Prolonged Breastfeeding Research Articles

Trajectory of Obesity and the Impact of Eating Behaviors on Obesity in Preschool Children: A Nationwide Population-Based Cohort Study in Korea

Background: Early childhood obesity is highly associated with obesity in adolescents and adults. However, studies on specific eating behaviors that have a decisive effect on obesity in early childhood (aged 3–5 years) are scarce. We hypothesized that critical risk factors associated with eating behaviors leading to obesity at ages of 3–5 years may be different. To confirm this hypothesis, we conducted a study on the risk factors of obesity related to eating behaviors in preschool children. Methods: Using the National Health Screening Program for Infants and Children (NHSPIC) in Korea’s general population cohort, we found the obesity trends in 3–5-year-olds. The risk factors of obesity in 3–5-year-olds were analyzed through logistic regression. Results: Among children with obesity at 3 years old, but without obesity at 4 years old, only 10.1% (107/1063) transitioned to obesity at 5 years old, whereas among children with obesity at 3–4 years old, 62.7% (398/635) transitioned to obesity at 5 years old. The risk factors for obesity at 3 years old were inclusion of meat in complementary food, prolonged breastfeeding, and consumption of sweetened beverages; at ages 4–5 years, the risk factors were the inclusion of meat in complementary food and consumption of sweetened beverages. Conclusions: Obesity at 4 years is more likely to lead to obesity in the following year than obesity at 3 years. The dietary factor with the greatest impact on obesity in children aged 3–5 years has been found to be consumption of sweetened beverages.

Association of breastfeeding duration with overweight and obesity among women in Ghana.

There is a general concurrence on the health benefits that breastfeeding confers to children, including offering maximal protection against obesity across their life course. However, the scientific evidence on similar benefits for women who breastfeed their children remains inconclusive. This study contributes to the discourse by examining the association of breastfeeding duration with overweight and obesity among women in Ghana. Data on 8,516 women of reproductive age were pooled from the last five (5) Ghana Demographic and Health Surveys, and analysed using descriptive proportions and logistic regression models. The prevalence of overweight and obesity was about 8% lower for women who breastfed their children beyond 18 months (overweight = 13%, obesity = 5%) compared with women who did not breastfeed (overweight = 21%, obesity = 13%) their children at all. With reference to women who did not breastfeed their children, a significant lower odds of obesity was observed for those who breastfed their children for 13-18 months (OR = 0.46, 95% CI = 0.268, 0.864) and >18 months (OR = 0.41, 95% CI = 0.216, 0.764), after adjusting for possible confounding factors. Women who breastfeed their children for a minimum of 12 months have lower risk of developing obesity. Promoting prolonged breastfeeding among mothers could be an effective pathway to preventing obesity among women in Ghana.

The Impact of Prolonged Breastfeeding on Growth, Development, and Diet Quality Until Age 24 months

The Impact of Prolonged Breastfeeding on Growth, Development, and Diet Quality Until Age 24 months

The association of breastfeeding duration on metabolic syndrome among children and adolescents, stratified by birth weight for gestational age.

This study aimed to examine the associations between breastfeeding duration and metabolic syndrome (MetS) in adolescents and to further investigate the role of birth weight for gestational age (GA) on these associations. A total of 10 275 participants aged 7 to 18 years were included applying multistage cluster random sampling from a Chinese national survey. Birth weight was classified into small for GA (SGA), appropriate for GA (AGA) and large for GA (LGA). Information was collected through a self-administered questionnaire, physical examination and blood biochemical examination. Multivariable linear regression, logistic regression models, restricted cubic spline models were applied to assess the relationships of breastfeeding duration and MetS with different birth weight for GA. The prevalence of non-breastfeeding, 0-5, 6-12 and >12 months groups were 16.2%, 23.1%, 42.5% and 18.2%, and the prevalence of SGA and LGA was 11.9% and 12.7%, respectively. Prolonged breastfeeding duration was associated with higher odds of MetS (β: 0.08, 95% CI: 0.03, 0.13), WC (β: 3.49, 95% CI: 2.82, 4.16) and SBP (β: 2.34, 95% CI: 1.80, 2.89). SGA and prolonged breastfeeding synergistically increased MetS risks, but LGA appeared to offset the adverse effects of prolonged breastfeeding. Prolonged breastfeeding may increase children's MetS risks. SGA synergies with prolonged breastfeeding increased MetS burden in children and adolescents, while LGA mitigated the risks. This reminds us that intensive attention should be paid to both early birth weight and subsequent living environment for children and adolescents' lifelong health.

A longitudinal study on the impact of breastfeeding with or without formula milk on dental caries

Concerns exist about prolonged breastfeeding increasing dental caries risk, but evidence is mixed. This 2-year cohort study followed 486 toddlers, to examine the association between breastfeeding duration and caries at age 3. Caregivers reported feeding practices and potential confounders every 6 months. “Full breastfeeding” was defined as feeding breastmilk without formula milk regardless of other foods/liquids, whereas “any breastfeeding” was feeding breastmilk with/without formula milk. A calibrated dentist performed dental examinations. We used multivariable log-binomial and negative binomial regressions to estimate relative risks (RRs) and 95% confidence intervals (CIs) for caries prevalence and severity, adjusted for confounders. At 3-year-old, 60.3% of children exhibited caries (mean decayed-and-filled-teeth, dft: 3.3). Notably, full breastfeeding for 6–17 months reduced caries prevalence (RR = 0.84, 95%CI 0.73–0.98 for 6–11 months; RR = 0.78, 95%CI 0.63–0.96 for 12–17 months). Conversely, any breastfeeding ≥ 18 months significantly increased caries risk (RR = 1.45, 95%CI 1.31–1.60). Full breastfeeding ≥ 6 months or any breastfeeding 6–17 months was associated with lower dft scores in children. Our findings suggest a complex relationship between breastfeeding duration and caries. Full breastfeeding for moderate durations (6–17 months) offers protective benefits, while any breastfeeding ≥ 18 months increases risk in this population.

Abstract PO2-28-04: Pregnancy-associated relapse of triple-negative breast cancer

Abstract Introduction: Pregnancy Triple-negative breast cancer(TNMC) is the absence of ER PR and HER2 receptor expression. It constitutes about 15-20% of all breast cancers and is known to be the aggressive form with a high relapse rate (1). Interestingly, it usually affects women aged < 40 and has a low survival rate in African-American females. This case is a typical presentation of a 38-year-old young woman with PMH of T2NO right triple-negative breast cancer diagnosed in 2017 s/p right mastectomy with sentinel LN biopsy, received immunotherapy and chemotherapy, has been cancer-free for two years, and developed metastatic cancer during her pregnancy. In this case, we understand the diagnostic and therapeutic challenges of TNBC during pregnancy. Case: A 38-year-old African American woman, G0, T2NO triple negative invasive ductal carcinoma, underwent a right breast mastectomy and sentinel LN biopsy. She received treatment with (Anti-PD-L1 Antibody) concomitant with weekly paclitaxel and Doxorubicin/Cyclophosphamide (AC) chemotherapy. However, she had a residual 4cm tumor for which she was treated with adjuvant therapy with capecitabine for six months. A repeat Mammogram in 2019 showed no evidence of malignancy. In 2021, the patient was G2P2L1, admitted to the hospital after having a seizure. CT reported cystic/necrotic left parietal lesion mass effect with 8mm right-sided midline shift with metastasis to lungs and abdominal wall. She underwent L parietal craniectomy with resection of the tumor. At 32 weeks of gestation , chemotherapy with carboplatin and paclitaxel was given after her C-section and Gamma knife radiosurgery for metastatic lesions. She developed super refractory seizures, was induced into a coma with therapeutically anesthetic agents, and passed eventually. Discussion: Little literature exists on pregnancy-associated relapse of triple-negative breast cancer and its deterioration. Our patient was in remission for two years and was diagnosed with metastatic cancer during her second pregnancy. John et al., (2018) discussed an interesting association between breastfeeding, parity, and occurrence of TNBC, that there is a two-fold increased risk of developing TNBC with high parity(3 full-term pregnancies) and short-term breastfeeding (< 12 months) (2). Studies have also shown that cancers during or postpartum pregnancy are aggressive with more tumor burden and metastasize to the lungs, liver, and brain, which is consistent with our patient. (3) Conclusion: Pregnancy-associated breast cancer is diagnostically and therapeutically challenging during or in the postpartum period and with a high propensity of the triple-negative type. It requires a multidisciplinary team approach, awareness in the African American population, clinical suspicion of breast mass during pregnancy warrants imaging, and prolonged breastfeeding postpartum. Diagnosis is usually delayed due to pregnancy, and more research is needed on the diagnostic modalities during pregnancy for early treatment initiation. References Almansour NM. Triple-Negative Breast Cancer: A Brief Review About Epidemiology, Risk Factors, Signaling Pathways, Treatment and Role of Artificial Intelligence. Front Mol Biosci. 2022 Jan 25;9:836417. doi: 10.3389/fmolb.2022.836417. PMID: 35145999; PMCID: PMC8824427. John EM, Hines LM, Phipps AI, et al. Reproductive history, breast-feeding and risk of triple-negative breast cancer: The Breast Cancer Etiology in Minorities (BEM) study. International Journal of Cancer. 2018;142(11):2273. doi:10.1002/ijc.31258 Amant F, Deckers S, Van Calsteren K, Loibl S, Halaska M, Brepoels L, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer (2010) 46(18):3158–68. 10.1016/j.ejca.2010.09.010 Citation Format: Vaidarshi Abbagoni. Pregnancy-associated relapse of triple-negative breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-28-04.

Maternal self-esteem and self-efficacy as factors affecting maternal long-term breastfeeding: Α comprehensive review of the literature

Background: Breastfeeding is widely recognized as the optimal feeding method for infants, providing numerous health benefits, both for the infant and the mother. Numerous factors have been noted to influence its success, and currently, maternal self-esteem and more particularly self-efficacy, have been recognized as important determinants as well. To this end, it is essential to take into account the role of maternal self-esteem in achieving and sustaining breastfeeding. Methods: This review of the current medical literature aims to investigate the correlation between maternal self-efficacy and breastfeeding duration. A total of 23 articles were selected for comprehensive review, following an online search for relevant literature dating from 2009 onward. All articles were analyzed, identifying key themes, approaches, and conclusions regarding breastfeeding behaviors and maternal self-efficacy. Results: The findings consistently demonstrated that higher levels of maternal self-efficacy were associated with better breastfeeding outcomes, including longer duration of exclusive breastfeeding. Interventions targeting self-efficacy, such as educational programs and counseling, were found to be effective in enhancing breastfeeding self-confidence and promoting prolonged breastfeeding. However, it was observed that maternal breastfeeding self-efficacy tends to decline over time, highlighting the need for continuous support and interventions. Conclusions: Maternal self-esteem, particularly self-efficacy, is vital in achieving long-term breastfeeding goals. Interventions and support programs that enhance maternal self-efficacy have shown promise in improving breastfeeding outcomes. Ongoing support, counseling, and access to breastfeeding resources are crucial for maintaining and improving self-efficacy levels throughout the breastfeeding journey. Healthcare professionals and policymakers should consider incorporating strategies to enhance maternal self-esteem into breastfeeding support initiatives for better breastfeeding outcomes. Further research is required to explore cultural and social influences on maternal self-esteem and develop tailored interventions for diverse populations

Abstract 2138: Understanding the link between breastfeeding and the risk of breast cancer through comparative analysis of the murine-based model of mammary gland involution

Abstract Introduction: A meta-analysis of 47 global epidemiological studies highlights a higher breast cancer risk in women who did not breastfeed or breastfed for a short time. Further studies showed this is especially true for triple-negative breast cancer (TNBC) patients. Premenopausal AA women (AAW) have a lower prevalence of breastfeeding and a higher incidence of TNBC and mortality. Our previous study compares short-term breastfeeding, abrupt involution (AI) with prolonged breastfeeding called gradual involution (GI), revealing that AI alone induces ductal hyperplasia four months postpartum. Our current investigation delves into early events during AI versus GI, employing a comprehensive approach encompassing histology, gene expression, and myeloid cell involvement. Methods: Utilizing FVB female mice, we conducted a comparative analysis of AI and GI. AI involved early pup removal, while GI was achieved through staggered weaning. The evaluation included analysis of histomorphology, gene/protein expression, and myeloid cell infiltration. Sequential mammary gland (MG) changes were monitored through H&E staining, TUNEL assay, and DNA damage analysis. 3D-organoid cultures of luminal progenitors (LPs) were employed to assess the impact of AI versus GI. qRT-PCR, IHC, Western blot, and flow cytometry/multiplex imaging were employed for the differential expression analysis of molecular and cellular factors associated with AI/GI. Results: Our research showed that AI had early adipocyte repopulation, rapid cell death, DNA repair, and myeloid cell infiltration, resulting in a chronically inflamed microenvironment. In contrast, the GI triggers a controlled immune response and prolonged cell death, facilitating comprehensive remodeling of the MG. Our flow cytometric or multiplexing imaging analyses revealed that AI-affected glands exhibit an enrichment of CCL9-producing CD206+ M2-like macrophages and CD11b+Gr1+ myeloid-derived suppressor cells. Moreover, exogenous CCL9 treatment on LPs in 3D-organoid culture results in disorganized acinar-type organoids, mirroring morphological differences observed in LPs from AI mammary glands on day56 PPM. Further analysis of CCL9 treated organoids revealed the expansion of Esr1- LPs population in ex-vivo organoid culture which might indicate an increase in the putative cells of origin of TNBC. Conclusion: Our studies comparing AI and GI demonstrate that AI is producing a pro-tumorigenic environment in the breast. It is important to note that prolonged breastfeeding protects the breast, although this cannot be a singular risk factor for TNBC. Therefore, understanding the mechanism will lead to prevention strategies to improve outcomes for all women but, has the potential to have a significant benefit in AAW. Citation Format: Sanjay Mishra, Neelam Shinde, Maria Cuitino, Morgan Bauer, Dinesh Ahirwar, Vijaya Bharti, Kate Ormiston, Resham Mawalkar, Sara Alsammerai, Gautam Sarathy, Xiaoli Zhang, Anna Vilgelm, Ramesh Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Understanding the link between breastfeeding and the risk of breast cancer through comparative analysis of the murine-based model of mammary gland involution [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2138.

Influence of Sociodemographic Factors on Stunting, Wasting, and Underweight Among Children Under Two Years of Age Born During the COVID-19 Pandemic in Central India: A Cross-Sectional Study.

Introduction The adverse effects of the coronavirus disease 2019 (COVID-19) pandemic on maternal and reproductive health extend beyond the immediate morbidity and mortality attributed directly to the disease. Pandemic-induced disruptions in the healthcare, social and economic infrastructures can exacerbate the already high burden of childhood undernutrition in India. Method A cross-sectional study was conducted in a selected district of the central Indian province of Madhya Pradesh. Data was collected from eligible children born during the COVID-19 pandemic (February 2020 to December 2021) who visited a selected tertiary care hospital for routine immunization during the study period. Weight-for-length, weight-for-age, and length-for-agewere compared with reference values to obtain corresponding z-scores. Children with z-scores two standard deviations below the reference values were considered wasting, underweight and stunting, respectively. Descriptive statistics were employed to summarise the sociodemographic characteristics of participants. The association of sociodemographic, nutritional, and pregnancy-related factors with the z-scores were assessed via unpaired t-test and ANOVA. Result The studied 147 children were in the age group of nine to 29 months, of which 61 (58.1%) were males. Forty-two (28.6%) were found to be underweight, 22 (14.9%) had wasting and 51 (34.7%) were stunted. These prevalences were comparable to the estimates of the National Family Health Survey 2019-2021 (NFHS-5) for Madhya Pradesh and lower than the NFHS-4 (2015-2016), showing no discernible effect of being born during the pandemic on growth indicators. However, mothers' employment and family income were independent predictors of stunting whereas gestational age at birth, maternal education, and prolonged breastfeeding were all substantially linked with wasting in this study. Conclusion This study adds to the evidence base by reporting the prevalence of stunting, wasting and underweight along with their determinants in central India among children born during the COVID-19 pandemic. Our data did not reflect the expected increase in child malnutrition due to the COVID-19 pandemic-related disruptions in healthcare, social and economic infrastructure. Future research should incorporate the lessons learnt from our study to design a population-based study of under-five children and compare the prevalence of undernutrition in pandemic-born versus non-pandemic-born children.

Prevalence, trend, and inequality of prolonged exclusive breastfeeding among children aged 6-23 months old in India from 1992-2021: A cross-sectional study of nationally representative, individual-level data.

Prolonged exclusive breastfeeding (PEB) for children older than six months old is a threat to appropriate complementary feeding practices. This study aims to examine the trend of PEB among children aged 6-23 months in India. We adopted five waves of National Family Health Survey (NFHS) data between 1992-93 and 2019-21. PEB was defined as children aged six months and above currently consuming breastmilk as the only source of energy, protein and micronutrients. We generated descriptive statistics and a series of multivariable logistic regressions to estimate the prevalence and trend in the PEB rate. Moreover, we assessed how child age and socioeconomic factors (i.e. child gender and age, place of residence, household wealth, and maternal education) were related with PEB using mutually and single-adjusted model. There were 184 891 Indian children aged 6-23 months old included in this study with 48.0% being female. We found that the proportion of PEB increased from 4.3% in 1992 to 7.7% in 2021, of which the rate for children aged six-eight months rose from 14.0 to 20.1%. Our results showed that children who were from poorer households or with lower-educated mothers were more likely to experience prolonged exclusive breastfed. Take the year of 2019-21 as an example, compared to the households of the richest quintile, children from households of the poorer quintile were significantly more likely to experience PEB, with odds ratio (OR) of 1.33 (95% confidence interval (CI) = 1.09-1.61). Moreover, children with illiterate mothers had 21% higher odds of having prolonged exclusively breastfeeding (OR = 1.21; 95% CI = 1.01-1.44) compared with children with mothers who have college and above education. PEB among children over six months old is prevalent in India, particularly among children from disadvantaged households. Poverty reduction and maternal education are of great potential importance for policymakers to promote appropriate complementary feeding practice.

Correlates of early child development among children with stunting: A cross-sectional study in Uganda.

Many children in low- and middle-income countries are not attaining their developmental potential. Stunting is associated with poor child development, but it is not known which correlates of stunting are impairing child development. We explored potential socioeconomic, nutritional, clinical, and household correlates of early child development among 12-59-month-old children with stunting in a cross-sectional study in Uganda. Development was assessed using the Malawi Development Assessment Tool (MDAT) across four domains of gross and fine motor, language, and social skills. Linear regression analysis was used to assess correlates of development in the four domains and total MDAT score. Of 750 children included, the median [interquartile range] age was 30 [23-41] months, 55% of the children resided in rural settings with 21% from female-headed households and 47% of mothers had no schooling. The mean ± standard deviation height-for-age z-score (HAZ) was -3.02 ± 0.74, 40% of the children had a positive malaria test and 65% were anaemic (haemoglobin < 110 g/L). One-third had children's books at home, majority (96%) used household objects to play with and most of them (70%) used toys as pretence items like those to mimic cooking. After age, sex, and site adjustments, HAZ (0.24, 95% confidence interval [CI]: 0.14-0.33) and head circumference (0.07, 95%CI: 0.02-0.12) were positive correlates of total MDAT score, whereas weight-for-height z-score (WHZ) was not. Current breastfeeding was associated with 0.41 (95%CI: 0.17-0.65) lower total MDAT score. Children from households with a single income earner had 0.22 (95%CI: 0.06-0.37) lower total MDAT score. Furthermore, severe food insecurity, inflammation and positive malaria test were associated with lower scores for motor development. All family care indicator subscales (FCIs) positively correlated with the total MDAT score and this association was independent of household's socioeconomic status. In conclusion, stunting degree, head circumference, number of household income earners and stimulation by improved FCIs correlate with early child development among stunted children. The negative association with prolonged breastfeeding is likely due to reverse causality. Identified correlates may inform initiatives to support children with stunting attain their development potential.

Knowledge and attitudes on oral health of women during pregnancy and their children: an online survey.

Life-long healthy behaviors are established during pregnancy and the first years of life. In this cross-sectional survey, new mothers with a high level of schooling living in Northern Italy (Lombardy Region) were interviewed to assess their knowledge and attitudes towards their and childoral health. A questionnaire (27 items) was developed to assess socio-demographic factors, knowledge, and attitudes towards maternal and child oral health. The questionnaire was disseminated in perinatal courses, private gynecological clinics, and via social media. Mothers aged ≥18 years, with at least a child aged 0-36 months, with a high school diploma or higher, were included in the survey. A total of 1340 women completed the questionnaire, 1297 of whom had a child aged 0-36 months, 792 lived in Lombardy, and 600 had a high level of education and were finally included. About half of the sample (44.67%) was aged between 31 and 35 years, 76.50% were employed, and the majority had only one child (81.50%). During pregnancy, 28.33% of the sample reported problems with teeth and gums, while only 36.00% visited a dentist. More than 40% of the sample said they were not aware of a possible link between oral health and pregnancy, and 73.17% had not received any advice about their oral health or the future health of their baby's mouth. Less than 20% of women were aware of the increased caries risk associated with prolonged or night-time breastfeeding. Better knowledge/attitude was associated with the age of the child (p < 0.05), the number of children (p < 0.05) and whether the mother had received advice during pregnancy (p < 0.05). The results of this survey show a lack of dental care during pregnancy, a lack of information about oral health from health professionals during and after pregnancy, and consequently gaps in the knowledge needed to care for the oral health of the woman and her child. There is a need for training in oral health for pregnant women and new mothers, but also a need for behavioural change among health professionals who care for pregnant women.

Knowledge, attitudes and practices in oral health of breastfeeding women

The benefits of breastfeeding on the health of infants and mothers are no longer in doubt. On the other hand, theadvantages in terms of maxillofacial development and the risks of prolonged breastfeeding onoral health are much less discussed. An exploratory qualitative study, carried out within the pediatric dentistry functional unit of the dental care service of the Lille University Hospital Center in2022, aimed to analyze the knowledge, attitudes and practices in oral health of breastfeeding women. This article will discuss the gaps in prevention as well as the obstacles and levers to improving care.

Knowledge and practices on anemia in representatives of children under 5 years of age from the "Luz y Libertad" Educational Unit in La Concordia, 2023

Childhood anemia is a public health problem that negatively affects the cognitive and physical development of children, with multifactorial causes including nutritional deficiencies and socioeconomic conditions. Diagnosis is based on a complete blood count, and low hemoglobin levels indicate anemia. In Ecuador, factors such as rural residence and micronutrient deficiencies contribute to the prevalence of anemia, with 25.7% of children under five years of age affected. This study, conducted at the "Luz y Libertad" Educational Unit, evaluated the knowledge and practices of 66 mothers about childhood anemia through questionnaires. The results showed a good level of knowledge, especially about the importance of iron, although areas such as the relationship between prolonged breastfeeding and anemia require more education. The economic situation influences child nutrition, with some prioritizing price over nutritional value. It is recommended that educational programs and economic support be implemented to improve the prevention of childhood anemia and ensure healthy development.

Breastfeeding Duration Is Associated with the Risk of Tooth Loss, Chewing Difficulty, and Undernutrition among Older Korean Women: Results of the Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2015.

We investigated whether older Korean women with prolonged breastfeeding duration have an increased risk of tooth loss, chewing difficulty, or undernutrition, as well as whether tooth loss and chewing difficulty mediate the association between breastfeeding duration and undernutrition risk. This study included 1666 women aged ≥65 years from the 2013-2015 Korea National Health and Nutrition Examination Survey who breastfed after delivery. The number of teeth and chewing ability were investigated based on the status of individual teeth and a self-report questionnaire, respectively. Dietary intake was estimated using the 24 h recall method. Compared with women who breastfed for 1-18 months, the odds ratios for tooth loss were 1.16 (95% confidence interval [CI] = 0.69-1.94), 1.79 (95% CI = 1.08-2.94), and 1.86 (95% CI = 1.16-2.97) among women who breastfed for 19-36, 37-72, and ≥73 months, respectively (p for trend = 0.004). Similar results were obtained for chewing difficulty and undernutrition. Furthermore, tooth loss and chewing difficulty partially mediated the association between breastfeeding duration and undernutrition risk. In conclusion, older Korean women who breastfed for longer periods are more likely to experience tooth loss, chewing difficulty, and undernutrition, which are particularly severe among women who breastfed for ≥37 months. The association between breastfeeding duration and undernutrition risk is mediated by tooth loss and chewing difficulty.

Vitamin D deficiency rickets in a toddler.

Nutritional rickets is the failure of normal bone formation in children, caused by vitamin D deficiency, low calcium intake, or a combination of both. In the United States, prolonged breastfeeding without vitamin D supplementation is a major risk factor. Increasing awareness of the rationale for and importance of vitamin D supplements for all breastfed infants and children should reduce the incidence of vitamin D deficiency rickets and prevent bone deformity.

A personalized approach to the management of breastfed infants with functional gastrointestinal disorders and cow’s milk allergy. The role of nutritional recommendations for a nursing mother

Introduction. Functional gastrointestinal disorders (FGID) in infants are a complex of symptoms from the gastrointestinal tract that cannot be explained by structural or biochemical disorders. To alleviate the symptoms of functional disorders, a set of measures is required, first of all, psychological support for the mother and, of course, rational feeding, which includes maintaining breastfeeding, optimizing the nutrition of the nursing mother. Despite the abundance of professional information on this issue, previous studies demonstrate a low level of women’s awareness of nutrition during breastfeeding. The aim of the work is to determine the effectiveness of recommendations on nursing mother’s nutrition in the complex treatment of breastfed children with FGID and allergy to cow’s milk proteins.&#x0D; Materials and methods. Seventy five mother–child pairs were included in the study. 1–4 months infants exclusively breastfed during the study were divided into two groups: 1 — FGID infants (n = 51) and 2 — infants with suspected cow’s milk allergy (CMA) n = 24. In addition to the comprehensive treatment of the child, mothers of both groups were given recommendations on the nursing woman’s nutrition. Mothers of children from group 2 were assigned a diagnostic dairy-free diet for a period of 1 month. &#x0D; Results. On the 2nd visit, when analyzing the symptoms of the FGID in group 1, the number of children with symptoms of regurgitation of more than 2 episodes per day decreased by 28% (p &lt; 0.001), crying for more than 3 hours per day — by 52% (p &lt; 0.001). Children of group 2 with a clear positive effect from the diagnostic dairy-free diet therapy of the mother (n = 20) were diagnosed with Allergic and alimentary gastroenteritis and colitis (K52.2 — 10th revision of ICD-10), the continuation of the dairy-free diet for the mother and the supervision of an allergist were prescribed. The survey of women showed that all nursing women were interested in nutrition issues during lactation, 92% of the surveyed mothers searched for this information on the Internet. At the same time, only 12% of women considered this information to be sufficient. Evaluating the presented materials on nutrition, the overwhelming majority of respondents replied that they helped them to adjust their diet and expand nutrition, as well as to maintain breastfeeding.&#x0D; Conclusion. Thus, an integrated approach in the management of FGID infants and gastrointestinal manifestations of food allergies, including the use of nutrition recommendations developed in the National Medical Research Center of Children’s Health for nursing women, allows achieving a positive effect on the side of symptoms both in FGID and CMA patients, and also contributes to the improvement of the psycho-emotional state of a woman and prolonged breastfeeding.

Study of risk factors of vitamin d deficiency in young children

Vitamin D deficiency in young children presents a current problem of public health in modern Russia. Statistical data on rickets incidence accounts only moderate and severe cases of rickets that is why the sample surveys in children population detect much more cases of clinical manifestation of vitamin D deficiency or its consequences. The purpose of the study was to find out the prevalence rate of rickets signs and risk factors of vitamin D deficiency in young children aged 1–3. Methodology of research: we used survey methods and content-analysis of out-patient records of a random sample that included 127 children aged 1 to 3 in a children polyclinic of Kursk city. By a specially designed questionnaire clinical symptoms of vitamin D deficiency were detected, risk factors of rickets in anamnesis, use of specific and non-specific antenatal and postnatal prophylaxis of rickets were investigated. Results of the study: minimum two signs of rickets were detected in children by 53 mothers – respondents (42% of the sample), the most frequent complaints were bald spots on the back of the head (71,7%), excessive back of the head sweating (58,5%), emotional instability (30,2%), frequent crying (22,6%), anxiety and poor sleep quality (20,8%). There were identified the following factors that had statistically significant association with development of clinical signs of rickets: short breast feeding, maternal complications during pregnancy, absence of specific prophylaxis of vitamin D deficiency in antenatal and postnatal periods (p&lt;0,05). Season of baby’s birth and maternal age did not have statistically significant association with rickets’ signs. Conclusion. The problem of vitamin D deficiency in young children often remains under-reported, so being untreated it can lead to delayed consequences for health of children and adolescents. A particular attention of pediatricians and parents must be paid to specific antenatal and postnatal prophylaxis, prolonged breast feeding until 12–18 months

Novel at-Home mother's milk conductivity sensing technology as an identification system of delay in milk secretory activation progress and early breastfeeding problems: feasibility assessment.

Prolonged exclusive breastfeeding is a public health priority and a personal desire by mothers but rates are low, with milk supply challenges as a predominant cause. Early breastfeeding management at home is key. Milk electrolytes, mainly Na+, are accepted as biomarkers of secretory activation processes throughout the first weeks after birth, and predictors for prolonged breastfeeding success, although not incorporated into routine care practice. To test the feasibility of a novel handheld smartphone operated milk conductivity sensing system, that was designed to compute a novel milk maturation (MM%) parameter calculated from milk sample conductivity, for tracking individual secretory activation progress in a real-world home setting. System performance was initially evaluated in data collected from laboratory-based milk analysis followed by a retrospective analysis of observational real-world data gathered with the system, on the spot at a home setting, implemented by lactation support providers or directly by mothers (N=592). Data includes milk sample sensing data, baby age, and self reported breastfeeding status and breastfeeding related conditions. The data was retroactively classified in a day after birth dependent manner, based breastfeeding exclusivity and breastfeeding problems associated with ineffective breastfeeding and low milk supply, and results were compared between the groups. Laboratory analysis in a set of breast milk samples demonstrated a strong correlation between system's results and Na+ levels. In the real world dataset, a total of 1511 milk sensing records were achieved on-the-spot with over 592 real-world mothers. Data gathered with the system revealed typical time dependent increase in the milk maturation parameter characterized by initial steep increase followed by moderate increase and reaching a plateau during the first weeks postpartum. Additionally, milk maturation parameter levels captured by the system were found sensitive to breastfeeding status classifications of exclusive breastfeeding and breastfeeding problems, manifested in differences in group means in several day range after birth, predominantly during the first weeks postpartum. Differences could be demonstrated also for per-case time after birth dependent progress in individual mothers. This feasibility study demonstrates that the use of smart milk conductivity sensing technology can provide a robust, objective measure of individual breastfeeding efficiency, facilitating remote data collection within a home setting. It holds considerable potential to augment both self-monitoring and remote breastfeeding management capabilities, as well as to refine clinical classifications. To further validate the clinical relevance and potential of this home milk monitoring tool, future controlled clinical studies are necessary. These will provide insights into its impact on user and care provider satisfaction, and its potential to meet breastfeeding success goals. See visual abstract Appendix.

Breastfeeding and the quality of the sibling relationship

ObjectiveTo examine the association between the type of breastfeeding practiced and the quality of the sibling relationship. DesignCross-sectional study. MethodParticipants were recruited between July and December 2019 through parenting associations and parenting support groups. They comprised a total of 149 mothers with two children between 2 and 7 years of age, who had practiced the same type of feeding with both children. Sibling relationship quality was assessed using the conflict/rivalry and warmth dimensions of the Parents' Expectations and Perceptions of Sibling Relationships with their Children (PEPC-SRQ) questionnaire. Analyses of covariance were used to identify any differences in these two dimensions of the PEPC-SRQ between the study groups (formula feeding, breastfeeding, non-prolonged breastfeeding, prolonged breastfeeding and tandem breastfeeding). ResultsNo significant differences were observed between any of the groups regarding the conflict/rivalry dimension; in contrast, significant differences were found in the warmth dimension between the breastfeeding and formula feeding groups. ConclusionsBreastfeeding, regardless of its duration and simultaneity, was associated with higher scores in the dimension of warmth of the sibling relationship. Implications for practiceThis information should be considered by healthcare professionals when providing advice on breastfeeding.