Partial Breastfeeding Research Articles

56 Iron deficiency is common in extreme preterm infants despite prophylactic iron supplementation

Abstract Background Iron deficiency (ID) in childhood is linked to adverse neurodevelopmental outcomes in the long-term. Extremely premature infants (EPI; born < 28 weeks gestation) are more susceptible to ID due to a multitude of factors including lower iron reserves at birth, rapid growth, immature erythropoiesis, and multiple phlebotomy tests during hospital stay. Therefore, professional societies advise prophylactic iron therapy for these infants from 2-6 weeks age until 6-12 months. However, there is paucity of data on the iron status in EPI receiving this prophylactic iron supplementation. Objectives To investigate the prevalence and risk factors associated with ID in EPI. Design/Methods A retrospective cohort study analyzed a Provincial database of EPIs born between 2005-2018. Infants with congenital malformations, chromosomal anomalies and blood disorders were excluded. All included infants received prophylactic iron supplementation from 2-4 weeks of chronological age that was recommended to continue at discharge until 9-12 months corrected age (CA). At 4-6 months CA, these infants underwent blood testing. ID was defined as serum ferritin < 20mcg/L at 4 months CA or SF < 12mcg/L at 6 months CA. Through a univariate analysis using single-variable logistic regression, factors linked to ID were identified. Those with a p-value < 0.20 progressed to a multivariable model, retaining variables with a p-value < 0.05. Results Of 146 infants, 45.9% had ID. ID group had lower mean ferritin (16.4 µg/L vs 50.0 µg/L, p < .001) and reticulocyte hemoglobin equivalent (28.4pg vs 31.6pg, p < .001) compared to the non-ID group. ID prevalence reduced from 59.7% in 2005-2011 to 40.3% in 2012-2018 cohort. Exclusive or partial breastfeeding at 4-6 months CA was protective against ID (Odds: 0.2, p = 0.003). Iron therapy at 4-6 months CA was not protective in the final model. Notably, 27.4% stopped iron therapy before 4-6 months CA, and exclusive formula-fed infants had notably lower iron intake than breastfed infants (66.1% vs 99.1%, p = 0.006). Conclusion Nearly half of the EPI exhibited ID at 4-6 months CA despite prophylactic iron supplementation. About a quarter discontinued therapy before reaching this age. Breastfeeding at this age was protective against ID. This high prevalence of ID in EPI underscores the need of future studies to discern strategies to mitigate ID in this vulnerable population.

Pelatihan Metode SPEOS (Stimulasi Pijat Endhorpin, Pijat Oksitosin dan Sugesti) Ibu Nifas Pada Tim Pendamping Keluarga di Wilayah Puskesmas Danau Marsabut Kecamatan Sipirok

Based on the 2018 Riskesdas results, the proportion of breastfeeding patterns for babies aged 0-5 months in Indonesia is 37.3% exclusive breastfeeding, 9.3% partial breastfeeding and 3.3% predominant breastfeeding. Predominant breastfeeding is breastfeeding the baby but giving a little water or a water-based drink, for example tea, as a prelacteal food/drink before the milk comes in. Meanwhile, partial breastfeeding is breastfeeding a baby and giving artificial food other than breast milk such as formula milk, porridge or other food before the baby is 6 months old, whether given continuously or as prelacteal food. North Sumatra Province Nutrition Program Data in 2018. The percentage of exclusive breastfeeding for babies 0-6 months in North Sumatra in 2018 was 65.57 percent, an increase compared to the percentage of exclusive breastfeeding in 2017, namely 54.4 percent (Sumatra Provincial Health Service, 2017). 2018). In the breastfeeding process, problems sometimes arise that can prevent giving breast milk to babies. Problems that mothers often experience when breastfeeding include inverted nipples, swollen breasts, sore and painful nipples, blocked milk ducts, breast inflammation and insufficient milk production (Purwoastuti, 2015). There are many non-pharmacological methods that can help postpartum mothers increase breast milk production, ranging from marmet massage, oxytocin massage, Woolwich massage to areola and rolling massage. Currently, based on the results of related research, there are non-pharmacological methods that are cheaper, easier, non-invasive and acceptable to respondents and without side effects. Nursing interventions that can be applied to help increase lactation in post partum mothers are the SPEOS method (Endorphin, Oxytocin and Suggestive Massage Stimulation).

Type 2 diabetes mellitus, obesity, cesarean section delivery, and lack of exclusive breastfeeding exposure in patients from the Guadalajara Metropolitan Area, Mexico.

the combination of cesarean section delivery and limited exposure to exclusive breastfeeding (EBF) in the first six months of life may increase the risk of obesity and diabetes mellitus. This study aimed to establish an association between type 2 diabetes mellitus (T2DM) in adulthood, cesarean section delivery and incomplete breastfeeding (FBF) in individuals from the metropolitan area of Guadalajara, Mexico. this analytical cross-sectional study included patients over 18 years of age with T2DM and normal weight, overweight or obesity, regardless of sex. Informed consent was obtained. Variables encompassed T2DM, type of delivery method, first-year diet, family history, demographic, socioeconomic, and educational characteristics, and anthropometric measurements. For statistical analysis, Student's t test, chi-square tests and odds ratios were employed. the study evaluated 218 patients with an average age of 57.8 years (± 12.7) and an average age at T2DM diagnosis of 46.2 years (± 12.5). FBF (65.6 %) and partial breastfeeding (PBF) (23.8 %) prevailed in the first six months. The average age at T2DM diagnosis was 46.7 years (± 12.1) for vaginally born patients and 30.7 years (± 15.5) for cesarean-born patients (p = 0.001). Cesarean delivery increased obesity risk by nine times in patients with T2DM [OR = 8.9 (CI, 1.05, 75.2), p = 0.02]. prioritizing the limitation of nonmedically justified cesarean section deliveries is crucial to mitigate the risk of obesity and T2DM in adulthood. .

Perinatal maternal factors influencing postpartum feeding practices at six weeks

ObjectiveDespite the World Health Organization’s recommendation of exclusive breastfeeding for the initial 6 months, breastfeeding rates decline within the first 6 weeks after delivery. This study aimed to (1) investigate the breastfeeding rate at 6 weeks postpartum and (2) explore the influence of perinatal factors on feeding patterns at 6 weeks postpartum.MethodA total of 635 participants were enrolled from February to August 2023 at outpatient clinics in three tertiary hospitals in Nantong City. Variables were collected through questionnaires during the third trimester of pregnancy, including demographic information, pregnancy stress, anxiety, depression, sleep, and resilience. At 6 weeks postpartum, information regarding feeding patterns, delivery and postpartum situations, postpartum stress, anxiety, depression, sleep, and resilience was gathered. Initial single-factor analyses were conducted using feeding pattern as the dependent variable, and variables with significance were chosen as independent variables. The disordered multi-classification logistic regression model was then established using the stepwise forward method.ResultsWithin the first 6 weeks, 35.28% (224/635) of postpartum women exclusively breastfed their infants. Factors influencing exclusive breastfeeding and formula feeding at 6 weeks postpartum included breast pain, sleep quality, mental resilience, difference between postpartum and late pregnancy anxiety, insufficient milk supply, and maternal herself caring for the infant (P < 0.05). Factors influencing the transition from exclusive to partial breastfeeding were insufficient milk supply and maternal herself caring for the infant (P < 0.05).ConclusionThe study reveals a relative low rate of exclusive breastfeeding in China’s first 6 weeks postpartum, along with a comparison of perinatal factors affecting three different feeding patterns. Our findings may contribute additional evidence to the association between perinatal factors and feeding patterns. This study guides healthcare professionals in developing strategies to promote exclusive breastfeeding and improve personalized counseling for exclusive breastfeeding and mental health.

Comprehensive Analysis of Breastfeeding's Influence on Child Health Outcomes: A Cross-Sectional Study.

Background Breastfeeding is recognized as a crucial determinant of child health and development, yet its multifaceted effects remain underexplored in many contexts. This cross-sectional study investigates the association between breastfeeding practices and various health and developmental outcomes in infants and young children, focusing on exclusive breastfeeding, partial breastfeeding, and formula feeding. Done at Khyber Teaching Hospital, Pakistan, the research aims to provide comprehensive insights into the nuanced impacts of breastfeeding on child well-being. Objectives This study aims to assess the association between breastfeeding duration and practices with the incidence of infectious diseases in infants and young children. It investigates the relationship between different breastfeeding practices: exclusive breastfeeding, partial breastfeeding, and formula feeding and cognitive development outcomes in early childhood. Additionally, the study evaluates the role of breastfeeding in the development of motor skills in infants and young children. Methodology A cohort of 390 participants, aged one month to three years, participated in the study. Data collection encompassed parental interviews, clinical assessments using standardized tools such as the Bayley Scales of Infant Development, and reviews of medical records. Statistical analyses, including frequency analysis and chi-square tests, were conducted to elucidate the relationships between breastfeeding practices and health outcomes. Results Exclusive breastfeeding exhibited a significantly lower incidence of infectious diseases compared to partial breastfeeding and formula feeding. Specifically, among exclusively breastfed children, incidences of colds, pneumonia, and diarrhea were 32%, 39.7%, and 40%, respectively. These rates were notably higher in partially breastfed and formula-fed children. Cognitive development outcomes also varied significantly across feeding groups. Exclusively breastfed children demonstrated superior cognitive performance, with 34.2% rated above average, compared to only 6.5% in the formula-fed group. Additionally, the prevalence of developmental delays was lowest among exclusively breastfed children (14.1%), contrasting with 62.8% in the partial breastfeeding group and 77.0% in the formula-feeding group. Conclusions The study underscores the pivotal role of exclusive breastfeeding in promoting optimal child health and development. Exclusive breastfeeding is associated with significantly reduced incidences of infectious diseases, superior cognitive development outcomes, and a lower prevalence of developmental delays. These findings highlight the importance of supportive interventions and policies aimed at encouraging exclusive breastfeeding practices, ultimately enhancing child well-being and developmental trajectories.

Effects of Breastfeeding Promotion Intervention and Dietary Treatment in Postpartum Women with Overweight and Obesity: Results from a Randomized Controlled Trial on Weight and Cardiometabolic Risk Factors

BackgroundChildbearing increases the risk of weight gain and cardiometabolic disease. The reset hypothesis suggests that lactation has protective cardiometabolic effects on the mother. The hypothesis is based on observational studies, and the possible interacting role of weight loss needs to be elucidated. ObjectivesThis study aimed to examine the individual and interaction effects of a breastfeeding promotion intervention (BPI) and dietary intervention for weight loss postpartum (Diet) on body weight and cardiometabolic risk factors at 6 mo postpartum. MethodsPregnant women (n = 156) with a prepregnancy BMI of 25 to 35 kg/m2 were randomized to 4 groups in a 2 × 2 factorial design: BPI, Diet, both treatments, or no treatment. BPI consisted of individual counseling by a lactation consultant during pregnancy, at childbirth, and monthly thereafter or more frequently based on individual needs. Diet was initiated at 11 wk postpartum. Body weight, body composition, waist and hip circumferences, markers of lipid and glucose metabolism, and blood pressure were measured at 2 wk and 6 mo postpartum. We analyzed main and interaction effects using 2-way analysis of covariance adjusted for baseline values. ResultsAmong the participants attending both visits (n = 108), 99% practiced any breastfeeding at baseline and 97% at follow-up. The BPI did not affect rates of exclusive or partial breastfeeding, age at introduction of complementary foods, or have main effects on body weight or cardiometabolic risk factors. There was a main effect of Diet reducing body weight, fat mass, fat-free mass, percentage fat mass, waist and hip circumferences, fasting glucose, and insulin (all P ≤ 0.03), with no interactions between the treatments. ConclusionsThere were no effects of BPI on body weight or cardiometabolic risk factors at 6 mo postpartum. Diet caused weight loss and had favorable effects on risk factors for cardiovascular disease and type 2 diabetes.This study was registered at clinicaltrials.gov as NCT03580057.

Breastfeeding patterns in one-year-old children was not affected by a breastfeeding support intervention

BackgroundBreastfeeding patterns in 12-month-old children play a central role in the mother-infant dyad, but studies describing the patterns are scarce. AimTo investigate breastfeeding patterns in 12-month-old infants before and after a breastfeeding support programme. Study designA baseline/intervention design as part of a larger implementation project aiming to revive the Ten Steps to Successful Breastfeeding programme. SubjectsDuring a 24-h period, 28 mothers from a baseline group and 24 mothers from an intervention group recorded all breastfeeding sessions on a pen and paper form. ResultsThe median (range) frequency of breastfeeding sessions was 6 (1−22) in the baseline group and 7 (1−20) times per 24 h in the intervention group. No significant difference was observed in frequencies between the two groups. The majority of children (57 % in the baseline group and 62 % in the intervention group) exhibited a pattern classified as partial breastfeeding, engaging in breastfeeding 6 or more times per 24 h throughout a substantial part of the day. A second pattern was classified as token breastfeeding, with few breastfeeding sessions, suggesting that breastfeeding occurred primarily for comfort. ConclusionThis study illuminates the breastfeeding behaviours of 12-month-old children and can serve to normalise frequent breastfeeding patterns, potentially aiding mothers who wish to continue breastfeeding beyond infancy. The findings indicate no difference between the groups, suggesting that the implemented intervention did not influence maternal breastfeeding practices at one year of age. This underscores the potential necessity for prolonged support for parents throughout the breastfeeding period.ISRCTN registry: doi.org/10.1186/ISRCTN91972905.

Lactation duration and development of type 2 diabetes and metabolic syndrome in postpartum women with recent gestational diabetes mellitus

BackgroundThe World Health Organization and United Nations Children’s Fund recommend exclusive breastfeeding (EBF) for the first six months of an infant’s life. Although evidence suggests that maintaining breastfeeding has positive impacts on glucose and lipid metabolism in postpartum women with a history of gestational diabetes mellitus (GDM), no study has investigated whether such effects differ between breastfeeding intensities. This study aimed to evaluate the impact of maintaining breastfeeding on prediabetes, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS) six months postpartum in women with GDM. This study also examined the potential variations in glucometabolic outcomes between EBF at six months and partial breastfeeding at six months.MethodsThis prospective cohort study included 130 women with recent GDM who experienced live births between 7 September 2020 and 31 January 2023 at a university hospital in Bangkok, Thailand. All the women were free of T2DM and MetS at baseline (six weeks postpartum). We followed up these women six months postpartum to assess their breastfeeding practices (EBF at six months, partial breastfeeding at six months, or not maintaining breastfeeding) and evaluate their progression to prediabetes, T2DM, and MetS. Maintaining breastfeeding was defined as breastfeeding for six months. EBF was determined using the “recall since birth” method.ResultsOf the 130 participants included, the rates of prediabetes, T2DM, and MetS six months postpartum were 33% (n = 43), 2% (n = 3), and 17% (n = 22), respectively. In the unadjusted model, maintaining breastfeeding was associated with a reduction in the risks of prediabetes and MetS but not T2DM. After adjusting for potential confounders, maintaining breastfeeding was a significant protective factor only for prediabetes. The adjusted risk ratios and 95% confidence intervals were 0.54 (0.29, 0.99) for prediabetes and 0.47 (0.19, 1.06) for MetS. When EBF at six months and partial breastfeeding at six months were separately analyzed, the risks of prediabetes and MetS differed between the two groups. In the EBF at six months-to-partial breastfeeding at six months comparison, the adjusted risk ratios (95% confidence intervals) of prediabetes and MetS were 0.46 (0.22, 0.97) vs. 0.79 (0.25, 2.49) and 0.34 (0.11, 0.99) vs. 0.69 (0.22, 2.07), respectively.ConclusionsMaintaining breastfeeding reduced the risk of prediabetes and MetS, but not of T2DM, six months postpartum; these effects were significant only with EBF. These findings indicate that supporting maternal efforts to practice EBF for six months may improve women’s health after GDM.Trial registrationThai Clinical Trials Registry Registration No. TCTR20200902003. Date of registration: September 2, 2020. Date of initial participant enrollment: September 7, 2020.

Assessing the Implementation of the Baby-Friendly Hospital Initiative in Hungary: A Cross-Sectional Study.

We assessed the prevalence of the "Ten Steps to Successful Breastfeeding" in Hungary and identified possible associations of the steps with breastfeeding. Our quantitative, cross-sectional research was conducted anonymously online in Hungary with a self-administered questionnaire in 2021. Targeted sampling was used, with biological motherhood and having at least one child no older than 60 months as inclusion criteria (n = 2008). The implementation of the "Ten Steps to Successful Breastfeeding" was analyzed separately for breastfeeding and non-breastfeeding mothers. A breastfeeding mother was defined as breastfeeding for at least six months. Descriptive statistics, χ2 test, and t-test were calculated with SPSSv25 (p < 0.05). No significant differences were found between breastfeeding and non-breastfeeding mothers in terms of supplementary feeding at the advice of a health professional (p = 0.624) and in terms of assistance with breastfeeding or suggested breastfeeding positions during hospitalization (p = 0.413). Significant differences were found for receiving breastfeeding-friendly recommendations by staff (p = 0.006), valuing breastfeeding (p < 0.001), skin-to-skin contact within 1 h (p = 0.002), receiving supplementary feeding (p < 0.001), rooming-in (p < 0.001), responsive feeding, recognizing hunger signs (p < 0.001), pacifier/bottle use (p < 0.001), and availability of breastfeeding support (p = 0.005). Significant differences were observed between breastfeeding and non-breastfeeding subsamples regarding the implementation of baby-friendly steps (p < 0.001). Breastfeeding mothers experienced the implementation of more baby-friendly steps and a higher rate of breastfeeding, while there was no significant difference in the duration of exclusive (p = 0.795) and partial breastfeeding (p = 0.250) based on the results. We concluded that exposure to the Baby-Friendly Hospital Initiative may be associated with increased 6-month breastfeeding but may not influence longer durations.

Dietary patterns of Sonoran breastfeeding women are associated to exclusive or partial breastfeeding regimes.

During breastfeeding, the maternal diet ensures mothers and infants health. Therefore, it is necessary to update information about the diet of exclusively or partially breastfeeding women in each population. We evaluated the diet of Sonoran breastfeeding women, identified their dietary patterns, and examined their association with the breastfeeding regime. In this cross-sectional study, 62 women breastfeeding exclusively (n = 43) or partially (n = 19) participated. The diet was assessed using a food frequency questionnaire, and patterns were identified through principal component analysis. Overall, fats and sodium intake were higher, while potassium intake was lower than recommended. Two dietary patterns were identified: "regional" (n = 36) and "prudent" (n = 26). Women following the "prudent" pattern consumed more protein, calcium, and potassium than those following the "regional" pattern (p < 0.05). The probability of exclusively breastfeeding women having a "prudent" dietary pattern was higher than that of partially breastfeeding women (adjusted odds ratios = 7.29, p = 0.019). Exclusive breastfeeding possibly motivated mothers to follow a more prudent diet than those who partially breastfed. Therefore, it is crucial to promote a healthy diet among breastfeeding mothers.

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study.

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.

The Effect of Husband Support and Economic Status Level on Exclusive Breastfeeding

The main problem of low exclusive breastfeeding in Indonesia is the influence of socio-cultural factors and lack of knowledge of pregnant women, families, and communities. This study aims to determine the effect of husband support and economic status level on exclusive breastfeeding. This research is quantitative with a cross-sectional approach where this design emphasizes the time of data measurement and observation of both variables. The sample of this study amounted to 57 respondents. The results of the study found that H1 received showed the influence of husband support on exclusive breastfeeding, H2 received showed the power of the level of economic status on exclusive breastfeeding, H3 received husband support and the level of financial quality simultaneously or jointly affected the dependent variable, namely exclusive breastfeeding. It can be concluded that husband support has a natural effect on partial exclusive breastfeeding, the influence of the level of economic status on exclusive breastfeeding, and husband support and the level of financial quality affect exclusive breastfeeding

Prevalence of functional gastrointestinal disorders in Saudi infants and toddlers: A cross-sectional multicenter study.

Functional gastrointestinal disorders (FGIDs) are common pediatric problems, but their prevalence in Saudi Arabia is unknown. We aimed to assess the prevalence of FGIDs and risk factors among children in six regions of Saudi Arabia. This was a cross-sectional multicenter study enrolling children aged 0-48 months, attending pediatric clinics. Questionnaires evaluated the clinical history, symptoms, and sociodemographic information. FGIDs were defined according to Rome IV criteria. The study involved 1011 infants and toddlers (mean [standard deviation (SD)] aged, 21.7 [19.4] months; FGIDs and mean [SD] age 17.4 [16.4] months; controls). FGIDs were diagnosed in 483 (47.7%) of all infants and toddlers. The prevalence of FGIDs was significantly higher in children aged 0-12 months than in those aged 13-48 months ( P < 0.001). The most common disorders were functional regurgitation (13.8%) in infants and functional constipation (9.6%) in toddlers. Univariate regression analysis confirmed that the rate of FGIDs was higher in term gestational age infants (odds ratio (OR) 2.7; 95% confidence interval (CI), 1.76-4.17, P < 0.001), in partial breastfeeding (OR 0.58; 95% CI, 0.40-0.84, P = 0.003), in formula feeding (OR 2.25; 95% CI, 1.51-3.35, P < 0.001), and in subjects with no history of food allergy (OR 2.40; 95% CI, 1.58-3.64, P < 0.001). FGIDs are common in Saudi infants and toddlers (47.7%). Regurgitation is most prevalent in infants, and functional constipation is most common in toddlers. Term gestational age infant, partial breastfeeding, formula feeding, and subjects with no history of food allergy are associated with the prevalence of FGIDs.

Impact of breastfeeding during infancy on functional constipation at 3 years of age: the Japan Environment and Children’s Study

BackgroundThere is a lack of large, nationwide, birth cohort studies in Japan that examine the relationships of initial feeding habits and breastfeeding period duration with offspring functional constipation at 3 years of age. This study assessed the impact of breastfeeding during infancy on early childhood functional constipation.MethodsThe fixed data of 70,078 singleton births from the ongoing Japan Environment and Children’s Study cohort study that commenced in 2011 were used to identify functional constipation as estimated by Rome III at 3 years of age. The exposure variables were breastfeeding period duration until 12 months of age (never, up to 6 months, or ≥ 7 months) as well as breastfeeding status at 1 month and 6 months of age (breastfeeding exclusively, partial breastfeeding, or infant formula feeding only). Multiple logistic regression analysis was employed to search for correlations for functional constipation development with breastfeeding period duration until 12 months of age and breastfeeding status during infancy.ResultsWe identified 8,118 toddlers (11.6%) who met the Rome III criteria at 3 years of age. After controlling for potential covariates, a breastfeeding period duration of 7 months or more was inversely related to functional constipation development (≥ 7 months: adjusted odds ratio [OR] [95% confidence interval (CI)] 0.76 [0.65, 0.88] versus never breastfed, P for trend < 0.001). Other initial feeding methods were significantly related to an increased risk of functional constipation as compared with breastfeeding exclusively at 1 month of age (partial breastfeeding: adjusted OR [95% CI] 1.17 [1.11, 1.23], formula feeding only: 1.23 [1.07, 1.40]) and 6 months of age (partial breastfeeding: adjusted OR [95% CI] 1.18 [1.12, 1.24], formula feeding only: adjusted OR [95% CI] 1.42 [1.20, 1.68]).ConclusionThis large nationwide survey revealed a possible protective effect of a prolonged breastfeeding period duration and early exclusive breastfeeding in infancy on functional constipation at 3 years.

BREAST MILK BANKS – THE WAY TO GLOBAL BREASTFEEDING SUPPORT IN UKRAINE AND THE WORLD

Breast milk is the standard of infant nutrition, recognized worldwide as the optimal fi rst source of food, and breastfeedingis the ideal way to feed children, meeting all their needs. Breast milk is especially valuable for premature infants, who require specialized medical care from the fi rst seconds of life and for a long time, and for sick newborns born at term. Preterm or sick preterm infants are most vulnerable to perinatal illness, have a high probability of dying and, most importantly, are at the greatest risk of not receiving the life-saving benefi ts of breast milk. In today’s world, the World Health Organization and the American Academy of Pediatrics recommend the use of donor human milk as the fi rst alternative for feeding preterm infants of any gestational age, including very preterm infants (&lt;32 weeks gestation) or very low birth weight infants (&lt;1500 g), when human milk is not available. Studies have shown that breastfeeding, even partial breastfeeding, reduces the risk of necrotizing enterocolitis and late neonatal sepsis, retinopathy of prematurity, and sudden infant death, improves cognitive outcomes in preterm infants, and helps establish optimal functioning of the digestive system and enteric digestive processes. In many countries around the world, targeted support for breastfeeding in neonatal intensive care units, including enteral feeding of sick and premature infants, is provided by donor human breast milk that is concentrated and stored in an established and functioning network of breast milk banks.A breast milk bank is an institution whose purpose is to collect breast milk from mothers who produce more than theirinfants need, and to process and store breast milk for the feeding of infants who, for medical or other reasons, cannot receive it temporarily or for a long period. International associations of breast milk banks have been established throughout the world to promote the activities of banks and to establish international cooperation among breast milk banks.The European Milk Banks Association (EMBA) was offi cially launched on October 15, 2010. There are currently 282 activebanks in 31 European countries and 18 banks in the process of becoming active. The Southern African Milk Banks Association (HMBASA) was established in 2009. HMBASA coordinates the activities of the network of milk banks throughout the country. The North American Milk Banks Association (HMBANA) was founded in 1985 and brings together 30 non-profi t breast milk banks in the United States and Canada. There is a positive trend in the establishment of new breast milk banks in all countries of the world. There are currently about 500 in 37 countries. Brazil is the world leader in breast milk banks, with 222 breast milk banks and 217 milk collection centers. The first donor breast milk bank in Ukraine was established in 2019 in Kyiv at the Perinatal Center, where about 80 % of all premature babies in the city are born. In December 2022, when the country was at war, a high-tech breast milk bank was opened at the Lviv Regional Clinical Perinatal Center. This is the second bank of donated breast milk successfully operating in Ukraine on the basis of perinatal centers.The operation of the breast milk bank at the Lviv Oblast Clinical Perinatal Center is one of the many modern high-tech areasof the healthcare facility. The breast milk bank is equipped with all the necessary equipment, which meets the highest modern world standards. Active daily teamwork of obstetricians, neonatologists, lactation consultants and mothers has allowed the bank to attract 32 donors of breast milk and collect more than 380 liters of donor milk since its opening. The fi rst batch of donor milk was received on January 12, 2023.Promoting the creation of a network of mother’s milk banks in Ukraine at the state level will help to make a signifi cantcontribution to the preservation of the full healthy development of newborns and infants in our country, which has becomeespecially important in the current military situation in Ukraine.

Breastfeeding following bariatric surgery among obese women with and without diabetes mellitus.

Information on exclusive breastfeeding (BF) and BF initiation following bariatric surgery (BS) among obese women with diabetes mellitus (DM) and without DM (non-DM) is limited. Retrospective cohort study. Obesity was defined by BMI (kg/m2) as grade 1 (30-34.9), grade 2 (35-39.9) or grade 3 (≥40). The 65 women in the DM group (40 women with gestational, 19 with Type 2 and 6 with Type 1) was similar to 84 with no-DM in BS type: Roux-en-Y (51 vs 55%), sleeve gastrectomy (32 vs 35%), laparoscopic gastric banding (17 vs 7%) and gastro-duodenal anastomosis (0 vs 4%). Women with DM were older (35 vs 33y), of advanced age (54 vs 27%), with higher prevalence of grade 3 obesity (66 vs 46%), chronic hypertension (31 vs 10%), delivery of late-preterm infants (23 vs 10%) and neonatal hypoglycemia (25 vs 12%). Although infant feeding intention was similar: BF (66 vs 79%), partial BF (9 vs 7%) or formula (25 vs 14%), at discharge women with DM had lower exclusive BF (29 vs 41%) and BF initiation rates (68 vs 76%) than those with no-DM. Women with grade 3 obesity (52% were DM) differed from those with grades 1-2 (34% were DM) in exclusive BF (27 vs 52%), and BF initiation rates (66 vs 86%). After BS, women with DM, especially those with grade 3 obesity, had higher rates of chronic hypertension and preeclampsia and lower rates of exclusive BF and BF initiation than those who had DM but had less severe obesity.

Breastfeeding Practices among Postpartum Women with and without a History of Gestational Diabetes Mellitus: A Prospective Study

Objective: To compare breastfeeding (BF) practices, particularly exclusive BF (EBF), among women with and without a history of gestational diabetes mellitus (GDM) during the first six postpartum months and assess the impact of EBF on offspring weight from birth to six months postpartum. Materials and Methods: The present study was a prospective study that included 244 women, with 123 with a history of GDM (GDM group) and 121 without a history of GDM (non-GDM group). All participants were first interviewed on the discharge date and then via telephone at 1, 2, 3, 4, 5, and 6 months postpartum. BF practices were classified as EBF, partial BF (PBF), or no BF. Data on infant weight at six months were evaluated. Results: Upon hospital discharge, women mostly practiced PBF with 53.6% PBF versus 30.1% EBF in the GDM group and 48.8% PBF versus 38.0% EBF in the non-GDM group. However, EBF was more commonly practiced than PBF, during the first six months postpartum. The 6-month EBF rates for the GDM and non-GDM groups were 28.4% and 17.4%, respectively (p=0.039). In a multivariate analysis, only the intended EBF period was a factor that significantly impacted 6-month EBF rates (adjusted odds ratio 3.49 and 95% confidence interval 1.48 to 8.22). EBF for six months resulted in reduced weight gain during the first six months of life among offspring of women in both groups. Conclusion: The GDM group practiced EBF for six months postpartum more frequently than the non-GDM group. However, a history of GDM was not an independent predictor of EBF success over six months. EBF demonstrated lower offspring weight gain from birth to six months postpartum for women with and without a history of GDM. These findings may be used to design targeted educational programs for informed postpartum BF practices. Keywords: Breastfeeding practices; Breastmilk; Exclusive breastfeeding; Gestational diabetes mellitus; Infant weight gain; Postpartum

Infant feeding practices and autism spectrum disorder in US children aged 2–5 years: the national survey of children’s health (NSCH) 2016–2020

ObjectiveTo investigate the relationship between infant feeding practices and autism spectrum disorder (ASD) among children aged 2–5 years in the United States (US).MethodsData from the 2016–2020 National Survey of Children’s Health, a nationally representative cross-sectional survey, were utilized for this study. Questionnaires were administered to parents of children aged 2–5 years to gather information on ASD diagnosis, infant feeding practices, and demographic factors (e.g., child sex, ethnic group, and maternal age at birth). Logistic regression with sample weights was employed to assess the association between infant feeding practices and ASD, while controlling for demographic variables. Polynomial regression models were used to examine trends in exclusive breastfeeding and ever breastfeeding rates among children with and without ASD.ResultsA total of 35,050 children aged 2–5 years were analyzed, including 616 diagnosed with ASD, after excluding participants with missing information on breastfeeding and ASD diagnosis. Of these children with ASD, 76.6% (n = 472) had a breastfeeding history, with 66.6% (n = 410) engaged in partial breastfeeding and 10.1% (n = 62) exclusively breastfed. Adjusted odds ratios for each additional month of breastfeeding compared to never being breastfed were 0.99 (95% CI, 0.97–1.01). The adjusted odds ratios for breastfeeding durations of > 0–6 months, > 6–12 months, > 12–24 months, and > 24 months were 0.84 (95% CI, 0.51–1.36), 0.76 (95% CI, 0.42–1.35), 0.79 (95% CI, 0.43–1.45), and 0.66 (95% CI, 0.32–1.35), respectively. Compared to children who were never breastfed, the adjusted odds ratio for children who were ever breastfed was 0.79 (95% CI, 0.50–1.25). Among children with ASD, the proportion of ever breastfeeding declined from 82.0% in 2017 to 64.3% in 2020, while exclusive breastfeeding decreased from 12.0% in 2016 to 5.9% in 2020.Conclusions and relevanceAlthough no significant association was found between infant feeding practices and ASD among US children aged 2–5 years, the rates of breastfeeding, particularly exclusive breastfeeding, were suboptimal among children with ASD. This highlights the need for specific policies and practices to promote and support breastfeeding among parents of children with ASD or those at high risk of having a child with ASD.

A Retrospective Chart Review and Infant Feeding Survey in the Irish Phenylketonuria (PKU) Population (2016-2020).

Phenylketonuria (PKU) is an inherited disorder of protein metabolism. It is generally treated using dietary management with limited intake of phenylalanine (Phe). Partial breastfeeding (BF) is encouraged among mothers of infants with PKU, together with a Phe-free mixture of synthetic amino acids. Our aim was to describe our current BF rates and complementary feeding practices, as well as examining parental experiences of infant feeding. The objective was to better understand the challenges faced by families so that improvements can be made to clinical care. A chart review was carried out on 39 PKU patients, examining the BF rate and duration, use of second stage synthetic protein (SP), and average complementary feeding age. A parental questionnaire on complementary feeding and BF experience was designed: 26% of babies were partially breastfed at three months of age; 70% of mums would like to have breastfed for longer and cited PKU as a reason for stopping; 52% of parents reported challenges during the complementary feeding process including food refusal, protein calculation, and anxiety around maintaining good Phe levels. Suggestions to improve BF continuation and duration include active promotion of the benefits and suitability, access to lactation consultant, and peer support. The delay in introducing a second stage SP may contribute to long-term bottle use for SP. Improved patient education, written resources, and support is necessary to improve food choices and long-term acceptance of SP.

Chinese herbs in maternal diets related to clinical presentations in breastfed infants

IntroductionFew studies explored the effects of maternal herb consumption on breastfed infants. Our aims were to investigate the relationship between maternal consumption of Chinese herb-enriched diets and clinical presentations of breastfed infants at 1 to 2 months of age. MethodsThis prospective study enroled healthy infants aged 25 to 60 days from the Taipei branch of Chang Gung Memorial Hospital in Taiwan during 2013-2019. We measured feeding type, weight gain, jaundice, stool frequency, irritability, sleeping hours, regurgitation, and flatulence. Four commonly used Chinese diets were assessed, including Eucommia ulmoides, Si-Wu-Tan, Sheng-Hua-Tang, and sesame oil chicken. ResultsWe enroled 751 infants, of whom 359 were on exclusive breastfeeding, 52 on formula feeding, and 340 on partial breastfeeding (at least one meal each of breast milk and formula daily). We observed significant differences in activity, sleeping hours, jaundice, and stool frequency between infants on exclusive breastfeeding, formula feeding, and partial breastfeeding. Regarding infants on exclusive breastfeeding, multivariate logistic regression analyses revealed that infants whose mothers consumed E ulmoides were at higher risk of prolonged jaundice. In contrast, infants whose mothers consumed Si-Wu-Tan were at lower risk of prolonged jaundice. Furthermore, stool passage frequency increased in infants whose mothers consumed E ulmoides, Si-Wu-Tang, and sesame oil chicken. ConclusionsOur results showed that maternal diets containing certain Chinese herbs, specifically E ulmoides and Si-Wu-Tan are related to breast milk jaundice, while E ulmoides, Si-Wu-Tang, and sesame oil chicken are related to increased stool frequency among breastfed infants.