Prolonged Breastfeeding Research Articles

Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study

Previous studies showed that prolonged breastfeeding increases the risk of caries. However, the observed associations were mainly based on non-European populations, and important confounding and mediating factors like socioeconomic position (SEP) and diet were often neglected. The aim of this study was to investigate the role of breastfeeding and bottle-feeding practices on dental caries during childhood while accounting for SEP, ethnic background, and sugar intake. This study was part of the Generation R Study, a prospective multiethnic cohort study conducted in Rotterdam, The Netherlands. In total, 4,146 children were included in the analyses. Information about feeding practices was derived from delivery reports and questionnaires during infancy. Caries was measured via intraoral photographs at the age of 6 years and defined as decayed, missing, and filled teeth (dmft). Negative binomial hurdle regression analyses were used to study the associations between several infant feeding practices and childhood caries. The prevalence of dental caries at the age of 6 years was 27.9% (n = 1,158). Prolonged breastfeeding (for >12 months) was associated with dental caries (OR 1.35, 95% CI 1.04–1.74) and the number of teeth affected by dental caries (RR 1.27, 95% CI 1.03–1.56). Furthermore, nocturnal bottle-feeding was associated with dental caries (OR 1.52, 95% CI 1.20–1.93). All associations were independent of family SEP, ethnic background, and sugar intake. Results from this Dutch cohort study confirmed the previously observed associations between prolonged breastfeeding and nocturnal bottle-feeding and the increased risk of childhood dental caries, even after proper adjustments for indicators of SEP, ethnic background, and sugar intake. Future studies are encouraged to elaborate further on possible explanations for the observed relationships. Healthcare professionals should be aware and advise caregivers about the potential risk of prolonged breastfeeding on caries development by applying the current recommendations on breastfeeding, oral hygiene, and feeding frequency.

Abstract PS17-28: Abrupt involution of lactating mammary gland induces metabolic reprogramming conducive to pro-tumorigenic changes

Abstract Background: Epidemiological studies indicate that prolonged breast feeding reduces the risk of triple negative breast cancer (TNBC), which carries the worst prognosis. Prolonged breastfeeding allows gradual involution (GI) of the breast while lack of or short-term breast feeding leads to abrupt involution (AI). We developed a novel murine model mimicking AI and GI of breast, and found that GI offers better protection to mammary glands from tissue remodeling associated injuries. Our data showed that AI leads to the development of pro-tumorigenic microenvironment and ductal hyperplasia1. Tissue remodeling involves orchestrated cell death and repopulation, and is closely associated with metabolic reprogramming from mitochondrial oxidative phosphorylation (OXPHOS) to glycolysis. Such metabolic alterations can contribute to cellular changes aiding malignant transformation2. We used our murine model to evaluate whether AI affects cellular metabolism differentially when compared to GI. Methods: Wild-type mice of FVB background were used in all our experiments. Twelve to fourteen week old uniparous mice were allowed to nurse (6 pups/dam) for 7 days postpartum. All pups were removed on day7 postpartum from the dams in AI cohort and three each on day28 and day31 from dams in GI cohort. Whole mammary glands and sorted luminal progenitor (LP) cells harvested on postpartum day28 were subjected to Affymetrix microarray analysis. Gene Set Enrichment Analysis (GSEA) was used to compute pathway enrichments in AI vs. GI glands. Differentially expressed genes were validated using qRT-PCR. Mammary glands harvested on day28 postpartum were subjected to mass spectrometry based untargeted metabolic profiling using Agilent QTOF. Raw data were analyzed using XCMS to assess key metabolic networks altered in AI vs GI glands. Targeted analysis for lactate, pyruvate, succinate and palmitic acid were performed using C13 labelled internal standards to compare OXPHOS vs glycolysis reliance in the AI and GI glands. Results: We observed enrichment of mitochondrial OXPHOS pathway, fatty acid metabolism and Myc target genes in both whole mammary gland and LP cells of AI vs. GI mice. Adipogenesis and hypoxia related genes were enriched in AI-glands. We observed significant upregulation of genes involved in glucose transport and fatty acid synthesis in AI glands, namely, Glut-5, Cidea, Acss2, Acsm3, Acly, Atp6v0d2, Acot11, and Elvol3. Several factors indicating a higher reliance on OXPHOS vs glycolysis, such as, Ppar-γ, Pgc1α, Cpt-2, Srebp1c and Chrebp were upregulated in AI glands. Upregulation of Cpt-2 and Srebp1c in the AI glands indicate higher flux through fatty acid oxidation and reliance on cholesterol synthesis. Metabolomic profiling revealed significant alteration in L-carnitine, GMP and XMP in AI glands which reflect mitochondrial fatty acid transport and nucleotide biosynthesis via guanine-guanosine salvage pathway. Pyruvate and lactate associated with glycolysis were increased in GI vs. AI glands. Conclusion: We show for the first time that in the abruptly involuting (AI) mammary glands following short-term breast feeding, there is a significant shift in the metabolic pathways towards mitochondrial OXPHOS and fatty acid oxidation compared to GI glands. Studies are underway to determine the effect of this metabolic shift on cellular transformation and tumorigenesis and the potential to target these pathways to reverse the detrimental effects of AI. 1. Basree MM, Shinde N, Koivisto C, et al. Breast Cancer Res. 2019; 21(1):80. 2. Ward PS, Thompson CB. Cancer Cell. 2012; 21(3):297. Citation Format: Neelam Shinde, Kirti Kaul, Allen Zhang, Saba Mehra, Resham Mawalkar, Hee Kyung Kim, Ramesh Ganju, Sarmila Majumder, Bhuvaneswari Ramaswamy. Abrupt involution of lactating mammary gland induces metabolic reprogramming conducive to pro-tumorigenic changes [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS17-28.

Adverse effects of maternal rheumatoid arthritis during pregnancy on children.

Adverse effects of maternal rheumatoid arthritis during pregnancy on children.

Fermented foods and probiotics for children. The importance of knowing their microbiological differences.

Breast milk provides microorganisms that colonize the gut and program the immune system to develop oral tolerance. Between the 6 months of exclusive breastfeeding and the recommended 2 years of prolonged breastfeeding, complementary feeding leads to a progressive reduction in the entry of live microorganisms into the gut ecosystem. This is because foods in general ‑unlike breast milk‑ are devoid of microorganisms or, if present, they are often inactivated during cooking. Fermented foods and probiotics could be a valuable nutritional strategy, as they would ensure the supply of live microorganisms in the face of a reduction or early cessation of breastfeeding. The terms "fermented foods" and "probiotics" are not synonymous. Microbiological identity, safety, and the existence of clinical efficacy studies supporting both are key to understand their differences and decide on an eventual dietary recommendation.

Fatores que impedem o aleitamento materno estendido em Unidades Básicas de Saúde de Guarulhos

Prolonged breastfeeding promotes several health benefits for the child, as well as for the mother, family, and society. Given this and the scarcity of studies on the aspects involved in the practice of breastfeeding after the sixth month of life, the present study aimed to discover the factors that make it difficult to maintain breastfeeding (from six monthx to two years or more). This was a cross-sectional study, carried out in four randomly selected basic health units located in the city of Guarulhos. The sample consisted of mothers and employees of the basic health units in question, with children aged between six and twenty-four months old. For data collection, two informative questionnaires with the study variables were used. Simple and multiple regression analyses were used to investigate associations between variables. The use of a bottle and a pacifier were important factors for the interruption of prolonged breastfeeding. However, in the adjusted analysis, maternal age predisposes them to interrupt of prolonged breastfeeding. According to the multiple logistic regression model, the use of a pacifier increases the chance of not maintaining prolonged breastfeeding by almost 20-fold, and children who use a bottle have this chance increased by six-fold. It is concluded that the child aging, bottle use, and pacifier use were decisive factors for not maintaining prolonged breastfeeding. Returning to work and storing breast milk were identified as the main difficulties in maintaining breastfeeding.

Caries and Its Association with Infant Feeding and Oral Health-related Behavior in 18-month and 3-year-old Japanese Children.

The primary aim of this study was to determine the prevalence of dental caries and its association with infant feeding and oral health-related behavior in Japanese children between the ages of 18 months and 3 years. A total of 387 infants were initially examined at the age of 18 months (or 19 months in some cases) and then again at 3 years (or at 3 years 1 month in some cases). The primary objective was to identify factors contributing to the prevalence of caries in children aged 18 months. The secondary objective was to follow up children with no caries at the age of 18 months to seek potential correlations between background factors and the increment of caries by the age of 3 years. In an adjusted multivariate logistic regression model, children who continued breastfeeding were approximately 7 times more likely to have dental caries at 18 months of age than those who did not. Infants brought in for an oral examination and consultation at around 12 months of age were less likely to develop dental caries at 18 months of age than those who were not. Multivariate logistic regression analysis revealed that infants who did not receive a dental check-up at 12 months of age showed a significantly higher incidence of dental caries at 3 years of age. The present results suggest that prolonged breastfeeding is a risk factor for early childhood caries at 18 months of age, and that infants in whom a regular oral care program is implemented from the age of 12 months are less likely to develop early childhood caries at 18 months or 3 years.

Family-centered lactation counseling and breastfeeding in preterm infants upon neonatal intensive care discharge

Background: There is great variability in breastfeeding implications upon neonatal intensive care unit discharge for preterm infants. Aims and Objectives: To examine the breastfeeding rates and the impact of lactation-counseling on the nutrition following hospital discharge in preterm infants. Materials and Methods: A three-page survey was applied to the families of infants of gestational age ≤34 weeks who were hospitalized between 2016-2018. Exclusion criteria were family reluctance to consent, foster-care placement, acquiring enteral feeding by orogastric tube/gastrostomy. The group categorization was based on lactation-counselling that involved both parents and elderly relatives who would assist the mother at neonatal care. Statistics were performed using SPSS-22 for covariates of neonatal intensive care interventions and post-discharge nutrition. Results: Exclusive breastfeeding was 49.2% at hospital-discharge and declined to 31.3% at six months. Early introduction of complementary foods was 51.1%. Total duration of breastfeeding was 7.38±3.98 months. Lactation-counseling prolonged breastfeeding duration to 8.47±3.87 months. The program presented the highest odds of extending breastfeeding interventions beyond six months (OR: 2.183, 95% CI: 1.354–3.520). It favored the outcomes by reducing the introduction of formulas and complementary foods before six months (P = 0.044, P = 0.018). The physical contribution of the father towards nutrition was the most significant benefit claimed by the participants. (71.6 versus 51.8%). Conclusion: Family-centered peer lactation-counseling by the medical staff and increasing awareness for infant nutrition are promising local strategies in reaching the goals of national nutrition policies guided by the international recommendations in preterm infants.

Environmental Tobacco Smoke Exposure and Breastfeeding Duration Influence the Composition and Dynamics of Gut Microbiota in Young Children Aged 0-2 Years.

The colonization characteristics of infant gut microbiota are influenced by many factors at various stages, but few studies have explored the longitudinal effects of environmental tobacco smoke exposure and quantitative breastfeeding duration on young children' gut microbiota. We explored the effects of smoke exposure and breastfeeding duration on gut microbiota by following 37 maternal and children pairs in China for 2 years. We collected the demographic information, frequency of smoke exposure, breastfeeding duration, and fecal samples (mothers in the late pregnancy and infants at 6, 12, and 24 months), and analyzed the microbiota results using the V3-V4 gene sequence of 16S rRNA. The diversity of gut microbiota in children was the highest at 24 months and most similar to that in mothers. Breastfeeding duration was positively correlated with Lactobacillus and negatively correlated with Clostridium_sensu_stricto_1. The α diversity of microbiota and the relative abundance of [Ruminococcus]_gnavus_group was higher in the non-smoke exposed group. The higher the smoke exposure, the higher the relative abundance of Megasphaera. Prolonged breastfeeding and reduced smoke exposure are beneficial to the diversity and composition of gut microbiota in young children.

Association Between Breastfeeding and the Development of Childhood Diabetes Mellitus Type I (DM I): The Effect of Prolonged Exclusive Breastfeeding on Gut Microbiome and the Link with DM I

The role of breastfeeding and dietary habits was studied in 10 children with DM I (case group) and compared with 10 healthy controls. Our results showed that the case group had significantly shorter exclusive breastfeeding duration compared with the control group (p = 0.006). An in silico comparative analysis of gut microbiota data from two recent studies was also performed in order to identify any specific bacterial genera potentially associated with DM I, due to prolonged breastfeeding. The Pasteurellaceae family, found in breast milk, was shown to have a significantly higher population in the intestine in the control group (p = 0.010). Overall, this preliminary study showed that exclusive breastfeeding duration is strongly associated with DM I. An association between breast milk microbiome and gut microbiome was also observed. This should encourage further research, aiming to examine both the effect of breastfeeding on gut microbiome and the possible links with DM I.

Baby-Led Weaning: uma revisão integrativa das evidências científicas de 2011 a 2019

Introdução: O Baby-led weaning (BLW) é uma abordagem alternativa para a introdução alimentar aos lactentes que tem se tornado popular. Objetivo: Investigar as evidências científicas a respeito do método BLW e sua versão modificada Baby-Led Introduction to Solids (BLISS). Métodos: A pesquisa de artigos foi realizada entre junho de 2018 e junho de 2019, por meio da base de dados US National Library of Medicine National Institutes of Health (PubMed) utilizando as seguintes palavras-chaves: ‘BLW’, ‘Baby-led weaning’, ‘BLISS’, e ‘Baby-Led Introduction to Solids’. Foram incluídos todos os artigos originais encontrados no idioma inglês, publicados entre 2011 e 2019. Resultado: Vinte e cinco estudos foram incluídos na análise. As pesquisas sobre BLW/BLISS focaram principalmente nos temas: características, comportamentos e atitudes de mães e crianças, conhecimento de mães e profissionais de saúde sobre os métodos de introdução alimentar, avaliação de peso e de índice de massa corporal, avaliação da ingestão energética e de nutrientes e avaliação de episódios de engasgo e reflexo de gag das crianças. Conclusão: A maioria das pesquisas aborda experiências relacionadas ao BLW/BLISS e ainda existem poucas evidências sobre o método em termos de adequação de ingestão de energia e nutrientes e de crescimento na infância. Pontos positivos para a criança podem ser observados como aleitamento materno prolongado, maior independência ao se alimentar e melhor resposta à saciedade. Os métodos de introdução alimentar não diferem entre si em relação à ocorrência de episódios de engasgos.

Religious dietary rules and their potential nutritional and health consequences.

The vast majority of the world population declares affiliation to a religion, predominantly Christianity and Islam. Many religions have special dietary rules, which may be more or less strictly adhered to. Religious food rules were collected from holy books and religious websites as well as their translation into dietary practices. The literature was searched for potential associations between these rules and potential nutritional consequences. Jewish, Islamic and Indian religions support prolonged breastfeeding. Religious avoidance of alcohol is probably beneficial to health. When strictly applied, a few rules may lead to nutritional inadequacies, mainly in populations living in unfavourable socio-economic or environmental conditions. In Jewish and Muslim observants, animal slaughtering procedures may increase the risk of iron deficiency. Jews may be at risk of excess sodium intake related to home-prepared foods. A vegan diet, as observed by some believers, often by drifting from original precepts, or by some Hindus or Buddhists, may result in vitamin B12, calcium, iron, zinc, selenium and n-3 fatty acids deficiencies. When implemented in accordance with the rules, most religious food precepts are not detrimental to health, as suggested by the fact that they have more or less been followed for millennia. Nevertheless, some practices may lead to nutritional inadequacies, such as iron, calcium, vitamin D and vitamin B12 deficiencies. Patients with low socio-economic status, children and women of childbearing age are of particular risk of such deficiencies. Being aware of them should help health professionals to take an individualized approach to decide whether to supplement or not.

Association between Early Childhood Caries and Maternal Factors among 18- to 36-month-old Children in a Rural Area of Cambodia.

To investigate the associations between early childhood caries (ECC) and maternal factors among 18- to 36-month-old children in one rural province of Cambodia. 121 mother-child pairs (male = 67, female = 54; mean age = 25.18 ± 6.24 months) were recruited at several villages in Stueng Trang district, Kampong Cham province. ECC and maternal caries experience were recorded following WHO guidelines. Maternal factors such as literacy and socioeconomic status, as well as child-rearing behaviours, were assessed through an interview questionnaire of the mothers. ECC and maternal caries prevalence were 54.5% and 84.3%, respectively. Statistically significant associations were found between ECC and: breast-feeding after 18 months; sugary food and beverage intake for the child (p < 0.05); maternal caries experience; illiteracy; night-time breastfeeding, bottle feeding, and late introduction of toothbrushing for the child (p < 0.01). A logistic regression revealed that ECC was more common in children whose mothers had DMFT > 0 (OR = 4.08; 95% CI =1.13-14.75; p = 0.032), children whose mothers were illiterate (OR = 8.21; 95% CI = 1.67-40.85; p = 0.009), children who had night-time breastfeeding after 18 months (OR = 2.76; 95% CI = 1.06-7.19; p = 0.037), and children for whom toothbrushing was introduced after 18 months (OR = 2.87; 95% CI = 1.03-7.97; p = 0.042). The findings of this study suggest that maternal caries experience and illiteracy, as well as a range of child-rearing behaviours including prolonged night-time breastfeeding and late introduction of toothbrushing were indicators for ECC in this population.

The Effect of Breastfeeding Duration on Domain-Specific Neurocognitive Performance

Does breastfeeding alter early brain development? In a recent retrospective study, our group examined the cross-sectional relationship between early infant feeding practice and white matter maturation and cognitive development. In groups matched for child and mother age, gestation duration, birth weight, gender distribution, and socio-economic status; we observed that children who were breastfed exclusively for at least 3 months showed, on average, increased white matter myelin development compared to children who either were exclusively formula-fed, or received a mixture of breast milk and formula. In secondary analysis on sub-sets of these children, again matched for important confounding variables, we found improved cognitive test scores of receptive language in the exclusively breast-fed children compared to formula or formula + breast-fed children; and that prolonged breastfeeding was associated with increased motor, language, and visual functioning in exclusively breast-fed children. In response to this work, Anderson and Burggren have questioned our methodology and, by association, our findings. Further, they use their critique as a platform for advancing an alternative interpretation of our findings: that observed results were not associated with prolonged breast-feeding, but rather delayed the introduction of cow's milk. In this response, we address and clarify some of the misconceptions presented by Anderson and Burggren.

Prolonged breastfeeding can reduce internalizing problem behaviours of young children by enhancing mothers’ social parenting

ABSTRACT Considerable studies have shown the protective effects of breastfeeding on internalizing problem behaviours in early childhood, yet little is known about the groundwork for this relationship. This study attempted to test the hypothesis that improvement of mothers’ positive parenting behaviours by breastfeeding can explain the relationship. We used longitudinal data sets containing a large sample of children from the Panel Study on Korean Children (PSKC). We found that when breastfeeding durations were longer, mothers exhibited higher levels of social parenting behaviours during their children’s infancy. Also, mothers’ social parenting behaviours during their children’s infancy played a protective role in reducing internalizing problem behaviours of children at age 5. In our model, mother’s social parenting behaviours partially mediated the relationship between breastfeeding duration and pre-schoolers’ internalizing problem behaviours. Results of this study suggest that prolonged breastfeeding should be encouraged for children’s mental health and mothers’ positive parenting behaviours.

Efecto de la exposición prenatal y posnatal al tabaco en el desarrollo de bronquiolitis aguda durante los dos primeros años de vida

Environmental exposure to tobacco increases the risk of respiratory disease in infants. However, the impact of maternal smoking on the development of acute bronchiolitis has hardly been assessed. The aim of this study was to determine the incidence of acute bronchiolitis and to analyse the effect of prenatal and postnatal maternal smoking on the development of this disease. A prospective, observational study was performed on healthy newborns from a third level hospital born between October 2015 and February 2016. Questionnaires were completed by the mothers at discharge from maternity and followed-up for 2years. These collected information about prenatal and postnatal smoking, lifestyle, family and personal history, and the development of bronchiolitis. A bivariate and multivariate logistic regression analysis was performed. A total of 223newborns were included, of whom 13.9% were exposed to tobacco smoking during gestation, 21.4% in the postnatal period, and 12.4% in both times. The incidence of bronchiolitis was 28.7% at one year of life, and 34.5% at 2years. The multivariate analysis demonstrated that the prenatal and postnatal exposure to tobacco is an independent risk factor for the development of bronchiolitis (OR4.38; 95%CI: 1.63-11.76), while prolonged breastfeeding is a protective factor (OR0.13; 95%CI: 0.04-0.48). Other factors that were statistically significant were: atopic dermatitis (OR2.91; 95%CI: 1.26-6.73), and gestational age (OR1.42; 95%CI: 1.08-1.88). Children exposed to prenatal and postnatal maternal smoking have a higher risk of suffering bronchiolitis. Reducing the smoking habit in women that intend to become pregnant must be a priority in preventive medicine.

The impact of the number of children in the family on the breastfeeding duration and vaccination coverage

Aim. To assess the impact of the number of children in the family on breastfeeding duration and vaccination coverage.&#x0D; Methods. 1724 mothers of 1-year old children were randomly chosen from seven children's polyclinics in St. Petersburg for an anonymous survey that was conducted by a specially designed form Questionnaire of a mother of 1-year old children. The questionnaire comprised of 20 open-ended and closed-ended questions, and included questions about: (1) timing of the attachment to the breast in obstetric hospitals; (2) causes and timing of breastfeeding abandonment; (3) presence or absence of vaccinations in the first year of life according to the National preventive vaccination schedule; (4) and reasons for mothers refusing to vaccinate their children.&#x0D; Results. The proportion of mothers who started artificial feeding in maternity wards immediately after the birth of the baby was the smallest among women for whom this baby was the first-born (3.4%), and the largest among families with many children (11.3%). On average, mothers with one child are breastfed until 7.360.11 months, with two children until 8.290.11 months, with three or more children until 8.780.10 months. By using one-way analysis of variance (ANOVA), it was shown the effect of the number of children in the family on the duration of breastfeeding (F=3.3). Correlation analysis revealed the negative relationship of the number of children in the family with the proportion of women who continued breastfeeding until 3 and 6 months (rxy=0.82 and rxy=0.88, respectively), and positive relationship with the proportion of mothers who continued to breastfeeding the baby after reaching a year (rxy=0.89). 12.3% of children of one-child families were not vaccinated according to the National preventive vaccination schedule, 17.7% with two-child families, 28.1% in families with three or more children. It was revealed the significant cross-group effect of the number of children in the family to vaccination coverage (F=48.7). With an increase in the number of children in the family, vaccination coverage decreases, both in general (rxy=0.88) and against individual infections, including hepatitis B, diphtheria, whooping cough, tetanus, polio, measles and rubella (rxy from 0.80 to 0.90).&#x0D; Conclusion. The number of children in a family impacts mothers' refusals of breastfeeding and vaccination; the more children in a family, the more prolonged breastfeeding, but less vaccination coverage due to the health status of children in the first year of life.

Association between the incidence of early childhood caries and attending childcare among toddlers in a rural area of Japan: a prospective cohort study

Objective The purpose of this study was to investigate the association between the incidence of early childhood caries (ECC) and factors of the daytime childcare environment among toddlers in a rural area of Japan. Material and methods This was a prospective cohort study. Data collected from 2011 to 2015 were obtained for initially caries-free, 18-month-old toddlers (N = 640). Dentists recorded the numbers of decayed, missing and filled teeth (caries incidence) of toddlers at baseline (age 18 months) and follow-up (age 3 years). In addition, a questionnaire survey was conducted on guardians at baseline to record data on lifestyle. Results In total, 159 (24.8%) toddlers had newly identified ECC at follow-up. Logistic regression analyses indicated that the incidence of ECC was significantly associated with receiving daytime care at a nursery school (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.05–2.30; p = .029), prolonged breastfeeding (OR, 1.71; 95%CI, 1.15–2.55; p = .008), and snacking ≥3 times a day (OR, 2.39; 95%CI, 1.53–3.74; p < .001). Conclusion These findings suggest that receiving daytime care at a nursery school, prolonged breastfeeding, and frequent snacking are associated with an increased risk of ECC among Japanese toddlers in rural areas.

Association of breastfeeding with thyroid function and autoimmunity in postmenopausal women.

Whether breastfeeding influences thyroid function and autoimmunity is not elucidated. We examined the association of history of breastfeeding with thyroid hormones and thyroperoxidase antibody (TPOAb). Cross-sectional study of data from the 2013-2015 Korea National Health and Nutrition Examination Survey. A total of 816 postmenopausal women were stratified into three groups according to the duration of breastfeeding and number of breastfed children. Thyroid hormones levels, TPOAb titers, and the prevalence of hypothyroidism and TPOAb positivity were evaluated in each group. Subjects with a history of prolonged breastfeeding had lower levels of thyrotropin (TSH) and TPOAb than the others. After adjusting for multiple confounding factors, the estimated means of TSH and TPOAb were associated with cumulative duration of breastfeeding. Duration of breastfeeding per child was associated with TSH levels, and number of breastfed children was associated with TPOAb titers. The odds ratio (OR) of hypothyroidism was significantly lower in group for ≥36 months of cumulative duration of breastfeeding, and the OR of TPOAb positivity was significantly lower in group with ≥3 breastfed children. In addition, duration of breastfeeding and the number of breastfed children were linearly correlated with log TSH and TPOAb each other in the multivariate model. The present study showed that prolonged breastfeeding was inversely associated with TSH and the prevalence of hypothyroidism. Moreover, TPOAb and the prevalence of TPOAb positivity were inversely associated with number of breastfed children. These results indicate that breastfeeding may exert a protective effect on thyroid function and autoimmunity.

2276-PUB: Fecal Profile of Short-Chain Fatty Acids: Associations with Environmental Factors in the First Year of Life of Women Participating in the Nutritionist’s Health Study

Introduction: Many studies report that environmental factors occurring in childhood may modulate the composition of the gut microbiota in adulthood, which in turn, produces short chain fatty acids (SCFA) with metabolic effects on inflammatory cascades associated with glycemic homeostasis. Objective: This study aims to analyze associations between type of delivery (vaginal/cesarean section), type of breast-feeding (maternal/artificial) and solid food introduction (start and quality) with fecal SCFA concentrations in women. Method: A cross-sectional study including 106 women, 28±5 years old and BMI 25±5 kg/m2, a questionnaire regarding from birth until the first year of life. For quantification of acetate, butyrate and propionate it was used gas chromatography-mass spectrometry in fecal samples. Results: Of the women surveyed 63% were cesarean delivered and 93% received maternal breast milk at some point. There was no correlation between SCFA concentration and type of delivery (p&amp;gt;0.05). Positive correlation was found between breastfeeding time and butyrate (r=0.24; p=0.02), there was a tendency with propionate (r=0.20; p=0.06). There was no correlation between time received infant formula and SCFA. There was a tendency of correlation between butyrate and beginning of cow’s milk intake (r=0.194; p=0.052). Age at solid food introduction correlates with propionate (r=0.22; p=0.026) and butyrate (r=0.25; p=0.012), and report a tendency with the acetate (r=0.18; p=0.07). In the first year of life, individuals who prefer salty crackers and pasta/potatoes had less concentration of propionate and acetate, respectively (p=0.026). Conclusion: The type of delivery was not associated with SCFA, but there was a favorable association with prolonged breastfeeding, late beginning of cow’s milk intake, introduction of solids starting after 6 months of age and lower intake of refined cereals. Disclosure M.G. Barbosa: None. I. Solar: None. R.G. Freitas: None. F.B. Ribeiro: None. C.O. Ramos: None. M.R. Sant’Ana: None. A.S. Hanada: None. N.S.K. Crouchan: None. C.M. Xavier: None. B.G. Neto: None. L.G.D. Folchetti: None. I.T. Silva: None. B. Almeida-Pititto: None. S.G. Ferreira-Vivolo: None. A.J. Vasques: None. Funding São Paulo Research Foundation (2017/10185-9, 2019/05450-0)

Model of stunting determinants: A systematic review

This study aimed to determine the factors associated with stunting base on modeling inferential analysis. This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The computerized bibliographic databases searched were Scopus, PubMed, and Google Schoolar. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. As many as 12 of 5690 articles met our inclusion criteria for review. The most consistent factors associated with childhood stunting were: low mother's education, increasing child's age, male sex, poor household, prolonged breastfeeding duration, low birth weight, mother's age (<20 years), drinking water source (unimproved), low mother's BMI (<18.5), diarrhoeal episode, low father's education and residence (rural). The factors that predispose a child to stunting are multifactors. Various factors causing stunting on children can be avoided through a holistic multi-strategy community-based approach.