Breast Milk Feeding Research Articles

ChyloBEST: Chylothorax in Infants and Nutrition with Low-Fat Breast Milk.

Chylothorax occurs in 2.8-5% of infants after cardiac surgery and can increase morbidity and mortality. First-line conservative treatment consists of a chest tube drainage and a fat-free and medium-chain triglyceride (MCT)-enriched diet. This typically leads to a discontinuity of breast milk feeding due to high content of long-chain triglycerides within the breast milk. Modified breast milk with low fat content (LFBM) could provide numerous benefits like immunological properties of breast milk even for patients with chylothorax. This study was conducted at Herzzentrum Leipzig comparing clinical and growth outcomes between infants with chylothorax after surgery for congenital heart disease treated with LFBM (n = 13) versus MCT-Formula (n = 10). LFBM was prepared by centrifugation of native breast milk added with MCT-oil and fortifier. There were no differences in volume and duration of chest tube drainage between LFBM and MCT-formula treatment groups. Furthermore, no statistically significant differences with regard to weight and length gains could be observed between both feeding groups. LFBM is an efficient and unharmful treatment for chylothorax following cardiac surgery in young children.

Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study

BackgroundBreastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage.PurposeThis study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea.MethodsWe retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups.ResultsAmong the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22–11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338).ConclusionThe severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

Human milk-derived fortifier versus bovine milk-derived fortifier for prevention of mortality and morbidity in preterm neonates.

Preterm infants who are fed breast milk in comparison to infant formula have decreased morbidity such as necrotizing enterocolitis. Multi-nutrient fortifiers used to increase the nutritional content of the breast milk are commonly derived from bovine milk. Human milk-derived multi-nutrient fortifier is now available, but it is not clear if it improves outcomes in preterm infants fed with breast milk. To determine whether the fortification of breast milk feeds with human milk-derived fortifier in preterm infants reduces mortality, morbidity, and promotes growth and development compared to bovine milk-derived fortifier. We searched the following databases for relevant trials in September 2018. Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, Issue 9), electronic journal reference databases including MEDLINE (1980 to 20 September 2018), PREMEDLINE, Embase (1974 to 20 September 2018), CINAHL (1982 to 20 September 2018), biological abstracts in the database BIOSIS and conference abstracts from 'Proceedings First' (from 1992 to 2011). We also included the following clinical trials registries for ongoing or recently completed trials: ClinicalTrials.gov (ClinicalTrials.gov), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP; www.whoint/ictrp/search/en/) and the ISRCTN Registry (www.isrctn.com/), and abstracts of conferences: proceedings of Pediatric Academic Societies (American Pediatric Society, Society for Pediatric Research and European Society for Paediatric Research) from 1990 in the 'Pediatric Research' journal and 'Abstracts online' (2000 to 2017). We included randomized and quasi-randomized controlled trials that compared preterm infants fed breast milk fortified with human milk-derived fortifier versus those fed with breast milk fortified with bovine milk-derived fortifier. The data were collected using the standard methods of Cochrane Neonatal. Two authors evaluated trial quality of the studies and extracted data. We reported dichotomous data using risk ratios (RRs), risk differences (RDs), number needed to treat (NNT) where applicable, and continuous data using mean differences (MDs). We assessed the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. One randomized trial with 127 infants met the eligibility criteria and had low risk of bias. Human milk-based fortifier did not decrease the risk of necrotizing enterocolitis in exclusively breast milk-fed preterm infants (RR 0.95, 95% CI 0.2 to 4.54; 1 study, 125 infants, low certainty of evidence). Human milk-derived fortifiers did not improve growth, decrease feeding intolerance, late-onset sepsis, or death. There is insufficient evidence evaluating human milk-derived fortifier with bovine milk-derived fortifier in exclusively breast milk-fed preterm infants. Low-certainty evidence from one study suggests that in exclusively breast milk-fed preterm infants human milk-derived fortifiers in comparison with bovine milk-derived fortifier may not change the risk of necrotizing enterocolitis, mortality, feeding intolerance, infection, or improve growth. Well-designed randomized controlled trials are needed to evaluate short-term and long-term outcomes.

Origins of human milk microbiota: new evidence and arising questions

ABSTRACT Human milk contains a diverse community of bacteria. The growing appreciation of commensal microbes and increasing availability of high-throughput technology has set the stage for a theory-driven approach to the study of milk microbiota, and translation of this knowledge to improve maternal and child health. We recently profiled the milk microbiota of healthy Canadian mothers and applied theory-driven causal modeling, finding that mode of breast milk feeding (nursing directly at the breast vs. pumping and feeding breast milk from a bottle) was significantly associated with milk microbiota composition. This observation could reflect an increased exposure to pumps and/or a decreased exposure to the infant mouth. Either way, it provides evidence for the retrograde mechanism of milk inoculation. Here, we discuss the implications of this research and related controversies, and raise new questions about the origins and function of milk bacteria.

Professionalism of the Female Teacher at Riau Palm Oil Plantation Sumatera Indonesia

This research shows professionalism of the female teachers at palm oil plantation’s school which belongs to Astra Agro Lestari Company 18% of the Astra Agro Lestary company’s employees is female, and some of them work as a teacher. Teacher’s professionalism is considered important to be investigated because by professionalism, teachers can perform their best to serve the need of education for their students. Individually, female teacher holds double tasks as a mother in their family and as a female teacher professionally. Research method of this research is descriptive quantitative with the total of the sample is 48 female teacher. In collecting the data, researcher used questionnaire. The result of the research shows that female teachers in the Astra Agro Lestary company’s palm oil plantation has worked professionally according to their tasks. Focus Group Discussion result and based on the data analysis, the researcher found out that female teacher who hasn’t married yet shows a dynamic behavior on technology development in teaching compares to the one who has married. Female teacher owns a primary task as a teacher and an additional task, helping the company in assisting the society internally and externally. The additional task is training and assisting maternal and child health services workers, introducing the central trash disposal to the society, assisting the community, assisting the day care workers, doing an assistance to the parents about the importance of breast milk feeding, and stimulating the mothers in following the family welfare programme activities.

Incidence of necrotising enterocolitis before and after introducing routine prophylactic Lactobacillus and Bifidobacterium probiotics

ObjectiveTo compare rates of necrotising enterocolitis (NEC), late-onset sepsis, and mortality in 5-year epochs before and after implementation of routine daily multistrain probiotics administration in high-risk neonates.DesignSingle-centre retrospective observational study...

The association of infant feeding patterns with food allergy symptoms and food allergy in early childhood

BackgroundThe role of infant feeding for food allergy in children is unclear and studies have not addressed simultaneous exposures to different foods. The goal of this study was to analyze existing data on feeding practices that represent realistic exposure and assess the risk of food allergy symptoms and food allergy in children.MethodsThe Infant Feeding Practices Study II conducted by the CDC and US-FDA enrolled pregnant women and collected infant feeding information using nine repeated surveys. Participants were re-contacted after 6 years. Food allergy data were collected at 4, 9, 12, and 72 months. In total, 1387 participants had complete infant feeding pattern data for 6 months and information on food allergy symptoms and doctors’ diagnosed food allergy. Feeding patterns constituted six groups: 3-months of feeding at breast followed by mixed feeding, 3-months of breast milk and bottled milk followed by mixed feeding, 1-month of feeding at breast followed by mixed feeding, 6-months of mixed feeding i.e., concurrent feeding of breast milk, bottled milk and formula, 2–3 months of formula followed by formula and solid food, and formula and solid food since the first month. To estimate risks of food allergy, we used linear mixed models, controlling for potential confounders.ResultsOf the 328 children with food allergy symptoms in infancy and at 6 years, 52 had persistent symptoms from infancy. Children exposed to mixed feeding had a higher risk of food allergy symptoms (Risk Ratio [RR] 1.54; 95% Confidence Interval [CI] 1.04, 2.29) compared to 3-months of feeding at breast adjusted for confounding. No statistically significant risk of infant feeding patterns was found for doctors’ diagnosed food allergy. Paternal allergy posed a higher risk for food allergy symptoms (RR 1.36; 95% CI 1.01, 1.83). Prenatal maternal smoking increased the risk for doctors’ diagnosed food allergy (RR 2.97; 95% CI 1.53, 5.79).ConclusionsAnalysis of this prospective birth cohort suggest that introduction of multiple feeding source may lead to food allergy symptoms. Future efforts are needed to determine acceptable approaches to improve the ascertainment of food allergy in children and the role of infant feeding.

2334. Saliva Screening for Congenital Cytomegalovirus Infection in the Neonatal Intensive Care Unit: Beware!

BackgroundCongenital cytomegalovirus (cCMV) infection is the most common cause of non-genetic sensorineural hearing loss in infancy. Screening of newborns for cCMV infection has been performed utilizing saliva due to ease of collection and high sensitivity. Positive saliva screens for CMV DNA by polymerase chain reaction (PCR) testing has been reported to occur secondary to breast milk feeding without signifying congenital infection. The NICUs of Nationwide Children’s Hospital recently began universal saliva screening of all admissions. We report 3 neonates whose saliva CMV screen was positive yet the urine CMV PCR test was negative in order to inform CMV screening strategies.MethodsRetrospective review of the electronic health records of neonates admitted to the neonatal intensive unit (NICU) at Nationwide Children’s Hospital, Columbus, OH who had CMV detected by PCR from saliva specimens but not from urine. Pertinent demographic and clinical data were obtained.ResultsThree female neonates had a positive saliva CMV DNA PCR test but urine CMV PCR was negative. The first infant (gestational age [GA] 34 weeks, birth weight [BW]1790 Grams) was a monochorionic diamionic twin gestation and born vaginally with unknown duration of rupture of membranes (ROM). At 16 days of age, the infant had a positive saliva CMV PCR but a negative urine CMV PCR test. The infant received maternal milk. The twin’s CMV PCR tests of saliva and urine were negative. The second infant (GA 38 weeks, BW 2952 grams) was born vaginally after 9 hours of ROM. On the first day of age, the infant had a positive saliva CMV PCR test that was followed by a negative urine CMV PCR on the third day of age. The infant had not been breastfed. The third infant (GA 33 weeks, BW 1762 grams) was born by C-section delivery with ROM at delivery. Saliva CMV PCR screen was positive on the second day of age but urine PCR was negative twice (days 5 and 7). All 3 infants had no signs/symptoms of cCMV infection and passed the newborn hearing screen.ConclusionTesting of saliva for CMV DNA by PCR is not always confirmatory for cCMV infection as contamination of saliva specimens with CMV could result from exposure to maternal milk and possibly vaginal secretions. Definitive diagnosis of cCMV infection requires additional confirmatory testing preferably with urine.Disclosures All authors: No reported disclosures.

Breast Milk Feeding Practices and Barriers and Supports Experienced by Mother-Infant Dyads With Cleft Lip and/or Palate.

To examine trends in breast milk provision and to characterize the breast milk feeding practices experienced by mother-infant dyads with cleft lip and/or palate (CL/P) in a large US sample. Cross-sectional study. An online survey was distributed through cleft-related social media sites in the United States and in a single cleft lip and palate clinic. Statistical analyses included Kruskal-Wallis H tests and post hoc Mann-Whitney tests to examine group differences based on cleft type and prenatal versus postnatal cleft diagnosis. Linear regression was used to estimate associations between obtained variables. One hundred fifty biological mothers of infants (8-14 months of age) with CL/P (15% cleft lip, 29% cleft palate, 56% cleft lip and palate). Forty-six percent of mothers of infants with CL/P provided breast milk to their infant for at least 6 months. Five percent of infants ever fed at breast, and 43% received pumped breast milk via bottle. The most commonly reported supports included lactation consultants, nurses, feeding therapists, and online support groups. Feeding therapy was received by 48% of infants. A lower percentage of mothers of infants with CL/P reported providing breast milk compared to national estimates of the general population of infants without clefting. Results suggested there are multiple barriers, as well as numerous medical and psychosocial supports that facilitated breast milk feeding success. Implications for care are discussed.

Reconstructing Breastmilk and Infant Formula Intake using Novel Biomarkers in Baby Teeth

TPS 911: Air pollution, epigenetics, biomarkers, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background/Aim: Early life diet is a major determinant of lifelong health trajectories. However, studies of the long term health outcomes of breastfeeding are difficult to study due to cost and time restraints in collecting data prospectively and the inherent limitations of questionnaires. A biomarker that can retrospectively measure the dose and duration of breastmilk and formula feeding would be a major advancement in the study of health trajectories associated with infant diet, particularly for health outcomes measured much later in life, years after the cessation of breastfeeding. We show that chemical signals in baby teeth can reconstruct breastfeeding histories. Methods: We measure chemical signatures in aged dentine layers to generate weekly estimates of biomarkers of infant diet. Using reversed distributed lag models (DLM) we identified chemical signatures in teeth associated with breastmilk or formula intake and developed an index of breastmilk intake using a lagged weighted quantile sum (WQS) regression approach. Biomarkers of milk intake were developed in a non-human primate model and refined in a human cohort. We tested the index against prospectively collected breastfeeding histories in a human cohort based in Mexico (n=225) and a replication cohort from the US (n=100). Results: Preliminary studies identified barium as a sensitive marker of infant diet transition from breastmilk to infant formula, identifying the timing of infant formula introduction in 70% of teeth. Reversed DLMs indicated strontium as a sensitive marker to infant formula intake and lithium as a marker for breastfeeding after 6 months. Using WQS, lithium and strontium were found to be the strongest contributors within a mixture to differentiate breastfed and formula fed infants. Conclusions: Breastmilk intake during childhood can be reconstructed using chemical signatures in teeth. This method can be applied to more accurately investigate associations of breastfeeding dose and duration with long term health outcomes.

The role of the preterm intestinal microbiome in sepsis and necrotising enterocolitis

Late-onset sepsis (LOS) and necrotising enterocolitis (NEC) account for the highest number of deaths in premature infants and often cause severe morbidity in survivors. NEC is an inflammatory mediated condition, but its pathophysiology remains poorly understood. There is increasing evidence that in LOS the causative organism most often translocates from the gut. No causative microorganism has been consistently associated with either LOS or NEC, but an aberrant gut microbiome development could play a pivotal role. A low bacterial diversity and a delay in anaerobic bacteria colonization may predispose preterm infants to disease development. Conversely, a predominance of Bifidobacterium species and breast milk feeding might help to prevent disease onset. With numerous studies reporting conflicting results, further research is needed to better understand the role of microorganisms and type of feeding in the health status of preterm infants.

The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE-2 cohort study.

Facilitating factors and barriers to breast milk feeding (BMF) for preterm infants have been mainly studied in very preterm populations, but little is known about moderate preterm infants. We aimed to analyze hospital unit characteristics and BMF policies associated with BMF at discharge for infants born at 32 to 34 weeks' gestation. EPIPAGE-2, a French national cohort of preterm births, included 883 infants born at 32 to 34 weeks' gestation. We investigated kangaroo care in the first 24 hr, early involvement of parents in feeding support, volume of the unit, BMF information given to mothers hospitalized for threatened preterm delivery, protocols for BMF, presence of a professional trained in human lactation, unit training in neurodevelopmental care, and regional BMF initiation rates in the general population. Multilevel logistic regression analysis was used to investigate associations between unit policies and BMF at discharge, adjusted for individual characteristics and estimating odds ratios (ORs) and 95% confidence intervals (CIs). Overall, 59% (490/828) of infants received BMF at discharge (27% to 87% between units). Rates of BMF at discharge were higher with kangaroo care (adjusted OR 2.03 [95% CI 1.01, 4.10]), early involvement of parents in feeding support (1.94 [1.23, 3.04]), unit training in a neurodevelopmental care programme (2.57 [1.18, 5.60]), and in regions with a high level of BMF initiation in the general population (1.85 [1.05, 3.28]). Creating synergies by interventions at the unit and population level may reduce the variability in BMF rates at discharge for moderate preterm infants.

Amine variations in faecal content in the first weeks of life of newborns in relation to breast-feeding or infant formulas.

Breast-feeding is the ideal nutrition for a newborn's integral necessities. It seems crucial therefore to know its composition in order to provide suitable infant formula when required. Of these, polyamines (with lactation and the microbiota being its intestinal source) are involved in the development of gut epithelium and immunity. Safety concerns limit human intervention studies. Therefore, we studied the amounts of polyamines supplied by breast milk (varying among mothers) or infant formula feeding, up to day 30 postpartum, in the faeces of newborns. Independent samples (68) of breast milk from fifty-nine healthy Caucasian woman (day 0, 1, 3, 5, 7, 15 and 30 postpartum) who had natural deliveries after week 38, same-day faeces of newborns when available (eighty-one from breast milk and fifty-five from infant formula fed) and six infant formulas were collected and the polyamine content was determined by HPLC. In breast milk, polyamines and isoamylamine (a primary amine), with inter-individual variations, increased over time (with a higher content of spermidine; no other amines were present). Overall, they were much higher than in infant formula. By the 2nd week after birth, polyamines, cadaverine and tyramine, but not isoamylamine, were higher in the faeces of those fed infant formula compared with those fed breast milk. Cadaverine and tyramine could be used to predict the feeding type used for newborns. The differences in the content may be related to distinct colonisation of amine-producing bacteria, which can be established by polyamines. Further studies are required to determine the clinical utility of these findings.

Analysis of clinical characteristics of 623 cases of neonatal necrotizing enterocolitis

Objective To investigate the incidence, mortality and clinical characteristics of neonatal necroti-zing enterocolitis(NEC) in Shanghai. Methods A retrospective study was conducted in 623 cases of NEC from January 2010 to December 2015 at Children′s Hospital of Fudan University.All analysis were performed by using the statistical software package Stata 12.0. Results Six hundred and twenty-three NEC neonates were included in the study, and 485 of them were preterm infants, including 304 cases of stage 1, 176 cases of stage 2 and 143 cases of stage 3.The gestational age was (33.2±3.9) weeks, and the birth weight was (1 979.7±813.5) g. The incidence of NEC in Children′s Hospital of Fudan University was 1.29% (410/31 662 cases), and that of the stage 2 and stage 3 was 1.01% (319/31 662 cases). The gestational age was smaller and birth weight was less in the stage 2 and stage 3 group than that in the stage 1 group (all P<0.001). The percentage of cases received breast milk feeding was 7%.The rate of prophylactic antibiotics within 3 days of their life and ibuprofen for patent ductus arteriosus prior to NEC in stage 1 group was lower than that in stage-2 and stage 3 groups (all P<0.05). The most common clinical presentations were abdominal distension(71.75%, 447/623 cases), decreased bowel sounds(56.02%, 143/623 cases), looked sick (45.43%, 283/623 cases) and bloody stools(40.45%, 252/623 cases). The bowel perforation rate of the preterm and the term infants was 17.73%(86/485 cases)and 13.04%(18/138 cases), respectively.The patients who received surgical management took up 25.36%.The neonates were most commonly complicated with post-NEC stenosis (10.27%) and a culture-proven sepsis(7.87%). The count of white blood cell (WBC)<4×109/L and platelet<100×109/L raising level in stage 2 and stage 3 were higher than those in stage 1(all P<0.05). The antibiotics used for NEC were metronidazole (69.34%), carbapenems (65.65%), cephalosporins(61.16%) and penicillins(58.59%). The prognosis of NEC showed that cure cases occupied 65.49%, discharged cases with a better condition 19.58%, and death cases occupied 14.93%.The mortality of stage 3 accounted for 45.46%. Conclusions Newborn NEC mainly had gestational age of 28-34 weeks and birth weight of 1 000-1 999 g, respectively.The incidence of NEC 1.29% and it is decreasing year by year, while that of very-low-birth weight(VLBW) is still as high as 11.82%.The mortality of NEC occupies 14.93%, while that of stage 3 reaches as high as 45.46%. Key words: Infant, newborn; Infant, premature; Necrotizing enterocolitis; Influencing factor

Improving Exclusive Breast Milk Feeding at Hospital Discharge: A Regional Quality Improvement Project

Improving Exclusive Breast Milk Feeding at Hospital Discharge: A Regional Quality Improvement Project

A Standardized Communication Approach to Promote Exclusive Breast Milk Feeding

Introduction: Breastfeeding is recognized and promoted by the AAP and ACOG as an important factor in neonatal growth and development, with numerous short- and long-term health benefits for both mother and baby, including ideal nutrition, decreased rates of childhood infections and atopic disease, and improved postpartum recovery. Focused review of the current literature yielded studies detailing barriers to successful hospital breastfeeding exclusivity, including disparities in provider knowledge and attitudes. Our children’s hospital is a BabyFriendly designated hospital with 4,800 deliveries per year. In late 2016, …

A Standardized Communication Approach to Promote Exclusive Breast Milk Feeding

A Standardized Communication Approach to Promote Exclusive Breast Milk Feeding

Improving Exclusive Breast Milk Feeding at Hospital Discharge: A Regional Quality Improvement Project

Introduction: Exclusive breastfeeding (EBF) at discharge is a core measure of hospital perinatal care quality. Hospital practices that support breastfeeding significantly impact success, exclusivity, and duration. However, there is variation in both hospital practices and provider recommendation of formula supplementation to breastfed infants, impacting EBF rates. Introduction of formula supplementation in the hospital can have a negative impact on breastfeeding outcomes post-discharge. We are an academic, regional practice providing newborn care at multiple sites. Publically available data from Joint Commission’s Quality Check website revealed that EBF rates ranged from 28-75% …

Analysis of Factor Affecting Nutrition Status on Children

The problem of malnutrition remains overlooked in Indonesia, especially on children, caused by various factors. Indonesia is the 17th country with 3 nutrition problems, including stunting (short body), wasting (skinny body), and overweight (obesity). This research aims to analyze factors affecting nutrition status on children in the area of West Java Province, including the mother’s and the child’s socio-demographics factor, and the child’s health status. The research method was descriptive quantitative with cross-sectional approach. The number of samples is 810. The research was conducted in 6 districts that support Family Planning (KB), including Bandung District, Bandung City, West Bandung District, Subang District, Sumedang District, and Garut District. The quantitative analysis consisted of univariates using percentage and frequency distribution, as well as bivariate analysis using chi square test. The result of the research shows that nearly all toddlers have good nutrition status as much as 87.9%, and toddlers with malnutrition as much as 10.6%. The analysis factor shows that there is a relationship between the mother’s age (p = 0.048; OR = 1.583), family income (p = 0.010; OR = 1.803), delivery complications (p = 0.008; OR = 2.091), provision of exclusive breastfed milk (ASI) at the age of 0 - 6 years old (p = 0.000; OR = 2.321), provision of exclusive breast milk and complementary feeding given to babies before 6 months old (MPASI) at the age of 6 months to 2 years old (p = 0.002; OR = 2.037), and the child’s history of hospitalization (p = 0.008; OR = 2.055), while other factors are considered irrelevant. This research suggests that healthcare staff collaborate in providing knowledge to mothers on the provision of exclusive breast milk and complementary feeding as well as the prevention of illness on their children.

The Perinatal Condition Around Birth and Cardiovascular Risk Factors in the Japanese General Population: The Suita Study.

Aim: To investigate the relationship between perinatal condition around birth and cardiovascular risk in later life.Methods: Retrospective data were examined from 1241 city dwellers (521 men, 720 women; age 41–69 years) who had undergone medical examination at a single institution including blood tests and physical measurements from 2007 to 2008. The questionnaire was conducted to determine how perinatal factors affect their lives later. We also selected and studied a total of 28 individuals (12 men and 16 women) specifically about the conformity rate of the breastfeeding method between participants' memories and what was written in the maternal and child health handbooks.Results: The conformity rate of the breastfeeding method between a self-questionnaire and his/her maternal and child health handbook was well correlated (r = 0.73; p < 0.025). Among the data in women who were born at home, HbA1C levels (5.36 ± 0.03 vs. 5.25 ± 0.05 mg/dL, p = 0.03) and low-density lipoprotein cholesterol (136.0 ± 1.4 vs. 129.3 ± 2.5 mg/dL, p = 0.04) were higher than women who were born at the hospital. Women raised by formula showed higher low-density lipoprotein cholesterol levels than women fed breast milk or a mixture of breast milk and formula (150.2 ± 4.8 vs. 138.7 ± 3.7, 142.5 ± 2.6 mg/dL, p = 0.04). Fasting blood glucose levels at an adult time in men and women born through breech presentation were higher than those by the cephalic presentation (123.2 ± 7.8 vs. 106.8 ± 1.2 mg/dL, p = 0.03).Conclusion: The study proposed that some perinatal conditions around birth such as delivery place, presenting part, and lactation affected especially Japanese women's cardiovascular risks between ages 41 and 69 years.