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Breastfeeding and Human Lactation
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Breastfeeding and Human Lactation

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 July 2018) | Viewed by 255182

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Assoc. Prof. Dr. Donna Geddes

E-Mail Website1 Website2
Guest Editor
School of Molecular Sciences, Faculty of Science, The University of Western Australia. The In-FLAME Global Network, an Affiliate of the World Universities Network (WUN), Australia
Interests: human milk composition; breastfeeding; milk production; milk removal; infant feeding; infant body composition
Dr. Sharon Perrella

E-Mail
Guest Editor
School of Molecular Sciences, Faculty of Science, The University of Western Australia. The In-FLAME Global Network, an Affiliate of the World Universities Network (WUN)
Interests: human milk composition; breastfeeding; milk production; milk removal; infant feeding; preterm infant feeding; gastric emptying

Special Issue Information

Dear Colleagues,

Human lactation has evolved to produce a milk composition that is uniquely-designed for the human infant. Not only does human milk optimize infant growth and development, it also provides protection from infection and disease. More recently, the importance of human milk and breastfeeding in the programming of infant health has risen to the fore. Anchoring of infant feeding in the developmental origins of health and disease has led to a resurgence of research focused in this area.

Milk composition is highly variable both between and within mothers. Indeed the distinct maternal human milk signature, including its own microbiome, is influenced by environmental factors, such as diet, health, body composition and geographic residence. An understanding of these changes will lead to unravelling the adaptation of milk to the environment and its impact on the infant. In terms of the promotion of breastfeeding, health economics and epidemiology is instrumental in shaping public health policy and identifying barriers to breastfeeding. Further, basic research is imperative in order to design evidence-based interventions to improve both breastfeeding duration and women’s breastfeeding experience. On this topic, you are invited to submit proposals for manuscripts that study the many varied aspects of human lactation.

Assoc. Prof. Dr. Donna Geddes
Dr. Sharon Perrella
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • human lactation
  • breastfeeding
  • milk composition
  • infant feeding
  • breast milk
  • human milk

Published Papers (31 papers)

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Editorial

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5 pages, 186 KiB  
Editorial
Breastfeeding and Human Lactation
by Donna Geddes and Sharon Perrella
Nutrients 2019, 11(4), 802; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11040802 - 09 Apr 2019
Cited by 14 | Viewed by 7957
Abstract
Breastfeeding is the very means by which humans have thrived and developed as a species [...] Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)

Research

Jump to: Editorial, Review, Other

15 pages, 629 KiB  
Article
Satiety Factors Oleoylethanolamide, Stearoylethanolamide, and Palmitoylethanolamide in Mother’s Milk Are Strongly Associated with Infant Weight at Four Months of Age—Data from the Odense Child Cohort
by Signe Bruun, Sandra Gouveia-Figueira, Magnus Domellöf, Steffen Husby, Lotte Neergaard Jacobsen, Kim F. Michaelsen, Christopher J. Fowler and Gitte Zachariassen
Nutrients 2018, 10(11), 1747; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10111747 - 13 Nov 2018
Cited by 16 | Viewed by 5614
Abstract
Regulation of appetite and food intake is partly regulated by N-acylethanolamine lipids oleoylethanolamide (OEA), stearoylethanolamide (SEA), and palmitoylethanolamide (PEA), which induce satiety through endogenous formation in the small intestine upon feeding, but also when orally or systemic administered. OEA, SEA, and PEA [...] Read more.
Regulation of appetite and food intake is partly regulated by N-acylethanolamine lipids oleoylethanolamide (OEA), stearoylethanolamide (SEA), and palmitoylethanolamide (PEA), which induce satiety through endogenous formation in the small intestine upon feeding, but also when orally or systemic administered. OEA, SEA, and PEA are present in human milk, and we hypothesized that the content of OEA, SEA, and PEA in mother’s milk differed for infants being heavy (high weight-for-age Z-score (WAZ)) or light (low WAZ) at time of milk sample collection. Ultra-high performance liquid chromatography-mass spectrometry was used to determine the concentration of OEA, SEA, and PEA in milk samples collected four months postpartum from mothers to high (n = 50) or low (n = 50) WAZ infants. Associations between OEA, SEA, and PEA concentration and infant anthropometry at four months of age as well as growth from birth were investigated using linear and logistic regression analyses, adjusted for birth weight, early infant formula supplementation, and maternal pre-pregnancy body mass index. Mean OEA, SEA, and PEA concentrations were lower in the high compared to the low WAZ group (all p < 0.02), and a higher concentration of SEA was associated with lower anthropometric measures, e.g., triceps skinfold thickness (mm) (β = −2.235, 95% CI = −4.04, −0.43, p = 0.016), and weight gain per day since birth (g) (β = −8.169, 95% CI = −15.26, −1.08, p = 0.024). This raises the possibility, that the content of satiety factors OEA, SEA, and PEA in human milk may affect infant growth. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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15 pages, 477 KiB  
Article
Maternal Nutrition and Body Composition During Breastfeeding: Association with Human Milk Composition
by Agnieszka Bzikowska-Jura, Aneta Czerwonogrodzka-Senczyna, Gabriela Olędzka, Dorota Szostak-Węgierek, Halina Weker and Aleksandra Wesołowska
Nutrients 2018, 10(10), 1379; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10101379 - 27 Sep 2018
Cited by 99 | Viewed by 16801
Abstract
The composition of human milk is dynamic and can vary according to many maternal factors, such as diet and nutritional status. This study investigated the association of maternal nutrition and body composition with human milk composition. All measurements and analyses were done at [...] Read more.
The composition of human milk is dynamic and can vary according to many maternal factors, such as diet and nutritional status. This study investigated the association of maternal nutrition and body composition with human milk composition. All measurements and analyses were done at three time points: during the first (n = 40), third (n = 22), and sixth (n = 15) month of lactation. Human milk was analyzed using the Miris human milk analyzer (HMA), body composition was measured with bioelectrical bioimpedance (BIA) using a Maltron BioScan 920-II, and the assessment of women’s nutrition was based on a three-day dietary record. The correlation coefficient (Pearson’s r) did not show a significant statistical relationship between human milk composition and nutrients in women’s diet at three time points. For women in the third month postpartum, we observed moderate to strong significant correlations (r ranged from 0.47 to 0.64) between total protein content in milk and the majority of body composition measures as follows: positive correlations: % fat mass (r = 0.60; p = 0.003), fat-free mass expressed in kg (r = 0.63; p = 0.001), and muscle mass (r = 0.47; p = 0.027); and negative correlation: % total body water (r = −0.60; p = 0.003). The variance in milk fat content was related to the body mass index (BMI), with a significant positive correlation in the first month postpartum (r = 0.33; p = 0.048). These findings suggest that it is not diet, but rather the maternal body composition that may be associated with the nutritional value of human milk. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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20 pages, 4185 KiB  
Article
Human Breast Milk NMR Metabolomic Profile across Specific Geographical Locations and Its Association with the Milk Microbiota
by Carlos Gómez-Gallego, Jose Manuel Morales, Daniel Monleón, Elloise Du Toit, Himanshu Kumar, Kaisa M. Linderborg, Yumei Zhang, Baoru Yang, Erika Isolauri, Seppo Salminen and Maria Carmen Collado
Nutrients 2018, 10(10), 1355; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10101355 - 21 Sep 2018
Cited by 74 | Viewed by 8650
Abstract
The composition of human breast milk is highly variable, and it can be influenced by genetics, diet, lifestyle, and other environmental factors. This study aimed to investigate the impact of geographical location and mode of delivery on the nuclear magnetic resonance spectroscopy (NMR) [...] Read more.
The composition of human breast milk is highly variable, and it can be influenced by genetics, diet, lifestyle, and other environmental factors. This study aimed to investigate the impact of geographical location and mode of delivery on the nuclear magnetic resonance spectroscopy (NMR) metabolic profile of breast milk and its relationship with the milk microbiome. Human milk metabolic and microbiota profiles were determined using NMR and 16S rRNA gene sequencing, respectively, in 79 healthy women from Finland, Spain, South Africa, and China. Up to 68 metabolites, including amino acids, oligosaccharides, and fatty acid-associated metabolites, were identified in the milk NMR spectra. The metabolite profiles showed significant differences between geographical locations, with significant differences (p < 0.05) in the levels of galactose, lacto-N-fucopentaose III, lacto-N-fucopentaose I and 2-fucosyllactose, 3-fucosyllactose, lacto-N-difucohexaose II, lacto-N-fucopentaose III, 2-hydroxybutyrate, 3-hydroxybutyrate, proline, N-acetyl lysine, methyl-histidine, dimethylamine, kynurenine, urea, creatine and creatine phosphate, formate, lactate, acetate, phosphocholine, acetylcholine, LDL, VLDL, ethanolamine, riboflavin, hippurate, spermidine, spermine and uridine. Additionally, the effect of caesarean section on milk metabolome was dependent on the geographical region. Specific interrelations between human milk metabolites and microbiota were also identified. Proteobacteria, Actinobacteria, and Bacilli were most significantly associated with the milk metabolites, being either positively or negatively correlated depending on the metabolite. Our results reveal specific milk metabolomic profiles across geographical locations and also highlight the potential interactions between human milk’s metabolites and microbes. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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25 pages, 1183 KiB  
Article
Human Milk Casein and Whey Protein and Infant Body Composition over the First 12 Months of Lactation
by Zoya Gridneva, Wan J. Tie, Alethea Rea, Ching Tat Lai, Leigh C. Ward, Kevin Murray, Peter E. Hartmann and Donna T. Geddes
Nutrients 2018, 10(9), 1332; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091332 - 19 Sep 2018
Cited by 30 | Viewed by 14675
Abstract
Human milk (HM) influences infant feeding patterns and body composition (BC). This small proof-of concept longitudinal study investigated relationships between infant/maternal BC and HM casein, whey and total protein during the first 12 months of lactation. BC of breastfeeding dyads (n = [...] Read more.
Human milk (HM) influences infant feeding patterns and body composition (BC). This small proof-of concept longitudinal study investigated relationships between infant/maternal BC and HM casein, whey and total protein during the first 12 months of lactation. BC of breastfeeding dyads (n = 20) was measured at 2 (n = 15), 5 (n = 20), 9 (n = 19), and/or 12 (n = 18) months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). Proteins concentrations and 24-h milk intake were measured and calculated daily intakes (CDI) determined. Higher maternal weight, body mass index, fat-free mass, fat-free mass index, and fat mass index were associated with higher concentration of whey protein (p ≤ 0.034, n = 20). There were no associations between infant BC and concentrations of all proteins, and CDI of whey and total protein. Higher CDI of casein were associated with lower infant fat-free mass (p = 0.003, n = 18) and higher fat mass (p < 0.001), fat mass index (p = 0.001, n = 18), and % fat mass (p < 0.001, n = 18) measured with ultrasound skinfolds. These results show a differential effect of HM casein on development of infant BC during the first year of life, suggesting that there is a potential to improve outcome for the infant through interventions, such as continuation of breastfeeding during the first 12 months of life and beyond, which may facilitate favourable developmental programming that could reduce risk of non-communicable diseases later in life. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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Graphical abstract

8 pages, 230 KiB  
Article
Endocannabinoid Metabolome Characterization of Transitional and Mature Human Milk
by Adriana V. Gaitán, JodiAnne T. Wood, Fan Zhang, Alexandros Makriyannis and Carol J. Lammi-Keefe
Nutrients 2018, 10(9), 1294; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091294 - 12 Sep 2018
Cited by 17 | Viewed by 5189
Abstract
Recognized as the gold standard, human milk (HM) is an extremely complex yet fascinating biofluid tailored to meet an infant’s nutritional requirements throughout development. Endocannabinoids and endocannabinoid-like compounds (endocannabinoid metabolome, ECM) are endogenous lipid mediators derived from long-chain polyunsaturated fatty acids that have [...] Read more.
Recognized as the gold standard, human milk (HM) is an extremely complex yet fascinating biofluid tailored to meet an infant’s nutritional requirements throughout development. Endocannabinoids and endocannabinoid-like compounds (endocannabinoid metabolome, ECM) are endogenous lipid mediators derived from long-chain polyunsaturated fatty acids that have been identified in HM. Previous research has shown that arachidonoylglycerol might play a role in establishing the infant’s suckling response during lactation by activating the type 1 cannabinoid receptor in the infant’s brain. The mechanisms of action and the role of the ECM in HM are not fully understood. Transitional and mature milk samples were collected from lactating women (n = 24) for ECM characterization, quantification, and to evaluate differences among the two stages. HM samples were analyzed by liquid chromatography-mass spectrometry. Identified members of the ECM were: arachidonoylethanolamine, palmitoylethanolamine, oleoylethanolamine, docosahexaenoylethanolamine, eicoapentaenoylethanolamine, eicosenoylethanolamine, arachidonoylglycerol, palmitoyglycerol, oleoylglycerol, docosahexaenoylglycerol, eicosapentaenoylglycerol, eiconenooylglycerol, arachidonic acid, docosahexaenoic acid, and eicosapentaenoic acid. Only docosahexaenoylglycerol was different across transitional and mature milk (p ≤ 0.05). Data from this cohort suggest that bioactive constituents in HM may also play a role in infant health and development. Future studies can be developed based on this study’s data to help elucidate specific roles for each ECM member in addition to understanding how the ECM modulates infant health. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
16 pages, 270 KiB  
Article
Mother–Infant Physical Contact Predicts Responsive Feeding among U.S. Breastfeeding Mothers
by Emily E. Little, Cristine H. Legare and Leslie J. Carver
Nutrients 2018, 10(9), 1251; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091251 - 06 Sep 2018
Cited by 45 | Viewed by 18918
Abstract
Responsive feeding—initiating feeding in response to early hunger cues—supports the physiology of lactation and the development of infant feeding abilities, yet there is a dearth of research examining what predicts responsive feeding. In non-Western proximal care cultures, there is an association between responsive [...] Read more.
Responsive feeding—initiating feeding in response to early hunger cues—supports the physiology of lactation and the development of infant feeding abilities, yet there is a dearth of research examining what predicts responsive feeding. In non-Western proximal care cultures, there is an association between responsive feeding and mother–infant physical contact, but this has not been investigated within Western populations. In two studies, we tested whether mother–infant physical contact predicted feeding in response to early hunger cues versus feeding on a schedule or after signs of distress among U.S. breastfeeding mothers. With an online questionnaire in Study 1 (n = 626), physical contact with infants (via co-sleeping and babywearing) predicted increased likelihood of self-reported responsive feeding. Mothers who reported responsive feeding were more likely to exclusively breastfeed for the first six months, breastfeed more frequently throughout the day, and had a longer planned breastfeeding duration than mothers who reported feeding on a schedule or after signs of infant distress. In Study 2 (n = 96), a three-day feeding log showed that mother–infant physical contact predicted feeding in response to early hunger cues but mother–infant proximity (without physical contact) did not. In sum, our results demonstrate that physical contact with infants may shape breastfeeding behavior among U.S. mothers, highlighting a connection between social interaction and infant nutrition that warrants further investigation. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
16 pages, 1066 KiB  
Article
Human Milk Composition and Dietary Intakes of Breastfeeding Women of Different Ethnicity from the Manawatu-Wanganui Region of New Zealand
by Christine A. Butts, Duncan I. Hedderley, Thanuja D. Herath, Gunaranjan Paturi, Sarah Glyn-Jones, Frank Wiens, Bernd Stahl and Pramod Gopal
Nutrients 2018, 10(9), 1231; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091231 - 04 Sep 2018
Cited by 69 | Viewed by 10649
Abstract
Human milk is nutrient rich, complex in its composition, and is key to a baby’s health through its role in nutrition, gastrointestinal tract and immune development. Seventy-eight mothers (19–42 years of age) of Asian, Māori, Pacific Island, or of European ethnicity living in [...] Read more.
Human milk is nutrient rich, complex in its composition, and is key to a baby’s health through its role in nutrition, gastrointestinal tract and immune development. Seventy-eight mothers (19–42 years of age) of Asian, Māori, Pacific Island, or of European ethnicity living in Manawatu-Wanganui, New Zealand (NZ) completed the study. The women provided three breast milk samples over a one-week period (6–8 weeks postpartum), completed a three-day food diary and provided information regarding their pregnancy and lactation experiences. The breast milk samples were analyzed for protein, fat, fatty acid profile, ash, selected minerals (calcium, magnesium, selenium, zinc), and carbohydrates. Breast milk nutrient profiles showed no significant differences between the mothers of different ethnicities in their macronutrient (protein, fat, carbohydrate, and moisture) content. The breast milk of Asian mothers contained significantly higher levels of polyunsaturated fatty acids (PUFAs), omega-3 (n-3) and omega-6 (n-6) fatty acids, docosahexaenoic acid (DHA), and linoleic acids. Arachidonic acid was significantly lower in the breast milk of Māori and Pacific Island women. Dietary intakes of protein, total energy, saturated and polyunsaturated fat, calcium, phosphorus, zinc, iodine, vitamin A equivalents, and folate differed between the ethnic groups, as well as the number of serves of dairy foods, chicken, and legumes. No strong correlations between dietary nutrients and breast milk components were found. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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15 pages, 4613 KiB  
Article
Expression of Granulisyn, Perforin and Granzymes in Human Milk over Lactation and in the Case of Maternal Infection
by Alecia-Jane Twigger, Gwendoline K. Küffer, Donna T. Geddes and Luis Filgueria
Nutrients 2018, 10(9), 1230; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091230 - 04 Sep 2018
Cited by 16 | Viewed by 4137
Abstract
Human milk has been previously found to contain various types of leukocytes however specific characteristics of these cells, such as whether they contain cytolytic antimicrobial proteins that may induce pathogen directed cell death, are unknown. This project aims to examine the presence and [...] Read more.
Human milk has been previously found to contain various types of leukocytes however specific characteristics of these cells, such as whether they contain cytolytic antimicrobial proteins that may induce pathogen directed cell death, are unknown. This project aims to examine the presence and localization of immune proteins such as perforin, granulysin and granzymes in human milk cells at the protein and mRNA level. Genes encoding these proteins were confirmed in human milk cell samples, which were particularly enriched in early milk and in the case of maternal infection. Fluorescence activated cell sorting (FACS) was used to investigate the co-expression of these proteins with pan-immune cell marker CD45 and epithelial marker EPCAM. Co-expression of antimicrobial proteins was found predominantly in CD45 positive cells, also increasing in the case of maternal infection. Our study suggests that human milk contains cells that carry hallmarks of activated or memory T-cells which are enriched early in lactation and in the case of maternal infection. Presence and prevalence of these cells in human milk may indicate a role in the protection of the maternal breast or for delivery to the vulnerable infant. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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11 pages, 1775 KiB  
Article
The Antisecretory Factor in Plasma and Breast Milk in Breastfeeding Mothers—A Prospective Cohort Study in Sweden
by Anna Gustafsson, Elisabeth Granström, Christina Stecksén-Blicks, Christina E. West and Sven-Arne Silfverdal
Nutrients 2018, 10(9), 1227; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091227 - 04 Sep 2018
Cited by 2 | Viewed by 3646
Abstract
Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and [...] Read more.
Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and inflammation. The objective of the study was to describe AF-levels in plasma and breast milk, and in relation to breast complications. Breastfeeding mothers (n = 95) were consecutively recruited at a Well Baby Clinic in Umeå, Sweden. At inclusion four weeks postpartum, samples of venous blood (10 mL) and breast milk (10 mL) were collected. Active AF was analyzed with ELISA using a monoclonal antibody mAb43, and was detected in all samples of plasma and breast milk with a positive correlation (Spearman coefficient = 0.40, p < 0.001; Pearson correlation = 0.34, p < 0.01). High AF-levels in plasma correlated with high AF-levels in breast milk. The results suggest a co-regulation between active AF in plasma and breastmilk, and/or a local regulation of AF in the breast. Further studies are needed to determine the pathways for the activation of AF-levels in breast milk and plasma. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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9 pages, 976 KiB  
Article
Comparison of Inductively Coupled Plasma Optical Emission Spectrometry with an Ion Selective Electrode to Determine Sodium and Potassium Levels in Human Milk
by Ching Tat Lai, Hazel Gardner and Donna Geddes
Nutrients 2018, 10(9), 1218; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091218 - 03 Sep 2018
Cited by 29 | Viewed by 5100
Abstract
Sodium (Na), potassium (K), and the ratio Na:K in human milk (HM) may be useful biomarkers to indicate secretory activation or inflammation in the breast. Previously, these elements have been measured in a laboratory setting requiring expensive equipment and relatively large amounts of [...] Read more.
Sodium (Na), potassium (K), and the ratio Na:K in human milk (HM) may be useful biomarkers to indicate secretory activation or inflammation in the breast. Previously, these elements have been measured in a laboratory setting requiring expensive equipment and relatively large amounts of HM. The aim of this study was to compare measurements of Na and K in HM using inductively coupled plasma optical emission spectrometry (ICP-OES) with small portable ion selective electrode probes for Na and K. Sixty-five lactating women donated 5 mL samples of HM. Samples were analyzed with two ion selective probes (Na and K) and also ICP-OES. The data were analyzed using paired t-test and Bland–Altman plots. Na concentrations were not significantly different when measured with ion selective electrode (6.18 ± 2.47mM; range: 3.59–19.8) and ICP-OES (5.91 ± 3.37 mM; range: 2.59–21.5) (p = 0.20). K concentrations measured using the ion selective electrode (11.7 ± 2.21 mM: range: 7.69–18.1) and ICP-OES (11.1 ± 1.55 mM: range: 7.91–15.2) were significantly different (p = 0.01). However, the mean differences of 0.65 mM would not be clinically relevant when testing at point of care. Compared to ICP-OES, ion selective electrode is sufficiently accurate to detect changes in concentrations of Na and K in HM associated with secretory activation and inflammation in the mammary gland. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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13 pages, 618 KiB  
Article
Levels of Growth Factors and IgA in the Colostrum of Women from Burundi and Italy
by Daniel Munblit, Priya Abrol, Shreya Sheth, Li Yan Chow, Ekaterina Khaleva, Alan Asmanov, Silvana Lauriola, Ezio M. Padovani, Pasquale Comberiati, Attilio L. Boner, John O. Warner, Robert J. Boyle and Diego G. Peroni
Nutrients 2018, 10(9), 1216; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091216 - 03 Sep 2018
Cited by 17 | Viewed by 4608
Abstract
Colostrum is produced in the first days postpartum. It is a known source of immune mediators for a newborn within the first week of life. Although it is still unclear if colostrum composition varies between populations, recent data suggest differences. Hepatocyte growth factor [...] Read more.
Colostrum is produced in the first days postpartum. It is a known source of immune mediators for a newborn within the first week of life. Although it is still unclear if colostrum composition varies between populations, recent data suggest differences. Hepatocyte growth factor (HGF); transforming growth factor-β (TGF-β) 1, 2, and 3; and immunoglobulin A (IgA) are key immunological components of colostrum that stimulate neonatal gastrointestinal and immune system development. We aimed to investigate the differences in the concentration between immune markers in the colostrum of mothers living in Burundi and Italy, and to identify the factors associated with differences. In this cross-sectional birth cohort study, a total of 99 colostrum samples from Burundian (n = 23) and Italian (n = 76) women were collected at 0 to 6 days postpartum. A clinical chemistry analyser was used for IgA quantification and electro-chemiluminescence, for HGF and TGFβ1-3 assessment. A univariate analysis and multivariate linear regression model were used for statistical testing. The concentrations of TGF-β2 (p = 0.01) and IgA (p < 0.01) were significantly higher in the colostrum from the women residing in Burundi than in Italy, both in a univariate analysis and upon the adjustment for confounding factors. A similar trend is seen for HGF, reaching statistical significance upon a multivariate analysis. We found a moderate to strong positive correlation between the TGF-β isoforms and IgA concentration in both countries (p < 0.01), with stronger concentration in the colostrum from Burundi. The results of this study are in support of previous data, suggesting that concentration of the immune active molecules is higher in the human milk of women residing in developing countries. However, with a small sample size, caution must be applied, as the findings require further confirmation. Future work should also be focused on other factors (e.g., lipid and microbial composition), as well as the investigation into colostrum and between populations comparison, adjusting for potential confounders. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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12 pages, 1441 KiB  
Article
Worldwide Variation in Human Milk Metabolome: Indicators of Breast Physiology and Maternal Lifestyle?
by Melvin C. L. Gay, Petya T. Koleva, Carolyn M. Slupsky, Elloise Du Toit, Merete Eggesbo, Christine C. Johnson, Ganesa Wegienka, Naoki Shimojo, Dianne E. Campbell, Susan L. Prescott, Daniel Munblit, Donna T. Geddes, Anita L. Kozyrskyj and InVIVO LactoActive Study Investigators
Nutrients 2018, 10(9), 1151; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091151 - 23 Aug 2018
Cited by 60 | Viewed by 9713
Abstract
Human milk provides essential substrates for the optimal growth and development of a breastfed infant. Besides providing nutrients to the infant, human milk also contains metabolites which form an intricate system between maternal lifestyle, such as the mother’s diet and the gut microbiome, [...] Read more.
Human milk provides essential substrates for the optimal growth and development of a breastfed infant. Besides providing nutrients to the infant, human milk also contains metabolites which form an intricate system between maternal lifestyle, such as the mother’s diet and the gut microbiome, and infant outcomes. This study investigates the variation of these human milk metabolites from five different countries. Human milk samples (n = 109) were collected one month postpartum from Australia, Japan, the USA, Norway, and South Africa and were analyzed by nuclear magnetic resonance. The partial least squares discriminant analysis (PLS-DA) showed separation between either maternal countries of origin or ethnicities. Variation between countries in concentration of metabolites, such as 2-oxoglutarate, creatine, and glutamine, in human milk, between countries, could provide insights into problems, such as mastitis and/or impaired functions of the mammary glands. Several important markers of milk production, such as lactose, betaine, creatine, glutamate, and glutamine, showed good correlation between each metabolite. This work highlights the importance of milk metabolites with respect to maternal lifestyle and the environment, and also provides the framework for future breastfeeding and microbiome studies in a global context. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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9 pages, 1304 KiB  
Article
Hourly Breast Expression to Estimate the Rate of Synthesis of Milk and Fat
by Jacqueline C. Kent, Hazel Gardner, Ching-Tat Lai, Peter E. Hartmann, Kevin Murray, Alethea Rea and Donna T. Geddes
Nutrients 2018, 10(9), 1144; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091144 - 22 Aug 2018
Cited by 10 | Viewed by 3996
Abstract
Objective measurement of the rate of synthesis of breast milk and fat in breastfeeding mothers requires test-weighing of each breastfeed and the measurement of each expression from each breast over 24 h, with the collection of milk samples before and after each breastfeed [...] Read more.
Objective measurement of the rate of synthesis of breast milk and fat in breastfeeding mothers requires test-weighing of each breastfeed and the measurement of each expression from each breast over 24 h, with the collection of milk samples before and after each breastfeed and expression. We sought an abbreviated technique for measuring these rates of synthesis. Participants completed a 24-h breastfeeding milk profile, and expressed their breasts on arrival at the research room and each hour thereafter for 3 h (4 expressions). The hourly rate of milk synthesis, as measured by the yield of milk from the fourth expression, was closely related to the hourly rate of milk synthesis calculated from the 24-h milk profile. The hourly rate of fat synthesis, calculated from the fat content of small samples of the first and last milk expressed during the fourth expression, was different from the rate of fat synthesis calculated from the fat content and volumes of all the breastfeeds and expressions during the 24-h milk profile. The study confirms the use of an abbreviated technique to measure the rate of breast milk synthesis, but is not reliable as a measure of the rate of fat synthesis for an individual. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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24 pages, 1087 KiB  
Article
Human Milk Adiponectin and Leptin and Infant Body Composition over the First 12 Months of Lactation
by Zoya Gridneva, Sambavi Kugananthan, Alethea Rea, Ching Tat Lai, Leigh C. Ward, Kevin Murray, Peter E. Hartmann and Donna T. Geddes
Nutrients 2018, 10(8), 1125; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10081125 - 20 Aug 2018
Cited by 42 | Viewed by 8315
Abstract
Human milk (HM) adipokines may influence infant feeding patterns, appetite regulation, and body composition (BC). The associations between concentrations/calculated daily intakes (CDI) of HM adipokines in the first 12 months postpartum and maternal/term infant BC, and infant breastfeeding parameters were investigated. BC of [...] Read more.
Human milk (HM) adipokines may influence infant feeding patterns, appetite regulation, and body composition (BC). The associations between concentrations/calculated daily intakes (CDI) of HM adipokines in the first 12 months postpartum and maternal/term infant BC, and infant breastfeeding parameters were investigated. BC of breastfeeding dyads (n = 20) was measured at 2, 5, 9, and/or 12 months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). 24-h milk intake and feeding frequency were measured along with whole milk adiponectin and skim and whole milk leptin (SML and WML) and CDI were calculated. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Adipokine concentrations did not associate with infant BC. Higher CDI of adiponectin were associated with lower infant fat-free mass (FFM; p = 0.005) and FFM index (FFMI; p = 0.009) and higher fat mass (FM; p < 0.001), FM index (FMI; p < 0.001), and %FM (p < 0.001). Higher CDI of SML were associated with higher infant FM (p < 0.001), FMI (p < 0.001), and %FM (p = 0.002). At 12 months, higher CDI of WML were associated with larger increases in infant adiposity (2–12 month: FM, p = 0.0006; %FM, p = 0.0004); higher CDI of SML were associated with a larger decrease in FFMI (5–12 months: p = 0.0004). Intakes of HM adipokines differentially influence development of infant BC in the first year of life, which is a critical window of infant programming and may potentially influence risk of later disease via modulation of BC. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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13 pages, 1936 KiB  
Article
Nutrition of Preterm Infants and Raw Breast Milk-Acquired Cytomegalovirus Infection: French National Audit of Clinical Practices and Diagnostic Approach
by Anne-Aurelie Lopes, Valerie Champion and Delphine Mitanchez
Nutrients 2018, 10(8), 1119; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10081119 - 18 Aug 2018
Cited by 13 | Viewed by 4932
Abstract
Raw breast milk is the optimal nutrition for infants, but it is also the primary cause of acquired cytomegalovirus (CMV) infection. Thus, many countries have chosen to contraindicate to feed raw breast milk preterm infants from CMV-positive mothers before a corrected age of [...] Read more.
Raw breast milk is the optimal nutrition for infants, but it is also the primary cause of acquired cytomegalovirus (CMV) infection. Thus, many countries have chosen to contraindicate to feed raw breast milk preterm infants from CMV-positive mothers before a corrected age of 32 weeks or under a weight of 1500 g. French national recommendations have not been updated since 2005. An audit of the French practices regarding the nutrition with raw breast milk in preterm infants was carried out using a questionnaire sent to all neonatal care units. Diagnosed postnatal milk-acquired CMV infections have been analysed using hospitalisation reports. Seventy-five percent of the neonatal units responded: 24% complied with the French recommendations, 20% contraindicated raw breast milk to all infants before 32 weeks regardless of the mothers’ CMV-status, whereas 25% fed all preterm infants unconditionally with raw breast milk. Thirty-five cases of infants with milk-acquired CMV infections have been reported. The diagnosis was undeniable for five patients. In France, a high heterogeneity marks medical practices concerning the use of raw breast milk and the diagnostic approach for breast milk-acquired CMV infection is often incomplete. In this context, updated national recommendations and monitored CMV infections are urgently needed. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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15 pages, 535 KiB  
Article
Predictors of Continued Breastfeeding at One Year among Women Attending Primary Healthcare Centers in Qatar: A Cross-Sectional Study
by Amal Nasser, Fadumo Omer, Fatima Al-Lenqawi, Rehab Al-awwa, Tamam Khan, Asmaa El-Heneidy, Rana Kurdi and Ghadir Al-Jayyousi
Nutrients 2018, 10(8), 983; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10080983 - 27 Jul 2018
Cited by 16 | Viewed by 4532
Abstract
The number of babies in Qatar being exclusively breastfed is significantly lower than the global target set by the World Health Organization. The purpose of this study was to assess knowledge, attitude, and practice (KAP), selected barriers, and professional support as well as [...] Read more.
The number of babies in Qatar being exclusively breastfed is significantly lower than the global target set by the World Health Organization. The purpose of this study was to assess knowledge, attitude, and practice (KAP), selected barriers, and professional support as well as their association with continued breastfeeding at one year of age. A sample of Qatari and non-Qatari mothers (N = 195) who attended a well-baby clinic held at primary health care centers in Qatar completed a self-administered questionnaire. Descriptive analysis, the Pearson Chi-squared test, and logistic regression were performed. Around 42% of the mothers stopped breastfeeding when their child was aged between 0 and 11 months old. Mothers who had only one or female child stopped breastfeeding between the ages of 0 and 6 months (p = 0.025, 0.059). The more optimal the breastfeeding practices followed by the mothers, the older the age of the infant when they stopped breastfeeding (p = 0.001). The following factors were inversely associated with breastfeeding duration: the mother’s perceptions that she “did not know how to breastfeed,” or “wasn’t making enough milk,” and the need “to return to work/school”, with p = 0.022, 0.004, and 0.022, respectively. These findings present factors that should be considered when planning for health education and promotion programs to prolong breastfeeding duration in Qatar. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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12 pages, 285 KiB  
Article
Lactation Duration and Long-Term Thyroid Function: A Study among Women with Gestational Diabetes
by Pranati L. Panuganti, Stefanie N. Hinkle, Shristi Rawal, Louise G. Grunnet, Yuan Lin, Aiyi Liu, Anne C. B. Thuesen, Sylvia H. Ley, Sjurdur F. Olesen and Cuilin Zhang
Nutrients 2018, 10(7), 938; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070938 - 21 Jul 2018
Cited by 8 | Viewed by 4547
Abstract
Lactation is associated with reduced postpartum weight retention and a lower risk of several cardiometabolic disorders in population-based studies. We examined the association between lactation and long-term thyroid function among women with history of gestational diabetes mellitus (GDM), a high-risk population for subsequent [...] Read more.
Lactation is associated with reduced postpartum weight retention and a lower risk of several cardiometabolic disorders in population-based studies. We examined the association between lactation and long-term thyroid function among women with history of gestational diabetes mellitus (GDM), a high-risk population for subsequent metabolic complications. The study included 550 women who developed GDM in the Danish National Birth Cohort (1996–2002) and followed-up in the Diabetes & Women’s Health Study (2012–2014). We assessed adjusted associations between cumulative lactation duration and concentrations of thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) measured at follow-up. Women with longer cumulative lactation duration tended to have higher fT3 levels (adjusted β and 95% confidence interval (CI) for ≥12 months vs. none: 0.19 (0.03–0.36); p-trend = 0.05). When restricted to women with a single lifetime pregnancy to control for parity (n = 70), women who lactated for >6 months (vs. none) had higher fT3 levels (0.46 pmol/L (0.12–0.80); p-trend = 0.02) and a higher fT3:fT4 ratio (0.61 (0.17–1.05); p-trend = 0.007). Our findings suggested that a longer duration of lactation may be related to greater serum fT3 levels and fT3:fT4 ratio 9–16 years postpartum among Danish women with a history of GDM. The association was particularly pronounced among women who only had one lifetime pregnancy. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
14 pages, 288 KiB  
Article
The Impact of Maternal Diet during Pregnancy and Lactation on the Fatty Acid Composition of Erythrocytes and Breast Milk of Chilean Women
by Cynthia Barrera, Rodrigo Valenzuela, Rodrigo Chamorro, Karla Bascuñán, Jorge Sandoval, Natalia Sabag, Francesca Valenzuela, María-Paz Valencia, Claudia Puigrredon and Alfonso Valenzuela
Nutrients 2018, 10(7), 839; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070839 - 28 Jun 2018
Cited by 80 | Viewed by 6272
Abstract
Maternal diet during pregnancy is relevant for fatty acid supply during fetal life and lactation. Arachidonic (AA) and docosahexaenoic (DHA) acids are also relevant for the normal growth and development of brain and visual system. AA and DHA provided by the mother to [...] Read more.
Maternal diet during pregnancy is relevant for fatty acid supply during fetal life and lactation. Arachidonic (AA) and docosahexaenoic (DHA) acids are also relevant for the normal growth and development of brain and visual system. AA and DHA provided by the mother to the fetus and infant are directly associated with maternal dietary intake and body stores. Our aim was to evaluate the impact of maternal diet, specially referring to the quality of fatty acid intake, in a sample of Chilean women during last stage of pregnancy and across the lactation period. Fifty healthy pregnant women (age range 20–33 years) were studied from the 6th month of pregnancy and followed until 6th month of lactation period. Diet characteristics were evaluated through food frequency questionnaires. Fatty acids composition of erythrocyte phospholipids and breast milk samples was assessed by gas-liquid chromatography. Overall, women had high saturated fatty acids intake with sufficient intake of mono- and polyunsaturated fatty acids (PUFA). Diet was high in n-6 PUFA and low in n-3 PUFA (mainly DHA), with imbalanced n-6/n-3 PUFA ratio. Erythrocytes and breast milk DHA concentration was significantly reduced during lactation compared to pregnancy, a pattern not observed for AA. We concluded that is necessary to increase the intake of n-3 PUFA during pregnancy and lactation by improving the quality of consumed foods with particular emphasis on its DHA content. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
10 pages, 720 KiB  
Article
Fat Loss in Continuous Enteral Feeding of the Preterm Infant: How Much, What and When Is It Lost?
by Carlos Zozaya, Alba García-Serrano, Javier Fontecha, Lidia Redondo-Bravo, Victoria Sánchez-González, María Teresa Montes and Miguel Saenz de Pipaón
Nutrients 2018, 10(7), 809; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070809 - 23 Jun 2018
Cited by 8 | Viewed by 4047
Abstract
Human milk fat is a concentrated source of energy and provides essential and long chain polyunsaturated fatty acids. According to previous experiments, human milk fat is partially lost during continuous enteral nutrition. However, these experiments were done over relatively short infusion times, and [...] Read more.
Human milk fat is a concentrated source of energy and provides essential and long chain polyunsaturated fatty acids. According to previous experiments, human milk fat is partially lost during continuous enteral nutrition. However, these experiments were done over relatively short infusion times, and a complete profile of the lost fatty acids was never measured. Whether this loss happens considering longer infusion times or if some fatty acids are lost more than others remain unknown. Pooled breast milk was infused through a feeding tube by a peristaltic pump over a period of 30 min and 4, 12 and 24 h at 2 mL/h. Adsorbed fat was extracted from the tubes, and the fatty acid composition was analyzed by gas chromatography-mass spectrometry. Total fat loss (average fatty acid loss) after 24 h was 0.6 ± 0.1%. Total fat loss after 24 h infusion was 0.6 ± 0.1% of the total fat infused, although the highest losses occur in the first 30 min of infusion (13.0 ± 1.6%). Short-medium chain (0.7%, p = 0.15), long chain (0.6%, p = 0.56), saturated (0.7%, p = 0.4), monounsaturated (0.5%, p = 0.15), polyunsaturated fatty (0.7%, p = 0.15), linoleic (0.7%, p = 0.25), and docosahexaenoic acids (0.6%, p = 0.56) were not selectively adsorbed to the tube. However, very long chain fatty (0.9%, p = 0.04), alpha-linolenic (1.6%, p = 0.02) and arachidonic acids (1%, p = 0.02) were selectively adsorbed and, therefore, lost in a greater proportion than other fatty acids. In all cases, the magnitude of the loss was clinically low. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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13 pages, 1216 KiB  
Article
Comparison of Human Milk Immunoglobulin Survival during Gastric Digestion between Preterm and Term Infants
by Veronique Demers-Mathieu, Mark A. Underwood, Robert L. Beverly, Søren D. Nielsen and David C. Dallas
Nutrients 2018, 10(5), 631; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10050631 - 17 May 2018
Cited by 65 | Viewed by 6567
Abstract
Human milk provides immunoglobulins (Igs) that supplement the passive immune system of neonates; however, the extent of survival of these Igs during gastric digestion and whether this differs between preterm and term infants remains unknown. Human milk, and infant gastric samples at 2 [...] Read more.
Human milk provides immunoglobulins (Igs) that supplement the passive immune system of neonates; however, the extent of survival of these Igs during gastric digestion and whether this differs between preterm and term infants remains unknown. Human milk, and infant gastric samples at 2 h post-ingestion were collected from 15 preterm (23–32 week gestational age (GA)) mother-infant pairs and from 8 term (38–40 week of GA) mother-infant pairs within 7–98 days postnatal age. Samples were analyzed via ELISA for concentration of total IgA (secretory IgA (SIgA)/IgA), total secretory component (SC/SIgA/SIgM), total IgM (SIgM/IgM), and IgG as well as peptidomics. Total IgA concentration decreased by 60% from human milk to the preterm infant stomach and decreased by 48% in the term infant stomach. Total IgM and IgG concentrations decreased by 33% and 77%, respectively, from human milk to the term infant stomach but were stable in the preterm infant stomach. Release of peptides from all Ig isotypes in the term infant stomach was higher than in the preterm stomach. Overall, the stability of human milk Igs during gastric digestion is higher in preterm infant than in term infants, which could be beneficial for assisting the preterm infants’ immature immune system. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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11 pages, 276 KiB  
Article
Factors Associated with Maternal Wellbeing at Four Months Post-Partum in Ireland
by Annemarie E. Bennett and John M. Kearney
Nutrients 2018, 10(5), 609; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10050609 - 14 May 2018
Cited by 13 | Viewed by 4391
Abstract
This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were [...] Read more.
This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p < 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p < 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49–20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20–12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02–1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29–6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
19 pages, 1008 KiB  
Article
Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study
by Kirsty V. Biggs, Katherine Hurrell, Eleanor Matthews, Ekaterina Khaleva, Daniel Munblit and Robert J. Boyle
Nutrients 2018, 10(5), 608; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10050608 - 14 May 2018
Cited by 17 | Viewed by 8518
Abstract
Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to [...] Read more.
Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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10 pages, 273 KiB  
Article
Concentrations of Water-Soluble Forms of Choline in Human Milk from Lactating Women in Canada and Cambodia
by Alejandra M. Wiedeman, Kyly C. Whitfield, Kaitlin M. March, Nancy N. Chen, Hou Kroeun, Ly Sokhoing, Prak Sophonneary, Roger A. Dyer, Zhaoming Xu, David D. Kitts, Timothy J. Green, Sheila M. Innis and Susan I. Barr
Nutrients 2018, 10(3), 381; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10030381 - 20 Mar 2018
Cited by 21 | Viewed by 4916
Abstract
Choline has critical roles during periods of rapid growth and development, such as infancy. In human milk, choline is mostly present in water-soluble forms (free choline, phosphocholine, and glycerophosphocholine). It is thought that milk choline concentration is influenced by maternal choline intake, and [...] Read more.
Choline has critical roles during periods of rapid growth and development, such as infancy. In human milk, choline is mostly present in water-soluble forms (free choline, phosphocholine, and glycerophosphocholine). It is thought that milk choline concentration is influenced by maternal choline intake, and the richest food sources for choline are of animal origin. Scarce information exists on milk choline from countries differing in animal-source food availability. In this secondary analysis of samples from previous trials, the concentrations of the water-soluble forms of choline were quantified by liquid chromatography-tandem mass spectrometry in mature milk samples collected from lactating women in Canada (n = 301) and in Cambodia (n = 67). None of the water-soluble forms of choline concentrations in milk differed between Canada and Cambodia. For all milk samples (n = 368), free choline, phosphocholine, glycerophosphocholine, and the sum of water-soluble forms of choline concentrations in milk were (mean (95%CI)) 151 (141, 160, 540 (519, 562), 411 (396, 427), and 1102 (1072, 1133) µmol/L, respectively. Theoretically, only 19% of infants would meet the current Adequate Intake (AI) for choline. Our findings suggest that the concentrations in milk of water-soluble forms of choline are similar in Canada and Cambodia, and that the concentration used to set the infant AI might be inaccurate. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
15 pages, 767 KiB  
Article
Preterm Infant Feeding: A Mechanistic Comparison between a Vacuum Triggered Novel Teat and Breastfeeding
by Donna Geddes, Chooi Kok, Kathryn Nancarrow, Anna Hepworth and Karen Simmer
Nutrients 2018, 10(3), 376; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10030376 - 19 Mar 2018
Cited by 20 | Viewed by 6576
Abstract
The goal for preterm infants is to achieve full oral feeds quickly and ultimately progress to full breastfeeding. Supplementary oral feeds are often given when the mother is not available to breastfeed. Bottles typically deliver milk in a different fashion compared to breastfeeding, [...] Read more.
The goal for preterm infants is to achieve full oral feeds quickly and ultimately progress to full breastfeeding. Supplementary oral feeds are often given when the mother is not available to breastfeed. Bottles typically deliver milk in a different fashion compared to breastfeeding, which is thought to hamper transition to full breastfeeding. The aim of this study was to compare the sucking dynamics of preterm infants fed at the breast to feeding with an experimental novel teat (NT) designed to release milk only upon the application of vacuum. Simultaneous ultrasound imaging of the infant oral cavity and measurement of intra-oral vacuum was performed during a breastfeed and a feed with the NT. Test weighs were used to measure milk intake. Linear mixed effects models were performed to investigate differences by feed type, and simultaneous linear regression was performed to investigate individual patterns. Tongue movement was not different between breastfeeding and the NT. Intra-oral vacuums (median (interquartile range: IQR)) were significantly lower with the NT (Baseline vacuum: −5.8 mmHg (−11.0, 0.1); Peak: 40.0 mmHg (−54.6, −27.1)) compared to breastfeeding (Baseline: −31.1 mmHg (−60.0, −12.7); Peak: −106.2 mmHg (−153.0, −65.5)). Milk intake was significantly higher with the NT (33 mL (22.5, 42.5)) compared to the breastfeed (12 mL (3, 15.5)). The novel teat encouraged a similar tongue action to breastfeeding, and infants transferred a greater volume of milk with the novel teat. Intra-oral vacuums were lower in strength with the novel teat compared to the breast. Use of the novel teat for the training of sucking dynamics in preterm infants has the potential to improve breastfeeding success and requires further investigation. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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26 pages, 2023 KiB  
Article
Relationships between Breastfeeding Patterns and Maternal and Infant Body Composition over the First 12 Months of Lactation
by Zoya Gridneva, Alethea Rea, Anna R. Hepworth, Leigh C. Ward, Ching T. Lai, Peter E. Hartmann and Donna T. Geddes
Nutrients 2018, 10(1), 45; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10010045 - 05 Jan 2018
Cited by 35 | Viewed by 7596
Abstract
Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC). A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term [...] Read more.
Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC). A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term infant BC (n = 20) and feeding parameters during first 12 months of lactation were investigated. BC was measured at 2, 5, 9 and/or 12 months postpartum with ultrasound skinfolds (US; infants only) and bioimpedance spectroscopy (infants and mothers). 24-h milk intake (MI) and feeding frequency (FFQ) were measured. Higher FFQ was associated with larger 24-h MI (p ≤ 0.003). Higher 24-h MI was associated with larger infant fat mass (FM) (US: p ≤ 0.002), greater percentage FM (US: p ≤ 0.008), greater FM index (FMI) (US: p ≤ 0.001) and lower fat-free mass index (FFMI) (US: p = 0.015). Lower FFQ was associated with both larger FFM (US: p ≤ 0.001) and FFMI (US: p < 0.001). Greater maternal adiposity was associated with smaller infant FFM measured with US (BMI: p < 0.010; %FM: p = 0.004; FMI: p < 0.011). Maternal BC was not associated with FFQ or 24-h MI. These results reinforce that early life is a critical window for infant programming and that breastfeeding may influence risk of later disease via modulation of BC. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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16 pages, 474 KiB  
Review
Lactoferrin: A Critical Player in Neonatal Host Defense
by Sucheta Telang
Nutrients 2018, 10(9), 1228; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091228 - 04 Sep 2018
Cited by 92 | Viewed by 8306
Abstract
Newborn infants are at a high risk for infection due to an under-developed immune system, and human milk has been shown to exhibit substantial anti-infective properties that serve to bolster neonatal defenses against multiple infections. Lactoferrin is the dominant whey protein in human [...] Read more.
Newborn infants are at a high risk for infection due to an under-developed immune system, and human milk has been shown to exhibit substantial anti-infective properties that serve to bolster neonatal defenses against multiple infections. Lactoferrin is the dominant whey protein in human milk and has been demonstrated to perform a wide array of antimicrobial and immunomodulatory functions and play a critical role in protecting the newborn infant from infection. This review summarizes data describing the structure and important functions performed by lactoferrin in protecting the neonate from infection and contributing to the maturation of the newborn innate and adaptive immune systems. We also briefly discuss clinical trials examining the utility of lactoferrin supplementation in the prevention of sepsis and necrotizing enterocolitis in newborn infants. The data reviewed provide rationale for the continuation of studies to examine the effects of lactoferrin administration on the prevention of sepsis in the neonate. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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11 pages, 274 KiB  
Review
Sex-Specific Human Milk Composition: The Role of Infant Sex in Determining Early Life Nutrition
by Laura Galante, Amber M. Milan, Clare M. Reynolds, David Cameron-Smith, Mark H. Vickers and Shikha Pundir
Nutrients 2018, 10(9), 1194; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091194 - 01 Sep 2018
Cited by 74 | Viewed by 35383
Abstract
Male and female infants respond differentially to environmental stimuli, with different growth and neurodevelopmental trajectories. Male infants are more likely to be disadvantaged when subjected to adversity and show a higher risk of perinatal complications. However, the underlying causes of this sex-bias are [...] Read more.
Male and female infants respond differentially to environmental stimuli, with different growth and neurodevelopmental trajectories. Male infants are more likely to be disadvantaged when subjected to adversity and show a higher risk of perinatal complications. However, the underlying causes of this sex-bias are not well defined and optimising the early life nutritional care may be necessary to minimise the “male disadvantage” that may be experienced early in life. Experimental models have demonstrated that animal milk composition differs according to offspring sex, suggesting that the tailoring of early life nutrition may be one mechanism to maximise health protection and development to infants of both sexes. However, evidence for a sex-specificity in human milk composition is limited and conflicting, with studies documenting higher milk energy content for either male or female infants. These data show sex differences, however, there has been limited compositional analysis of the current data nor strategies proposed for how sex-specific compositional differences in early life nutrition may be used to improve infant health. The present narrative review highlights that an improved understanding of sex-specific human milk composition is essential for promoting optimal infant growth and development. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
20 pages, 1469 KiB  
Review
Human Milk Lipidomics: Current Techniques and Methodologies
by Alexandra D. George, Melvin C. L. Gay, Robert D. Trengove and Donna T. Geddes
Nutrients 2018, 10(9), 1169; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091169 - 26 Aug 2018
Cited by 33 | Viewed by 7905
Abstract
Human milk contains a complex combination of lipids, proteins, carbohydrates, and minerals, which are essential for infant growth and development. While the lipid portion constitutes only 5% of the total human milk composition, it accounts for over 50% of the infant’s daily energy [...] Read more.
Human milk contains a complex combination of lipids, proteins, carbohydrates, and minerals, which are essential for infant growth and development. While the lipid portion constitutes only 5% of the total human milk composition, it accounts for over 50% of the infant’s daily energy intake. Human milk lipids vary throughout a feed, day, and through different stages of lactation, resulting in difficulties in sampling standardization and, like blood, human milk is bioactive containing endogenous lipases, therefore appropriate storage is critical in order to prevent lipolysis. Suitable sample preparation, often not described in studies, must also be chosen to achieve the aims of the study. Gas chromatography methods have classically been carried out to investigate the fatty acid composition of human milk lipids, but with the advancement of other chromatographic techniques, such as liquid and supercritical fluid chromatography, as well as mass spectrometry, intact lipids can also be characterized. Despite the known importance, concise and comprehensive analysis of the human milk lipidome is limited, with gaps existing in all areas of human milk lipidomics, discussed in this review. With appropriate methodology and instrumentation, further understanding of the human milk lipidome and the influence it has on infant outcomes can be achieved. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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10 pages, 248 KiB  
Review
Supporting Mothers of Very Preterm Infants and Breast Milk Production: A Review of the Role of Galactogogues
by Elizabeth V. Asztalos
Nutrients 2018, 10(5), 600; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10050600 - 12 May 2018
Cited by 24 | Viewed by 6408
Abstract
Human milk, either mother’s own milk or donor human milk, is recommended as the primary source of nutrition for very preterm infants. Initiatives should be in place in neonatal units to provide support to the mother as she strives to initiate and maintain [...] Read more.
Human milk, either mother’s own milk or donor human milk, is recommended as the primary source of nutrition for very preterm infants. Initiatives should be in place in neonatal units to provide support to the mother as she strives to initiate and maintain a supply of breast milk for her infant. The use of galactogogues are considered when these initiatives alone may not be successful in supporting mothers in this endeavor. Although there are non-pharmacologic compounds, this review will focus on the pharmacologic galactogogues currently available and the literature related to their use in mothers of very preterm infants. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)

Other

9 pages, 283 KiB  
Brief Report
Zinc Deficiency among Lactating Mothers from a Peri-Urban Community of the Ecuadorian Andean Region: An Initial Approach to the Need of Zinc Supplementation
by Camila Narváez-Caicedo, Gabriela Moreano, Bernardo A. Sandoval and Miguel Á. Jara-Palacios
Nutrients 2018, 10(7), 869; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070869 - 05 Jul 2018
Cited by 10 | Viewed by 3933
Abstract
Zinc is an important mineral for biological and physiological processes. Zinc deficiency (ZD) is one of the most common micronutrient deficiencies worldwide and a crucial determinant of pregnancy outcomes and childhood development. Zinc levels and the zinc supplementation rate among lactating women have [...] Read more.
Zinc is an important mineral for biological and physiological processes. Zinc deficiency (ZD) is one of the most common micronutrient deficiencies worldwide and a crucial determinant of pregnancy outcomes and childhood development. Zinc levels and the zinc supplementation rate among lactating women have not been assessed neither in Ecuador nor in the Andean region. We conducted a pilot study including 64 mothers of infants between eight days to seven months old from a primary care center located in Conocoto, a peri-urban community of Quito, Ecuador. The mothers were interviewed and a fasting blood sample was taken to determine plasma zinc levels. The prevalence of ZD was calculated and compared with the prevalence of ZD among Ecuadorian non-pregnant non-lactating women, and the sample was analysed considering zinc supplementation during pregnancy. The prevalence of ZD among the participants was 81.3% (95% CI: 71.7–90.9), higher than the reported among non-pregnant non-lactating women (G2 = 18.2; p < 0.05). Zinc supplementation rate was 31.2%. No significant differences were found comparing the groups considering zinc supplementation. The insights obtained from this study encourage extending studies to document zinc levels and its interactions among breastfeeding women in areas with a high prevalence of ZD in order to determine the need of zinc supplementation. Full article
(This article belongs to the Special Issue Breastfeeding and Human Lactation)
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