Quality Of Breast Milk Research Articles

Abstract 14050: Characteristics of Extracellular Vesicle miRNAs in the Breast Milk

Introduction: An increasing number of obese mothers is a rising issue that may negatively impact the overall benefit of breastfeeding. Extracellular vesicles (EVs) in breast milk are important mediators transferring biological molecules of mothers to children, because EV-miRNAs can survive in the stomach and then might be internalized into gut epithelial cells. In this study, we examined breast milk EV-miRNAs to determine the impact of the mother’s pre-pregnancy BMI on the EV-miRNA profiles. Methods: We recruited healthy nursing mothers who delivered a singleton baby in the past 6 months. Mothers pumped breast milk after 1-hour fasting and froze them. EVs were isolated from breast milk with ultracentrifugation. EV characteristics were examined by flow cytometry using 39 different EV markers. A total of 800 miRNAs were screened using a human miRNA panel (NanoString diagnostics, WA). Differential expression analysis was performed using DESEQ2. Results: We included 27 nursing mothers; the mean age was 31.1±7.6 years old, and 92% were Caucasian. All mothers breastfed their children and 22% of mothers supplemented with formula. Mean pre-pregnancy BMI was 21.6±2.0 kg/m 2 in the lean group (BMI<25kg/m 2 , n=17), and 29.1±4.5 kg/m 2 in the overweight/obese group (BMI≥25kg/m 2 , n=10). Besides BMI, all other demographics were not significantly different between groups. Breast milk EVs expressed not only general EV markers including CD9, CD63, and CD81, but also CD14, CD24, CD133/1, HLA-DRDPDQ and CD326. The most highly expressed marker is CD326 showing more than 2 times higher intensity than the general EV markers. Marker profiles were not different between groups. After normalization with housekeeping genes and spike-in controls, we obtained 10 differentially expressed miRNAs in the overweight/obese group (p<0.05 cut-off). Among those, miR-490-5p, miR-139-3p, and miR-291a-3p were the top 3 deregulated miRNAs downregulated in the overweight/obese group with a fold change >1.5. Conclusion: We found (1) CD326 as a breast milk EV marker, and (2) deregulated miRNAs in the overweight/obese mothers’ breast milk. Our findings will provide the opportunity to improve the quality of breast milk which ultimately promotes the children’s growth and health.

Metals contamination and trace element level in breast milk samples of mothers in Kenitra, Morocco

ABSTRACT The current study aimed to examine the quality of breast milk in Kenitra city (Morocco), regarding its levels of essential elements Iron (Fe), Copper (Cu), and Zinc (Zn) and heavy metals chromium (Cr), lead (Pb), and cadmium (Cd), besides carried out the inter-element correlation and investigated their association with some sociodemographic parameters of lactating women. For this, a total of 95 (n = 95) samples of breast milk were collected, at the second postpartum month from mothers in five governmental health care centres in Kenitra. After total mineralisation, human milk sample analysis was conducted by using flame atomic absorption spectrophotometry (AAS) for the essential elements detection, and heavy metal quantification was performed by using the atomic absorption spectrophotometer with a graphite furnace. Mean levels of Fe, Cu and Zn were 0.43, 0.26 and 6.11 mg/L, while the main concentrations of Cr, Pb and Cd were 8.84, 3.20 and 0.60 µg/L, respectively. Statistical analysis had proved a highly significant correlation between surveyed elements, especially between Cu and Zn, Pb and Cd, besides the strong relationship between the essential elements mentioned before and the heavy metals. Moreover, breast milk elements are most affected by sociodemographic parameters, principally the body mass index (BMI) of mothers, dietary habits and newborn gender. Moreover, 6.46% and 27.37% of samples are exceeded the recommended limits for Cd and Pb, respectively, which verify the low contamination of surveyed breast milk samples. Whereas, the mean values of Cr and Zn were above the limits recommended by the word human organisation, but so far there are no reports of adverse effects on newborns at those reported doses. These data justify the requirement to set surveillance policies by health organisations with the purpose of limit maternal and foetal exposure to heavy metals and strengthen health education.

Protein Quality in Infant Formulas Marketed in Brazil: Assessments on Biodigestibility, Essential Amino Acid Content and Proteins of Biological Importance.

Infant formulas, designed to provide similar nutritional composition and performance to human milk, are recommended when breastfeeding is not enough to provide for the nutritional needs of children under 12 months of age. In this context, the present study aimed to assess the protein quality and essential amino acid content of both starting (phase 1) and follow-up (phase 2) formulas from different manufacturers. The chemical amino acid score and protein digestibility corrected by the amino acid score were calculated. The determined protein contents in most formulas were above the maximum limit recommended by FAO and WHO guidelines and at odds with the protein contents declared in the label. All infant formulas contained lactoferrin (0.06 to 0.44 g·100 g−1) and α-lactalbumin (0.02 to 1.34 g·100 g−1) below recommended concentrations, whereas ĸ-casein (8.28 to 12.91 g·100 g−1), α-casein (0.70 to 2.28 g·100 g−1) and β-lactoglobulin (1.32 to 4.19 g·100 g−1) were detected above recommended concentrations. Essential amino acid quantification indicated that threonine, leucine and phenylalanine were the most abundant amino acids found in the investigated infant formulas. In conclusion, infant formulas are still unconforming to nutritional breast milk quality and must be improved in order to follow current global health authority guidelines.

Myths and Facts About Breast Feeding in Primary Health Care Center in Sohag, Egypt

Background: Environment influences infant feeding decisions of mothers, which have influence on growth, development, health and nutrition of infants and children. Objectives: To assess the maternal knowledge and practices towards breast-feeding among mothers in Sohag. To correlate breast-feeding practices with maternal education, parity, mode of delivery, socioeconomic status and employment. Patients and methods: This cross-sectional study included 500 mothers of infants attending some primary health centers from 1st January to 30th November 2020. Data were collected using a self-administered standardized questionnaire. Results: Information present in this questionnaire were taken from 500 mothers, their information was founded to be taken from what friends (33%), media (10%) and primitives (57%). 52% of mothers knew that breast feeding was used as contraceptives. 63% of mothers agreed that babies breast fed naturally were healthier than those who breast feed artificially. 67%of mothers agreed that breast milk is useful but not satisfy the nutritional needs to sustain optimal growth beyond 6 months not due to decrease quality of breast milk but increased demand. Breast-feeding is related to educational level, parity, and socioeconomic status, in which (58%) and (80) of mothers had moderate educational level and moderate socioeconomic level respectively. Despite 61% of mothers disagree with the concept that they should stop nursing after only one year. Only 20% of them agreed to give bottle-feeding as complementary. Conclusion: It is really an encouraging observation that majority of the mothers had good knowledge and a positive attitude towards breast-feeding. Majority of the mothers fed the baby colostrum. Late initiation of breast-feeding has implications for health education programs and neonatal feeding strategies.

THE FIRST 6TH-MONTH NUTRITIONAL STATUS OF A FULL-TERM CHILD IN EXCLUSIVE BREASTFEEDING: A LITERATURE REVIEW

Background: The first six months after birth are part of the first 1000 days, a golden period for child development. In this period, the child needed proper nutrition to support optimal development and as nutrition programming. WHO recommends exclusive breastfeeding (EBF) for the first 6th-month. Adequacy of nutrition and optimal growth can be assessed using the nutritional status. 
 Aim: This study analyzes the relationship between EBF for the first 6 months with the nutritional status of a full-term infant aged 0-6 months. The nutritional status assessed using anthropometric measurements and child growth standards.
 Methods: This type of literature review research uses the PRISMA, PICO, and Boolean Operator methods. The research question with PICO standard "What is a relationship between exclusive breastfeeding practice and nutritional status of children aged 0-6 months?". Relevant literature was obtained from 8 databases: Scopus, Portal Garuda, Proquest, Mendeley, Pubmed, Oxford, Science Direct, and Sage. Literature was limited to the last 10 years. There are 6 relevant pieces of literature included for review. The literature quality assessment uses a quantitative study quality assessment tool released by the EPHPP (Effective Public Health Practice Project) and produces 5 pieces of literature worthy of review.
 Results: From 5 kinds of literature, there were various indicators of nutritional status such as weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), Body Mass Index (BMI)-for-age, and head circumference (HC)-for-age. The results were dominated by insignificant results, except the HC-for-age indicator stated that there were significant results. The author explores the causes of insignificant results. Explores based on the indicators that include in studies, the information based on studies, and the possible consequences that adjusted to the data based on the studies. The Author found that the mother plays an important role in the production and provision of breast milk. The quality of breastmilk depends on the mother, also how she gives it to their infant. It has to be based on the WHO recommendation.
 Conclusion: The result of these studies affirms that EBF didn't significantly affect the indicators of WAZ, LAZ, WLZ, and BMI-for-age, but significantly affected the head circumference-for-age indicator.

PKM KELOMPOK IBU MENYUSUI DI POSYANDU MELATI DESA BUKIT KRATAI WILAYAH KERJA UPT BLUD PUSKESMAS RUMBIO KABUPATEN KAMPAR

Breastfeeding is a very useful activity, not only for mothers but also for children. For infants and toddlers, breast milk is the best source of nutrition and has proven its efficacy in saving lives. Breast milk helps protect children from various diseases. Some breastfeeding mothers experience problems in giving breast milk to their babies, these problems include there are still mothers who complain of discomfort in breastfeeding so that it causes sore nipples and the amount of breast milk is decreasing. Education for breastfeeding mothers is very necessary so that mothers can comfortably give breast milk to their babies without feeling difficulties and worries about the quality of breast milk that will be enjoyed by their babies. This starts from the preparation stage, the implementation of activities. After PKM was carried out on breastfeeding mothers on July 02, 2021. The results showed that mothers felt more understanding and enjoyed the process of breastfeeding their babies so that the baby felt safe and comfortable in giving breast milk, this was shown by the babies becoming calmer and more relaxed. rest comfortably.

The Effect of Storage Temperature In Cooler Bag on Breast Milk Quality

Breast milk is a quality baby food because it contains nutrients and immunity. The high percentage of working mothers who breastfeed (92.5%) is directly proportional to the number of babies who consume pumped breast milk. It is feared that the storage of breast milk at a specified temperature and time can reduce its quality, including immunoglobulin A (IgA) levels. Objective: The objective of this study was to prove the effect of storage temperature on the quality of breast milk (IgA). Methods: This study used a quasi-experimental design with a pre-post-test design with a control group design. The sampling technique used purposive sampling of 32 nursing mothers in the experimental group and 32 nursing mothers in the control group included in the inclusion criteria (divided into control and experimental groups). The bivariate analysis utilized paired until t-test followed by independent t-test. Results: There was a decrease in IgA levels in the cooler bag storage temperature (4-8 0C) for 6 hours with an average difference of -18.264 ng/ml (p-value 0.012). IgA levels also decreased at room temperature storage (26 0C) for 6 hours with an average difference of -373.209 ng/ml (p-value 0.000). Different tests in the two groups had an average difference in IgA levels of -354.945 ng/ml (p-value 0.000), which meant significant differences. Conclusion: Storage temperature at cooler bag temperature 4-8 0C is better than room temperature of 26 0C on breast milk quality (IgA level).

Impact of storage temperature and duration on the nutritive content quality of Human Breastmilk

Impact of storage temperature and duration on the nutritive content quality of Human Breastmilk

Differences in Infant Weight Gain between Mothers who Consumed Bangun-Bangun Tea (Coleus amboinicus Lour) and Katuk Leaf Tea (Saoropus androgynous)

Breast milk is a complete nutrient content that is needed for the growth and development of children. The quality and quantity of breast milk depends on several factors, one of which is the food consumed. Efforts to improve the quality and quantity of breast milk are done both traditionally and modernly, one of which is by consuming the leaves and katuk leaves that have been packaged more practically in the form of tea so as to facilitate nursing mothers in consuming it. This study aims to find out if there is a difference in baby weight gain between mothers who consume wake-up leaf tea (Coleus amboinicus Lour) and mothers who consume katuk leaf tea (Saoropus androgynus). The study used quasi-experimental methods of both groups given different treatments. Comparison of values in both groups to determine the comparison of infant weight gain. The sample count in this study was 30 respondents divided into two groups that were adjusted to the inclusion criteria. Analyze the data using independent sample t-test. The results of the study that there was no significant difference in infant weight gain between mothers who consumed wake-up leaf tea and mothers who consumed katuk leaf tea with a p-value of 0.061. Conclusion Tea Leaves Wake-Up (Coleus amboinicus Lour) and Katuk Leaf Tea (Saoropus androgynus) can increase the weight of the baby.

Formulation of Snack Bar from Torbangun Leaf as Food Source for Iron and Calcium

Indonesia has local unutilized food and it contains mineral, it is torbangun leaf. Consumption of torbangun leaf can increase level of several mineral such as iron, calcium, zink, and magnesium in breast milk. Torbangun leaf powder contains 70.77 mg iron; 1258.29 mg calcium; dan 97.42 mg Phosphor. Torbangun leaf also contains lactogogum which can stimulate breast milk gland on mother by proliferating secretion cell of mamari. Therefore the quality and quantity of breast milk could increase. Torbangun leaves can be developed into emergency food items such as snack bars. The aim of this study was to develop snack bar with substitution torbangun leaves. From trial error, torbangun leaf was substitution until 10 g, 15 g, and 20 g. The best formula was substituted 10 g torbangun leaf which 9.6% protein; 10.43% fat; 66.3% carbohydrate; 1006.54 mg calcium; and 44.76 mg iron, with total an energy was 397.47 kcal/100 g.

Colour-Based Extraction Methods for the Classification of Breast Milk (ASI)

The development of cellular devices makes accessing information in the form of text or images more easier. In line with the growing field of computer vision, various processes in image/image processing continue to increase. Image processing can be done by increasing image quality (image enhancement) and image recovery (image restoration). Feature extraction is divided into three types, namely feature form extraction, texture feature extraction, and color feature extraction. The application of color-based feature extraction methods has been widely used by researchers in the process of classification of various objects. This paper aims to review the technology that can be applied to image processing in a CBIR system with the object of breast milk so that it can measure the quality of breast milk based on its color.

Bacteriology of feeding bottles

The study was conducted to determine the bacteriological quality of 112 infants’ feeding bottles. Samples were collected from the feeding bottles brought by the caregivers of infants in the OPD of Dept. of Pediatrics, Nalanda Medical College and Hospital, Patna from the period of August 2015 to October 2016. The study was selected because it has been observed that more number of babies were found to be sick that were bottle fed than breast fed infants presenting in the OPD, also bottle fed infants had multiple OPD visits compared to breast fed infants The coliform group of bacteria, like E.Coli,4 Enterobacter spp., Klebsiella spp., Citrobacter spp.; enteric pathogens such as enteropathogenic E.Coli, Salmonella, Shigela spp., S. aureus, and Bacillus cereus; fungus like Candida were isolated in the significant colony count of 104colonies/ml or more from inoculation of swab samples of feeding bottles or nipples in the appropriate culture media. Not only the milk, but the process of storage and milk preparation itself contributes to the growth of bacteria. Contamination due to improper cleaning, disinfection and handling of feeding bottles as well as repeatedly feeding of the milk kept in the feeding bottle over prolonged period of time has been observed to cause infections in bottle fed infants. In the results shown, high level of bacteriological contamination of milk is apparent which is caused due to the incorrect dilution, improper storage, inadequate cooking and poor hygiene. Nursing mothers should be taught on the proper handling of feeding utensils and emphasize on the superior quality of breast milk. To reduce the diarrheal diseases in infants, well controlled community based, longitudinal studies are recommended. Key​words:​ Feeding bottle, Bacterial contamination, Diarrheal illness, Recurrent illness.

The Effect of Maternal Eating Habits and Diet Modulation on Infantile Gastroesophageal Reflux Disease Signs and Symptoms: A Randomized Clinical Trial

Background: According to the instructions of Iranian traditional medicine (ITM), modification of breast milk through nursing mothers, is the first step in the treatment of infant disorders. In fact, maternal lifestyle, especially diet and eating habits, can change the quality and quantity of breast milk. The modern medical literature emphasizes that exclusive breastfeeding is the optimal nutrition for infants with gastroesophageal reflux disease (GERD). Objectives: The present study was conducted to evaluate the effect of maternal eating principles and diet based on ITM on infantile GERD symptoms. Methods: Exclusive-breastfeeding, under 5 - month infants with clinical diagnosis of GERD and their nursing mothers, were selected for this 6-weeks parallel randomized, controlled trial. All participants were randomly assigned to the intervention and the control group. The mothers of infants in the intervention group received ITM-based dietary principles, and feeding-positioning modifications were trained to the mothers of all infants of both groups, because of observation of ethical issues (not deprived of standard treatment). Age-Specific Questionnaire for Infants (GSQ-I) was used to assess the frequency and intensity of the GERD symptoms. Measuring the difference between the mean Composite Symptom Score (CSS) in week 0, 4, and 6, between the intervention group and the control group, was the main outcome of this study. Results: Both the intervention and control groups had statistically significant differences in the mean CSS of week 4 and 6 compared with baseline (P < 0.05). Also, there was a significant reduction of the mean CSS values in the intervention group compared to the control group (P < 0.05). Conclusions: Maternal eating principles and diet based on Iranian Traditional Medicine appears to affect the reduction of infantile GERD signs and symptoms.

CRITICAL ANALYSIS OF SUTIKA PARICHARYA AND ITS SIGNIFICANCE IN MODERN ERA IN SAFE MOTHERHOOD

Mortality and morbidity of mother are most challenging problems of our country. In our day to day life, we see many mothers complaining of increase in their physical problems like back-ache, anemia, joint pains and many other infections after puerperium. Frequent post-partum morbidity and its association with adverse perinatal outcome suggest the need for post-partum care in developing countries for both mother and baby. Lady after delivery of placenta is called as Sutika (puerperal woman). Sutikakala (duration of puerperium) is the period following childbirth during which all body tissues revert back approximately to a pre-pregnant state. Duration of this period varies according to different Ayurvedic classics. It is well known that certain psycho-somatic changes take place during Sutikakala such as loss of weight, loss of body fluid, lacerated genital tract, constipation, mental stress etc. Most of these changes lead to ati-aptarparpana (emaciation) of mother during Sutikakala. This status causes Vata-vriddhi which is responsible for different types of health problems such as puerperal sepsis, Stanyadushti (vitiated breast milk), anaemia, prolapse of uterus etc. According to Kashyapa Samhita, treatment of Sutika is as difficult as cleaning of unclean, tattered and old cloth. In olden days, ladies used to follow strict guidelines during early postpartum days i.e. in Sutikakala, which helped them for early recovery from stress and strain caused during delivery. It also improves the quality and quantity of breast milk and it also avoids various neonatal infections. Mothers who breast feed their babies are at low risk for breast cancer. In modern era due to changing lifestyle and Mithya aahaar-vihaar (abnormal dietetics and mode of Life), pregnant lady is usually prone to Vataprakopa. Many modern Sutika feel ancient guidelines during early puerperal days as age old and time consuming to follow. Hence, guided Sutika paricharya with logical use of classical referenced medicine would be the proper solution to avoid psycho-somatic disorders in order to promote early recovery of mother.

The Impact of Moringa Leaves, Katuk Leaves and Oxytocin Massage on Quantity and Quality of Mother's Milk as Patients Health Center in Bali

The problem of breastfeeding is part of the problem of discomfort in postpartum mothers for 2 hours after giving birth. This problem often causes trauma to postpartum mothers during breastfeeding, psychological disturbances, and increases morbidity in the mother and baby due to inadequate breast milk. The practice of Oxytocin massage, Moringa leaves and Katuk leaves at the same time can improve the quantity and quality of breast milk in maternal patients with 36-40 weeks' gestation. This type of research is quantitative research. Respondents numbered 30 were selected by determining purposive sampling in each group consisting of 10 mothers. Data were analyzed using a Paired t-test and Independent sample t-test with an α level of 0.05. The results showed that there was an increase in the quantity of breastfeeding. On the 3rd day, the quantity of breast milk with volume of 45 cc. In the week I with a volume of 10.50 cc, week II 86.50 cc, week III 168.50 cc and week IV as much as 275 cc. It shows that there are differences in quality on days 3 to week IV. The results of data analysis also showed that the 3rd day the quality of breast milk is rather yellow and rather thick, then the first week to the third week rather yellow and thin. At week IV, the quality of breast milk is white and runny. There is an increase in the quality and quantity of breast milk in all three groups.

The Effectiveness of Kelor Leaves Powder on The Production of Breast Milk and Immunoglobulin A (Ig.A)

Nutrition problems in infants are still a public health problem that is often found in Indonesia. Malnutrition due to lack of breast milk has not been resolved, and the prevalence of nutritional problems is starting to increase. Composition of ASI contains essential nutrients that are sufficient for the baby even though the mother is in a state of malnutrition and is able to overcome infection through phagocyte and immunoglobulin cell components. Moringa leaves are proven to increase the nutrition of breast milk, containing Amino Acid and high enough protein that can improve the quality of breast milk. The purpose of this study to determine the effectiveness of Moringa leaf powder in increasing the production of exclusive breastfeeding and increasing immunoglobulin A (Ig.A) in infants. This research uses quantitative research with quasi-experimental method with a pre-post test design research design. The sample in this study was breastfeeding mothers with lack of milk production. The number of respondents in this study were 60 respondents breastfeeding mothers who were divided into control groups and treatment groups. Analysis of research results using the Wilcoxon test. Tha result showed that value of Zcount = 6.600> Ztable = 1.645 and p-value = 0.003 (<0.05). Based on the results of this analysis it can be concluded that there is an effect of the effectiveness of Moringa leaf powder on increasing the production of exclusive breastfeeding and immunoglobulin A (Ig.A) in infants.

Hubungan Topografi Wilayah Tempa Tinggal Ibu Menyusui dengan Kadar Fe dalam ASI di Sumatera Barat

The quantity and quality of breast milk produced are affected by the food consumed by mothers daily. Judging from the geographical condition and aquatic resources, people in lowland (coastal) blood will consume more animal foods that come from the sea, such as fish, shellfish, and the like. People in the highlands will be more likely to consume food items derived from small livestock such as poultry and the like. This is thought to have an impact on the levels of Fe in breast milk (ASI), considering that the concentration in breast milk is influenced by the mother's diet. This study is an observational study with a cross-sectional comparative design to see the differences in Fe levels in breast milk in breastfeeding mothers who live in the highlands and the lowlands. The sample used is the minimum sample for experimental research and questionnaires, namely 40 respondents for each region. To determine Fe levels, measurements were taken in the LLDIKTI X integrated laboratory using AAS. The FFQ questionnaire was used to determine the nutritional content. Data analysis used the Mann-Whitney nonparametric test. The results of this study were that the iron intake in breastfeeding mothers was higher in the lowlands than mothers in the highlands so that there was a regional topographic relationship to iron levels in breastfeeding mothers with a p-value: 0.000.

Plants, food and treatments used by BaKongo tribes in U\xedge (northern Angola) to affect the quality and quantity of human breast milk

BackgroundAngola has one of the highest annual under-five mortality rates in in the world and malnutrition poses a severe problem in the country. This study is the first to focus on the traditional knowledge of plants, foods, and treatments used by the local population in the province of Uíge to affect the quality and quantity of human breast milk, since decades of independence and civil war impeded ethnobotanical studies in this area.MethodsThis study was conducted in eight municipalities in the province of Uíge, Northern Angola in February and March 2018. In 265 semi-structured interviews, 360 informants in 40 rural villages were asked about plants, food, and treatments used to affect the quality and quantity of human breast milk. Additionally, information on child mortality and the duration of breastfeeding were collected. Whenever possible, plant specimens were collected for later identification. To determine the local importance of the collected plants, food, and treatments, the Relative Frequency of Citations was calculated.ResultsMost women reported to have no problems with their breast milk production. The duration of breastfeeding meets the recommendations of the World Health Organization (WHO). Across all use categories, 69 plants from 36 plant families, and 21 other foods and treatments could be identified.ConclusionsThe study shows an overview of a variety of plants, foods, and treatments used by mothers as galactagogues, to “clean” or to reduce their breast milk and those which they avoided to use during the lactation period. There is great potential for further research into this traditional knowledge. Also, further analysis of some of the plants could be of interest.

PERBANDINGAN TEKNIK PEMERAHAN ASI TANGAN DENGAN MANUAL BREAST PUMP TERHADAP KENYAMANAN IBU DAN KUALITAS ASI

The scope of exclusive breastfeeding is low caused by many factors, one of which is a working mother. The government supports the program of exclusive breastfeeding for mothers by promoting breastfeeding by expressed breast milk. Expressed breast milk can be done by hand and manual tools such as pump. Expressed breast milk can be influenced by mother’s experience and the pain at the time of expressing breast milk, this can lead to a sense of comfort. The differences in expressing techniques might lead to contamination of different bacteria and fungi. the purpose of this research is to analyze the differences in hand milking techniques and manual breast pump on the comfort of the mother and the quality of breast milk This was an observational study with cross sectional approach and conductive in Taman Sari district, Bandung. The samples were 35 mothers who fulfilled the inclusion and exclusion criteria. Mann Whitney, Wilcoxon and McNemar were used in examining mothers’ comfort and breast milk quality. The result of of comfort score showed 65.6 in hand expressed and 59.5 has in manual breast pump. There were several significant differences in expressing techniques to mothers’comfort (p = 0.046). Hand expressing were contaminated by yeast (60%), total mesophilic bacteria (20%), and enterobacter (17.1%). Manual breast pump was contaminated by yeast (80%), total mesophilic bacteria (8.6%), and enterobacter (20%). Breast milk quality in hand expressed was better than the manual breast pump (p = 0.032). It was concluded that hand expressed more comfortable and had better quality breast milk than manual breast pump techniques.

The Effect of Moringa Oleifera on the Life Outcome of Pregnant and Breastfreeding Mothers: Literature Review

Background: As an extraordinary plant, moringa oleifera is nutritios plant which is also a source of medicine having content different from other common plants. Moringa also contains all elements of essential amino acids. Moringa is believed to have potential to decrease malnutrition, hunger, increase breast milk volume as well as prevent and heal various diseases due to its nutritious content. Objective: This literature study aims to obtain input regarding the effect of moringa oleifera on the life outcome of the pregnant and breastfeeding mothers in Indonesia. Method: The literature review was conducted through Google scholar and electronic database of PubMed, Clinical Key and Springer. The keywords of Moringa oleifera, pregnancy, galactogogue, breastfeeding, nutrition, health and diseases were used to search original research or literature review on both open access English national and international journal. As many as 24 articles published in 2009 to 2019 were reviewed and synthesized using unsystematic narrative review, obtaining suitable 26 articles and unsuitable 14 articles. Results: This research found that moringa oleifera is good for pregnant and breast feeding mothers. Conclusion: As one of alternative plants, Moringa oleifera is believed to have potential in decreasing malnutrition, hunger, preventing BBLR, increasing breast milk volume and quality, increasing HB level and preventing anaemia which commonly happens among the pregnant mothers.