Longer Duration Of Breastfeeding Research Articles

Breastfeeding, long-chain polyunsaturated fatty acids in colostrum, and infant mental development.

Breastfeeding has been associated with improved neurodevelopment in children. However, it remains unknown to what extent nutritional advantages of breast milk may explain this relationship. We assessed the role of parental psychosocial factors and colostrum long-chain polyunsaturated fatty acid (LC-PUFA) levels in the relationship between breastfeeding and children's neurodevelopment. A population-based birth cohort was established in the city of Sabadell (Catalonia, Spain) as part of the INMA-INfancia y Medio Ambiente Project. A total of 657 women were recruited during the first trimester of pregnancy. Information about parental characteristics and breastfeeding was obtained by using a questionnaire, and trained psychologists assessed mental and psychomotor development by using the Bayley Scales of Infant Development in 504 children at 14 months of age. A high percentage of breastfeeds among all milk feeds accumulated during the first 14 months was positively related with child mental development (0.37 points per month of full breastfeeding [95% confidence interval: 0.06-0.67]). Maternal education, social class, and intelligence quotient only partly explained this association. Children with a longer duration of breastfeeding also exposed to higher ratios between n-3 and n-6 PUFAs in colostrum had significantly higher mental scores than children with low breastfeeding duration exposed to low levels. Greater levels of accumulated breastfeeding during the first year of life were related to higher mental development at 14 months, largely independently from a wide range of parental psychosocial factors. LC-PUFA levels seem to play a beneficial role in children's mental development when breastfeeding levels are high.

Duration of breast feeding and risk of developmental delay in Taiwanese children: a nationwide birth cohort study

The purpose of this study was to examine the relationship between duration of breast feeding and four developmental domains: gross motor, fine motor, language, and personal/social skills. This study included 14,621 infants from birth to 18 months of age. In the Taiwan Birth Cohort Study, four developmental screening items adapted from the Denver Development Screening Test were most appropriate for children aged 15 to 18 months. The proportion of young children who had mastered specific milestones increased consistently with longer duration of breast feeding. The adjusted odds ratios of the risk of developmental delay for the longest duration of breast feeding vs. never breast-fed were 0.69 [95% confidence interval (CI) 0.57, 0.83] for gross motor, 0.64 [95% CI 0.53, 0.77] for fine motor, 0.74 [95% CI 0.60, 0.91] for language, and 0.76 [95% CI 0.64, 0.90] for personal/social skills. Regardless of when the mothers returned to work, duration of breast feeding was found to have an inverse association with developmental delay in young children. The protection against developmental delays remained significant for those children who were breast-fed for more than 6 months. Children who were breast-fed for longer than 6 months had a lower risk of developmental delay than those who were never breast-fed. These data support the hypothesis that duration of breast feeding is positively related to young children's neurodevelopment.

THE EFFECT OF PREVIOUS BREASTFEEDING ON THE BIRTH WEIGHT OF SUBSEQUENT CHILDREN

Background and Aims: Studies have shown that birth weight increases with parity, while breastfeeding lowers the maternal body burden of persistent environmental toxicants. We hypothesized that women with longer history of previous breastfeeding have a reduced risk of adverse birth outcomes in subsequent pregnancies due to the decreased exposure of the fetus to such toxicants. Methods: We restricted our analysis to second gravida women with singleton births from the “Norwegian Human Milk Study” (HUMIS, n=806 mother-newborn pairs), the Spanish multi-center “INMA” study (n=737), and the Greek “Rhea” cohort (n=404). Breastfeeding duration in previous pregnancy (in months) was assessed by a questionnaire, and data on birth outcomes; birth weight, small for gestational age, large for gestation age, difference in birth weight between index and previous pregnancy, were obtained from the women’s clinical records and questionnaires. Multivariable log-binomial and linear regression models were used, adjusting for several potential confounders. Results: Breastfeeding duration in previous pregnancy is associated with a slightly reduced risk for small for gestational age neonates in index pregnancy, consistently in the three cohorts, though not statistically significant in any cohort. A per month increase in breastfeeding duration in Rhea cohort increased the birth weight in index pregnancy by 9.3 gr (b coefficient: 9.3; 95% CI: 2.5, 16.1), while smaller increases were observed in the INMA and HUMIS cohorts. Results will be presented on additional birth outcomes including large for gestational age, birth weight and the difference in birth weight between index and previous pregnancy. Conclusions: This is the first time that this research hypothesis is being investigated. Results indicate that long duration of breastfeeding may slightly reduce the risk of adverse birth outcomes in subsequent pregnancies, although residual confounding of breastfeeding habits by socioeconomic-status is a challenge and cannot be fully eliminated.

Forearm bone mineral density changes during postpartum and the effects of breastfeeding, amenorrhea, body mass index and contraceptive use

Prospective cohort study performed to evaluate bone mineral density (BMD) changes up to 12 months postpartum of healthy women and its association with breastfeeding, contraceptive methods, amenorrhea, and body mass index (BMI). There is a trend in bone loss during the first 6 months with posterior recovery, with evidence of a protective effect of hormonal contraception. This study was conducted to evaluate bone mineral density (BMD) changes during postpartum period among healthy women and its association with breastfeeding, use of contraceptive methods, amenorrhea and body mass index (BMI). A prospective cohort study including 100 healthy women. Distal BMD was measured 7-10 days, 3, 6, and 12 months postpartum at the nondominant forearm using dual-energy X-ray absorptiometry. Data about breastfeeding duration, amenorrhea, contraceptive use and BMI were collected. Seventy-eight women had a complete set of BMD measurements. The mean duration of exclusive breastfeeding was 125.9 (±66.6) days, with a median total lactation period of 263.5 days. The mean duration of amenorrhea was 164.2 (±119.2) days. BMD measurements showed a significant decrease in the distal radius, however with no significance in the ultradistal radius. When considering only the nonhormonal contraceptive users, the difference at 12 months was significant. Multivariate analysis of variance showed that both BMI and contraceptive use were significantly correlated with BMD. Multiple linear regression analysis showed significant correlation of distal radius with baseline BMD at the same site, pregestational BMI, age, years of schooling and difference in BMI. For ultradistal radius, there was a significant direct correlation with its baseline BMD and pregestational BMI. There was a trend in bone loss during the first 6 months postpartum with posterior recovery. Also, hormonal contraceptive methods provided protection of bone loss. However, the long duration of breastfeeding and the follow-up were not sufficient to draw definitive conclusions on postweaning BMD conditions.

Breastfeeding Protects Against Type 1 Diabetes Mellitus: A Case–Sibling Study

Some epidemiological studies have shown a protective effect of breastfeeding against type 1 diabetes mellitus (T1DM), whereas others have found opposite results. The role of early exposure to cow's milk protein and shorter duration of breastfeeding are still controversial. This study aimed to compare the frequency and duration of breastfeeding among siblings with and without T1DM. A case-control study was conducted at the Prof. Fernando Figueira Institute of Integral Medicine, Recife, PE, Brazil, between June 2009 and August 2010. The case patients were children with T1DM, and the controls were their unaffected sibling. The World Health Organization criteria for T1DM were used. All T1DM cases had the diagnostic criteria confirmed by checking their medical records. Data on infant feeding during the first year of life, prenatal care, gestational age, delivery, birth weight, and immunization status were collected through information provided by the mothers. In total, 123 children with diabetes mellitus type 1 and their respective siblings were studied. There was no difference in breastfeeding rates among the two groups, but patients with diabetes had a shorter duration of breastfeeding (3.3 vs. 4.6 months, p < 0.001). The diabetic group was exposed earlier to cow's milk. After controlling for other associated variables it was shown that a longer duration of breastfeeding was associated with a protective effect against diabetes. Our data support the proposal that a shorter breastfeeding interval may contribute to T1DM in Brazilian children.

Glucose tolerance and insulin resistance in Indian children: relationship to infant feeding pattern

Our objective was to examine whether longer duration of breast-feeding and later introduction of complementary foods are associated with lower glucose concentrations and insulin resistance (IR-HOMA) in Indian children. Breast-feeding duration (six categories from <3 to ≥18 months) and age at introduction of complementary foods (four categories from <4 to ≥6 months) were recorded at 1, 2 and 3 year follow-up of 568 children from a birth cohort in Mysore, India. At 5 and 9.5 years of age, 518 children were assessed for glucose tolerance and IR-HOMA. All the children were initially breast-fed; 90% were breast-fed for ≥6 months and 56.7% started complementary foods at or before the age of 4 months. Each category increase in breast-feeding duration was associated with lower fasting insulin concentration (β = -0.05 pmol/l [95% CI -0.10, -0.004]; p = 0.03) and IR-HOMA (β = -0.05 [95% CI -0.10, -0.001]; p = 0.046) at 5 years, adjusted for the child's sex, age, current BMI, socioeconomic status, parent's education, rural/urban residence, birthweight and maternal gestational diabetes status. Longer duration of breastfeeding was associated with higher 120-min glucose concentration at 5 years (β = 0.08 mmol/l [95% CI 0.001, 0.15; p = 0.03]) but lower 120-min glucose concentration at 9.5 years (β = -0.09 [95% CI -0.16, -0.03]; p = 0.006). Age at starting complementary foods was unrelated to the children's glucose tolerance and IR-HOMA. Within this cohort, in which prolonged breast-feeding was the norm, there was evidence of a protective effect of longer duration of breast-feeding against glucose intolerance at 9.5 years. At 5 years longer duration of breast-feeding was associated with lower IR-HOMA.

Breastfeeding: More Than Just Good Nutrition

Breastfeeding: More Than Just Good Nutrition

Commentary: breastfeeding and obesity--the 2011 Scorecard

Commentary: breastfeeding and obesity--the 2011 Scorecard

Higher Infant Blood Lead Levels with Longer Duration of Breastfeeding

Higher Infant Blood Lead Levels with Longer Duration of Breastfeeding

Growth patterns of large, small, and appropriate for gestational age infants: impacts of long-term breastfeeding: a retrospective cohort study

In several studies, since high and low birth weights are demonstrated as associated with obesity in childhood, these values should be followed up and documented carefully. The aim of this retrospective cohort study is to demonstrate the variation on body mass index outcomes of large (LGA), small (SGA), appropriate (AGA) for gestational age infants from birth to the end of fourth year of age and the effects of breastfeeding duration on these outcomes. Four hundred and seven infants were recruited in the study (304AGA, 85 LGA, 18 SGA infants). LGA was frequent in boys and SGA in girls (p = 0.001). The mothers with gestational diabetes mellitus did have LGA infants (10.0% vs. 3.3%) (p = 0.022). The SGA infants performed rapid catch-up growth in the second month while the LGA infants performed catch-down growth in the ninth month. After the first 4 months, there was no difference on the values of BMI depending on breastfeeding time, less or more than 4 months, on the basis of the AGA and LGA infants. However, the body mass index (BMI) of LGA infants breastfed more than 12 months were not different from the AGA; unless the breastfeeding ceased earlier, the means of BMI remained significantly higher until 3 years. Consequently, long duration of breastfeeding might protect LGA infants from childhood obesity risk.

Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome

The purpose of this study was to determine whether head circumference (HC) catch-up is associated with improved neurocognitive development. A retrospective cohort study was conducted in 179 preterm very low birth weight (VLBW) (BW≤1500 g) infants. The infants were born in 2000-2002 and were followed to the age of 5.5 years. The association between HC catch-up and neurodevelopmental outcome was assessed and perinatal risk factors, infant characteristics and nutritional practices associated with HC catch-up were determined. HC catch-up occurred in 59 (34%) infants and was positively correlated with neurodevelopmental outcome. The likelihood of HC catch-up increased with increasing birth weight and gestational age. HC catch-up occurred more often with breast milk feeding during hospitalization and with supplemental formula feeding at discharge, but decreased in prevalence with longer duration of breastfeeding after discharge. HC catch-up was more likely to occur in first-born infants and in families with high socioeconomic status. Most HC catch-up occurred between birth and three months corrected age. Among preterm-VLBW infants, there is a close relation between HC growth and neurodevelopmental outcome. Efforts to improve neurocognitive outcomes should focus on factors associated with HC catch-up.

Infant-feeding patterns and cardiovascular risk factors in young adulthood: data from five cohorts in low- and middle-income countries.

Background Infant-feeding patterns may influence lifelong health. This study tested the hypothesis that longer duration of breastfeeding and later introduction of complementary foods in infancy are associated with reduced adult cardiovascular risk.Methods Data were pooled from 10 912 subjects in the age range of 15–41 years from five prospective birth-cohort studies in low-/middle-income countries (Brazil, Guatemala, India, Philippines and South Africa). Associations were examined between infant feeding (duration of breastfeeding and age at introduction of complementary foods) and adult blood pressure (BP), plasma glucose concentration and adiposity (skinfolds, waist circumference, percentage body fat and overweight/obesity). Analyses were adjusted for maternal socio-economic status, education, age, smoking, race and urban/rural residence and infant birth weight.Results There were no differences in outcomes between adults who were ever breastfed compared with those who were never breastfed. Duration of breastfeeding was not associated with adult diabetes prevalence or adiposity. There were U-shaped associations between duration of breastfeeding and systolic BP and hypertension; however, these were weak and inconsistent among the cohorts. Later introduction of complementary foods was associated with lower adult adiposity. Body mass index changed by −0.19 kg/m2 [95% confidence interval (CI) −0.37 to −0.01] and waist circumference by −0.45 cm (95% CI −0.88 to −0.02) per 3-month increase in age at introduction of complementary foods.Conclusions There was no evidence that longer duration of breastfeeding is protective against adult hypertension, diabetes or overweight/adiposity in these low-/middle-income populations. Further research is required to determine whether ‘exclusive’ breastfeeding may be protective. Delaying complementary foods until 6 months, as recommended by the World Health Organization, may reduce the risk of adult overweight/adiposity, but the effect is likely to be small.

BREASTFEEDING PRACTICES IN A RURAL COMMUNITY IN KEDAH

Breast feeding has been actively encouraged in Malaysia in the last few years in all public hospitals. This study proposes to find out the prevalence of breast feeding in three villages in a rural community in Kedah, Malaysia. This was a cross sectional study on breastfeedingpractices in Kubang Pasu, a district of Kedah. Majority of the mothers initiated breast feeding but exclusive breastfeeding was only 21% for four months and predominant breastfeeding was about 12.6%. The breastfeeding practice was more prevalent among women from the higher educational strata and higher income than those from the lower strata and lower income (p&lt;0.05). Mothers with a positive attitude on breastfeeding and those who possess a higher knowledge were associated with a longer mean total duration of breastfeeding (p&lt;0.05).Spouse and family members played an important role in building up a mother's confidence to breast feed her child. Majority of the mothers received breast feeding information before birth from mainly the doctors and nurses. Older mothers, house wives and mothers with formaleducation practiced a longer duration of breast feeding (p&lt;0.05). The study also showed that there is an increase in the knowledge of breast feeding among the mothers and that they have a positive attitude to breastfeeding. Most of the mothers initiated breast feeding earlyand they received support on breastfeeding from the nurses and doctors.

Young age at first live birth and long duration of breast feeding: Are they universally accepted protective factors against breast cancer? A case control study of the Cancer Research Group in Pakistan.

1572 Background: This study has been conducted in Pakistan in order to find out the association and relationship of different hormonal and reproductive factors with breast cancer. These factors have been identified either as risk factors or protective factors for breast cancer in other communities but not in Pakistani women. Preliminary results were presented in SABCS 2009 (Cancer Research . Vol 69. Abstr 2071) Here, we present the final results. Methods: Patients were interviewed by the trained medical personals and the findings were recorded in a proforma. Age and area matched unrelated controls were randomly selected and interviewed with same questions. SPSS version 11.5 was used for statistical analysis. Results: From June 2008 to October 2009 thirteen hundred and seventy two cases were compared with an equal number of controls. Median age of cases was 47 years (16-90 years) and controls 48 years (16- 88 years). Three hundred and eighty five of cases (28.06%) and 256 of controls (18.66%) gave first fu...

Towards universal Kangaroo Mother Care: recommendations and report from the First European conference and Seventh International Workshop on Kangaroo Mother Care

The hallmark of Kangaroo Mother Care (KMC) is the kangaroo position: the infant is cared for skin-to-skin vertically between the mother's breasts and below her clothes, 24 h/day, with father/substitute(s) participating as KMC providers. Intermittent KMC (for short periods once or a few times per day, for a variable number of days) is commonly employed in high-tech neonatal intensive care units. These two modalities should be regarded as a progressive adaptation of the mother-infant dyad, ideally towards continuous KMC, starting gradually and progressively with intermittent KMC. The other components in KMC are exclusive breastfeeding (ideally) and early discharge in kangaroo position with strict follow-up. Current evidence allows the following general statements about KMC in affluent and low-income settings: KMC enhances bonding and attachment; reduces maternal postpartum depression symptoms; enhances infant physiologic stability and reduces pain, increases parental sensitivity to infant cues; contributes to the establishment and longer duration of breastfeeding and has positive effects on infant development and infant/parent interaction. Therefore, intrapartum and postnatal care in all types of settings should adhere to a paradigm of nonseparation of infants and their mothers/families. Preterm/low-birth-weight infants should be regarded as extero-gestational foetuses needing skin-to-skin contact to promote maturation. Kangaroo Mother Care should begin as soon as possible after birth, be applied as continuous skin-to-skin contact to the extent that this is possible and appropriate and continue for as long as appropriate.

Higher Infant Blood Lead Levels with Longer Duration of Breastfeeding

To determine whether longer breastfeeding is associated with higher infant lead concentrations. Data were analyzed from 3 studies of developmental effects of iron deficiency in infancy: Costa Rica (1981-1984), Chile (1991-1996), and Detroit (2002-2003). The relation between duration of breastfeeding and lead levels was assessed with Pearson product-moment or partial correlation coefficients. More than 93% of the Costa Rica and Chile samples was breastfed (179 and 323 breastfed infants, respectively; mean weaning age, 8-10 months), as was 35.6% of the Detroit sample (53 breastfed infants; mean weaning age, 4.5 months). Lead concentrations averaged 10.8 microg/dL (Costa Rica, 12-23 months), 7.8 microg/dL (Chile, 12 months), and 2.5 microg/dL (Detroit, 9-10 months). Duration of breastfeeding as sole milk source and total breastfeeding correlated with lead concentration in all samples (r values = 0.14-0.57; P values = .06-<.0001). Longer breastfeeding was associated with higher infant lead concentration in 3 countries, in 3 different decades, in settings differing in breastfeeding patterns, environmental lead sources, and infant lead levels. The results suggest that monitoring lead concentrations in breastfed infants be considered.

Reliability of reported breastfeeding duration among reproductive‐aged women from Mexico

Breastfed children have lower risk of infectious diseases, post-neonatal mortality and chronic diseases later in life. Because epidemiologic studies usually rely on reported history of previous breastfeeding, data on the accuracy and precision of recalled histories allow improved interpretation of the epidemiologic findings. We evaluated the reliability of two reported breastfeeding durations in 567 reproductive-aged women from Mexico using information obtained from nearly identical sets of questions applied at different times after weaning. We compared differences between reports, and examined the intraclass correlation coefficient (ICC) for any and for exclusive breastfeeding (EBF). Logistic regression was used to evaluate the determinants of poor recall (difference between reports of >20%). The reliability of duration of any breastfeeding was high (ICC 0.94). Overall, differences between reports of duration were usually <1 month, and for 385/567, the difference was < or =0.5 months. Predictors of poorer recall were having > or =4 children, and time between reports of >2 months. The only predictor of better recall was greater age of the baby at weaning. The reliability of EBF duration was lower (ICC 0.49). In this population with a relatively long duration of breastfeeding, reliability of any breastfeeding duration was high. Age, education and previous breastfeeding were not important predictors of recall, in contrast to findings in earlier studies. Consistent with previous reports, however, parity and length of recall were associated with poorer recall of duration of any breastfeeding. Future studies that use reported breastfeeding duration may want to consider the effect of these variables on recall.

Early discharge with tube feeding at home for preterm infants is associated with longer duration of breast feeding

Objective:Mothers of preterm infants are more likely to discontinue breast feeding early than mothers of term infants. We evaluated the effect of early discharge with tube feeding of preterm infants...

Breast Milk Hormones and Their Protective Effect on Obesity

Data accumulated over recent years have significantly advanced our understanding of growth factors, cytokines, and hormones in breast milk. Here we deal with leptin, adiponectin, IGF-I, ghrelin, and the more recently discovered hormones, obestatin, and resistin, which are present in breast milk and involved in food intake regulation and energy balance. Little is known about these compounds in infant milk formulas. Nutrition in infancy has been implicated in the long-term tendency to obesity, and a longer duration of breastfeeding appears to protect against its development. Diet-related differences in serum leptin and ghrelin values in infancy might explain anthropometric differences and differences in dietary habits between breast-fed and formula-fed infants also later in life. However, there are still gaps in our understanding of how hormones present in breast milk affect children. Here we examine the data related to hormones contained in mother's milk and their potential protective effect on subsequent obesity.

Breast-feeding Duration and Infant Atopic Manifestations, by Maternal Allergic Status, in the First 2 Years of Life (KOALA Study)

Snijders BEP, Thijs C, Dagnelie PC, et al. J Pediatr. 2007;151(4):347–351 PURPOSE OF THE STUDY. To investigate the potential effect of modification by maternal allergic status on the relationship between breastfeeding duration and infant atopic manifestations in the first 2 years of life. STUDY POPULATION. Data from 2705 infants of the KOALA Birth Cohort Study (Netherlands) were analyzed. METHODS. The data were collected by repeated questionnaires at 34 weeks’ gestation and 3, 7, 12, and 24 months postpartum. Total and specific immunoglobulin E measurements were taken on venous blood samples collected during home visits when the infants were 2 years of age. Relationships were analyzed by using logistic regression analysis. RESULTS. Longer duration of breastfeeding was associated with a lower risk for eczema in infants of mothers without allergy or asthma (Ptrend = .01) and slightly lower risk in those of mothers with allergy but no asthma (Ptrend = .14). There was no such association for asthmatic mothers (Ptrend = .87). Longer breastfeeding duration decreased the risk of recurrent wheeze independent of maternal allergy (Ptrend = .02) or asthma (Ptrend = .06) status. CONCLUSIONS. The findings show that the relationship between breastfeeding and infant eczema in the first 2 years of life is modified by maternal allergic status. The protective effect of breastfeeding on recurrent wheeze may be associated with protection against respiratory infections. REVIEWER COMMENTS. The role of diet in preventing and treating atopic disease has been and continues to be an active area of clinical research. Snijders et al found that a longer duration of breastfeeding was associated with a lower risk of eczema in infants of mothers without allergy or asthma. There was a slight effect in mothers with allergy but no asthma, yet no such relationship was observed for asthmatic mothers. It is interesting to note that no effect modification of maternal allergy/asthma on infant IgE or allergen sensitization was observed. Finally, longer breastfeeding reduced the risk of recurrent wheezing independent of maternal allergic or asthma status, which the authors speculated may be the effect of reduced numbers of respiratory infections. Overall, these findings do support the role of breastfeeding in prevention of atopy, and additional studies are needed to better define the influence of maternal and infant diets during this time frame.