Maternal Milk Intake Research Articles

Maternal, neonatal, and nutritional risk factors for medical and surgical necrotizing enterocolitis.

To identify maternal and neonatal risk factors associated with progression to surgery or death after diagnosis of NEC. Forty-seven demographic and clinical factors were evaluated across 216 validated cases of NEC occurring between 2010-2020. Nutrition at NEC onset was evaluated in 149 cases. The binary outcome of surgical NEC (progressing to surgery or death) vs. medical NEC (resolved with antibiotic/bowel rest) was compared across variables. Elevated CRP, rapidly decreasing platelet counts, inotropic medication, intubation, and positive blood cultures within 24 h of diagnosis were associated with progression to surgery/death. Infants with surgical NEC had higher abdominal circumferences at birth. Maternal milk intake and receipt of human milk fortifiers were associated with medical NEC, and infants receiving fortified, maternal milk showed the lowest progression to surgery/death. The index of suspicion should be heightened for surgical NEC when these risk factors are present.

Maternal milk intake and the foetus growth: A bio-cultural study in Pune

The relationship between maternal diet and foetal parameters has been a matter of debate because of the number of parameters and various dimensions associated with it. The study has gained attraction because of its importance despite of uncertainty and controversy in it.: The objective of this study was to investigate the relationship between maternal milk consumption and fetal growth as well as the birth weight of the newborn. To achieve this objective, dietary information was collected using a 24-hour diet recall survey, and protein intake was evaluated based on dietary intake. A total of 455 ultrasound observations from 229 respondents were collected by using a Prospective Observational Cohort Mixed Longitudinal study design in the second and last trimester of pregnancy from one private and two government hospitals in Pune, India where direct interviews were taken. Dietary data were collected using 24-hour diet recall. Food Frequency questionnaire was administered to understand the dietary habits and preferences. The average protein intake was 77.33g/day. Birth weight and Protein intake of mother do not show statistically significant linear relationship (=0.605) The descriptive test shows that the majority of respondents had tendency to consume less than one cup (155.64 mL) of milk per day. The study shows better tendency of foetal growth in BPD, HC, AC, FL, FW, Weight at birth in the group of the respondent consuming milk more than 4 cups (>717mL) per day. This growth might be due to the micronutrient intake of mother. There is no association between maternal milk intake and the fetus growth.

Potentially probiotic Limosilactobacillus reuteri from human milk strengthens the gut barrier in T84 cells and a murine enteroid model.

At conception, the infant gut barrier is immature, gradually developing with regular intake of maternal milk. This study addressed whether the barrier-strengthening effect of breast feeding might be attributable, at least in part, to autochthonous beneficial human milk bacteria. Twelve bacterial strains from the breast milk of Pakistani mothers who underwent cesarean delivery (NPL-88, NPL-157, NPL-179, NPL-181, NPL-388 (Limosilactobacillus reuteri), NPL-76, NPL-495, NPL-504 (Limosilactobacillus fermentum), NPL-415 (Lactobacillus pentosus), NPL-412, NPL-416 (Lactiplantibacilllus plantarum) and NPL-374 (Bifidobacterium longum) were shortlisted based on their tolerance to acidic pH (2.8-4.2) and bile (0.1-0.3%). The effect of these bacteria on gut barrier function in the presence and absence of pathogens was assessed as changes in transepithelial electrical resistance (TEER) in the human T84 colonic epithelial cell line and in murine enteroid-derived monolayers (EDMs). The TEER of T84 cells monolayers rose in the presence of most of the human milk strains, being most pronounced in case of L. reuteri NPL-88 (34% within five h), exceeding the effect of the well-known probiotic L. acidophilus (20%). qRT-PCR, western blot and immunofluorescent staining associated the increase in TEER with enhanced expression of tight junction proteins. Pretreatment of murine EDMs with NPL-88 also largely prevented the ability of the pathogen, Salmonella, to decrease TEER (87±1.50%; P<0.0001, n=4). Human milk lactic acid bacteria are potential probiotics that can strengthen gut barrier function and protect breastfed neonates against enteric infections.

Urinary levels of energy metabolism hormones in association with the proportional intake of maternal milk and weight gain in very preterm neonates.

This study prospectively investigated the levels of energy metabolism hormones in very preterm neonates to identify their change over time and association with intake of maternal milk as well as weight gain velocity. We measured and compared the leptin, adiponectin, ghrelin, and insulin-like growth factor I (IGF-1) levels in the urine of 70 very preterm neonates, before the initiation of any enteral feeding (baseline level) and twice within 14 days on full enteral feeding (FEF). Regression models identified the role of intake of maternal milk on the levels of the tested energy metabolism hormones in the enteral-fed infants. We also analyzed the adequacy of the weight gain velocity defined by the fetal-infant growth reference (FIGR). Additionally, we collected and analyzed the infants' clinical and feeding characteristics during the birth hospitalization. The preterm infants' baseline levels of the energy metabolism hormones significantly predicted their increase at the end of two weeks of observation on FEF. The leptin level was associated with increased intake of maternal milk, whereas the feeding volume was associated with increased ghrelin and IGF-1, and decreased leptin and adiponectin. Infants with comparable FIGR had higher leptin levels than those with inadequate weight gain velocity. Early postnatal levels of leptin, adiponectin, ghrelin, and IGF-1 predicted the increase of these hormones in the fully enteral fed very preterm neonates. Moreover, greater intake of maternal milk by the study infants contributed to an increased leptin-associated weight gain velocity.

Associations of Maternal Milk Feeding With Neurodevelopmental Outcomes at 7 Years of Age in Former Preterm Infants

Maternal milk feeding may have unique long-term neurodevelopmental benefits in very preterm infants. To examine the extent to which maternal milk feeding after very preterm birth is associated with cognitive, academic, and behavioral outcomes at school age. This prospective cohort study assessed 586 infants born at less than 33 weeks' gestation at 5 Australian perinatal centers and enrolled in the Docosahexaenoic Acid for Improvement of Neurodevelopmental Outcomes study (January 1, 2001, to December 31, 2005) who were evaluated at a corrected age of 7 years. The statistical analysis was completed on January 19, 2022. Maternal milk intake, including mean volume (milliliters per kilogram per day) during neonatal hospitalization and total duration (in months). Neurodevelopmental outcomes at 7 years of age were (1) IQ (Wechsler Abbreviated Scale of Intelligence), (2) academic achievement (Wide Range Achievement Test, Fourth Edition), (3) symptoms of attention-deficit/hyperactivity disorder (ADHD) (Conners Third Edition ADHD Index, parent reported), (4) executive function (Behavior Rating Inventory of Executive Functioning, parent reported), and (5) behavior (Strengths and Difficulties Questionnaire, parent reported). A total of 586 infants (mean [SD] gestational age at birth, 29.6 [2.3] weeks; 314 male [53.6%]) born to 486 mothers (mean [SD] age, 30.6 [5.5] years; 447 [92.0%] White) were included. Mean (SD) maternal milk intake in the neonatal intensive care unit was 99 (48) mL/kg daily, and mean (SD) maternal milk duration was 5.1 (5.4) months. Mean (SD) full-scale IQ was 98.5 (13.3) points. After covariate adjustment, higher maternal milk intake during the neonatal hospitalization was associated with higher performance IQ (0.67 points per additional 25 mL/kg daily; 95% CI, 0.10-1.23 points), reading scores (1.14 points per 25 mL/kg daily; 95% CI, 0.39-1.89 points), and math scores (0.76 points per 25 mL/kg daily; 95% CI, 0.14-1.37 points) and fewer ADHD symptoms (-1.08 points per 25 mL/kg daily; 95% CI, -1.96 to -0.20 points). Longer duration of maternal milk intake was associated with higher reading (0.33 points per additional month; 95% CI, 0.03-0.63 points), spelling (0.31 points per month; 95% CI, 0.01-0.62 points), and math (0.30 points per month; 95% CI, 0.03-0.58 points) scores. Maternal milk was not associated with improved full-scale IQ, verbal IQ, executive function, or behavior. Most associations were stronger among infants born at lower gestational ages, particularly less than 30 weeks (interaction P values <.01). In this cohort study of preterm infants, maternal milk feeding during the neonatal hospitalization and after discharge were associated with better school-age performance IQ and academic achievement and with a reduction in ADHD symptoms, particularly among infants born at less than 30 weeks' gestation.

Maternal First-Trimester Cow-Milk Intake Is Positively Associated with Childhood General and Abdominal Visceral Fat Mass and Lean Mass but Not with Other Cardiometabolic Risk Factors at the Age of 10 Years.

ABSTRACTBackgroundHigher maternal cow-milk intake during pregnancy is associated with higher fetal growth measures and higher birth weight.ObjectiveThe aim of this study was to assess the associations of maternal milk intake during pregnancy with body fat measures and cardiometabolic risk factors at the age of 10 y.MethodsIn a population-based cohort of Dutch mothers and their children (n = 2466) followed from early pregnancy onwards, we assessed maternal first-trimester milk intake (milk and milk drinks) by food-frequency questionnaire. Maternal milk intake was categorized into 0–0.9, 1–1.9, 2–2.9, 3–3.9, 4–4.9, and ≥5 glasses/d, with 1 glass equivalent to 150 mL milk. For children at the age of 10 y, we calculated BMI and obtained detailed measures of body and organ fat by DXA and MRI. We also measured blood pressure and lipid, insulin, and glucose concentrations. Data were analyzed using linear and logistic regression models.ResultsCompared with children whose mothers consumed 0–0.9 glass of milk/d during their pregnancy, those whose mothers consumed ≥5 glasses of milk/d had a 0.29 SD (95% CI: 0.10, 0.48) higher BMI, 0.27 SD (95% CI: 0.08, 0.47) higher fat mass, 0.26 SD (95% CI: 0.07, 0.46) higher lean mass, 0.30 SD (95% CI: 0.09, 0.50) higher android-to-gynoid fat mass ratio and 0.38 SD (95% CI: 0.09, 0.67) higher abdominal visceral fat mass. After correction for multiple comparisons, groups of maternal milk intake were not associated with pericardial fat mass index, liver fat fraction, blood pressure, or lipid, insulin, or glucose concentrations (P values >0.0125).ConclusionsOur results suggest that maternal first-trimester milk intake is positively associated with childhood general and abdominal visceral fat mass and lean mass, but not with other cardiometabolic risk factors.

The epigenetic role of breastfeeding in mammary differentiation.

Maternal milk consumption can cause changes in the mammary epithelium of the offspring that result in the expression of molecules involved in the induction of differentiation, reducing the risk of developing mammary cancer later in life. We previously showed that animals that maintained a higher intake of maternal milk had a lower incidence of mammary cancer. In the present study, we evaluated one of the possible mechanisms by which the consumption of maternal milk could modify the susceptibility to mammary carcinogenesis. We used Sprague Dawley rats reared in litters of 3 (L3), 8 (L8), or 12 (L12) pups per mother in order to generate a differential consumption of milk. Whole mounts of mammary glands were performed to analyze the changes in morphology. Using real-time polymerase chain reaction (PCR), we analyzed the expression of mammary Pinc, Tbx3, Stat6, and Gata3 genes. We use the real-time methylation-specific polymerase chain reaction method to assess the methylation status of Stat6 and Gata3 CpG sites. Our findings show an increase in the size of the epithelial tree and a smaller number of ducts called terminal end buds in L3 vs. L12. We observed an increased expression of mRNA of Stat6, Gata3, Tbx3, and a lower expression of Pinc in L3 with respect to L12. Stat6 and Gata3 are more methylated in the CpG islands of the promoter analyzed in L12 vs. L3. In conclusion, the increased consumption of maternal milk during the postnatal stage generates epigenetic and morphological changes associated with the differentiation of the mammary gland.

Unpasteurised maternal breast milk is positively associated with growth outcomes in extremely preterm infants.

AimExtrauterine growth restriction is common among extremely preterm infants. We explored whether intake of unpasteurised maternal milk (MM) and pasteurised donor milk (DM) was associated with longitudinal growth outcomes and neonatal morbidities in extremely preterm infants.MethodsObservational study of 90 preterm infants born between 2013 and 2015 in Gothenburg, Sweden. Data were prospectively collected on nutritional and breast milk intakes during the first 28 days.ResultsNinety infants (39 girls and 51 boys) with a median gestational age of 25.3 (22.7‐27.9) weeks were evaluated. MM intake (mL/kg/d) correlated positively with almost all z‐scores for weight, length and head circumference at 28 postnatal days and at postmenstrual age (PMA) 32 and 36 weeks. After multivariable adjustment, MM intake and weight z‐score at 28 postnatal days and at PMA 32 and 36 weeks remained significantly associated. Infants consuming ≥80% MM had more favourable weight z‐scores at PMA 32 and 36 weeks. Intake of DM did not correlate with any growth outcomes. Infants without retinopathy of prematurity had a significantly higher intake of MM (mL/kg/d).ConclusionUnpasteurised MM was positively associated with longitudinal growth outcomes. Motivating mothers to provide their infants with their own milk after preterm birth should be emphasised.

Low concentration of serum immunoglobulin G is associated with pre-weaning diarrhea in young mink kits (Neovison vison)

BackgroundPre-weaning diarrhea (PWD) is a severe syndrome, with world-wide occurrence, affecting farmed mink (Neovison vison) kits during the lactation period. Kits affected by PWD often display clinical signs such as: yellow-white diarrhea, greasy skin, and dehydration. In severe cases the kits eventually die. It is common practice to treat PWD using antimicrobials; however the effect is not well documented. Due to the multifactorial etiology of PWD vaccine development is not feasible. The role played by the immune status of the mink kits with respect to their susceptibility to PWD is not well studied. To elucidate the possible association between PWD and total IgG serum concentration in young kits we analyzed blood collected from kits from 100 litters on two mink farms during the same breeding period, one farm being a case farm with high prevalence of PWD, and the other being a control farm with no cases of PWD.ResultsKits affected by PWD had a significantly reduced weight gain compared to unaffected control kits. Litters born later in the breeding period came down with PWD at an earlier age than litters born at the start of the breeding period. We found that PWD affected kits had significantly lower concentrations of serum IgG compared to unaffected kits at 13–15 days of age (the last blood sampling point of the study).ConclusionThe results in this study suggest that PWD affected kits less efficiently absorbed IgG from maternal milk or had a lower intake of maternal milk, potentially contributing to the exacerbation of disease. A lower intake of IgG and/or less absorption from maternal milk could also pre-dispose kits for PWD. Future studies will be needed to elucidate if the circulating level of IgG is directly related to protection against disease and to investigate if administration of IgG could be helpful in alleviating and/or preventing PWD in mink kits.

Effects of Milk and Dairy Product Consumption on Pregnancy and Lactation Outcomes: A Systematic Review

Pregnancy and lactation are considered critical periods in a female's life. Thus, the maternal diet must provide sufficient energy and nutrients to meet the mother's higher than usual requirements as well as the needs of the growing fetus. The maternal diet must enable the mother to provide stores of nutrients required for adequate fetal development, and good health and quality of life in infancy and later adulthood. Among the food and beverage groups, milk and dairy products can play a very important role in achieving these targets due to their high nutrient density and bioavailability, as well as their availability and widespread consumption. The objective of this study was to evaluate the influence of maternal milk and dairy consumption on pregnancy and lactation outcomes in healthy women. This report mainly focuses on the effects of the mother's intake of dairy products on infant birth weight and length, fetal femur length, head circumference, gestational weight gain, preterm birth, spontaneous abortion, breast milk consumption, and human milk nutritional value. A systematic review of available studies published up to May 2018 was conducted. A preliminary broad search of the literature yielded 5,695 citations. Four of the investigators independently selected studies for inclusion according to predefined eligibility criteria. Thirty-seven full-text articles were evaluated for potential inclusion, and 17 studies were finally included. Six were prospective cohort studies, 3 were intervention studies, 3 were retrospective cohort studies, 3 were cross-sectional studies, and 2 were case-control studies. Although the number and types of studies prevent definite conclusions, there appears to be a trend that maternal milk intake during pregnancy is positively associated with infant birth weight and length. The lack of studies prevents any conclusions being drawn related to preterm deliveries, spontaneous abortion, and lactation.

Introduction and Executive Summary of the Supplement, Role of Milk and Dairy Products in Health and Prevention of Noncommunicable Chronic Diseases: A Series of Systematic Reviews

ABSTRACTMilk and dairy products contain multiple nutrients and contribute significantly to meet the nutritional requirements for protein, calcium, magnesium, phosphorus, potassium, zinc, selenium, vitamin A, riboflavin, vitamin B-12, and pantothenic acid. However, consumption of dairy is decreasing and moving away from the advised level in many countries and the potential benefits of milk and dairy products for health have come under question. This, in spite that numerous studies report health benefits associated with dairy consumption. The present supplement aims to assess and summarize scientific evidence regarding the impact of dairy intake on health and all-cause mortality, and on the prevention of diverse chronic diseases, mainly from meta-analyses of observational studies and randomized controlled trials (RCTs). There seem to positive associations between moderate maternal milk intake during pregnancy and infant birth weight, length and bone mineral content during childhood. Moreover, consumption of dairy products in older subjects may reduce the risk of frailty and decrease the risk for sarcopenia. The highest consumption of dairy products did not show a clear association with total osteoporotic fracture and hip fracture risk; however, a diminished risk of vertebral fracture was found. Analysis of the differences between high and low dairy consumption and for dose-response found no association between dairy product consumption and risk of all-cause mortality. Total and low-fat dairy consumption is associated with a reduced risk of developing metabolic syndrome and current evidence supports that consumption of dairy does not adversely affect the risk of cardiovascular outcomes and may even have a subtle protective effect. Moreover, evidence has been provided of an inverse association between the consumption of dairy products and ischemic heart disease and myocardial infarction. Also, the evidence suggests that dairy consumption, particularly low-fat dairy and yogurt is associated with a lower risk of type 2 diabetes. Likewise, moderate compared with medium consumption of dairy is associated lower risk for colorectal and bladder cancer and has no association with prostate cancer. Finally, consumption of milk or dairy products did not show a proinflammatory effect on healthy subjects, overweight/obese individuals, or individuals with other metabolic abnormalities, and fortification of dairy products with phytosterols and ω-3 fatty acids seems to be a good approach to improve cardiometabolic risk biomarkers. In conclusion, the systematic reviews and meta-analyses of the present supplement support adequate milk consumption at various stages of life and in the prevention/control of various noncommunicable chronic diseases.

High Intake of Maternal Milk Prevents the Development of Mammary Cancer in Pups Maintaining Elevated Ingestion of Saturated Fat

Fil: Santiano, Flavia Eliana. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Mendoza. Instituto de Medicina y Biologia Experimental de Cuyo; Argentina

High maternal milk intake in the postnatal life reduces the incidence of breast cancer during adulthood in rats.

Environmental factors during perinatal life can lead to changes in the mammary gland, making it susceptible to cancer in adulthood. Breastfeeding has a special importance since it takes place at a critical period of growth and development of the newborn. We aimed to analyze if an appropriate lactation protects the offspring against mammary carcinogenesis during adult life and explore the mechanisms involved in the protective effect. One-day-old Sprague-Dawley female rats were randomly distributed in litters of three (L3), eight (L8) or 12 (L12) pups per dam, to induce a differential consumption of breast milk. At 55 days of age, the animals were treated with a single dose of dimethylbenzanthracene to study tumor latency, incidence and progression. Histological, immunohistochemical and Western blot studies were performed. We observed lower incidence and higher latency in L3 compared to the other groups. The mitotic index and expression of proliferating cell nuclear antigen (PCNA) was significantly augmented in tumors of L12 rats compared to L3 and L8, while the apoptotic index was augmented in tumors of L3 v. L12. Cleaved caspase 8 was significantly higher in tumors from L3 compared to L12. Tumors developed in L3 have a greater number of apoptotic bodies and a greater expression of caspase 8. These results demonstrate that the animals that maintained a higher intake of maternal milk (L3) presented lower incidence and greater tumor latency. Lower consumption of breast milk (L12) would increase tumor mitosis and the expression of PCNA, explaining the higher tumor incidence observed in this group.

Maternal intake of milk and milk proteins is positively associated with birth weight: A prospective observational cohort study

A striking number of low birth weight (LBW) Indian babies are born annually. Previous studies have confirmed the positive association between milk intake and birth weight. However, the relations between protein and vitamin B12 from milk and birth weight have not been systematically explored. We examined the relations between birth weight and maternal intake of milk, protein from milk and vitamin B12 from milk. This prospective, observational cohort study was conducted in an urban South Indian hospital. The dietary intakes of milk and milk products were assessed using validated food frequency questionnaire and at delivery birth outcomes were measured. The relations between milk products, milk protein, and vitamin B12 from milk with birth weight and gestational weight gain were assessed in 2036 births with first trimester dietary and delivery data. Median consumption of milk products in the first trimester was 310g·day-1 and average birth weight was 2876g. Birth weight was positively associated with intake of milk products and of % protein from milk products (%milk protein) in the first trimester [β=86.8, 95% confidence interval (CI): 29.1, 144.6; β=63.1, 95% CI: 10.8, 115.5; P<0.001 for both]. Intake of milk products and of %milk protein in the third trimester was positively associated with gestational weight gain (GWG) between the second and third trimester (One-way ANOVA, P<0.001 and=0.001, respectively). Neither birth weight nor GWG were associated with %vitamin B12 from milk products. These findings indicate that intake of milk products in the first trimester and especially, protein from milk products is positively associated with birth weight in this South Asian Indian population.

Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of necrotizing enterocolitis (NEC) for extremely low birth weight (ELBW) infants as a function of preterm formula (PF) and maternal milk intake and calculate the impact of suboptimal feeding on the incidence and costs of NEC. We used aORs derived from the Glutamine Trial to perform Monte Carlo simulation of a cohort ofELBW infants under current suboptimal feeding practices, compared with a theoretical cohort in which 90% of infants received at least 98% human milk. NEC incidence among infants receiving ≥98% human milk was 1.3%; 11.1% among infants fed only PF; and 8.2% among infants fed a mixed diet (P=.002). In adjusted models, compared with infants fed predominantly human milk, we found an increased risk of NEC associated with exclusive PF (aOR=12.1, 95% CI 1.5, 94.2), or a mixed diet (aOR 8.7, 95% CI 1.2-65.2). In Monte Carlo simulation, current feeding of ELBW infants was associated with 928 excess NEC cases and 121 excess deaths annually, compared with a model in which 90% of infants received ≥98% human milk. These models estimated an annual cost of suboptimal feeding of ELBW infants of $27.1 million (CI $24 million, $30.4 million) in direct medical costs, $563 655 (CI $476 191, $599 069) in indirect nonmedical costs, and $1.5 billion (CI $1.3 billion, $1.6 billion) in cost attributable to premature death. Among ELBW infants, not being fed predominantly human milk is associated with an increased risk of NEC. Efforts to support milk production by mothers of ELBW infants may prevent infant deaths and reduce costs.

Cord IGF-I concentrations in Indian newborns: associations with neonatal body composition and maternal determinants.

Indian newborns have been described as 'thin-fat' compared with European babies, but little is known about how this phenotype relates to the foetal growth factor IGF-I (insulin-like growth factor I) or its binding protein IGFBP-3. To assess cord IGF-I and IGFBP-3 concentrations in a sample of Indian newborns and evaluate their associations with neonatal adiposity and maternal factors. A prospective cohort study of 146 pregnant mothers with dietary, anthropometric and biochemical measurements at 28 and 34 weeks gestation. Neonatal weight, length, skin-folds, circumferences, and cord blood IGF-I and IGFBP-3 concentrations were measured at birth. Average cord IGF-I and IGFBP-3 concentrations were 46.6 (2.2) and 1269.4 (41) ng mL(-1) , respectively. Girls had higher mean IGF-I than boys (51.4 ng mL(-1) vs. 42.9 ng mL(-1) ; P < 0.03), but IGFBP-3 did not differ. Cord IGF-I was positively correlated with all birth size measures except length, and most strongly with neonatal sum-of-skin-folds (r = 0.50, P < 0.001). IGFBP-3 was positively correlated with ponderal index, sum-of-skin-folds and placenta weight (r = 0.21, 0.19, 0.16, respectively; P < 0.05). Of maternal demographic and anthropometric characteristics, only parity was correlated with cord IGF-I (r = 0.27, P < 0.001). Among dietary behaviours, maternal daily milk intake at 34 weeks gestation predicted higher cord IGF-I compared to no-milk intake (51.8 ng mL(-1) vs. 36.5 ng mL(-1) , P < 0.01) after controlling for maternal characteristics, placental weight, and newborn gestational age, sex, weight and sum-of-skin-folds. Sum-of-skin-folds were positively associated with cord IGF-I in this multivariate model (57.3 ng mL(-1) vs. 35.1 ng mL(-1) for highest and lowest sum-of skin-fold quartile, P < 0.001). IGFBP-3 did not show significant relationships with these covariates. In this Indian study, cord IGF-I concentration was associated with greater adiposity among newborns. Maternal milk intake may play a role in this relationship.

Dairy products and calcium intake during pregnancy and dental caries in children

BackgroundMaternal nutrition status during pregnancy may affect fetal tooth development, formation, and mineralization, and may affect dental caries susceptibility in children. We investigated the association between maternal intake of dairy products and calcium during pregnancy and the risk of childhood dental caries.MethodsSubjects were 315 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed through a diet history questionnaire. Outcome data was collected at 41–50 months of age. Children were classified as having dental caries if one or more primary teeth had decayed or been filled.ResultsHigher maternal cheese intake during pregnancy was significantly inversely associated with the risk of dental caries in children, showing a clear inverse dose–response relationship; the adjusted odds ratio (OR) in comparison of the highest tertile with the lowest was 0.37 (95 % confidence interval [CI]: 0.17-0.76, P for trend = 0.01). The inverse associations between maternal intake of total dairy products, yogurt, and calcium during pregnancy and the risk of childhood dental caries were of borderline significance: the adjusted ORs for the highest tertile of total dairy products, yogurt, and calcium were 0.51 (95 % CI: 0.23-1.09, P for trend = 0.07), 0.51 (95 % CI: 0.23-1.10, P for trend = 0.07), and 0.50 (95 % CI: 0.23-1.07, P for trend = 0.08), respectively. There was no evident relationship between maternal milk intake and the risk of childhood dental caries.ConclusionThese data suggested that high intake of maternal cheese during pregnancy may reduce the risk of childhood dental caries.

Does milk and dairy consumption during pregnancy influence fetal growth and infant birthweight? A systematic literature review

It is increasingly acknowledged that the maternal diet influences fetal development and health of the child. Milk and milk products contribute essential nutrients and bioactive substances; they are of ample supply and have a long tradition in Nordic countries. To revise and update dietary guidelines for pregnant women valid in Nordic countries, the Pregnancy and Lactation expert group within the NNR5 project identified a need to systematically review recent scientific data on infant growth measures and maternal milk consumption. The objective of this study was to assess the influence of milk and dairy consumption during pregnancy on fetal growth through a systematic review of studies published between January 2000 and December 2011. A literature search was run in June 2011. Two authors independently selected studies for inclusion from the 495 abstracts according to predefined eligibility criteria. A complementary search in January 2012 revealed 64 additional abstracts published during the period June to December 2011, among them one study of interest previously identified. Of the 33 studies extracted, eight were relevant research papers. Five were prospective cohort studies (including a retrospective chart review), one was a case–control study, and two were retrospective cohort studies. For fetal length or infant birth length, three studies reported no association and two reported positive associations with milk or dairy consumption. For birthweight related outcomes, two studies reported no associations, and four studies reported positive associations with milk and/or dairy consumption. There was large heterogeneity in exposure range and effect size between studies. A beneficial fetal growth-increase was most pronounced for increasing maternal milk intake in the lower end of the consumption range. Evidence from prospective cohort studies is limited but suggestive that moderate milk consumption relative to none or very low intake, is positively associated with fetal growth and infant birthweight in healthy, Western populations.

Gestational vitamin D and the risk of multiple sclerosis in offspring

Vitamin D may have a protective role in the etiology of multiple sclerosis (MS), but the effect of gestational vitamin D on adult onset MS has not been studied. In 2001, 35,794 mothers of participants of the Nurses' Health Study II completed a questionnaire inquiring about their experiences and diet during pregnancy with their nurse daughters. We studied the association of maternal milk intake, maternal dietary vitamin D intake, and predicted maternal serum 25-hydroxyvitamin D (25(OH)D) during pregnancy and their daughters' risk of developing MS. MS was diagnosed in 199 women. The relative risk of MS was lower among women born to mothers with high milk or vitamin D intake during pregnancy. The multivariate adjusted rate ratio (RR) of MS was 0.62 (95% confidence interval [CI], 0.40-0.95; p trend = 0.001) for nurses whose mothers consumed 2 to 3 glasses of milk per day compared with those whose mothers consumed <3 glasses per month, and 0.57 (95% CI, 0.35-0.91; p trend = 0.002) for nurses with mothers in the highest quintile of dietary vitamin D intake compared with those in the lowest. The predicted 25(OH)D level in the pregnant mothers was also inversely associated with the risk of MS in their daughters. Comparing extreme quintiles, the adjusted RR was 0.59; (95% CI, 0.37-0.92; p trend = 0.002). Higher maternal milk and vitamin D intake during pregnancy may be associated with a lower risk of developing MS in offspring.

Bovine Lactoferrin Supplementation for Prevention of Late-Onset Sepsis in Very Low-Birth-Weight Neonates&lt;subtitle&gt;A Randomized Trial&lt;/subtitle&gt;

Sepsis is a common and severe complication in premature neonates, particularly those with very low birth weight (VLBW) (<1500 g). Whether lactoferrin, a mammalian milk glycoprotein involved in innate immune host defenses, can reduce the incidence of sepsis is unknown. In animal models, the probiotic Lactobacillus rhamnosus GG (LGG) enhances the activity of lactoferrin but has not been studied in human infants. To establish whether bovine lactoferrin (BLF), alone or in combination with LGG, reduces the incidence of late-onset sepsis in VLBW neonates. Prospective, multicenter, double-blind, placebo-controlled, randomized trial conducted in 11 Italian tertiary neonatal intensive care units. Patients were 472 VLBW infants enrolled from October 1, 2007, through July 31, 2008, and assessed until discharge for development of sepsis. Infants were randomly assigned to receive orally administered BLF (100 mg/d) alone (n = 153), BLF plus LGG (6 x 10(9) colony-forming units/d) (n = 151), or placebo (n = 168) from birth until day 30 of life (day 45 for neonates <1000 g at birth). First episode of late-onset sepsis, ie, sepsis occurring more than 72 hours after birth with isolation of any pathogen from blood or from peritoneal or cerebrospinal fluid. Demographic, clinical, and management characteristics of the 3 groups were similar, including type of feeding and intake of maternal milk. Incidence of late-onset sepsis was significantly lower in the BLF and BLF plus LGG groups (9/153 [5.9%] and 7/151 [4.6%], respectively) than in the control group receiving placebo (29/168 [17.3%]) (risk ratio, 0.34; 95% confidence interval, 0.17-0.70; P = .002 for BLF vs control and risk ratio, 0.27; 95% confidence interval, 0.12-0.60; P < .001 for BLF plus LGG vs control). The decrease occurred for both bacterial and fungal sepsis. No adverse effects or intolerances to treatment occurred. Compared with placebo, BLF supplementation alone or in combination with LGG reduced the incidence of a first episode of late-onset sepsis in VLBW neonates. isrctn.org Identifier: ISRCTN53107700.