Breastfeeding Period Research Articles

Infants with Excessive Weight Gain while Exclusively Breastfeeding: Follow-Up at 36 Months.

Objectives: Rapid weight gain in infancy is associated with an increased risk of later adiposity. Very rarely, however, exclusively breastfed infants experience excessive weight gain (EWG) during the period of exclusive breastfeeding (EBF) when breast milk is the only source of nutrition. We investigated growth and body composition at 36 months in children experiencing EWG during EBF. Methods: Ten infants with EWG during the first 6 months of EBF were followed up at 36 months. The infants had been followed from age 5 months. Examinations included anthropometry, body composition by bioimpedance, and blood samples. Body composition and plasma leptin concentrations were available for eight and five children, respectively. Results: From 5 to 36 months, body mass index-for-age z-scores (BAZ) decreased from (mean ± standard deviation) 2.33 ± 0.94 to 1.48 ± 0.57, and only one child still being overweight (BAZ >2). Fat mass and fat mass index (FMI) decreased from 18 to 36 months (4.71 ± 0.56 to 3.57 ± 0.67 kg and 6.50 ± 0.34 to 3.66 ± 0.72 kg/m2, respectively) with a concurrent 45% decrease in leptin. The increase in lean mass was higher than the increase in weight (5.27 versus 3.65 kg, respectively) due to fat loss. There was substantial conformity within the sample in the patterns of body composition change. Conclusion: This unusual group of children continued to decrease in BAZ and FMI with a concomitant increase in fat-free mass, indicating an ongoing normalization of body weight and composition.

Phenotypic characterization of NK cells in 5-year-old children exposed to maternal HIV and antiretroviral therapy in early-life

BackgroundHIV-exposed uninfected (HEU) children are at increased risk of morbidity during the first years of life. Although the immune responses of HEU infants in early-life are relatively well described, studies of natural killer (NK) cells in older HEU children are lacking. NK cell subsets were analysed in HEU children and compared to those in HIV unexposed uninfected (HUU) children aged ~ five years.MethodsMulti-parametric flow cytometry was used to characterize peripheral blood-derived NK cell CD56, CD16, CD57, NKG2A and KIR3DL1/KIR2DL2/L3 expression, including intracellular perforin and granzyme B. NK cell subsets were compared between HEU children exposed to prenatal antiretroviral therapy (ART) from conception [long-term (HEULT)]; those exposed to ART during pregnancy [medium-term (HEUMT)] with continued exposure throughout the breastfeeding period and HUU peers. Furthermore, clinical data of the children, including sick clinic visits and hospitalizations documented in morbidity diaries from birth to 5 years were compared between HEU and HUU groups. Frequencies of CD56bright and CD56dim NK cell were correlated with these clinical parameters.Results139 children were enrolled however, 133 comprising 43 HEULT, 38 HEUMT and 52 HUU were included in the main analyses. Total NK cell, CD56bright nor CD56dim NK cell proportions differed between HEU and HUU children. However, HEULT children had lower frequencies of CD56dim NK cells compared to HEUMT children, (p = 0.002) which maintained significance after controlling for preterm birth, p = 0.012. No differences were observed between HEULT and HUU. The expressions of NKG2A, KIR3DL1/KIR2DL2/L3 and CD57 on CD56bright and CD56dim NK cells were similar between the three groups. Furthermore, the frequencies of granzyme B and perforin double positive NK cells were similar between the HUU with HEULT and HEUMT children. CD56dim NK cell counts had a significant moderate negative correlation with recurrent respiratory infections (rho=-0.38; p = 0.010) in HUU children and negatively correlated with total sick clinic visits in HEUMT (rho=-0.40, p = 0.064).ConclusionThe proportions of total NK cell, CD56bright and CD56dim NK cells, NK cells inhibitory and differentiation surface marker expression and cytolytic granule-positive cells were similar between HEU and HUU children. These data suggest that early-life HIV/ART exposure may not result in major changes in NK cell subsets at 5 years of age.

Women’s lived experience of intimate partner violence manifestations during the breastfeeding period: a lifeworld hermeneutic study

BackgroundOne in three women will experience Intimate Partner Violence (IPV). Exposure during breastfeeding endangers women’s and children’s health and wellbeing, negatively affects breastfeeding, and violates human rights and global sustainability goals. Previous qualitative studies have demonstrated that existential aspects are crucial in the separate experience of both IPV and breastfeeding. However, there is a lack of studies examining the meaning of the concurrent experience of these phenomena. An enhanced understanding of the experience of IPV manifestations during the breastfeeding period may inform the provision of care and support for women exposed to IPV. Accordingly, the study aims to explain and understand women’s lived experience of IPV manifestations during the breastfeeding period.MethodsThe study adopts a lifeworld hermeneutic approach based on Reflective Lifeworld Research. Data collection was conducted between June 2022 and August 2023. Swedish women with experience of the phenomenon IPV manifestations during the breastfeeding period participated either through written lifeworld stories (forty-nine women) or lifeworld interviews (nine women). Data were analysed interpretatively. The main interpretation was inspired by Liz Kelly’s theory ‘The continuum of violence’.ResultsThe results show that women experience IPV manifestations during breastfeeding in terms of being accused, devalued, neglected, controlled, opposed, forced to adapt, and/or punished. The main interpretation suggests that the manifestations are intertwined within a multidimensional continuum where the most frequent IPV manifestations are less commonly recognised as violence. The main interpretation further illustrates that the continuum is dependent on both the subjective lifeworld of the woman and the patriarchal context in which it exists. In relation to the patriarchal context, the breastfeeding intimacy within the mother–child dyad is pivotal to explaining and understanding the phenomenon.ConclusionsThe breastfeeding intimacy within the mother–child dyad seems to change the intersubjective power balance in the partner relationship and provoke partners, making breastfeeding women especially vulnerable to IPV. Knowledge of breastfeeding women’s lived experience of exposure to IPV is central for carers to strengthen their ability to support women’s health and wellbeing.

Vulvar Lactating Adenoma: A Rare Representation of Mammary-Like Anogenital Glands.

Mammary-like anogenital glands are considered a normal constituent of the anogenital area. These glands can have epithelial components with eccrine or apocrine features. They often undergo transformation into mammary-like lesions, including lactational changes that occur during pregnancy and the breastfeeding period. When they form mass lesions they are referred to as lactating adenomas. Their appearance can clinically be mistaken for other more common benign and malignant entities in the vulva. We describe a vulvar lesion in a 26-year-old woman. The lesion was excised and determined by histologic examination to be a benign lactating adenoma. Subsequent immunohistochemistry was performed. The epithelial cells were positive for GATA3 and estrogen receptor while negative for PAX8, supporting mammary-like differentiation. The myoepithelial markers p63 and calponin were positive at the periphery of the ducts, supporting the benign nature of this lesion.

Effectiveness of Relactation Supportive Program in Sustaining Exclusive Breastfeeding: A Prospective Observational Study.

Relactation is the process of re-establishing breastfeeding after stopping or after a period of little breastfeeding. The study aimed to assess the Relactation Supportive Program (RSP)'sefficacyin sustaining breastfeeding and to determine the impact of RSP on breastfeeding initiation, timing, and correlation with the lactation gap. A prospective observational studywas done with 60 infant-mother dyads, aged seven days to 14 weekswho stopped breastfeeding for 6-28 days or never breastfed. Mothers in the RSP group received hands-on guidance on techniques like supplemental feeding methods and nipple stimulation, alongside psychological and emotional support. In the Routine Counseling (RC) group, mothers received counseling about the benefits of breastfeeding, breast milk expression, correct attachment, and motivation for breastfeeding. In the RSPgroup, 21 infants achieved and sustained exclusive breastfeeding by six months (p=0.003), compared to 10 in the RC group. RSP initiated lactation earlier (10.04±4.02 days, p=0.002) than the RCgroup(13.43±3.59 days). Relactation durationwasinversely correlated with the lactation gap. RSP significantly promoted earlier and sustained relactation compared to RC alone.

Maternal Nutrition and Human Milk Nutrients: A Scoping Review.

To explore the influence of maternal nutrition factors, including body mass index, nutritional supplementation, and dietary intake during the breastfeeding period, on macro and micronutrient composition in human milk. We conducted a scoping review using the PRISMA-ScR checklist, initially identifying 5,984 original studies published in the English language from PubMed, Scopus, and Web of Science that presented findings on the association of maternal nutritional factors on human milk nutrient composition. After screening the title and abstract, we selected 69 studies for full review, including 3 studies found through checking reference lists. After full review, we included 23 studies in this scoping review. Most studies found maternal body mass index and supplement consumption affected human milk macro and micronutrient composition, whereas inconsistent results were found on the relationship between maternal diet and human milk nutrients. Methodologies varied substantially across studies, especially for milk sample collection methods and maternal nutrition assessments. Maternal nutrition factors may affect levels of human milk nutrients, requiring maternal nutrition monitoring during breastfeeding. However, given the considerable variability in the results between studies and methodological approaches, further studies should use standardized and validated procedures to strengthen the findings on this topic.

Effectiveness of Oral Herbal in Postpartum and Breastfeeding

Background: Health care during the postpartum and breastfeeding periods fulfils the needs of the mother and baby. 'Jamu', or herbal medicine, is often used for this purpose, but there needs to be more evidence of its effectiveness. The public's insufficient understanding of herbal medicine necessitates a systematic review to assess its contents, benefits, and side effects. The systematic review aimed to examine oral herbal medicines during puerperium or breastfeeding, using the RCT method to provide evidence of IB levels in EBM. Methods: Inclusion criteria were articles in randomised controlled trials (RCTs) to investigate the effectiveness of oral herbs during the puerperium and lactation. The methodological quality of articles was tested with the Jadad Score. Results: The five (5) selected articles have good quality (the Jadad Score was 5–8). The study tested five herbs, including fenugreek, honey, bitter fennel, Brazilian propolis, barley malt, and Thai herbal tea "Wang Nam Yean" (a mixture of sappan wood (secang), bael (maja) fruit, licorice, ginger, and tuba (Derris scandens)). Comparators included placebo and other herbs or Domperidone. Most clinical outcomes involved successful breastfeeding, but complications, infant weight gain, and side effects were also observed. Conclusion: Herbs can aid in healthy breastfeeding, but they should be taken cautiously and in conjunction with the assessment, counselling, and support of healthcare professionals. No herbal medicine has the best evidence-based practices because the evidence has not been applied to clinical practice, so changes in clinical practice results have yet to be documented.

The Significance of Plant Nutrition in the Creation of the Intestinal Microbiota-Prevention of Chronic Diseases: A Narrative Review.

Dysbiosis of the gastrointestinal tract is the most common cause of disease in childhood and adulthood. The formation of the intestinal microbiome begins in utero, and composition modification during life depends mainly on various genetic, nutritional, and environmental factors. The main cause of intestinal dysbiosis is improper nutrition due to a short period of breastfeeding, insufficient intake of fresh fruits and vegetables, and/or consumption of a large amount of processed food. The benefits of a diet based on grains, legumes, fruits, and vegetables are reflected in reducing the risk of cancer, cardiovascular diseases, myocardial infarction, stroke, rheumatoid arthritis, high blood pressure, asthma, allergies, and kidney stones. Anaerobic fermentation of fibers produces short-chain fatty acids (SCFA) that have an anti-inflammatory role and great importance in shaping the intestinal microbiota. Factors associated with high fiber in a plant-based diet promote increased insulin sensitivity. Insulin and insulin-like growth factor 1 (IGF-I) act as promoters of most normal and pre-neoplastic tissues. Conclusion: A plant-based diet high in fiber prevents disease by creating metabolites in the gut that reduce oxidative stress.

Association of breastfeeding and early cereal introduction with development of type 1 diabetes mellitus in children in Pakistan: Case study.

Objective: The aim of this study is to examine the association between type 1 diabetes mellitus development, breastfeeding and early cereal introduction in Pakistani children. Study Design: Case-control study. Setting: Allied Hospital in Faisalabad, Pakistan. Period: November 2023 to February 2024. Methods: Involving 220 children ranged from 2 to 10 years were selected for case (diagnosed with type 1 diabetes) and Control group (without diagnosed with type 1 diabetes). Researchers developed a questionnaire based on information about breastfeeding, cereal introduction and other factors associated with type 1 diabetes. Parents were requested to complete the questionnaire regarding their child, mother, and family. Results: The mean ages of children were slightly higher in the control group (6.2±5.5 years) compared to the case group (5.67±7.4 years). This research determined that a one-month cumulative increase in exclusive breastfeeding for the duration of the breastfeeding period decreased the individual risk by 47.8% to 13.9% less probability in type 1 DM case. Among cases, 47.8% of the children were exclusively breastfed for less than one month, which was very low, while in the control group, this proportion was lower at 30. 6%. Furthermore, more cases (22.6%) were exclusively breastfed for 6 months compared to controls (13.9%). Among cases, 45.5% of children did not consume formula, whereas in the control group, this percentage was lower at 54.2%. Additionally, a higher proportion of controls (39.8%) were introduced to the formula before 6 months compared to cases (30.0%). Cereals were introduced to 5.55% of cases and 3.12% of controls prior to six months of age. Conclusion: Children who were breastfed for a longer period of time had a lower chance of type 1 diabetes, while children who were introduced to cereal and other food at an early age had a higher risk of the disease. Extended breastfeeding lowers the risk of diabetes by offering important protective effects from birth.

Nutritional requirements in pregnancy and lactation

Optimal nutrition during pregnancy and lactation is vital for the health of the mother and fetus. Nutritional needs should begin in the preconception period, as the fetus depends on the placenta for essential nutrients required for growth and development. A balanced diet rich in nutrient-dense foods—such as whole grains, vegetables, fruits, dairy, legumes, fish, and lean meats—is essential to meet caloric needs during pregnancy. Assessment of maternal health, including dietary history and micronutrient status, is critical to identify potential risks and ensure adequate nutrition. The increased need for micronutrients must be met to prevent complications and fetal growth.Exclusive breastfeeding is recommended for the first six months, and continued breastfeeding is recommended throughout the first year and beyond. During pregnancy and lactation, calorie intake should be increased by focusing on protein and healthy fats. The composition of breast milk is adapted during the breastfeeding period, so that it can provide the necessary nutrients for the growth of the infant. Personalized nutrition plans, developed in consultation with health care professionals, are critical to optimizing maternal and infant health outcomes. This manuscript supports the importance of comprehensive nutritional strategies during pregnancy and lactation to reduce risks and support healthy growth and development of mother and child.

EMPODERANDO MÃES: O CRUCIAL PAPEL DO ENFERMEIRO NA PROMOÇÃO E APOIO À AMAMENTAÇÃO – REVISÃO INTEGRATIVA DE LITERATURA APOIO À AMAMENTAÇÃO

Some mothers may face difficulties during the breastfeeding process, which can be influenced by the presence of a hormone called oxytocin, which stimulates the release of breast milk. Furthermore, it is important to emphasize that breastfeeding is considered the ideal nutrition for all children due to its nutrient composition. Regarding methodology, this study is an integrative literature review, allowing for the analysis and subsequent synthesis of existing academic production on breastfeeding in a humanized process. The final sample of this integrative literature review consisted of 5 scientific articles included in this study as they met the previously established inclusion and exclusion criteria and, consequently, answered the research question. Finally, it is highlighted that nurses can be available to address mothers’ doubts and concerns about the subject, offering continuous support throughout the breastfeeding period and helping to resolve issues that may arise, such as low milk production or difficulties with the baby’s latch, as well as providing emotional support during this process.

A biogeochemical approach to examining sub-adult diet and the weaning process at Neolithic Tepecik-Çiftlik, Türkiye

Tepecik-Çiftlik, a Neolithic settlement located in the Cappadocia region of Central Anatolia, within the boundaries of Niğde province in modern Türkiye is crucial for helping us to better understand social behaviour and human mobility in the Neolithic, as well as relations between different groups. To investigate dietary habits, subsistence practices, and intra-societal variations stable carbon and nitrogen isotope ratio analysis has been conducted on the Neolithic human and faunal population. Further to this, 21 sub-adults were also sampled for stable carbon and nitrogen isotope ratio analysis to examine sub-adult diet, complementary feeding, and the cessation of breastfeeding as part of the weaning process. This isotopic investigation into the weaning process is complemented by a previously conducted study using Sr/Ca ratios from bone apatite of the same population. The δ13C values of the sampled sub-adults range from −19.8 ‰ to −19.0 ‰ and the δ15N values range from 8.0 ‰ to 15.2 ‰. The isotopic data suggest a very early onset of complementary feeding (ca. 0.2 years of age) and a brief breastfeeding period, relative to other prehistoric populations. The cessation of breastfeeding and this very brief weaning process was likely completed by ca. 1–1.5 years old. This early commencement of complementary feeding was most probably a deliberate social and cultural choice, supported by the presence of bowls and feeding spoons in the graves of very young babies and infants. However, this cultural choice may also have affected the mortality profile of the Neolithic population.

Intermittent preventive treatment for malaria in pregnancy and infant growth: a mediation analysis of a randomised trial

Intermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses. We analysed data from 633 infants born to mothers enrolled in a randomised trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs. sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0 to 12 months of age. Using generalised linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anaemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrolment, maternal age, maternal parasitaemia at enrolment, education, and wealth. SP increased mean LAZ by 0.18-0.28 Z from birth through age 4 months compared to DP, while DP increased mean WLZ by 0.11-0.28 Z from 2 to 8 months compared to SP among infants of multigravidae; at these ages, confidence intervals for mean differences excluded 0. We did not observe differences among primigravida. Mediators of SP included birth weight, birth length, maternal stem cell factor, and DNER. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery. In high malaria transmission settings, this exploratory study suggests different IPTp regimens may influence infant growth among multigravidae, potentially through distinct pathways, in the exclusive breastfeeding period, when few other interventions are available. Stanford Center for Innovation in Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation.

Composition and Antioxidant Status of Human Milk of Women Living in Bydgoszcz (Poland).

The aim of this study was to compare cortisol concentrations, nutritional composition, and the antioxidant status of human milk of women living in Bydgoszcz (Poland), taking into account maternal factors (fertility, area of residence, economic activity, and breastfeeding period). The basic composition of human milk was evaluated using the MIRIS HMATM analyzer. The level of cortisol was determined by the enzyme-linked immunosorbent method. In order to determine the antioxidant activity, the DPPH radical method was used. It was observed that the concentration of cortisol in human milk in the group of women living in the city center was higher compared to the milk of women living on the outskirts of the city. In the group of women breastfeeding from 3 to 5 weeks after childbirth, the concentration of cortisol in milk was higher compared to the group of women breastfeeding less than 12 months of age and compared to the group of women lactating over 12 months of age. The antioxidant status of human milk was highest in the group of professionally active women and in the group of breastfeeding women from 3 to 5 weeks after childbirth. The basic composition and the caloric value of human milk differed statistically significantly in the study groups. Based on this study, it can be concluded that the composition and antioxidant status of human milk depends on maternal factors (fertility, professional activity, area of residence, and breastfeeding period). Higher cortisol concentrations in breast milk are probably determined by the area of residence (city center and associated higher noise/sound and stress levels) and lactation period (hormonal imbalance, fatigue, and postpartum period). Milk from economically active women shows greater protection against reactive oxygen species compared to milk from inactive women, protecting against the occurrence of diseases of civilization. Milk from breastfeeding women over 12 months of age also shows protection against reactive oxygen species, despite the fact that the highest level of antioxidant status of human milk occurs in the initial period of lactation.

Systematic Characterization of the Oligosaccharide Profile of Human Milk in Rural Areas of Central China: Quantitative Tracking of Human Milk Oligosaccharide Composition during 12 Months of Lactation.

This study investigates changes in human milk oligosaccharide (HMO) composition over a 12 month breastfeeding period in rural central China. The HMO profiles of 97 mothers were analyzed by graphitized carbon liquid chromatography-electrospray ionization-mass spectrometry. This method was simple to prepare samples and can simultaneously and absolutely quantify at least 20 neutral and acidic HMOs. All mothers were classified into four milk groups based on the presence or absence of specific α-1,2 and α-1,4-fucosylated HMOs. The main oligosaccharides in milk groups I and II were 2'-FL, LDFT, LNFP-I, and LNDFH-I, while LNT, 3-FL, LNFP-II, LNFP-V, LNDFH-II, and DFLNH-b were predominant in milk groups III and IV. Additionally, the lactation period was the primary factor affecting the concentration of individual HMOs. The concentrations of most HMOs decreased with lactation and stabilized after 180 days. However, the concentrations of 3-FL, LDFT, and LNDFH II increased gradually over the lactation period, and the concentration of 3'-SL decreased during early lactation (5-180 days) but increased during later lactation (180-365 days). Furthermore, Spearman correlation analysis revealed that maternal factors and infant factors may also affect the concentration of various HMOs. These findings provide fundamental insights for the development of a comprehensive human milk database.

Efficacy and safety of 2-drug regime dolutegravir/lamivudine in pregnancy and breastfeeding- clinical implications and perspectives.

To assess the efficacy and safety of a two-drug regimen (2DR) with dolutegravir (DTG) and lamivudine (3TC) in maintaining viral suppression during pregnancy and breastfeeding, and to evaluate its potential as an alternative to the recommended three-drug regimen (3DR) in preventing mother-to-child transmission (MTCT) of HIV. We present a case of a 34-year-old pregnant woman who, after discontinuing 3DR due to side effects and poor adherence, was switched to DTG/3TC at gestational week 23. Maternal viral load (VL) and infant HIV status were monitored throughout pregnancy and a ten-month breastfeeding period. Data on pharmacokinetic changes in pregnancy and the risks associated with 2DR were reviewed. The patient's VL remained suppressed (<20 copies/mL) from gestational week 23 until the end of the breastfeeding period. A healthy HIV-negative baby was born at 39 weeks, and the child remained HIV-negative after ten months of breastfeeding. The 2DR was well-tolerated, improved adherence, and reduced fetal drug exposure. Despite limited experience with 2DR in pregnancy, no viral rebound occurred, and no adverse effects were observed. Although 3DR remains the preferred therapy during pregnancy and breastfeeding, this case indicates that DTG/3TC may be an effective alternative for patients experiencing intolerance or poor adherence to 3DR. Further studies are needed to explore the impact of pharmacokinetic changes in pregnancy on 2DR efficacy and to confirm its safety and role in preventing MTCT.

Factors Hindering Male Participation in Prevention of Mother-to-Child Transmission of HIV (PMTCT) at National Council of Churches of Kenya (NCCK) Huruma Clinic, Nairobi

Mother-to-child transmission (MTCT) occurs when a pregnant woman with Human immunodeficiency Virus (HIV) passes the virus to her baby either during pregnancy, labour and delivery or breastfeeding period. Vertical transmission during pregnancy is between 20-25%. Globally, about 330,000 children were newly infected with HIV in 2011. It is estimate that more than 90% of these infections were through mother-to-child transmission. According to statistics, 1,400,00 – 1,800,000 people were living with HIV and AIDS by the end of 2007. Male involvement in prevention of mother-to-child transmission of HIV still remains a major challenge. This was facility based descriptive cross-sectional study which was aimed at assessing the factors hindering male participation in Prevention of Mother-to-Child Transmission of HIV (PMTCT) at National Council of Churches of Kenya (NCCK) Huruma clinic in Nairobi. The factors studied were demographic characteristics, knowledge and awareness of prevention of mother-to-child transmission of HIV and socio-cultural influence on male participation in PMTCT. Systematic random sampling method was used to obtain a sample population of 122 antenatal mothers. The data was collected between October and November 2012 using a structured and semi-structured questionnaire. Data was validated, cleaned, coded and entered in the computer. Data analysis was done using the statistical package for social sciences (SPSS). The results of the study showed that majority of the respondents, 77.87% (n=95), were between the age of 20 to 39 years with the least, 16.39% (n=20) aged between 40-49 years. There were low levels of knowledge and awareness on PMTCT among male partners. Socio-cultural factors were seen to contribute to low male involvement in PMTCT. The study recommends creation of awareness and also formulation of health messages which target men and are culture sensitive.

Socio-Cultural Study of Nutrition in Families of Stunted Toddlers in Coastal Communities in Jember Regency

Background: Cultures, traditions, or habits that exist in society, such as dietary restrictions and wrong eating patterns, can lead to increased nutritional problems, especially in toddlers, which ultimately impacts their growth and development. Low-income family parenting patterns in feeding and primary health care for toddlers can also increase the incidence of stunting in toddlers. This could be the cause of the stunting rate in the Jember Regency, especially in coastal areas. Dietary problems, including stunting, in coastal areas should be less likely to occur because the availability of high-protein animal foods such as fish is quite high, but Curahnongko Village is included in the stunting locus area in Jember Regency. Aims: This research aims to describe the socio-cultural nutrition and parenting styles of toddlers in Curahnongko Village. Methods: The study used qualitative and research methods with a case study approach. Results: The socio-culture during pregnancy in the coastal communities of Jember Regency regarding TTD consumption, routine check-ups, taboos during pregnancy, and visits to midwives are quite good. Socio-culturally during the breastfeeding period, it can be concluded that all informants carried out Early Breastfeeding Initiation (IMD). Socio-culturally during the feeding period for toddlers, all informants do not give food other than breast milk to babies when they are born. Conclusion: The socio-cultural aspect that appears to influence the occurrence of stunting is during the feeding period for toddlers, namely the frequency of children's snack consumption outside the home.

In utero nicotine exposure affects murine palate development.

Despite data linking smoking to increased risk of fetal morbidity and mortality, 11% of pregnant women continue to smoke or use alternative nicotine products. Studies confirm that nicotine exposure during pregnancy increases the incidence of birth defects; however, little research has focused on specific anatomic areas based on timing of exposure. We aim to determine critical in utero and postnatal periods of nicotine exposure that affect craniofacial development, specifically palate growth. Malformation of the palatal structures can result in numerous complications including facial growth disturbance, or impeding airway function. We hypothesized that both in utero and postnatal nicotine exposure will alter palate development. We administered pregnant C57BL6 mice water supplemented with 100 μg/mL nicotine during early pregnancy, throughout pregnancy, during pregnancy and lactation, or lactation only. Postnatal day 15 pups underwent micro-computed tomography (μCT) analyses specific to the palate. Resultant pups revealed significant differences in body weight from lactation-only nicotine exposure, and μCT investigation revealed several dimensions affected by lactation-only nicotine exposure, including palate width, palate and cranial base lengths, and mid-palatal suture width. These results demonstrate the direct effects of nicotine on the developing palate beyond simple tobacco use. Nicotine exposure through tobacco alternatives, cessation methods, and electronic nicotine delivery systems (ENDS) may disrupt normal growth and development of the palate during development and the postnatal periods of breastfeeding. Due to the recent dramatic increase in the use of ENDS, future research will focus specifically on this nicotine delivery method.

Breastfeeding patterns in infants are associated with a later diagnosis of autism Spectrum disorder.

Breastfeeding is associated with medical and developmental benefits. This study aimed to assess associations between nutritional patterns in the first year of life and the likelihood of autism spectrum disorder (ASD). 270 children diagnosed with ASD (cases) and 500 neurotypical children (controls) matched to cases by sex, ethnicity, and birth date (± 3 months) were included in this retrospective case-control study. Both groups were ascertained from children born between 2014 and 2017 whose development/nutrition were monitored at mother-child health clinics in southern Israel. Conditional logistic regression was used to determine the independent association of nutritional patterns with ASD while adjusting for socio-demographic and clinical characteristics. Both exclusive and partial breastfeeding modes were associated with decreased odds of ASD diagnosis (aOR = 0.221, 95%CI = 0.136-0.360; aOR = 0.494, 95%CI = 0.328-0.743, respectively). A breastfeeding duration of >12 months was associated with lower ASD odds (aOR = 0.418, 95%CI = 0.204-0.855), while the introduction of solids after 6 months of age was associated with higher ASD odds than the introduction of solids at 6 months (aOR = 2.455, 95%CI = 1.116-4.201). These findings suggest that a longer period of exclusive breastfeeding is associated with a subsequent reduced likelihood of ASD diagnosis, thus reiterating the importance of proper post-natal nutrition for infant neurodevelopment.