Full Breast Research Articles

Effects and kinetics of maternal supplementation on vitamin concentrations in human milk

Maternal supplementation in lactation could be an effective approach for improving breast milk quality in populations consuming poor quality diets. To determine acute effects of micronutrient (MN) supplementation on concentrations in milk during a 24h period, we recruited 18 healthy Bangladeshi women at 2-4 mo lactation for a 3d supplementation study. On d 1, no supplements were given, while in the morning of d 2 and 3 the participants received a dose of ~1x and 2x RDA respectively. Aliquots of a full breast milk expression were collected during every feed from the same breast on each study day and analyzed for vitamins A, E, B1, B2, B3, B6, and B12. All but vitamin A showed differences in mean concentrations based on collection day (P < 0.05, n = 448). To explore kinetics of vitamin secretion into milk, samples were grouped into 2h time intervals/d and mean values of the same intervals across days were compared. B2 and B6 concentrations both spiked after supplement consumption. The B2 spike occurred in the first post-supplement sample (2-8 fold increases vs. d 1), while the B6 spike showed a 2-5 fold increase in the first sample and remained elevated 2-4 fold vs. d 1 for the second sample. In fact, a 1.5-3 fold increase in B6 persisted throughout the study days. No other vitamin showed a spike. Therefore, a fasting sample underestimates daily output of B2 and B6 by up to 36% if a MN supplement is consumed later that day. Conversely, the spikes in B2 and B6 will cause a gross overestimate of 24h output in samples collected at 2 (B2 up to 390%) and 4h (B6 up to 190%) after supplement is consumed. Timing of collection is key to obtain representative daily concentrations. Funded by Bill & Melinda Gates Foundation (OPP1061055).

A Novel Approach for Removal of Pectoral Muscles in Digital Mammogram

Removal of noise and pectoral muscles are the two important pre-processing steps in CAD system for the diagnosis of breast cancer. This work combines Robust Outlyingness Ratio (ROR) mechanism with extended NL-Means (ROR-NLM) filter based on Discrete Cosine Transform (DCT) for the detection and removal of noise. This method removes Gaussian and impulse noise very effectively without any loss of desired data. For segmenting and removing pectoral muscles, this paper uses global thresholding to identify pectoral muscles, edge detection processes to identify the edge of the full breast and connected component labelling to identify and remove the connected pixels outside the breast region. The result shows that our approach removes Gaussian and impulse noise effectively without any loss of desired data and overall gives 90.06% accuracy.

TRAM flap in reconstructive operations in patients with breast cancer

The treatment of breast cancer (BC) is a relevant problem. Surgery is a key treatment method for BC. The volume of its operations varies from radical mastectomies to lumpectomies and, in the areas of regional metastases, from three-level lymphadenectomy to sentinel lymph node biopsy. Objective: to assess whether a displaced TRAM flap may be used for reconstructive operations for BC. The paper presents some experience in treating 11 BC patients in whom a displaced TRAMP flap was employed for reconstruction. At this time, the displaced TRAM flap was applied for delayed reconstruction in 3 patients. The mean age of the patients was 45.5 ± 15.7 years. In 8 BC patients undergoing one-stage reconstruction with a displaced TRAM flap, the treatment schedule was as follows: surgical treatment in 1 patient, combined treatment in 2 patients, and multimodality treatment in 5. The patients received targeted therapy in 3 cases or hormone therapy in 6. A lower abdominal skin-and-fat flap on one vascular pedicle was used in all the 11 patients. Indications for using a displaced TRAM flap were determined; complications were analyzed. The percentage of complications due to the use of a displaced TRAM flap was 9.1 % in our study. To reduce the rate of complications after breast reconstruction with a displaced TRAM flap, we carefully selected patients for this choice of a plastic component. The displaced TRAM flap is one of the variants for delayed breast reconstruction despite its duration and complexity. Corrective surgery is further used to achieve breast symmetry. Corrective operations, namely, breast liposuction and submammary fold formation, were performed in 2 patients. For full breast recovery, the nipple-areolar complex is to be formed following skin-sparing mastectomies and delayed breast reconstructions. The cosmetic effect was evaluated in 11 patients as excellent in 4 (36.4 %) cases, good in 7 (63.6 %). Neither local recurrences nor distant metastases were revealed in the 11 patients during one-year follow-up.

Treatment of maternal hypergalactia.

Treatment of maternal hypergalactia.

Breast tumor segmentation in high resolution x-ray phase contrast analyzer based computed tomography.

Phase contrast computed tomography has emerged as an imaging method, which is able to outperform present day clinical mammography in breast tumor visualization while maintaining an equivalent average dose. To this day, no segmentation technique takes into account the specificity of the phase contrast signal. In this study, the authors propose a new mathematical framework for human-guided breast tumor segmentation. This method has been applied to high-resolution images of excised human organs, each of several gigabytes. The authors present a segmentation procedure based on the viscous watershed transform and demonstrate the efficacy of this method on analyzer based phase contrast images. The segmentation of tumors inside two full human breasts is then shown as an example of this procedure's possible applications. A correct and precise identification of the tumor boundaries was obtained and confirmed by manual contouring performed independently by four experienced radiologists. The authors demonstrate that applying the watershed viscous transform allows them to perform the segmentation of tumors in high-resolution x-ray analyzer based phase contrast breast computed tomography images. Combining the additional information provided by the segmentation procedure with the already high definition of morphological details and tissue boundaries offered by phase contrast imaging techniques, will represent a valuable multistep procedure to be used in future medical diagnostic applications.

MODERN METHODS OF PRESERVING BREAST FEEDING IN CHILDREN OF THE FIRST MONTHS OF LIFE WITH HEALTH DISORDERS

научный биометрический журнал, который знакомит читателя с клиническими рекомендациями и особенностями применения лекарственных и вакцинных средств у детей, предоставляет исчерпывающую информацию о воздействии лекарственных средств на плод, о проводимых в

Improving coding of breast reconstruction surgery

Introduction: Accurate clinical coding of operative procedures is crucial for the allocation of appropriate resources, billing and since this year, for individual surgeons’ outcomes data. The expansion of oncoplastic breast surgery has led to increased complexity, since cancer treatment is combined with breast remodelling, autologous and implant reconstructions in various permutations and combinations. Our District General Hospital has two full time oncoplastic breast surgeons who observed inaccurate coding.

Radiation dose in breast CT imaging with monochromatic x-rays: simulation study of the influence of energy, composition and thickness

Recent developments have shown that high resolution phase contrast x-ray computed tomography (CT) of the breast can be performed at clinically compatible doses. Results have yet been obtained in vitro on full breasts, and the clinical translation of the technique seems more and more possible. This work presents a method to quickly estimate the average dose in the organ using the software GATE. The influence of different parameters on the dose distribution, like breast composition and thickness, and for preclinical test, the presence of a skin/PMMA external layer, has been investigated. Several correction factors, to be applied to the given dose database, are also introduced to allow the use of these results in geometries different from those studied here. An energy optimization study is presented that considers also the influence on the energy choice of x-ray detector. A simple analytical method to estimate the best energy that minimizes the dose-transmittance ratio in CT imaging is presented and compared with the results of simulations.

농촌지역 영유아의 모유수유 관련 요인

본 연구는 농촌지역의 모유수유 실태를 파악하고 이에 영향을 미치는 관련 요인을 살펴보고자 하였다. 2012년 3월 20일부터 4월 19일까지 울산광역시 울주군의 보건소 및 보건지소와 어린이집을 다니는 60개월 미만의 영유아를 둔 어머니 139명을 대상으로 실시하였다. 자료분석은 SPSS Win 18.0 프로그램을 이용하였고 영역별 분석은 평균과 표준편차, 다중회귀분석으로 통계적 진술하였다. 다중 로지스틱 회귀분석 결과 모유수유에 영향을 미치는 관련 요인으로는 어머니의 직장유무, 산전 모유수유 교육 여부, 생후 1개월에 완전모유수유 유무가 영향을 미치는 것으로 나타났다. 지속적인 완전모유수유율을 높이기 위해서는 분만 전 병의원이나 보건소 등을 통한 교육의 실시, 직장 여성에게는 출산휴가나 육아휴직 사용 등으로 인한 불이익이 없는 지역사회 환경이 필요할 것으로 사료된다. The purpose of this research is to observe the rate of breastfeeding and to identify factors related to the breastfeeding in rural area. We conducted a survey targeting 139 mothers whose infants are less than 60 months old in Ulju-gun, Ulsan. SPSS Win 18.0 program was used as the data analysis and a statistical statement by mean, standard deviation, and logistic regression analysis. According to the findings of this study, it indicated that the factors affecting the rate of breastfeeding in a rural region are mothers'job, 1 month breastfeeding after birth and the education of breastfeeding before birth. In this study we need to continuously conduct the breast feeding education by hospitals or clinics before birth, so that breast feeding can be provided well after birth. Also, we need to establish the social system and atmosphere without any disadvantages resulting from maternity leave so that working mothers can provide full breast feeding for six months after birth because the return to work can interfere with the practice of breast feeding.

Pursuing optimal thresholds to recommend breast biopsy by quantifying the value of tomosynthesis.

A 2% threshold has been traditionally used to recommend breast biopsy in mammography. We aim to characterize how the biopsy threshold varies to achieve the maximum expected utility (MEU) of tomosynthesis for breast cancer diagnosis. A cohort of 312 patients, imaged with standard full field digital mammography (FFDM) and digital breast tomosynthesis (DBT), was selected for a reader study. Fifteen readers interpreted each patient's images and estimated the probability of malignancy using two modes: FFDM versus FFDM + DBT. We generated receiver operator characteristic (ROC) curves with the probabilities for all readers combined. We found that FFDM+DBT provided improved accuracy and MEU compared with FFDM alone. When DBT was included in the diagnosis along with FFDM, the optimal biopsy threshold increased to 2.7% as compared with the 2% threshold for FFDM alone. While understanding the optimal threshold from a decision analytic standpoint will not help physicians improve their performance without additional guidance (e.g. decision support to reinforce this threshold), the discovery of this level does demonstrate the potential clinical improvements attainable with DBT. Specifically, DBT has the potential to lead to substantial improvements in breast cancer diagnosis since it could reduce the number of patients recommended for biopsy while preserving the maximal expected utility.

The Saartjie Baartman’s Body Shape versus the Victorian Dress: The Untold African Treasures

In most African countries, it is still a common belief that thin women are not attractive. Until the 21st century, full-figured women were considered attractive, were respected, and their padded (with flesh) and curvaceous bodies represented wealth, fertility and good health. The western society views a thin woman as ideal body and has forced many women including Africans to believe that a body that deviates from it is unaccepted. Fashion designers use the thin model as a basis from which to create ready-to-wear clothing for all consumers including those whose body characteristics do not comply with the ideal body features. This has resulted in unsatisfied consumers with clothing sold in the retail stores and negative reactions towards their bodies. The problem of ideal body versus un-ideal body shape date back to 19th Century, where Saartjie Baartman’s body shape characterised by full breasts, narrow waist and extra large buttocks was viewed by Europeans as ugly, yet later on, the same body, though not acknowledged, was used to inspire the creation of Victorian bustle dress that resembled her body in every aspect. This article examines the relationship between the Victorian Bustle dress that became popular from 1870 onwards and the unique body features of Saartjie Baartman, an African slave who was displayed in Europe against her wish as from 1810 to 1815, and even after her death, her body continued to be exhibited in a Museum in Paris. This paper concludes that her body could have inspired the development of the Victorian bustle dress. The paper encourages African women to view their bodies sensibly rather than basing their beauty on the western standard ideologies. Likewise, promotional media houses are encouraged to portray all body shapes fairly and positively. African researchers are advised to search beyond surfaces of historical events for the purposes of documenting underlying important facts affecting Africa.

Lucky

Lucky

Automated fibroglandular tissue segmentation and volumetric density estimation in breast MRI using an atlas‐aided fuzzy C‐means method

Breast magnetic resonance imaging (MRI) plays an important role in the clinical management of breast cancer. Studies suggest that the relative amount of fibroglandular (i.e., dense) tissue in the breast as quantified in MR images can be predictive of the risk for developing breast cancer, especially for high-risk women. Automated segmentation of the fibroglandular tissue and volumetric density estimation in breast MRI could therefore be useful for breast cancer risk assessment. In this work the authors develop and validate a fully automated segmentation algorithm, namely, an atlas-aided fuzzy C-means (FCM-Atlas) method, to estimate the volumetric amount of fibroglandular tissue in breast MRI. The FCM-Atlas is a 2D segmentation method working on a slice-by-slice basis. FCM clustering is first applied to the intensity space of each 2D MR slice to produce an initial voxelwise likelihood map of fibroglandular tissue. Then a prior learned fibroglandular tissue likelihood atlas is incorporated to refine the initial FCM likelihood map to achieve enhanced segmentation, from which the absolute volume of the fibroglandular tissue (|FGT|) and the relative amount (i.e., percentage) of the |FGT| relative to the whole breast volume (FGT%) are computed. The authors' method is evaluated by a representative dataset of 60 3D bilateral breast MRI scans (120 breasts) that span the full breast density range of the American College of Radiology Breast Imaging Reporting and Data System. The automated segmentation is compared to manual segmentation obtained by two experienced breast imaging radiologists. Segmentation performance is assessed by linear regression, Pearson's correlation coefficients, Student's paired t-test, and Dice's similarity coefficients (DSC). The inter-reader correlation is 0.97 for FGT% and 0.95 for |FGT|. When compared to the average of the two readers' manual segmentation, the proposed FCM-Atlas method achieves a correlation of r = 0.92 for FGT% and r = 0.93 for |FGT|, and the automated segmentation is not statistically significantly different (p = 0.46 for FGT% and p = 0.55 for |FGT|). The bilateral correlation between left breasts and right breasts for the FGT% is 0.94, 0.92, and 0.95 for reader 1, reader 2, and the FCM-Atlas, respectively; likewise, for the |FGT|, it is 0.92, 0.92, and 0.93, respectively. For the spatial segmentation agreement, the automated algorithm achieves a DSC of 0.69 ± 0.1 when compared to reader 1 and 0.61 ± 0.1 for reader 2, respectively, while the DSC between the two readers' manual segmentation is 0.67 ± 0.15. Additional robustness analysis shows that the segmentation performance of the authors' method is stable both with respect to selecting different cases and to varying the number of cases needed to construct the prior probability atlas. The authors' results also show that the proposed FCM-Atlas method outperforms the commonly used two-cluster FCM-alone method. The authors' method runs at ∼5 min for each 3D bilateral MR scan (56 slices) for computing the FGT% and |FGT|, compared to ∼55 min needed for manual segmentation for the same purpose. The authors' method achieves robust segmentation and can serve as an efficient tool for processing large clinical datasets for quantifying the fibroglandular tissue content in breast MRI. It holds a great potential to support clinical applications in the future including breast cancer risk assessment.

Design and evaluation of a laboratory prototype system for 3D photoacoustic full breast tomography.

Photoacoustic imaging can visualize vascularization-driven optical absorption contrast with great potential for breast cancer detection and diagnosis. State-of-the-art photoacoustic breast imaging systems are promising but are limited either by only a 2D imaging capability or by an insufficient imaging field-of-view (FOV). We present a laboratory prototype system designed for 3D photoacoustic full breast tomography, and comprehensively characterize it and evaluate its performance in imaging phantoms. The heart of the system is an ultrasound detector array specifically developed for breast imaging and optimized for high sensitivity. Each detector element has an acoustic lens to enlarge the acceptance angle of the large surface area detector elements to ensure a wide system FOV. We characterized the ultrasound detector array performance in terms of frequency response, directional sensitivity, minimum detectable pressure and inter-element electrical and mechanical cross-talk. Further we evaluated the system performance of the laboratory prototype imager using well-defined breast mimicking phantoms. The system possesses a 2 mm XY plane resolution and a 6 mm vertical resolution. A vasculature mimicking object was successfully visualized down to a depth of 40 mm in the breast phantom. Further, tumor mimicking spherical objects with 5 and 10 mm diameter at 20 mm and 40 mm depths are recovered, indicating high system sensitivity. The system has a 170 × 170 × 170 mm(3) FOV, which is well suited for full breast imaging. Various recommendations are provided for performance improvement and to guide this laboratory prototype to a clinical version in future.

Protocol versus ad libitum feeds after laparoscopic pyloromyotomy: A prospective randomized trial

BackgroundWe conducted a prospective, randomized trial comparing protocol to ad libitum (ad lib) feeding after laparoscopic pyloromyotomy. MethodsInfants undergoing laparoscopic pyloromyotomy were randomized to protocol versus ad lib feeding strategies. The protocol started with Pedialyte® two hours post-operative. This was repeated by another round of Pedialyte®, then two rounds of half-strength formula or breast milk, followed by two rounds of full strength formula or breast milk, followed by the home feeding regimen, at which time the patient was discharged if feeding well. The ad lib group was allowed formula or breast milk two hours after the operation and considered for discharge after tolerating three consecutive feeds. The primary outcome variable was the length of postoperative hospitalization. ResultsOne hundred fifty infants were enrolled between January 2010 and December 2011. There were no differences in patient characteristics at presentation. While the ad lib group reached goal feeds sooner than the protocol group, this did not translate into a difference in duration of postoperative hospitalization. There were more patients with emesis in the ad lib group after goal feeding was reached, but no difference in readmissions. ConclusionAd lib feeding allows patients to reach goal feeds more rapidly than protocol feeding following laparoscopic pyloromyotomy. However, this goal is usually reached beyond discharge hours, resulting in a similar duration of hospitalization.

Accelerated breast MRI for breast cancer screening.

1 Background: Current breast MRI protocols are designed for diagnostic, not for screening purposes, and are therefore time consuming to acquire and to read. We investigated whether an abridged breast MRI protocol, consisting only of the first post contrast subtracted (FAST) images and their maximum intensity projection (MIP), would be suitable for screening purposes. Idea was to trade some of the very high sensitivity of breast MRI for acquisition and interpretation speed. Long term goal is to increase the access to breast MRI by reducing the cost associated with the examination. Methods: 443 women at increased risk of breast cancer, with negative digital mammography, underwent 606 breast MRI screening studies. Images were prospectively read by experienced breast radiologists. Readers were asked to first review the MIPs and search for significant enhancement, then to evaluate the FAST images for possible further categorization of enhancement, and only thereafter, to analyse the full diagnostic breast MRI protocol. We compared diagnostic yield and accuracy of MIP and of FAST readings vs. that of the full protocol. Results: MR table time for the full protocol was 21 minutes, table time for FAST images and MIPs was under 3 minutes. Average time to read MIP and FAST image was 2.8 seconds and 28 seconds, respectively. A total 11 breast cancers (4 DCIS, 7 invasive, median size 8 mm, all intermediate or high grade), were diagnosed in the 603 examinations for an additional cancer yield of 18.2/1000. MIPs were positive in 9/11 (82%); FAST readings as well as the full protocol were positive in 10/11 (91%). NPV of the MIP and FAST readings was 99.6% (484/486) and 99.8%, respectively. Specificity of FAST readings was equivalent to that of the full protocol (94.4%), with 33 vs. 35 false-positive diagnoses. Conclusions: In this high risk screening cohort, an MR table time of 3 minutes and an expert radiologist reading time of 2 seconds for the interpretation of the MIP image was sufficient to establish absence of breast cancer with a negative predictive value of 99.6%. With the same abridged MR protocol and an expert reading time of under 30 seconds for interpretation of FAST images, sensitivity and specificity was identical to that of the full protocol, allowing an additional cancer yield of 18.2/1,000.

Loss of Blood = Loss of Breast Milk? The Effect of Postpartum Hemorrhage on Breastfeeding Success

<h2>Childbearing Poster Presentation</h2><h3>Background</h3> Postpartum hemorrhage (PPH) can trigger a series of events that prevent a mother from fully breastfeeding. Routine evidence‐based actions to increase breastfeeding success become interrupted. Mother and infant may be separated, causing a delay in breastfeeding initiation. Maternal fatigue may also necessitate formula supplementation. A traumatic birth and maternal stress and fatigue associated with PPH often interfere with the normal onset of lactogenesis II. Blood loss and hypotension may cause ischemia or infarct of the highly vascular pituitary gland. During lactogenesis II, prolactin, which stimulates human milk production, releases from the anterior pituitary. Following pituitary insult, altered prolactin levels likely cause insufficient milk production. In the rare complication of Sheehan's Syndrome, the necrotic pituitary completely loses function resulting in failure to lactate. Insufficient milk and delayed onset of milk production, consequences of PPH, can have a significant impact on new mothers who often identify low milk supply with failure. <h3>Case</h3> A primipara delivered vaginally a large for gestational age infant who nursed strongly for 25 minutes within the first hour. The mother's initial blood loss of 300 ml and a subsequent bleed of 850 ml caused her hemoglobin to drop from 12.6 mg/dl to 6.8 mg/dl. She was transferred to a high‐risk unit and transfused. Breastfeeding was interrupted for the next 22.5 hours while the infant was formula fed. When reunited, the infant nursed strongly for 40 minutes but was not satisfied. At this time, a lactation consultant informed mother of the risk of delayed onset of copious milk production. A collaborative team of nurse, patient, and lactation consultant initiated a plan to stimulate the mother's full lactation potential, which eased the mother's anxiety over potential insufficient milk supply. The mother was taught signs of ineffective breastfeeding and delayed milk onset prior to discharge and referred to breastfeeding support resources. The mother noted breast changes at 8 days. At 2 weeks old, the infant regained birth weight, and formula supplementation decreased. At 1 month, the mother elected to use occasional formula, but was feeding the infant at breast to her satisfaction. <h3>Conclusion</h3> Nurses can collaborate to offer appropriate practical and emotional breastfeeding support for mothers experiencing PPH. Even when full breastfeeding is not attained immediately, evidence supports the possibility of transitioning from partial to full breast milk feeding. Mothers who experience PPH need nurse champions to support their breastfeeding goals during this precarious time.

English

Accessory breasts are an uncommon entity & more uncommon when it is functioning. They may present as asymptomatic mass along the mammary ridge or symptoms evident during menarche, menstruation, pregnancy & lactation. We report a case of unilateral accessory breast in right axilla which was secreting milk on day 3rd postpartum. CASE REPORT: A 28 years old primipara presented with swelling in right axilla of 4 years duration which slowly increased to present size. The swelling was small in the beginning then in 4th month of pregnancy she noticed marked increase in size. There is also h/o pain in the swelling during menses. Caesarean section was done for cephalo-pelvic disproportion. On 3rd postoperative day she started complaining of pain & milk secretion from the accessory breast. On examination ,a large pendulous swelling was palpable in right axilla, the size being 7cm x 4cm in size , mobile, with skin free from the underlying tissue. It was hyperpigmented with a small opening from where milk could be expressed. Clinically, other pathology of breast was excluded. Sonomammography was done which showed normal breast tissue. Thus a diagnosis of functioning accessory breast was made. She was advised regular feeding with expression of milk from the accessory breast &follow up after 6 months for definite treatment. DISCUSSION: Aberrant breast tissue is usually present along the milk line above or below the normal breast location. This results due to incomplete embryological regression of mammary ridges. Occasionally they are found in unusual locations, such as the axilla, scapula, thigh & labia majora. Accessory breasts occur in 0.4% of women. They may present as asymptomatic masses or cause pain, restriction of arm movements, cosmetic problems, or anxiety. Commonly accessory breasts are bilateral & usually become noticeable only after hormostimulation, during puberty, pregnancy or lactation. Accessory tissue may range from a subcutaneous focus of breast tissue to full accessory breast complete with areola and nipple. When nipple and areola are absent, the diagnosis becomes exceedingly challenging. It may also be a diagnostic challenge, as other benign and malignant lesions occur in the body. Interestingly, soft tissue sarcomas (malignant fibrous histiocytoma) have been reported. Mammographic and sonographic findings include mass like density that is identical of the normal breast parenchyma in the axilla. Fine needle aspiration is a useful tool. Ectopic

Oral–Motor Function and Feeding Intervention

ABSTRACTThis article presents the elements of the Oral Motor Intervention section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy interventions presented in this path are evidence based as well as infant driven and family focused. In the context of anticipated maturation of suck–swallow–breathe coordination, the timing and methods for initiation of oral feedings and transition from gavage to full breast or bottle-feedings are presented with supporting evidence.

Relationship of insulin, glucose, leptin, IL‐6 and TNF‐α in human breast milk with infant growth and body composition

Numerous appetite, growth, obesity-related hormones and inflammatory factors are found in human breast-milk, but there is little evidence on their relationship with infant body composition. OBJECTVIE: The purpose of the present cross-sectional pilot study was to assess the cross-sectional associations of appetite-regulating hormones and growth factors (leptin, insulin and glucose) and inflammatory factors (interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α)) in human breast-milk with infant size, adiposity, and lean tissue at 1-month of age in healthy term infants. Human breast-milk was collected from nineteen exclusively breast-feeding mothers using one full breast expression between 8:00 and 10:00 a.m. The milk was then mixed, aliquoted, stored at -80°C and then centrifuged to remove the milk fat, prior to analyses using commercially available immunoassay kits; milk analytes were natural log transformed prior to analysis. Infant body composition was assessed using a Lunar iDXA v11-30.062 scanner (Infant whole body analysis enCore 2007 software, GE, Fairfield, CT). Maternal pre-pregnancy BMI was positively associated with milk leptin concentration (P = 0.0027), and so maternal-BMI-adjusted Spearman correlations were examined between breast-milk analytes and infant growth and body composition variables. As previously reported, greater milk leptin was associated with lower BMIZ (BMI-for-age z-score based on WHO 2006 growth charts; r = -0.54, P = 0.03). Glucose was positively associated with relative weight (r = 0.6, P = 0.01), and both fat and lean mass (0.43-0.44, P < 0.10). Higher concentrations of milk insulin were associated with lower infant weight, relative weight, and lean mass (r = -0.49-0.58, P < 0.06). Higher milk IL-6 was associated with lower relative weight, weight gain, percent fat, and fat mass (r = -0.55-0.70, P < 0.03 for all), while higher TNF-α was associated with lower lean mass (r = -0.58, P = 0.05), but not measures of adiposity. These preliminary data suggest for the first time that in the first months of life, breast-milk concentrations of insulin, glucose, IL-6 and TNF-α, in addition to leptin, may be bioactive and differentially influence the accrual of fat and lean body mass.