Breast Milk Feeding Research Articles

Preliminary Exploration into the Impact of Mistimed Expressed Breast Milk Feeding on Infant Sleep Outcomes, Compared to Other Feeding Patterns.

Background and Objective: The presence and fluctuation of melatonin in breast milk during the night and day may be providing sleep timing information to infants, thereby supporting/enabling the development of their own circadian cycle. If this is the case, then it is important that infants consume breast milk according to the time of day it is produced. However, breast milk is not always consumed at the "right" time. The aim of this study was to investigate whether consuming mistimed expressed breast milk impacts infant sleep compared with other feeding types. Methods: A total of 329 mothers completed an online anonymous survey. Mothers were grouped into one of five groups; direct breastfed only, formula only, express mistimed, express-timed, and combined breastfed/formula fed. Results: Cross-sectional analysis showed mistimed expressed breast milk was significantly associated with delayed sleep onset of the infant (p < 0.001), but direct breastfed infants had significantly more awakenings at night (p < 0.001). Conclusions: The findings from this study suggest a potential effect of mistimed expressed breast milk consumption on an infant's circadian rhythm, affecting some aspects of their sleep. This is an important first step in exploring mistimed feeding on infant sleep outcomes and provides preliminary evidence that warrants future research.

Nurse-Reported Staffing Guidelines and Exclusive Breast Milk Feeding.

Nursing care is essential to overall quality of healthcare experienced by patients and families-especially during childbearing. However, evidence regarding quality of nursing care during labor and birth is lacking, and established nurse-sensitive outcome indicators have limited applicability to maternity care. Nurse-sensitive outcomes need to be established for maternity care, and prior research suggests that the initiation of human milk feeding during childbirth hospitalization is a potentially nurse-sensitive outcome. The aim of this study was to determine the relationship between nurse-reported staffing, missed nursing care during labor and birth, and exclusive breast milk feeding during childbirth hospitalization as a nurse-sensitive outcome. 2018 Joint Commission PC-05 Exclusive Breast Milk Feeding rates were linked to survey data from labor nurses who worked in a selected sample of hospitals with both PC-05 data and valid 2018 American Hospital Association Annual Survey data. Nurse-reported staffing was measured as the perceived compliance with Association of Women's Health, Obstetric and Neonatal Nurses staffing guidelines by the labor and delivery unit. Data from the nurse survey were aggregated to the hospital level. Bivariate linear regression was used to determine associations between nurse and hospital characteristics and exclusive breast milk feeding rates. Generalized structural equation modeling was used to model relationships between nurse-reported staffing, nurse-reported missed care, and exclusive breast milk feeding at the hospital level. The sample included 184 hospitals in 29 states and 2,691 labor nurses who worked day, night, or evening shifts. Bivariate analyses demonstrated a positive association between nurse-reported staffing and exclusive breast milk feeding and a negative association between missed nursing care and exclusive breast milk feeding. In structural equation models controlling for covariates, missed skin-to-skin mother-baby care and missed breastfeeding within 1 hour of birth mediated the relationship between nurse-reported staffing and exclusive breast milk feeding rates. This study provides evidence that hospitals' nurse-reported compliance with Association of Women's Health, Obstetric and Neonatal Nurses staffing guidelines predicts hospital-exclusive breast milk feeding rates and that the rates are a nurse-sensitive outcome.

Breast feeding practice in a selected peri urban area of Bangladesh

Background: Exclusive breastfeeding (EBF) offers optimum growth and development up to first six month of life. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014.the aim of the study is to assess the exclusive breast feeding practice and associated factors among children in peri- urban area of Bangladesh. Methods: This is a cross sectional observational study conducted at Jhalkuri under Narayanganj districts during the period of July to December 2014. Total 109 mothers having infants aged 6-12 months interviewed and included in this study. Results: It was found that only 26(24%) mother went for regular antenatal checkup and remaining 83 (76%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Knowledge about breast milk as first food in 44(40%) mother. Mother informed to breast feeding exclusively upto six months only 53 (48%).Breastfeeding was initiated with in 1 hour of birth in 42(39%) cases and 67 (61%) cases after 1hour of birth. Exclusive breastfeeding (EBF) was found in 43 (40%) children. Among them 34 (79%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 52 children among them 25 (49%) were the children of housewife mothers. Only formula milk was given to 14 children of them 5(35%) were the children of housewife mothers. Exclusive breast milk was not given by 26(39%) mothers due to job or other occupation whereas 40(61%) mother did not give EBF due to insufficient breast milk. Conclusion: In the study rate of exclusive breast feeding was 40%. This is lower compare to national level. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding. Bangladesh J Medicine 2022; 33: 274-279

Oral lactase for infantile colic: a randomized double-blind placebo-controlled trial

BackgroundInfantile colic is a common problem during the first three months of life. This randomized, double-blind, placebo-controlled trial conducted in an urban hospital in Delhi, India evaluated the efficacy and safety of oral lactase in management of infantile colic.MethodsOne hundred sixty-two clinically healthy infants aged < 5 months age [mean (SD) = 63.5 (30.5) days] fulfilling the Rome-IV diagnostic criteria for infantile colic were enrolled. Eligible children were randomly allocated to receive 5 drops of lactase (600 FCC units/mL) (n = 80) or placebo (n = 82) mixed with breast milk or formula feed four times a day for a duration of 4 weeks. Primary outcomes were duration of crying or fussing (min/d), and number of days with colic lasting > 3 h/d; secondary outcomes were parental satisfaction and adverse events.ResultsAt the end of four weeks, mean (SD) crying or fussing time (min/d) was significantly shorter in infants receiving lactase in comparison to placebo [89.9 (115.2) vs.178.5 (153.2); P = 0.001]. The mean (SD) number of days with colic was also significantly less in the lactase group as compared to placebo group at the end of the treatment [12.1 (7.8) vs 17.6 (8.4); P < 0.001]. By the end of 4th week, parental satisfaction in terms of infant’s mood, activity, alertness, comfort and oral intake was better in intervention group. The adverse event profile was comparable between two groups.ConclusionsOral lactase treatment in infantile colic results in symptomatic relief in terms of shortening of duration of crying or fussing, and better parental satisfaction.Trial registrationClinical trial registry of India (CTRI/2017/12/010930) registered on 20/12/2017.

PERBEDAAN PENGETAHUAN DAN SIKAP IBU TENTANG ASI EKSKLUSIF SEBELUM DAN SESUDAH PENYULUHAN

Basic health research (Riskesdas) in the year 2013 found 30.2% 0-6 month baby gets BREAST MILK alone in the last 24 hours. The numbers are still relatively low, whereas BREAST MILK and breastfeeding is very beneficial for the mother and her baby. The constraints of the mother in breast-feeding there are 2 factors i.e. internal factors and external factors. Internal factors namely the mother's lack of knowledge about lactation management and external factors i.e. BREAST MILK has not come out on the first day so that mothers think need to add milk formula. The mother did not know the benefits of BREAST MILK for mothers and babies and not knowing that it is the Exclusive breast feeding BREAST MILK only up to the age of 6 months baby. For it is done the research that aims to analyse the comparison of the knowledge and attitudes of mothers before and after illumination of diDesa Siatas Exclusive BREAST MILK and fold in Kajang. This research is a research quasi experimental design study one group pretest-posttest. This research population is mothers who have babies age 6 months at the time of data retrieval is performed in the village and the village of Kajang Siatas Folding with the amount of 45 people and is entirely made of samples and data were analyzed with paired t-test test. The results of the research there is a difference in the average Maternal Knowledge before and after the Extension Of Exclusive breast milk (0-6) in the village of Folding And Siatas Kajang with p value = 0.001 (p &lt; 0.05), and there is a difference Score the attitude of mothers before and after Extension About Exclusive breast milk (0-6) in the village of Folding And Siatas Kajang with p value = 0.001 (p &lt; 0.05). Expected for the respondents to increase knowledge about BREAST MILK by following the guidance in the ASI counseling posyandu and lactation classes.

Comparing the effect of a lactation-specific relaxation and visualisation intervention versus standard care on lactation and mental health outcomes in mothers of very premature infants (the EXPRESS trial): study protocol for a multi-centre, unmasked, randomised, parallel-group trial

BackgroundPremature birth is the leading cause of neonatal death and can cause major morbidity. Maximising the amount of maternal breastmilk given to very premature infants is important to improve outcomes, but this can be challenging for parents. Parents of infants receiving neonatal care also have high rates of anxiety and distress. There is growing evidence for the impact of maternal relaxation interventions on lactation, as well as mental health. The trial will assess whether a brief self-directed relaxation and visualisation intervention, recommended for use several times a day during expression of milk, improves lactation and mental health outcomes for mothers of very premature infants.MethodsMulti-centre, randomised, controlled, unmasked, parallel-group trial with planned 132 participants who have experienced premature birth between 23 weeks and 31 weeks and 6 days of gestation and plan to express milk for at least 14 days. The primary outcome is the highest 24-h expressed milk yield recorded on any of day 4, day 14 or day 21 after birth. Secondary outcomes include exclusive breastmilk feeding at 36 weeks post-menstrual age and at 4 months after the estimated date of delivery, Spielberger State Trait Anxiety Index at day 21 and Post-traumatic stress Check List (for DSM 5) at day 21.DiscussionBreastmilk feeding for premature infants is an important research priority, but there are few randomised controlled trials assessing interventions to help parents reach lactation goals in this challenging context. This trial will assess whether a no cost, easily scalable relaxation tool has a role in this setting. Given the lack of harm and potential for immediate dissemination, even a small benefit could have an important global impact.Trial registrationISRCTN16356650. Date assigned: 19/04/2021.

Prevalence and Associated Factors of Stunting among School Age Children in Addis Ababa City, Ethiopia 2021.

Introduction:Stunting has long been regarded as one of the most important indicators of malnutrition, serving as a proxy for not just chronic nutritional deficiency but also long-term socioeconomic disadvantage among children and society as a whole. In 2016, stunting alone afflicted an estimated 154.8 million (22.9%) children under the age of five over the world. It is one of Ethiopia’s most serious undernutrition and health problems among school-aged children.Objective:To determine the prevalence and associated factors of stunting among school-aged children in Addis Ababa city, Ethiopia 2021.Methods:An institutional-based cross-sectional study was conducted among primary school students in Addis Ababa city. By using a single population proportion, a formula of 627 students was recruited. From 11 sub-cities, 4 sub-cities were selected by lottery method, and 21 (30%) of the schools from the sub-city were selected. Finally, from each school, study participants were selected by using systematic random sampling, using their attendance list as a frame. A self-administered questionnaire was used to collect data, and anthropometric measurements were taken. In order to see the association between the dependent (stunting) and independent variables, bi-variable and multi-variable logistic regression were used. During bi-variable analysis, variables that had p-values of less than 0.2 were entered into multivariable analysis to see the effect of confounding factors. Adjusted Odds Ratios with 95% confidence intervals and a P-value of less than 0.05 were used to see the level of significance.Result:The prevalence of stunting was 108/607 (18.0%) with a 95% CI of 14.5–20.9). Being a male child (AOR = 0.616, 95% CI, 0.34–0.96), type of water source (AOR = 3.4, 95% CI, 1.12–10.37), not feeding breast milk (AOR = 3.411, 95% CI, 1.09–10.07), educational status, and ability to read and write (AOR = 2.11, 95% CI, 1.15–3.88) were predictors of stunting.Conclusion:The study showed that the prevalence of stunting was high, and it explored that stunting remains a noticeable attribute of urban school-age children. The higher educational status of the mother, exclusive breast feeding, using ground water, and being a female child were negatively associated with the prevalence of stunting. The risk of stunting was higher among male than female school-aged children. Findings from the study suggest the need to strengthen the strategies that lead to Sustainable Development Goal 4 to ensure all girls and boys complete primary and secondary schooling by 2030.

The impact of a Donor Human Milk Program on the provision of mothers' own milk at discharge in very low birth weight infants.

Examine the effect of a donor human milk (DHM) program on mothers' own milk feedings at discharge for very low birth weight (VLBW) infants. A single center retrospective analysis of feeding outcomes in preterm infants. Data were assigned as: (1) pre DHM era (2) Bridge DHM era (3) Full DHM era. Each era was divided into infants <1500 g (n = 724) or ≥1500 g (n = 784). Both the percentage of mothers' own milk feeds and percent of infants exclusively receiving mothers' own milk at discharge were increased in the <1500 g (p = 0.003, p = 0.002) and the ≥1500 g group (p = 0.007, p = 0.004) respectively, following the introduction of DHM for VLBW infants. Practice changes that accompany a donor milk program likely play a prominent role in the provision of mothers' own milk and exclusivity of breast milk feedings at discharge for very low birth weight infants.

The Use of Leaflet as A Health Education Media in Increasing The Knowledge of Complementary Feeding for Breastfeeding Mothers

About a third of children around the world begin their untimely breastfeeding. Although several strategies have been implemented around the world to improve complementary feeding, progress has been slow. Improper feeding of complementary foods remains a significant global public health problem. The purpose of this study aims to determine the use of leaflets as a health education media in increasing the knowledge of complementary food in breastfeeding mothers. The study is Quasi-Experimental. with Pretest-Posttest with a Control Group. The Accidental Sampling sampling technique is breastfeeding mothers who have babies aged 7-24 months as many as 53 mothers as an experimental group and 53 mothers as a control group with the same criteria at the Posyandu of Belang Wetan Village. Primary data were collected with questionnaires containing objective questions. Secondary data with cohorts from village midwives. A hypothesis test is carried out after the pre-test, to find out whether or not there is an influence between free and bound variables, then using a paired sample t-test or paired sample t-test . The results of the analysis obtained a p-value of 0.000 less than 0.05. It can be concluded that there is an influence of health education methods using leaflet media and without using leaflet media on increasing knowledge that has a significant comparison of effectiveness. There is an influence of health education with leaflet media on increasing the knowledge of breastfeeding mothers about complementary feeding of breast milk in infants aged 7-24 months

Complementary feeding with traditional and baby led weaning (BLW) methods - assessment of selected aspects of infant's diet

Background: Infant nutrition is a topic of constant debate between parents and doctors. The recommendations themselves have been modified several times over the past 6 decades. Baby Led Weaning (BLW) method is gaining more and more popularity in infant nutrition during the period of expanding the infant menu. The main aim of the study was to evaluate selected aspects of dietary expansion in a group of their children, taking into account dietary expansion with the use of the traditional method and the BLW method. Material and method: An exploratory cross-sectional study was conducted in December 2021-January 2022 among a randomly selected sample of 523 mothers of children in infancy aged up to 12 months. Data for the study were collected anonymously using the CAWI method. The information collected from 500 women was considered for the final data analysis taking into account the inclusion and exclusion criteria. Results: 66.6% of the women surveyed (N=333) stated that their child is or was fed breast milk during the first six months. The child's diet was most often expanded with complementary meals after 6 months of age. This answer was indicated by 58.8% of respondents (N=294). 85.6% of the surveyed women (N=428) first introduced or intend to introduce vegetables to their diet. 13% of the respondents (N=65) introduced or planned to introduce vegetables and fruit at the same time. In the studied group of mothers the BLW method was not known or not used by 7 mothers (1.4%), 343 mothers used or intended to use the BLW method (68.6%), whereas 150 women knew the BLW method (30.0%), but did not use it or did not intend to use it during the expansion of their child's diet. Conclusions: The majority of mothers surveyed used the BLW method during the expansion of their children's diet, accepting the principle that it is the child who decides whether and how much to eat, and the parent who decides what and when the child eats.

P088 A Feasibility Trial of an Asynchronous Web-based Infant Feeding Course for Child and Adult Care Food Program Providers

<h3>Background</h3> The Child and Adult Care Food Program (CACFP) provides meals and snacks to children at eligible, participating locations. Previous nutrition interventions for providers presented improved knowledge of CACFP nutrition standards, behavioral intentions, and confidence about feeding practice. However, few studies focusing on infant feeding for providers have been reported. <h3>Objective</h3> To describe the development and implementation of an asynchronous virtual training course aiming to improve infant feeding practices of providers and report program outcomes. <h3>Study Design, Settings, Participants</h3> This study was a single group, pretest-posttest quasi-experimental design. A three-module course was developed and implemented through a partnership between the State Department of Education and an Extension system. Each module consisted of 2-3 sessions and was offered through the Canvas platform. Providers completed pre-survey (n = 51) and/or post-survey (n = 57), respectively. Participants (n = 32) who completed both were included for analysis. <h3>Measurable Outcome/Analysis</h3> Self-confidence and knowledge related to infant feeding were measured. Recommended changes were assessed qualitatively. Descriptive statistics and a marginal homogeneity test were used for analysis. <h3>Results</h3> Approximately 37% of participants were teachers and 24% were center directors or owners. After the course, participants' self-confidence significantly improved (<i>P</i> <0.001). In particular, they became very confident in describing breast milk storage (<i>P =</i> 0.001), when a child should switch from a bottle to a cup (<i>P =</i> < 0.001), and when a baby is ready to start eating solid foods (<i>P =</i> < 0.001). Also, participants significantly improved knowledge of infant feeding (<i>P</i> < 0.001). Qualitative responses emphasized the importance of educating staff to feed in response to hunger cues, rather than at set times. The participants mentioned that providing refresher training, and posting signage about breast milk and formula feeding and storage guidelines in classrooms would be beneficial. Constant communication with families was perceived to be important as well. <h3>Conclusions</h3> An asynchronous virtual training course implemented through an Extension was feasible and effective for improving self-efficacy and knowledge related to infant feeding. It also has potential for program sustainability. <h3>Funding</h3> USDA; US Department of Agriculture Child and Adult Care Food Program Meal Service Training Grant through the Maryland State Department of Education.

Analysis of Clinical Impact of Prenatal and Postpartum Care on Breast Milk Secretion and Feeding in Primipara

Analysis of Clinical Impact of Prenatal and Postpartum Care on Breast Milk Secretion and Feeding in Primipara

The Effects of COVID-19 Hospital Practices on Breastfeeding Initiation and Duration Postdischarge.

Background: Early in the COVID-19 pandemic, many birth hospitals separated SARS-CoV-2-positive mothers from their newborn infants and advised against breastfeeding to decrease postnatal SARS-CoV-2 transmission. Information on how these practices impacted breastfeeding postdischarge is limited. Objectives: In a statewide sample of SARS-CoV-2-positive mothers, we aimed to determine the extent to which (1) mother-infant separation and (2) a lack of breastfeeding initiation in-hospital were associated with breast milk feeding postdischarge. Design/Methods: From 11 birthing hospitals in Massachusetts, we identified 187 women who tested positive for SARS-CoV-2 from 14 days before to 72 hours after delivery (March 1-July 31, 2020) and their newborn infants. We abstracted chart data from the delivery hospitalization on main exposure variables (mother-infant separation, in-hospital breast milk feeding [expressed milk feeding and/or direct breastfeeding]) and from outpatient visits until 30 days postdischarge. We evaluated associations of in-hospital practices with outcomes up to 30 days postdischarge, adjusting for confounders using multivariable logistic and linear regression. Results: Mother-infant separation in-hospital was associated with a shorter duration of any breast milk feeding (regression coefficient estimate -5.29 days, 95% confidence intervals [CI] [-8.89 to -1.69]). Direct breastfeeding in-hospital was associated with higher odds of any breast milk feeding (adjusted odds ratios [AOR] 5.68, 95% CI [1.65-23.63]) and direct breastfeeding (AOR 8.19, 95% CI [2.99-24.91]) postdischarge; results were similar for any breast milk feeding in-hospital. Conclusions: Perinatal hospital care practices implemented early in the COVID-19 pandemic, specifically mother-infant separation and prevention of breast milk feeding initiation, were associated with adverse effects on breast milk feeding outcomes assessed up to 1 month postdischarge.

Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19.

Despite the well-known benefits of breastfeeding and the World Health Organization’s breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk’s protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.

The Case Number 112 of Congenital Chylous Ascites and Its Successful Treatment

Background:Congenital chylous ascites is a very rare condition that has been well recognized as early as the 1950s, and was mostly called “Congenital chyloperitoneum” during that time. Few cases have been reported during the 1960s, and in 1967, Craven et al attributed the development of congenital chylous ascites to obstruction of the cisterna chyli and chylous reflux into the peritoneal space and small intestine and they demonstrated lymphangiographically. Patients and methods: The use of a unique dietary therapy for the treatment of congenital chylous ascites is briefly described and the relevant literature is described. Results:An infant with congenital chylous ascites was seen at about the age of two and half months. He was initially treated with intravenous somatostatin infusion, and thereafter by repeated paracentesis, and continued to receive breast and bottle milk feedings. However, when he was first seen, ultrasound was still showing moderate ascites. The boy was successfully treated a combination of a unique form of very low-fat diet and octreotide acetate subcutaneous injections. Treatment was not associated with a negative effect on growth or development, and no evidence of nutritional deficiency was observed. Conclusion: The case number 112 of congenital chylous ascites is reported and its unique therapeutic approach is described.

Effects of antenatal counseling on additional kangaroo mother care and Non Nutritive Sucking vs routine care to improve breastmilk feeding and growth at discharge–A randomized controlled trial

IntroductionAdditional antenatal counselling of KMC and NNS improves breastmilk feeding in preterm infants however needs implementation. MethodsThis RCT was conducted in a level III hospital (6 months) to evaluate the effect of antenatal counseling of KMC and NNS on exclusive human milk feeding and growth in preterm infants (intervention group). Outcomes were proportion of neonates discharged on breast feeding + spoon feeding and weight gain. ResultsIn intervention group 53% (35 of 66) were discharged on breast feeding + spoon feeding as compared to 5% (3 of 63) in routine group (p=<0.001). In intervention group, 47% (31 of 66) were discharged on spoon feeding only as compared to 95% (60 of 63) in control group (p=<0.001). Mean weight gain was similar in both groups. ConclusionAdditional antenatal counseling on KMC and NNS improved breastmilk feeding, KMC and NNS rates during hospital stay and at discharge.

Patterns and Predictors of Breast Milk Feeding from Birth to Age 4 Months among Primiparous African American Mother-Infant Dyads.

The health benefits of breast milk feeding have been well-established, yet disparities exist, with African American mothers having the lowest breast milk feeding rates in the United States. This prospective, longitudinal study examined infant feeding (breast milk and/or infant formula) from birth to age 16 weeks, predictors of any breast milk feeding by age 1 week, and predictors of cessation of any breast milk feeding by ages 3, 8, and 16 weeks among primiparous African American mothers. This secondary analysis included 185 mother–infant dyads from the Sleep SAAF (Strong African American Families) study, a randomized clinical trial testing a responsive parenting vs. child safety control intervention. Mothers reported sociodemographic and psychosocial characteristics at age 1 week and infant feeding practices at ages 1, 3, 8, and 16 weeks. Rates of any breast milk feeding decreased from 66.5% at 1 week to 23.3% at 16 weeks. Bivariate logistic regression models showed that prepregnancy BMI (OR = 1.09), working prepregnancy (OR = 2.25), and food insecurity (OR = 2.49) significantly increased the odds of mothers feeding any breast milk by 1 week, whereas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation (OR = 0.21) significantly decreased the odds. Bivariate logistic regression models showed that Supplemental Nutrition Assistance Program (SNAP) participation (OR = 2.86) and racial discrimination (OR = 2.14) significantly increased the odds of cessation of any breast milk feeding by 3 weeks. SNAP (OR = 2.33) and WIC (OR = 2.38) participation significantly increased the odds of cessation of any breast milk feeding by 8 weeks, whereas higher prepregnancy BMI (OR = 0.95) decreased the odds. Higher mother’s age (OR = 0.92) significantly decreased the odds of cessation of any breast milk feeding by 16 weeks. The findings can be used to inform targeted interventions to promote mothers feeding any breast milk and help reduce breast milk feeding disparities among African American mothers.

Risk Factors Associated with Methicillin Resistance in Hospitalized Newborn Infants with Staphylococcus aureus Infection.

BackgroundAn increasing number of infections due to methicillin-resistant Staphylococcus aureus (S. aureus) have been reported worldwide. To explore the risk factors associated with methicillin-resistance among the neonates with confirmed S. aureus infections and thereby to help selection of appropriate empirical antibiotics.MethodsWe compared a group of hospitalized neonates with culture confirmed methicillin-resistant S. aureus (MRSA) infections to a group with methicillin-sensitive S. aureus (MSSA) based on antimicrobial susceptibility reports. We used multivariable regression analysis to determine the risk factors for neonatal MRSA infections.ResultsThere was no difference in the ratio of local to systemic infections or mortality between the two groups. However, the total hospitalization days and the medical care expenses in the MRSA group were significantly increased when compared to that of the MSSA group. Prior use of antibiotics for more than 48 hours was an independent risk factor for neonatal acquisition of MRSA infections, while exclusive breast milk feeding was a protective factor against MRSA infections.ConclusionRestrictions on antibiotic abuse and promotion of breast milk feeding may protect newborns from MRSA infections. Prior history of antibiotic use and exclusive breast milk feeding may be important factors to consider in the selection of appropriate empirical antibiotics for use in neonates prior to the availability of the results of antimicrobial susceptibility testing.

Complementary Feeding and Growth Among Low Birthweight Infants in the The Second Half of Infancy: Results From a Multi-Site Observational Cohort

ObjectivesThis study was designed to address the high prevalence of infant undernutrition among low birthweight (LBW, < 2.5kg) infants in the second half of infancy, and the dearth of evidence on the optimal transition and provision of complementary feeding and growth of LBW infants. The objectives were to understand the complementary feeding profile and growth outcomes in the second half of infancy; and to assess the relationship between poor nutritional status at the time of transition to complementary feeding and poor growth outcomes at one year.MethodsThe results presented in this abstract are part of the larger Low Birthweight Infant Feeding Exploration (LIFE) study conducted in India, Malawi and Tanzania. This was a formative, multi-site, observational cohort study that collected data on over 1100 moderately LBW infants throughout infancy. After the six month visit, mother-infant pairs were visited at nine and 12 months.ResultsA total of 1114 infants and their mothers were enrolled in the observational study. More than 95% of infants were fed breast milk at six, nine and 12 months of age. At nine and 12 months respectively, 48% and 31% of infants were not achieving a minimum acceptable diet, highlighting gaps in dietary diversity. A lack of dietary diversity was exacerbated among infants born to younger, less educated and/or multiparous mothers. Proteins were more limited than any other food group; only 66% and 70% of infants were fed animal source foods at nine and 12 months, respectively. Prevalence of stunting (>30%) increased from six to 12 months while underweight (26%) and wasting (10%) remained consistent; regional differences were observed. Importantly, poor growth outcomes at six months were predictive of those at 12 months even when adjusted for key covariates (stunting RR = 2.84, p < 0.001; underweight RR = 6.41, p < 0.001; wasting RR = 4.89, p < 0.001).ConclusionsGiven the gaps in the optimal quality of complementary feeding and predictive relationship between six and 12 month growth outcomes, efforts should be made to enhance the promotion of feeding counseling before and during the transition to complementary feeding and to address key barriers to the provision of a diverse diet. In addition, growth monitoring and proactive intervention at six months or earlier could serve to prevent poor outcomes at one year of life.Funding SourcesBill & Melinda Gates Foundation.

The Use of Probiotics in Preterm Infants

Probiotics are live microorganisms that positively affect host health by altering the composition of the host microbiota. Gastrointestinal dysbiosis refers to adverse alterations of the intestinal flora and is associated with several diseases, including necrotizing enterocolitis, late-onset sepsis in preterm infants as well as atopic disease, colic, diabetes, and diarrhea in term infants. The risk factors for gastrointestinal dysbiosis are preterm birth, cesarean section delivery, and formula feeding, in contrast to term birth infants, vaginal delivery and breast milk feeding. Probiotics have been used to restore synbiosis in infants with gastrointestinal dysbiosis. Probiotics inhibit colonization of pathogenic bacteria in the gastrointestinal tract, thereby improving the barrier function of the gastrointestinal tract, and the immune function. In preterm infants, probiotics reduce mortality as well as rates of necrotizing enterocolitis and late-onset sepsis. The combined use of probiotics such as &lt;i&gt;Lactobacillus&lt;/i&gt; and &lt;i&gt;Bifidobacterium&lt;/i&gt; and the combination of probiotics with prebiotics yield better outcomes in the prevention of necrotizing enterocolitis than those achieved with a single pro- or prebiotic strain. However, the routine use of probiotics has been hindered by the lack of pharmaceutical-quality products, and a definite effect has yet to be demonstrated in preterm infants with a birth weight &lt;1,000 g. Therefore, to reduce the risk of necrotizing enterocolitis in preterm infants, probiotics should be provided along with breast milk and other strategies aimed at preventing gastrointestinal dysbiosis.