies in BM of COVID-19 positive mothers, and we discussed the unique existing study investigating BM of SARS-CoV-2 positive mothers through metabolomics, and the evidence regarding microbiomics BM variation in COVID-19. Moreover, we tried to correlate metabolomics and microbiomics findings in BM of positive mothers with potential effects on breastfed infants metabolism and health. To our knowledge, this is the first review summarizing the current knowledge on SARS-CoV-2 effects on BM, resuming both “conventional data” (antibodies) and “omics technologies” (metabolomics and microbiomics). Full article

(This article belongs to the Special Issue Breast Milk and Infant Well-Being)

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