Role Of Breastfeeding Research Articles

Severity of Myocardial Infarction

Cardiovascular disease constitutes a burden of epidemic proportion,1 and understanding its determinants is essential to designing effective interventions. Doing so requires the ability to track disease burden at the population level. In the United States, without national registries, community surveillance is the method of choice.2 Community surveillance studies are mostly retrospective by design, rely on diagnostic codes for case finding, and require a defined population in which events can be consistently and reliably captured and validated with standardized approaches. Applied to cardiovascular disease, community surveillance measures its burden in communities by tracking the incidence of events, their severity, and their mortality, thereby enabling the appraisal of the components of cardiovascular diseases in a given population.2 Because of the aforementioned methodological requirements, few surveillance studies exist in the United States. They include the Atherosclerosis Risk in Communities (ARIC) Study,3 the Minnesota Heart Survey,4 the Olmsted County Study,5 and the Worcester Heart Attack Study.6 The data from these studies indicate that, although deaths from coronary disease have declined, the incidence of myocardial infarction in the United States has remained mostly stable. Thus, the decline in mortality can be envisioned as reflecting an improvement in survival, which may be mediated by a declining severity of myocardial infarction. Article p 503 The article by Myerson et al7 in this issue of Circulation specifically addresses this important and understudied issue in ARIC between 1987 and 2002. They examined a large, multiracial population and relied on several indicators, including the composite Predicting Risk of Death in Cardiac Disease Tool (PREDICT) score to conclude that the severity of infarction declined over time. Indeed, the proportion of infarctions with major ECG abnormalities, ST-segment elevation, and Q waves decreased, as did biomarker values and the proportion of persons presenting with shock. …

Risk factors for colonisation of newborn infants during an outbreak of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in an intermediate-risk neonatal unit

We describe a cross-sectional survey to identify risk factors for colonisation of neonates by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae. This occurred following exposure to a colonised healthcare worker during an outbreak in an intermediate-risk neonatal unit. In total, 120 neonates admitted consecutively during a three-month period were screened for ESBL-producing K. pneumoniae by rectal swabbing and 27 were identified as colonised. Multivariate analysis showed colonisation to be independently associated with use of antibiotics and absence of breastfeeding. Previous use of antibiotics presented an odds ratio (OR) of 12.3 [95% confidence interval (CI): 3.66-41.2, P<0.001]. The most commonly used antibiotics were penicillin and amikacin. Breastfeeding was associated with reduced risk for colonisation (OR: 0.22; 95% CI: 0.05-0.99; P=0.049). Nine isolates recovered during the first stage of the outbreak and 27 isolates from surveillance cultures were typed thereafter by pulsed-field gel electrophoresis, revealing six different profiles (A-F). Clones A, C, and E were implicated in the first stage of the outbreak, whereas among the 27 strains recovered from surveillance cultures, all six clones were identified. Clone A was also found on the hand of a nursing auxiliary with onychomycosis. We concluded that prior antimicrobial use predisposed to colonisation. The possible role of breastfeeding as a protective factor needs to be further elucidated. Detection of different genotypes of ESBL-producing K. pneumoniae suggests that dissemination of mobile genetic elements bearing the ESBL gene may have been superimposed on the simple dissemination of a clone during the outbreak.

Case Study Revisiting the Association Between Breastfeeding and Postpartum Depression

Recent studies have focused on the impact of postpartum depression on breastfeeding; however, the role of breastfeeding and weaning in the onset of postpartum depression has not been adequately studied. This article describes the case of a woman who had 3 episodes of major depression, each following closely the cessation of breastfeeding. The clinical and research implications of the association between weaning and the onset of postnatal depression are discussed.

The yeast connection: is Candida linked to breastfeeding associated pain?

The objective of the study was to determine whether the isolation of Candida from breastfeeding women is associated with self-reported pain. A prospective cohort study was conducted from May 2004 to July 2006. Ninety-eight breastfeeding women were enrolled: 20 women reported breastfeeding associated pain, and 78 women were asymptomatic. Cultures were obtained from breast milk, areolae, and infants' oropharynx. Six of the 20 symptomatic women had breast milk cultures positive for yeast, compared with 6 of 78 controls (30% vs 7.7%, P = .015). Among the 12 women from whom yeast was isolated, 11 grew Candida albicans. Incidence of Staphylococcus aureus isolation did not differ significantly between groups (5 of 20 vs 15 of 78, P > .05). C. albicans is found more often in breastfeeding mothers who report pain as compared with asymptomatic breastfeeding mothers. Further studies, including treatment trials, are needed to determine whether Candida plays an etiologic role in breastfeeding associated pain.

O papel do aleitamento materno, da dieta e do estado nutricional no desenvolvimento de asma e atopia

In many populations, the prevalence of asthma and atopy has increased in recent years. As a result, both conditions have become major public health problems. The possible influence of nutrition-related factors has been demonstrated in an increasing number of studies. Information regarding the role of breastfeeding, diet, nutritional status (obesity in particular), as well as regarding the immunologic responses triggered, helps to improve our understanding of the correlation between oxidative stress, bronchial inflammation, and the development of atopic and asthma symptoms. The article presents a review of the published literature on the relationships established between and among nutrition, asthma, and atopy over the last two decades.

Breastfeeding and the risk of epithelial ovarian cancer in an Italian population

Objectives Breastfeeding has been inversely related to the risk of ovarian cancer, but results from published studies are inconsistent. In order to provide further information, we analyzed data from a large case-control study conducted in four Italian areas. Methods Cases were 1031 women with epithelial ovarian cancer. Controls were 2411 women admitted to the same network of hospitals for a wide spectrum of acute non-neoplastic conditions, unrelated to known risk factors for ovarian cancer. Results There were inverse trends in risk with increasing duration of breastfeeding and number of children breastfed, but when parity and several other potential confounding factors were taken into account, no residual association was evident (odds ratio = 1.21 for 17 or more months of breastfeeding and 0.90 for those who had breastfed 4 or more children, as compared to women who had never breastfed). Conclusions This study showed an inverse relation between breastfeeding and ovarian cancer risk, which however was accounted for by parity. The analyses by histologic subtypes suggested that a role of breastfeeding would be larger for serous neoplasms in the absence, however, of significant heterogeneity.

The Role of Breastfeeding in Postpartum Disease Activity in Women with Inflammatory Bowel Disease

Women with inflammatory bowel disease (IBD) have an increased risk of experiencing a flare in the postpartum period. Work in other autoimmune disorders has found that breastfeeding may be associated with an increased risk for developing postpartum disease relapse. To assess the association between breastfeeding behavior and postpartum disease activity. Women with IBD followed at a tertiary care center with a history of childbirth within the past 5 yr were recruited. Medical records were reviewed for disease type, disease activity during and after pregnancy, medication use, smoking, and breastfeeding behavior. The exposure of interest was breastfeeding prior to the onset of disease activity following a successful asymptomatic pregnancy. One hundred and twenty-two consecutive women who fit eligibility criteria were studied. Overall, only 44% (54/122) of the women had breastfed their infant. Reasons included physician recommendation, fear of medication interactions, and personal choice. Forty-three percent (23/54) of those who breastfed experienced a postpartum flare of their disease. The unadjusted odds ratio for disease activity with a history of breastfeeding was 2.2 (95% CI 1.2-3.9, p= 0.004). When stratified by disease type, the OR for ulcerative colitis was 0.89 (0.29-2.7, p > 0.05) and Crohn's disease 3.8 (1.9-7.4, p < 0.05). When adjusted for medication cessation, the OR became nonsignificant. A significant number of women with IBD do not breastfeed their children. Any relationship between breastfeeding and disease activity may be more a consequence of discontinuation of IBD therapies.

Effects of bilateral resection of facial nerves on suckling in developing rats

The purpose of the present study is to investigate functional role of the facial nerve on suckling in developing rats. The bilateral resection of facial nerves on postnatal day 1 (P1) resulted in cell loss of facial motoneurons and complete facial paralysis without any whisker movement or nictitating reflex at the end of the postnatal 3 weeks. Although the body weight of the nerve-resected rats increased gradually for the postnatal 3 weeks, they weighed less than the control rats without nerve resection. The nerve-resected rats contained less milk (0.25±0.02 g) than the control rats (0.35±0.02 g) in the stomach on P17. On P21, the body weight of the nerve-resected rats (25.33±0.32 g) was decreased by 28% compared to that of the control rats (35.08±0.57 g). Although their growth was substantially more retarded than that of the control animals, most (92%) of the nerve-resected pups could survive without facial nerve innervation. The orofacial musculature innervated by the facial nerve plays an important role in breastfeeding, but the present study shows that these muscles are not essential for the survival of neonatal rats.

Anticuerpos anti-albúmina bovina (BSA) en niños diabéticos tipo 1 recién diagnosticados y su asociación con lactancia materna y exposición a leche de vaca

Environmental and genetic factors (viruses, toxins and diet) are involved in the aetiology of type 1 diabetes. Among the dietary factors, the role of breast feeding and exposure to cow's milk proteins deserve special attention. To determine the anti-BSA-IgG levels in type 1 diabetic children and to analyse the possible association with breast feeding duration, exposure to cow's milk and beta pancreatic auto-antibodies. Blood samples were collected from 161 diabetic children and 144 controls to measure anti-BSA-IgG level, GAD65, IA-2 and ICA autoantibodies. All children answered a questionnaire about dietary habits during infancy. anti-BSA-IgG was positive (using a cut off point of 25.6 ng/ml) in 98% of diabetic children and 0% of the control population. The length of breast feeding or early exposure to cow's milk did not influence the concentration of anti-BSA-IgG. Positive BSA titers did not increase the beta pancreatic reactivity (ICA+, GAD+, IA2+). Our data confirm the high frequency of anti-BSA-IgG among diabetic children. However, a specific role in the immunological process of type 1 diabetes cannot be attributed to this protein.

The Long-Term Effects of Early Nutrition: The Role of Breastfeeding on Cholesterol Levels

The Long-Term Effects of Early Nutrition: The Role of Breastfeeding on Cholesterol Levels

Early determinants of childhood overweight and adiposity in a birth cohort study: role of breast-feeding.

The prevalence of adiposity in childhood is increasing. Is breast-feeding protective as suggested by cross-sectional studies? In a longitudinal birth cohort study, we tested whether breast-feeding for more than 2 months has preventive effects against overweight and adiposity at 6 y. Of 1314 children representing the catchment areas of six delivery units, 918 could be followed up to the age of 6 y. Height, weight, and skin-fold thickness were measured at regular visits. As the criteria of overweight, obesity, and adiposity in the children, the 90th and the 97th percentiles of BMI and skin-fold values were used. Parents with a BMI at or above the 90th percentile, which was 27 kg/m(2) or more, were considered overweight. Infants bottle-fed from birth or breast-fed for less than 3 months were classified as 'bottle-fed' (BO), and those breast-fed for 3 months and more as 'breast-fed' (BR). Univariate comparisons and logistic regression analysis were performed applying SAS 6.12. The final logistic model consisted of the 480 cases for whom complete data for all variables were available. The potential effect of loss to follow-up was analysed by the Cochran-Mantel-Haenzel test: the outcomes were not significantly influenced by loss to follow-up. At birth BMIs were nearly identical in both groups. By 3 months, BO had significantly higher BMIs and thicker skin folds than BR. From 6 months on, compared to BR, a consistently higher proportion of BO children exceeded the 90th and the 97th percentile of BMI and skin-fold thickness reference values. From the age of 4 y to 5 and 6 y, in BO the prevalence of obesity nearly doubled and tripled, respectively. With only minor changes of obesity prevalence in BR, the difference of BMI and skin-fold thickness between groups became statistically significant. Logistic regression analysis revealed that overweight of the mother, maternal smoking during pregnancy, bottle feeding, and low social status remained important risk factors for overweight and adiposity at 6 y of age. A maternal BMI of > or =27, bottle-feeding, maternal smoking during pregnancy, and low social status are risk factors for overweight and adiposity at 6 y of age. Early bottle-feeding brings forward the obesity rebound, predictive of obesity in later life.

The role of breastfeeding in prevention of neonatal infection

The immune system of the human newborn is of very limited size. It expands rapidly, especially due to the exposure to the gut microflora. Normally the newborn is colonized with microbes from the mother's intestinal flora at and after delivery. The many defence factors of the mother's milk include large amounts of secretory IgA antibodies produced by lymphocytes which have migrated from the mother's gut to the mammary glands. Therefore the SIgA antibodies are mainly directed against the mother's previous and recent gut microflora. Thus breastfeeding modulates the early exposure of the neonate's intestinal mucosa to microbes and limits bacterial translocation through the gut mucosa. This may be a major reason why breastfeeding protects efficiently against neonatal septicaemia, as well as several other infections. The defence factors of the milk prevent infections already at the mucosal level. The transplacentally obtained maternal IgG antibodies protect primarily in tissues and do so at the cost of cytokine-induced clinical symptoms, tissue engagement and high energy consumption.

The Role of Breastfeeding in Obesity

Most studies examining the effects of breastfeeding on later obesity have found an insignificant effect. Breastfeeding was positively associated with later body fatness in two studies. A protective effect of breastfeeding on childhood obesity was seen in four studies. An effect of breastfeeding on later obesity, if any, is probably weaker than genetic and other environmental factors. Also, an observed association between breastfeeding and later obesity does not prove causality. Controlling for confounders in an attempt to minimize the effects of differences between breastfeeding and formula-feeding mothers was done to a varying extent across studies. In several of the later studies, adjustment for confounders obliterated the effect of breastfeeding. Whether all the pertinent confounding factors have been measured and whether the differences between mothers who chose to breastfeed and mothers who chose to formula-feed have been controlled for adequately are always questionable. The dose response observed with the duration of breastfeeding is consistent with a causal association, but confounders associated with breastfeeding also may covary in a graded response. Although a highly provocative concept, the protective effect of breastfeeding on later obesity remains controversial.

The Role of Breastfeeding in Sudden Infant Death Syndrome

The objective of this article is to review the literature regarding the risk of sudden infant death syndrome (SIDS) in bottle-fed infants compared to those that are breastfed. A meta-analysis and qualitative literature review were performed. Cohort and case-control studies were included if they met a minimum SIDS definition and presented data allowing calculation of an odds ratio (OR). Twenty-three studies were included in the meta-analysis. The studies were heterogeneous, and a majority (14) were of "fair" or "poor" quality. Crude ORs from 19 individual studies favored breastfeeding as protective against SIDS. The combined analysis indicated that bottle-fed infants were twice as likely to die from SIDS (pooled OR = 2.11; 95% CI 1.66-2.68). The results of the analysis show that there is an association between bottle-feeding and SIDS, but this may be related to confounding variables.

Breast milk and breastfeeding in the 1990s.

The biology of human breast milk, and the policy of encouraging breastfeeding, continue to be the object of much scientific inquiry. The past year has seen several advances in these fields of nutrition, and this article reviews some of the most interesting and pertinent studies. Four general themes have been apparent in the recent literature: 1) the role of breastfeeding and breast milk in the incidence of infectious diseases; 2) the effect of breastfeeding on neurodevelopmental outcome; 3) the nutritional composition of breast milk; and 4) the determinants of breastfeeding among adolescents and ethnic minority mothers. Review of these studies will assist the office-based pediatrician in knowing the scientific rationale, and the best methodology, for the promotion of breastfeeding.

Breast-Feeding in Immigrant Women: The Role of Social Support and Acculturation

This study assessed the influence of social support and acculturation on breast-feeding in 962 low-income immigrant women in New York Women completed a questionnaire during their postpartum visit. Logistic regression analyses revealed that more acculturated women were 2 times less likely to decide to breast-feed than less acculturated women. The influence of acculturation decreased, however, when controlling for other predictor variables. Predictor variables of breast-feeding (p &lt; .OS) were intent, being a nonsmoker, breast-feeding role modeling, and a negative response to the item "A modern woman breast-feeds her baby." Acculturation did not influence breast-feeding. More acculturated women reported more social support. The results indicate a need to target breast-feeding promotion to the most vulnerable group of young mothers (i.e., recent arrivals and women who are undecided about their infantfeeding method).

Indices of mercury contamination during breast feeding in the Amazon Basin

Mercury pollution, due to gold mining has spread through the Amazon ecosystem reaching the food chain and affecting the indigenous people of the region. We studied the mercury contamination of 47 mothers and infants and the role of breast feeding in indices of mercury body burden in both groups, by measuring hair and milk Hg levels. Total mercury concentration of breast milk ranged from 0.0 to 24.8 (5.85, 5.2 S.D.) ng/g. Calculated levels of mercury exposure of breast fed babies indicated that 53% were above tolerable daily intakes (0.5 μg/kg body weight) recommended for adults by WHO. Mercury concentration in maternal hair was higher than in hair from breast-fed babies. Correlation analysis showed that mercury hair concentration in infants was significantly affected by maternal mercury contamination during pregnancy, but not during the post-natal breast-feeding period. The mercury concentration in milk was not significantly correlated with maternal or infant’s hair Hg. A statistically significant correlation was found only between maternal and infant’s hair mercury concentration ( r=0.675; P=0.0001).

Understanding the health and nutritional status of children in Ghana

Abstract The data set of the Ghana Living Standards Survey (GLSS, round 1, 1987/1988) was utilized to analyse the principal determinants (publicly and privately) of health and nutrition of children under five in Ghana. While in most health and nutrition studies the emphasis is either on health-related factors such as occurrence of illness, immunization, accessibility to light (electricity), the role of breastfeeding, or on food availability and food-consumption-related factors, in the present study, an attempt has been made to incorporate both aspects simultaneously. On the basis of the GLSS, Ghanaian households spend at the average approximately 60% of total expenses on food. Changes in relative prices of the various food commodities differently affect household food availability. Lowering prices of relatively cheap foods (e.g., millet, cassava) tends to have a strong positive effect on total household kcal availability. At the level of the household, the absolute number of nondependents, presumed to represent the available labour force, is positively correlated with household food availability. There is also a positive correlation between the mothers' level of education (10 yrs of schooling and above) and the nutrition level of children. Occurrence of illness in children could be shown to negatively affect their health and nutrition status. Finally, a specific finding in the analysis was a rather strong negative effect of prolonged breastfeeding on the nutritional status of children. Among the policy recommendations emanating from the research are: (1) promotion of efficient production and marketing of cassava, (2) efforts to achieve slowing down of rural-urban migration to prevent labour shortages in rural households, (3) improving water and sanitation conditions, (4) expanding immunization programmes in particular in rural areas, and (5) promoting better weaning practices when children are no longer fully breastfed.

Understanding the health and nutritional status of children in Ghana

AbstractThe data set of the Ghana Living Standards Survey (GLSS, round 1, 1987/1988) was utilized to analyse the principal determinants (publicly and privately) of health and nutrition of children under five in Ghana. While in most health and nutrition studies the emphasis is either on health‐related factors such as occurrence of illness, immunization, accessibility to light (electricity), the role of breastfeeding, or on food availability and food‐consumption‐related factors, in the present study, an attempt has been made to incorporate both aspects simultaneously. On the basis of the GLSS, Ghanaian households spend at the average approximately 60% of total expenses on food. Changes in relative prices of the various food commodities differently affect household food availability. Lowering prices of relatively cheap foods (e.g., millet, cassava) tends to have a strong positive effect on total household kcal availability. At the level of the household, the absolute number of nondependents, presumed to represent the available labour force, is positively correlated with household food availability. There is also a positive correlation between the mothers' level of education (10 yrs of schooling and above) and the nutrition level of children. Occurrence of illness in children could be shown to negatively affect their health and nutrition status. Finally, a specific finding in the analysis was a rather strong negative effect of prolonged breastfeeding on the nutritional status of children. Among the policy recommendations emanating from the research are: (1) promotion of efficient production and marketing of cassava, (2) efforts to achieve slowing down of rural‐urban migration to prevent labour shortages in rural households, (3) improving water and sanitation conditions, (4) expanding immunization programmes in particular in rural areas, and (5) promoting better weaning practices when children are no longer fully breastfed.

Chinese zuo yuezi (sitting in for the first month of the Postnatal period) in Scotland

Objective: to examine how Chinese women experience postnatal care in a Scottish setting, their beliefs, needs and experience, and why any differences exist. The aim is to bring the knowledge forward and to improve these women's childbearing experience. Design: a qualitative comparative approach. Setting: maternity units in Scotland. Participants: ten Chinese and ten Scottish women, ten health workers, five relatives, five Chinese women's friends, and five Scottish women's friends, plus two group discussions of four and six Chinese discussants, and one group discussion with four Scottish mothers and a health worker. Method: four stage semi-structured interviews with the two comparison groups of ten Chinese and ten Scottish women, and non-structured interviews/talks/discussions with ten health workers, ten women, five relatives and ten friends Findings: zuo yuezi is a popular integrated set of postnatal practices for Chinese mothers, not only in China, but also in Scotland, in their convalescence after giving birth. This traditional postnatal behaviour is embedded in culture. It is used to facilitate the physical recovery of the mothers, to prevent chronic illness, and also to strengthen their intra-family relationships. Conclusion: zuo yuezi serves as a physical convalescence, a preventative measure, a social sanction to rest, a consolation, and a prompt for Chinese women to concentrate on their baby and their role of breast feeding, as well as an occasion to strengthen the intra-family tie, especially between the woman and her own mother or mother-in-law. This practice has a direct bearing upon the psychological well-being of Chinese women postnatally and in their future life. This suggests that these puerperal practices and the custom deserve the cognitive recognition of midwives, so that they can be aware of and respect the indigenous beliefs and practices that link the events of childbearing, the health status of women, and family relationships in order to provide better maternity care for this group of women.