Does breast milk increase a child's intelligence?

Submitted by: Anonymous

Yes. While the bulk of the studies in this list for which we identified answers agrees with this conclusion, some studies came to different conclusions. We encourage you to consider each of the studies for yourself to understand why they differ. Note that some of the studies in this list have been commented on or critiqued. Links to these comments/critiques appear on the corresponding study summaries below.
This short answer was generated by aggregating the answers that each of the 15 studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.


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Literature Reviews
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QUESTIONS TO CONSIDER
Do formula-fed infants sleep more than breastfed infants?
15 studies
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SUMMARIES OF STUDIES
Total studies in list: 15
Sorted by publication year
1
Breastfeeding, Cognitive and Noncognitive Development in Early Childhood: A Population Study.
"Background And Objectives: There is mixed evidence from correlational studies that breastfeeding impacts children's development. Propensity score matching with large samples can be an effective tool to remove potential bias from observed confounders in correlational studies. The aim of this study was to investigate the impact of breastfeeding on children's cognitive and noncognitive development at 3 and 5 years of age.Methods: Participants included ∼8000 families from the Growing Up in Ireland longitudinal infant cohort, who were identified from the Child Benefit Register and randomly selected to participate. Parent and teacher reports and standardized assessments were used to collect information on children's problem behaviors, expressive vocabulary, and cognitive abilities at age 3 and 5 years. Breastfeeding information was collected via maternal report. Propensity score matching was used to compare the average treatment effects on those who were breastfed.Results: Before matching, breastfeeding was associated with better development on almost every outcome. After matching and adjustment for multiple testing, only 1 of the 13 outcomes remained statistically significant: children's hyperactivity (difference score, -0.84; 95% confidence interval, -1.33 to -0.35) at age 3 years for children who were breastfed for at least 6 months. No statistically significant differences were observed postmatching on any outcome at age 5 years.Conclusions: Although 1 positive benefit of breastfeeding was found by using propensity score matching, the effect size was modest in practical terms. No support was found for statistically significant gains at age 5 years, suggesting that the earlier observed benefit from breastfeeding may not be maintained once children enter school."
AUTHORS
Richard E Tremblay
Orla Doyle
Lisa-Christine Girard
PUBLISHED
2017 in PEDIATRICS
High quality source
No
No
2
Breast Milk Feeding, Brain Development, and Neurocognitive Outcomes: A 7-Year Longitudinal Study in Infants Born at Less Than 30 Weeks' Gestation.
"Objectives: To determine the associations of breast milk intake after birth with neurological outcomes at term equivalent and 7 years of age in very preterm infantsStudy Design: We studied 180 infants born at <30 weeks' gestation or <1250 grams birth weight enrolled in the Victorian Infant Brain Studies cohort from 2001-2003. We calculated the number of days on which infants received >50% of enteral intake as breast milk from 0-28 days of life. Outcomes included brain volumes measured by magnetic resonance imaging at term equivalent and 7 years of age, and cognitive (IQ, reading, mathematics, attention, working memory, language, visual perception) and motor testing at 7 years of age. We adjusted for age, sex, social risk, and neonatal illness in linear regression.Results: A greater number of days on which infants received >50% breast milk was associated with greater deep nuclear gray matter volume at term equivalent age (0.15 cc/d; 95% CI, 0.05-0.25); and with better performance at age 7 years of age on IQ (0.5 points/d; 95% CI, 0.2-0.8), mathematics (0.5; 95% CI, 0.1-0.9), working memory (0.5; 95% CI, 0.1-0.9), and motor function (0.1; 95% CI, 0.0-0.2) tests. No differences in regional brain volumes at 7 years of age in relation to breast milk intake were observed.Conclusion: Predominant breast milk feeding in the first 28 days of life was associated with a greater deep nuclear gray matter volume at term equivalent age and better IQ, academic achievement, working memory, and motor function at 7 years of age in very preterm infants."
AUTHORS
Deanne K Thompson
Charlotte Molesworth
Katherine J Lee
Victoria A Nowak
Peter J Anderson
Mandy B Belfort et al
PUBLISHED
2016 in The Journal of Pediatrics
High quality source
Yes
Yes
3
Breastfeeding and IQ Growth from Toddlerhood through Adolescence.
"Objectives: The benefits of breastfeeding for cognitive development continue to be hotly debated but are yet to be supported by conclusive empirical evidence.Methods: We used here a latent growth curve modeling approach to test the association of breastfeeding with IQ growth trajectories, which allows differentiating the variance in the IQ starting point in early life from variance in IQ gains that occur later in childhood through adolescence. Breastfeeding (yes/ no) was modeled as a direct predictor of three IQ latent growth factors (i.e. intercept, slope and quadratic term) and adjusted for the covariates socioeconomic status, mother's age at birth and gestational stage. Data came from the Twins Early Development Study (TEDS), a prospective cohort study of twins born between 1996 and 1994 in the United Kingdom, who were assessed 9 times on IQ between age 2 and 16 years (N = 11,582).Results: Having been breastfed was associated with a small yet significant advantage in IQ at age 2 in girls (β = .07, CI 95% from 0.64 to 3.01; N = 3,035) but not in boys (β = .04, CI 95% from -0.14 to 2.41). Having been breastfeeding was neither associated with the other IQ growth factors in girls (slope: β = .02, CI 95% from -0.25 to 0.43; quadratic: β = .01, CI 95% from -0.02 to 0.02) nor in boys (slope: β = .02, CI 95% from -0.30 to 0.47; quadratic: β = -.01, CI 95% from -0.01 to 0.01).Conclusions: Breastfeeding has little benefit for early life intelligence and cognitive growth from toddlerhood through adolescence."
AUTHORS
Robert Plomin
Sophie von Stumm
PUBLISHED
2015 in PLoS ONE
High quality source
No
No
4
Breastfeeding and intelligence: a systematic review and meta-analysis.
"Aim: This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.Methods: Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity.Results: We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies.Conclusion: Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal."
AUTHORS
Cesar G Victora
Christian Loret de Mola
Bernardo L Horta
PUBLISHED
2015 in Acta paediatrica (Oslo, Norway : 1992)
UNRANKED SOURCE
Literature Review
Yes
Yes
5
Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil.
"Background: Breastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.Methods: A prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula.Findings: From June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20-5·33), more years of education (0·91 years, 0·42-1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8-588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income.Interpretation: Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.Funding: Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health."
AUTHORS
Denise P Gigante
Ricardo Tavares Pinheiro
Luciana Quevedo
Christian Loret de Mola
Bernardo Lessa Horta
Cesar G Victora et al
PUBLISHED
2015 in The Lancet. Global health
UNRANKED SOURCE
Yes
Yes
6
Breast milk and cognitive development--the role of confounders: a systematic review.
"Objectives: The association between breastfeeding and child cognitive development is conflicted by studies reporting positive and null effects. This relationship may be confounded by factors associated with breastfeeding, specifically maternal socioeconomic class and IQ.Design: Systematic review of the literature.Setting And Participants: Any prospective or retrospective study, in any language, evaluating the association between breastfeeding and cognitive development using a validated method in healthy term infants, children or adults, was included.Primary And Secondary Outcome Measures: Extracted data included the study design, target population and sample size, breastfeeding exposure, cognitive development assessment tool used and participants' age, summary of the results prior to, and following, adjustment for confounders, and all confounders adjusted for. Study quality was assessed as well.Results: 84 studies met our inclusion criteria (34 rated as high quality, 26 moderate and 24 low quality). Critical assessment of accepted studies revealed the following associations: 21 null, 28 positive, 18 null after adjusting for confounders and 17 positive-diminished after adjusting for confounders. Directionality of effect did not correlate with study quality; however, studies showing a decreased effect after multivariate analysis were of superior quality compared with other study groupings (14/17 high quality, 82%). Further, studies that showed null or diminished effect after multivariate analysis corrected for significantly more confounders (7.7±3.4) as compared with those that found no change following adjustment (5.6±4.5, p=0.04). The majority of included studies were carried out during childhood (75%) and set in high-income countries (85.5%).Conclusions: Much of the reported effect of breastfeeding on child neurodevelopment is due to confounding. It is unlikely that additional work will change the current synthesis. Future studies should attempt to rigorously control for all important confounders. Alternatively, study designs using sibling cohorts discordant for breastfeeding may yield more robust conclusions."
AUTHORS
Gideon Koren
Alex Cressman
Corey Sermer
Asnat Walfisch
PUBLISHED
2013 in BMJ Open
High quality source
Literature Review
Couldn't Identify
Couldn't Identify
7
Impact of breastfeeding on the intelligence quotient of eight-year-old children.
"Objective: This study aimed to determine the influence of breastfeeding on the intellectual capacity of children from a cohort in a developing country, with a control for the main confounding factors.Methods: A prospective cohort study was performed including all infants born in the hospitals of a medium-size city, and a random sample of these newborns was monitored at 30, 90, and 180 days of life, and at age 8 years. Several aspects of breastfeeding were assessed in the follow-up and, at 8 years, general intellectual capacity was assessed through the Raven's Colored Progressive Matrices test. The statistical analyses used Student's t-test, ANOVA, and linear regression and logistics, considering p-values less than 0.05 as statistically significant associations.Results: At age 8 years, 560 children were assessed with Raven's Colored Progressive Matrices test. The average score was 22.56 points, with a standard deviation of 5.93. The difference in the averages found between the breastfed and non-breastfed groups at six months of age was 1.33 (p=0.008). Mother's and child's skin color, social and economic class, maternal education and smoking, and breastfeeding at six months of age (p=0.007) were still associated with the outcome.Conclusions: Children that were breastfed for six months or more had better performance in the general intellectual assessment, even after adjusting for the main confounding factors."
AUTHORS
Vera L M de Figueiredo
Ivana H Neves
Cristina C Kaufmann
Elaine P Albernaz
Ana L M Fonseca
PUBLISHED
2012 in Jornal de Pediatria
Q2
Yes
Yes
8
Impact of Breast Milk on Intelligence Quotient, Brain Size, and White Matter Development
"Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesized that breast milk mediates cognitive effects by affecting brain growth. We used detailed data from a randomized feeding trial to calculate percentage of expressed maternal breast milk (%EBM) in the infant diet of 50 adolescents. MRI scans were obtained (mean age = 15 y 9 mo), allowing volumes of total brain (TBV) and white and gray matter (WMV, GMV) to be calculated. In the total group, %EBM correlated significantly with verbal intelligence quotient (VIQ); in boys, with all IQ scores, TBV and WMV. VIQ was, in turn, correlated with WMV and, in boys only, additionally with TBV. No significant relationships were seen in girls or with gray matter. These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. The selective effect in males accords with animal and human evidence regarding gender effects of early diet. Our data have important neurobiological and public health implications and identify areas for future mechanistic study."
AUTHORS
Alan Lucas
David G Gadian
Wui K Chong
Brian T Quinn
Bruce R Fischl
Elizabeth B Isaacs
PUBLISHED
2010 in Pediatric Research
High quality source
Couldn't Identify
Couldn't Identify
9
Impact of breast milk on intelligence quotient, brain size, and white matter development.
"Although observational findings linking breast milk to higher scores on cognitive tests may be confounded by factors associated with mothers' choice to breastfeed, it has been suggested that one or more constituents of breast milk facilitate cognitive development, particularly in preterms. Because cognitive scores are related to head size, we hypothesized that breast milk mediates cognitive effects by affecting brain growth. We used detailed data from a randomized feeding trial to calculate percentage of expressed maternal breast milk (%EBM) in the infant diet of 50 adolescents. MRI scans were obtained (mean age=15 y 9 mo), allowing volumes of total brain (TBV) and white and gray matter (WMV, GMV) to be calculated. In the total group, %EBM correlated significantly with verbal intelligence quotient (VIQ); in boys, with all IQ scores, TBV and WMV. VIQ was, in turn, correlated with WMV and, in boys only, additionally with TBV. No significant relationships were seen in girls or with gray matter. These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. The selective effect in males accords with animal and human evidence regarding gender effects of early diet. Our data have important neurobiological and public health implications and identify areas for future mechanistic study."
AUTHORS
Alan Lucas
David G Gadian
Wui K Chong
Brian T Quinn
Bruce R Fischl
Elizabeth B Isaacs
PUBLISHED
2010 in Pediatric Research
High quality source
Yes
Yes
10
Breastfeeding and child cognitive development: new evidence from a large randomized trial.
"Context: The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant.Objective: To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years.Design: Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005.Setting: Thirty-one Belarussian maternity hospitals and their affiliated polyclinics.Participants: A total of 17,046 healthy breastfeeding infants were enrolled, of whom 13,889 (81.5%) were followed up at age 6.5 years.Intervention: Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF.Main Outcome Measures: Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects.Results: The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P < .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (-3.3 to +9.1) for performance IQ, and +5.9 (-1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing.Conclusion: These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.Trial Registration: isrctn.org Identifier: ISRCTN37687716."
AUTHORS
Lidia Matush
Robert W Platt
Irina Vanilovich
Elena Mironova
Frances Aboud
Michael S Kramer et al
PUBLISHED
2008 in Archives of general psychiatry
UNRANKED SOURCE
Yes
Yes
11
Breast-fed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology.
"Numerous studies report positive effects of breast-feeding on infant development. Such effects are apparent early in development as well as in later years. Recently, elements in breast milk, polyunsaturatred fatty acids (PUFAs), have been identified as having great potential for increasing nutritional benefits. PUFAs are long-chain fatty acids containing two or more double bonds. While some scientists are enthusiastic about the long-term benefits of PUFAs on brain and cognitive development, many of the positive pharmacological effects attributed to PUFAs remain unsubstantiated. The present study investigated the differential impact of breast-feeding vs. PUFA-enriched formula in a small but well-matched population of 12 infants tested at 6 months of age. Event-related potential (ERP) and a range of behavior measures were recorded. ERP waveforms identified marked differences between the breast-fed and PUFA-fed infants by 6 months of age. When a range of biological, perinatal, and cognitive factors were equated between the two groups, only the ERPs recorded from breast-fed infants changed throughout their recorded period (700 msec), differentiated between all speech sounds, and generated differences in scalp recordings across all regions recorded across both hemispheres. Such differences in the range of their brain responses could signal an advantage for the breast-fed infants for later linguistic and cognitive development."
AUTHORS
Peter J Molfese
Melissa Ferguson
PUBLISHED
2007 in Developmental Neuropsychology
Q3
Yes
Yes
12
Breast feeding and cognitive development at age 1 and 5 years.
"Aim: To examine whether duration of breast feeding has any effect on a child's cognitive or motor development in a population with favourable environmental conditions and a high prevalence of breast feeding.Methods: In 345 Scandinavian children, data on breast feeding were prospectively recorded during the first year of life, and neuromotor development was assessed at 1 and 5 years of age. Main outcome measures were Bayley's Scales of Infant Development at age 13 months (Mental Index, MDI; Psychomotor Index, PDI), Wechsler Preschool and Primary Scales of Intelligence (WPPSI-R), and Peabody Developmental Scales at age 5.Results: Children breast fed for less than 3 months had an increased risk, compared to children breast fed for at least 6 months, of a test score below the median value of MDI at 13 months and of WPPSI-R at 5 years. Maternal age, maternal intelligence (Raven score), maternal education, and smoking in pregnancy were significant confounders, but the increased risk of lower MDI and total IQ scores persisted after adjustment for each of these factors. We found no clear association between duration of breast feeding and motor development at 13 months or 5 years of age.Conclusion: Our data suggest that a longer duration of breast feeding benefits cognitive development."
AUTHORS
L S Bakketeig
G Jacobsen
T Vik
N K Angelsen
PUBLISHED
2001 in Archives of Disease in Childhood
High quality source
Yes
Yes
13
Breast is best: human milk is the optimal food for brain development.
"The statement that breast-fed children score higher on tests of cognitive function than do formula-fed children is not universally accepted. The main criticism given by skeptics is that observational studies have been interpreted inappropriately and without sufficient adjustment for confounding variables such as socioeconomic status or maternal education.Anderson et al (1) compiled 20 studies published during the past 3 decades and selected results from 11 studies in order to perform a meta-analysis. Using this approach, they quantitated a 5.3-point intelligence quotient (IQ) difference in cognitive development favoring breast-fed children; after adjustment for covariates the difference dropped to 3.2 points. The IQ advantage increased with duration of breast-feeding, reaching a plateau at 4–6 mo. Low-birth-weight infants received the greatest benefits. The cognitive development of ≈10000 children per feeding category was evaluated at ages ranging from infancy to adolescence. The conclusion given by the authors is clear and simple, “breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding.” We agree with this conclusion but must point out the main limitation of this meta-analysis study, namely, that none of the studies were randomized."
AUTHORS
P Peirano
R Uauy
PUBLISHED
1999 in The American Journal of Clinical Nutrition
High quality source
Yes
Yes
14
Breast-feeding and cognitive development: a meta-analysis.
"Background: Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education.Objective: Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children.Design: In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models.Results: Of 20 studies meeting initial inclusion criteria, 11 studies controlled for >/=5 covariates and presented unadjusted and adjusted results. An unadjusted benefit of 5.32 (95% CI: 4.51, 6.14) points in cognitive function was observed for breast-fed compared with formula-fed children. After adjustment for covariates, the increment in cognitive function was 3.16 (95% CI: 2.35, 3.98) points. This adjusted difference was significant and homogeneous. Significantly higher levels of cognitive function were seen in breast-fed than in formula-fed children at 6-23 mo of age and these differences were stable across successive ages. Low-birth-weight infants showed larger differences (5.18 points; 95% CI: 3.59, 6.77) than did normal-birth-weight infants (2.66 points; 95% CI: 2.15, 3.17) suggesting that premature infants derive more benefits in cognitive development from breast milk than do full-term infants. Finally, the cognitive developmental benefits of breast-feeding increased with duration.Conclusion: This meta-analysis indicated that, after adjustment for appropriate key cofactors, breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding."
AUTHORS
D T Remley
B M Johnstone
J W Anderson
PUBLISHED
1999 in The American Journal of Clinical Nutrition
High quality source
Literature Review
Yes
Yes
15
Breast milk and subsequent intelligence quotient in children born preterm.
"There is considerable controversy over whether nutrition in early life has a long-term influence on neurodevelopment. We have shown previously that, in preterm infants, mother's choice to provide breast milk was associated with higher developmental scores at 18 months. We now report data on intelligence quotient (IQ) in the same children seen at 7 1/2-8 years. IQ was assessed in 300 children with an abbreviated version of the Weschler Intelligence Scale for Children (revised Anglicised). Children who had consumed mother's milk in the early weeks of life had a significantly higher IQ at 7 1/2-8 years than did those who received no maternal milk. An 8.3 point advantage (over half a standard deviation) in IQ remained even after adjustment for differences between groups in mother's education and social class (p less than 0.0001). This advantage was associated with being fed mother's milk by tube rather than with the process of breastfeeding. There was a dose-response relation between the proportion of mother's milk in the diet and subsequent IQ. Children whose mothers chose to provide milk but failed to do so had the same IQ as those whose mothers elected not to provide breast milk. Although these results could be explained by differences between groups in parenting skills or genetic potential (even after adjustment for social and educational factors), our data point to a beneficial effect of human milk on neurodevelopment."
AUTHORS
C Leeson-Payne
G Lister
T J Cole
R Morley
A Lucas
PUBLISHED
1992 in Lancet (London, England)
High quality source
Yes
Yes







ADDITIONAL STUDIES TO CONSIDER ADDING TO LIST
Total additional studies: 41
State of K's algorithms generated the list of studies below based on the studies that were added to the above list. Some of these studies may also examine: "Does breast milk increase a child's intelligence?" If a study examines this question, add it to the list by pressing the button.

Only add studies that examine the same question. Do not add studies that are merely on the same topic.

Does breast-feeding increase the child's risk of breast cancer?
You can view the abstract at: https://www.ncbi.nlm.nih.gov/pubmed/5035412
AUTHORS
J F Fraumeni
R W Miller
PUBLISHED
1972 in PEDIATRICS

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Effect of breast feeding on intelligence in children: prospective study, sibling pairs analysis, and meta-analysis.
"Objective: To assess the importance of maternal intelligence, and the effect of controlling for it and other important confounders, in the link between breast feeding and children's intelligence.

Design: Examination of the effect of breast feeding on cognitive ability and the impact of a range of potential confounders, in particular maternal IQ, within a national database. Additional analyses compared pairs of siblings from the sample who were and were not breast fed. The results are considered in the context of other studies that have also controlled for parental intelligence via meta-analysis.

Setting: 1979 US national longitudinal survey of youth.

Subjects: Data on 5475 children, the offspring of 3161 mothers in the longitudinal survey.

Main Outcome Measure: IQ in children measured by Peabody individual achievement test.

Results: The mother's IQ was more highly predictive of breastfeeding status than were her race, education, age, poverty status, smoking, the home environment, or the child's birth weight or birth order. One standard deviation advantage in maternal IQ more than doubled the odds of breast feeding. Before adjustment, breast feeding was associated with an increase of around 4 points in mental ability. Adjustment for maternal intelligence accounted for most of this effect. When fully adjusted for a range of relevant confounders, the effect was small (0.52) and non-significant (95% confidence interval -0.19 to 1.23). The results of the sibling comparisons and meta-analysis corroborated these findings.

Conclusions: Breast feeding has little or no effect on intelligence in children. While breast feeding has many advantages for the child and mother, enhancement of the child's intelligence is unlikely to be among them.

"
AUTHORS
Ian J Deary
G David Batty
Geoff Der
PUBLISHED

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Breast Feeding and Children's Intelligence
"Breast feeding was reported in 1992 by Lucas, et al. to provide advantages for the development of intelligence in children of low birth weight, possibly through nutrients or other biological factors found in human breast milk but not cow's milk. Research on breast feeding and intelligence in children of normal birth weight has yielded mixed results, probably because measurement of environmental influences has not been thorough and the range of intelligence components measured has been limited. Our research with 204 3-year-old children of normal birth weight included control measures for the environment and maternal intelligence (Hollings-head socioeconomic status, Home Observation for the Measured Environment, Shipley) and two measures of childhood intelligence (Stanford-Binet Fourth Edition and Peabody Picture Vocabulary Test-Revised). Controlling for environmental variables and maternal intelligence, initiation of breast feeding predicted scores on intelligence tests at age three. Breast feeding was associated with 4.6-point higher mean in children's intelligence."
AUTHORS
Virgil M. Howie
Paul R. Swank
Constance D. Baldwin
Dale L. Johnson
Mary Owen
PUBLISHED
1996 in Psychological Reports

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Allergy to nondairy proteins in mother's milk as assessed by intestinal permeability tests.
"The intestinal permeability test is a noninvasive method which, when done during a food provocation procedure, can detect the deleterious effect of food on the intestinal mucosa in allergic children. We report on a 1-month-old breast-fed boy with a history of regurgitation, diarrhea, difficult feeding, and malaise suggesting food allergy. Intestinal permeability tests were done with the mother's milk and showed breast-milk-induced alterations of intestinal permeability. No improvement occurred in the child's clinical symptoms or in the results of the intestinal permeability test when the mother withdrew dairy products from her diet. Disappearance of the child's symptoms and normalization of intestinal permeability during provocation with the milk were obtained after elimination of egg and pork from the mother's diet. This observation suggests that dietary proteins different from cow's milk antigens may be transferred to breast milk and induce adverse reactions in hypersensitive infants."
AUTHORS
J Badoual
D de Boissieu
C Dupont
PUBLISHED
1994 in Allergy

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Exploring the stem cell and non-stem cell constituents of human breast milk.
"The immense potency of nutritional components of human breast milk and importance of breastfeeding is known worldwide. Recent researches had identified stem cells as integral component of human breast milk. Nevertheless, there is little proof of evidence on the stem cell constituents of breast milk. It is imperative to explore the cellular constituents of human breast milk, including of stem cells, to open new avenue in child's development and regeneration. Thus, we aimed at identifying the cellular constituents of human breast milk by phenotypic characterisation of diverse cell surface markers of hematopoietic stem cells (CD 34, CD 133, CD 117), mesenchymal stem cells (CD 90, CD 105, CD 73), myoepithelial cells (CD 29, CD 44), Immune cells (CD 209, CD 86, CD 83, CD 14, CD 13, HLADR, CD 45), as well as cell adhesion molecules (CD 31, CD 54, CD 166, CD 106, CD 49d), and other markers (ABCG2, CD140b) using flowcytometry. We found a lower expression of CD 34 (13.07 ± 2.0 %), CD 90 (7.79 ± 0.8 %) and CD 73 (2.19 ± 0.41 %), indicating scanty hematopoietic and mesenchymal stem cell population in human breast milk. On contrary, myoepithelial progenitors, cell adhesion molecules, immune cells and growth factors were identified as the major constituents of breast milk. Overall, this study illuminates the benefits of breast feeding as breast milk encompasses heterogeneous cellular components that benefits child's growth, immunity and development. However, further research on these constituents of human breast milk will widen their applicability in treatment of neonatal disorders."
AUTHORS
D Sudarsanam
J S Rajkumar
S Indumathi
M Dhanasekaran
PUBLISHED
2013 in Cytotechnology

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Subclinical mastitis, cell-associated HIV-1 shedding in breast milk, and breast-feeding transmission of HIV-1.
"Background: Mastitis has been identified as a risk factor for mother-to-child transmission (MTCT) of HIV-1 through breast-feeding. It is unclear whether this association is mediated by increased cell-free virus (CFV) versus cell-associated virus (CAV) HIV shedding in breast milk.

Methods: We examined the risk of MTCT associated with subclinical mastitis and the relation between mastitis and CFV or CAV shedding in breast milk. Fifty-nine women who transmitted HIV through breast-feeding (cases) were individually matched to 59 nontransmitting controls nested in a cohort from Tanzania. For each case, we selected a milk specimen obtained before the infant's first positive test to quantify sodium (Na) and potassium (K) and measure CFV and CAV concentrations. Controls were matched on the child's age at the time of sample collection.

Results: Women with a breast milk Na/K ratio suggestive of mastitis (>1.0) had an 11-fold greater odds of transmission (95% confidence interval [CI]: 1.2 to 98.1), compared to women with a Na/K <or=0.6, after adjusting for maternal CD4 cell count and vitamin A supplementation. Although mastitis was positively related to both CFV and CAV shedding in breast milk, only the association with the latter was strong and statistically significant.

Conclusion: Increased cell-associated HIV-1 shedding in breast milk could mediate the association between mastitis and MTCT.

"
AUTHORS
Eduardo Villamor
Wafaie W Fawzi
Said Aboud
Irene N Koulinska
Serpil Kantarci
PUBLISHED

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Breastfeeding, dummy use, and adult intelligence.
"Background: Several studies show that children who were breastfed as babies gain higher scores on intelligence tests than those who were bottlefed. Although these findings suggest that breastfeeding in early life may promote cognitive development, their interpretation is complicated by the current association between breastfeeding and higher social class. We investigated the relation between method of feeding in infancy and adult intelligence in a setting where breastfeeding was not linked with socioeconomic advantage.

Methods: We followed up 994 men and women, born between 1920 and 1930 in Hertfordshire, UK, for whom information on infant feeding had been recorded by health visitors. Intelligence was measured by the AH4 IQ test, taken on a computer. Factors significantly linked with IQ were investigated by multivariate analysis.

Findings: Study participants who had been exclusively breastfed gained slightly higher scores on the IQ test than those who had been exclusively bottlefed, or fed with both breast and bottle. IQ was lower in participants who had used a dummy (pacifier) in infancy, in those whose fathers were in manual occupations at the time of their birth, and in those whose mothers were young at the time they were born. Scores on the IQ test fell as the number of older siblings increased. In multivariate analysis, after adjustment for the effect of all other variables, no association was found between adult intelligence and method of feeding. Dummy use in infancy, number of older siblings, maternal age at birth of the participant, and father's occupational class remained independent predictors of adult intelligence.

Interpretation: The mechanisms that link type of feeding in early life with later intelligence may have more to do with the child's social environment that with the nutritional qualities of the milk.

"
AUTHORS
C N Martyn
C R Gale
PUBLISHED
1996 in Lancet (London, England)

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Suplementação com vitamina A em gestantes e puérperas brasileiras: uma revisão sistemática
"Objective: To assess the impact of vitamin A supplementation on adult pregnant and puerperal women in Brazil regarding the content of vitamin A and secretory immunoglobulin A on colostrum and breast milk, in child's health conditions, and in mother-child binomial vitamin A status.

Methods: A research was conducted in Medline, Scopus, Web of Science, and Lilacs electronic databases for the studies published between January 2000 and January 2014. The methodological quality of the studies was assessed according to Jadad scale. The study search was conducted in January 2014, independently by two authors.

Results: Seven studies were found concerning the effects of vitamin A supplementation in the puerperal period on breast milk and infant morbidity. No study regarding pregnant women supplementation was found. The supplementation in the puerperal period raised the retinol content on breast milk, thus increasing the offer of vitamin A for the child and the concentration of secretory immunoglobulin A on colostrum. There was no description of effects on infant morbidity.

Conclusion: It seems that the advantages of postpartum supplementation were not established in the Brazilian program, although the supplementation contributes to a better nutritional status of vitamin A for both the child and the puerperal woman and increases the offer of vitamin A for the newborn through the breast milk.

"
AUTHORS
Denise Cavalcante de Barros
Andréa Ramalho
Paulo Augusto Ribeiro Neves
Cláudia Saunders
PUBLISHED
2015 in Revista Brasileira de Epidemiologia

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Breast milk feeding and cognitive ability at 7-8 years.
"Objective: To examine the association between duration of breast milk feeding and cognitive ability at 7-8 years in a birth cohort of very low birthweight infants.

Design: 280 survivors from a national birth cohort of 413 New Zealand very low birthweight infants born in 1986 were assessed at age 7-8 years on measures of verbal and performance intelligence quotient (IQ) using the WISC-R. At the same time mothers were questioned as to whether they had elected to provide expressed breast milk at birth and the total duration of breast milk feeding.

Results: Some 73% of mothers provided expressed breast milk and 37% breast fed for four months or longer. Increasing duration of breast milk feeding was associated with increases in both verbal IQ (p < 0.001) and performance IQ (p < 0.05): children breast fed for eight months or longer had mean (SD) verbal IQ scores that were 10.2 (0.56) points higher and performance IQ scores that were 6.2 (0.35) points higher than children who did not receive breast milk. These differences were substantially reduced after control for selection factors associated with receipt of breast milk. Nevertheless, even after control for confounding, there remained a significant (p < 0.05) association between duration of breast milk feeding and verbal IQ: children breast fed for eight months or longer had adjusted mean (SD) verbal IQ scores that were 6 (0.36) points higher than the scores of those who did not receive breast milk.

Conclusions: These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development.

"
AUTHORS
B A Darlow
N Mogridge
L J Horwood
PUBLISHED
2001 in Archives of disease in childhood. Fetal and neonatal edition

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Longitudinal study of human milk creamatocrit and weight gain in exclusively breastfed infants.
"Objective: To determine the creamatocrit values of breastmilk at different lactational periods during the first 6 months after delivery and its relation to infant growth.

Design: Prospective follow-up study.

Setting: Maternity and well baby clinics of a metropolitan teaching, a rural teaching and a suburban municipal hospital.

Subjects: 1322 exclusively breastfed infants and their mothers. There were 160 preterm, 281 term low birth weight (LBW) and 881 term appropriate for date (AFD) babies.

Methods: Creamatocrit of breastmilk and infant's body weight were recorded at 4,8,12,16,20 and 24 weeks after birth.

Results: Creamatocrit values of breastmilk in all mothers increased upto 16 post partum weeks and then declined. There were no significant differences in creamatocrit values of breastmilk of mothers of preterm, term LBW and term non-LBW infants. Preterm and term LBW infants showed a catch up in body weight with the term AFD group by 20 weeks post-partum.

Conclusions: The breastmilk creamatocrit progressively rises upto the fourth month of lactation but is not influenced by gestation or intra uterine growth retardation. There is no relationship between breastmilk creamatocrit and infant growth. Exclusive breast feeding adequately supports growth of LBW infants in comparison to their normal peers during the first 6 months of life.

"
AUTHORS
B Roy
R Chatterjee
S Chatterjee
T Datta
P Marimuthu
PUBLISHED
1997 in Indian Pediatrics

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Knowledge of, and attitudes to giving expressed breastmilk to infants in rural coastal Kenya; focus group discussions of first time mothers and their advisers.
"Background: The World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative step number five of the "Ten steps to successful breastfeeding" states "Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants." Urban mothers in Nairobi have low rates of exclusive breastfeeding after returning to work but there are no published data on rural Kenya mothers' infant feeding practices when working or schooling away from home.

Methods: We explored knowledge of, and attitudes to, the practice of giving expressed breastmilk in a mixed methods observational study of breastfeeding in rural Kenyan mothers. Fifty mothers with newborns, identified by nurses and community health workers, were asked questions about their experiences of breastfeeding and who they had sought or received advice from on breastfeeding. Focus group discussions, one with community health workers, and four each with mothers and their named advisers were held. Recordings were analyzed using a thematic framework approach.

Results: The main themes were: the baby's right to feed from the breast, lack of knowledge about expressing and giving breastmilk, negative attitudes towards expressed breastmilk, and traditional customs for disposing of expressed breast milk. Most participants did not have any experience of giving expressed breastmilk to infants. They described practices of expressing and discarding milk when the mother or baby was ill, to relieve discomfort from engorgement or after the baby had died.

Conclusions: Feeding expressed breastmilk to infants is a new concept in this context. Promotion of, and training in this practice would help mothers to maintain their milk supply when away from their babies and benefit the infants of working and schoolgirl mothers.

"
AUTHORS
Alison W Talbert
James A Berkley
Martha Mwangome
Edward Mumbo
Benjamin Tsofa
PUBLISHED
2018 in International Breastfeeding Journal

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LATCH Scores and Milk Intake in Preterm and Term Infants: A Prospective Comparative Study
"Objectives: We aimed to detect the breastmilk intake in preterm and term infants and to determine if the LATCH scoring system (latch; audible swallowing; type of nipple; comfort [breast/nipple]; hold [positioning]) could be helpful to denote that infants have taken enough breastmilk according to their postnatal age and weight.

Materials And Methods: Sixty-six breastfeeding sessions were monitored and scored simultaneously by using the LATCH scoring system. The weight of the 66 infants (33 preterm, 33 term) was measured before and after a breastfeeding session, and thereby milk intake by breastfeeding was determined. The expected amount of milk volume that infants should receive for each feeding session was calculated according to the postnatal age and weight. The breastmilk intake by breastfeeding was compared with LATCH scores and the expected milk volume for each feeding.

Results: We observed that 25 term infants (75.8%) took 100% of the expected milk volume for each feeding session, compared with two preterm infants (2.1%) (p=0.009). The median LATCH scores were 7.0 (minimum-maximum=5-9) in preterm babies and 9 (minimum-maximum=7-10) in term babies (p<0.0001). Term babies could consume 95.4% of the expected milk volume for each feeding session, whereas this ratio was only 45% in preterm babies. In each group, babies receiving a score of ≥7 took at least 50% of the expected milk volume for each feeding session. In each group, higher LATCH scores were associated with higher median intake, but the minimum and maximum intake for each LATCH score revealed marked variability.

Conclusions: High LATCH scores (7-10) may be helpful to determine that infants take at least 50% of the expected breastmilk volume for each feeding in both preterm and term infants. However, LATCH scores cannot substitute for test weights in premature infants because of variability in minimum and maximum milk intake per LATCH score.

"
AUTHORS
Serpil Akkurt
Hasan Cem Razi
Nilgun Altuntas
Mehmet Fatih Kislal
Mesut Kocak
PUBLISHED
2015 in Breastfeeding Medicine

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Ethical responsibilities of the Australian media in the representations of infant feeding.
"Despite the fact that human milk is the ideal food for human babies, many Australian babies are still weaned sooner than the World Health Organization guidelines recommend. Australian mothers want to breastfeed--and initially do so. However, there is a rapid decline in the percentage of babies being offered breastmilk as newborns compared to six months old. Data collected in 2004 indicated that although 90% of newborn infants in NSW were put to the breast, or offered expressed milk, at least once, only 77% of infants were receiving at least some breastmilk regularly at the end of their first month. By six months of age only 4.6% of babies in NSW were being exclusively breastfed. This paper aims to analyse some of the reasons women in Australia prematurely wean their infants. Particular emphasis will be given to the representation of infant feeding in the media, how consumers use this information to make decisions about infant feeding, and the ethical responsibilities of said media in their portrayal of infant feeding."
AUTHOR
Nicole Bridges
PUBLISHED
2007 in Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia

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Changes in Public Attitudes toward Breastfeeding in the United States, 1999-2003
"Data from the HealthStyles survey, an annual national mail survey to US adults, were examined to understand changes in public attitudes toward breastfeeding. The 1999 and 2003 HealthStyles surveys included four breastfeeding items related to public attitudes toward breastfeeding in public and toward differences between infant formula and breastmilk. The percentage of respondents in agreement with the statement, "Infant formula is as good as breastmilk," increased significantly from 14.3% in 1999 to 25.7% in 2003. The increase was particularly large among people of low socioeconomic status. The percentage increase in agreement that "feeding a baby formula instead of breastmilk increases the chances the baby will get sick" grew at a statistically significant level, but the total change was small (2.7 percentage points). No significant total changes were found for the other two survey items. The perception that infant formula is as good as breastmilk would be expected to soften a woman's commitment to breastfeeding should she be faced with obstacles to doing so. The findings underscore the need to educate the general public that breastfeeding is the best method of feeding and nurturing infants. Pediatricians and other health professionals should recommend human milk for all infants for whom breastfeeding is not specifically contraindicated."
AUTHORS
Valerie J. Rock
Ruowei Li
Laurence Grummer-Strawn
PUBLISHED
2007 in Journal of the American Dietetic Association

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Water supplementation in exclusively breastfed infants during summer in the tropics.
"This study was designed to determine the need for water supplementation to maintain water homoeostasis in exclusively breastfed infants during summer in a tropical country. A prestudy questionnaire revealed that 97% of 34 nurses and 63% of 70 doctors advocated such supplementation. 45 healthy, male, exclusively breastfed babies, aged 1-4 months, were recruited from a well-baby clinic. 9 who had never received supplemental water plus a random selection of 14 others were allocated to group I (breastmilk only); the remaining 22 infants were allocated to group II (breastmilk plus supplemental fluid according to the mother's usual practice). The babies were studied at the hospital for 8 h; breastmilk intake was measured by weighing the infant before and after each feed, water intake by calibrated bottles, and urine output by accurate collection and measurement. The maximum room temperatures were 34-41 degrees C and relative humidities 9-60% (below 50% in all but 3 infants). In group II the mean water intake was 11% (95% confidence interval 7-16%) of the total fluid intake. Both breastmilk intake (274 vs 210 ml) and total fluid intake (274 vs 233 ml) were higher in group I than in group II (p = 0.003, p = 0.073, respectively), after adjustment for age, weight, length, room temperature, and humidity. However, there were no significant differences between the groups in urine output, urine or serum osmolality, weight change, or rectal temperature whether or not the factors adjusted for included total fluid intake. Thus, exclusively breastfed infants do not need supplemental water to maintain water homoeostasis; a reduced breastmilk intake is a potential disadvantage of this practice."
AUTHORS
R K Puri
S Kumar
L Satyanarayana
J Krishna
H P Sachdev
PUBLISHED
1991 in Lancet (London, England)

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It's all formula to me: women's understandings of toddler milk ads.
"This study utilised semi-structured interviews to investigate how women expecting a first baby perceived print advertisements for 'toddler milks' in order to determine whether they function as indirect advertising for infant and follow-on formula. Examination of the marketing literature, analysis of the advertisers' websites and the advertisements themselves provided sources of triangulation. Fifteen women expecting a first baby were recruited from antenatal classes conducted by staff of the Northern Sydney Central Coast Area Health Service. These respondents clearly understood toddler milk advertisements to be promoting a range of products that included infant and follow-on formula and accepted their claims quite uncritically These claims contradicted public health messages about breastfeeding and the evidence of health risks associated with formula feeding. Toddler milk advertisements appear to function as indirect advertising for infant and follow-on formula. The Marketing in Australia of Infant Formula: Manufacturers' and Importers' Agreement is failing to protect the Australian community from the advertising of breastmilk substitutes as required by World Health Assembly Resolution 33.47, the International Code of Marketing of Breastmilk Substitutes. Further research is recommended to determine whether the responses of this group of primiparous women from a single area in NSW are representative of the wider population of Australian mothers."
AUTHORS
Sandra Jones
Don Iverson
Nina J Berry
PUBLISHED
2010 in Breastfeeding review : professional publication of the Nursing Mothers' Association of Australia

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Sociocultural factors and the promotion of exclusive breastfeeding in rural Yoruba communities of Osun State, Nigeria.
"Child survival strategies include prolonged and intensive breastfeeding, together with its early initiation, and breastmilk only for the first six months of life. This paper reports on local knowledge and attitudes of breastfeeding and the sociocultural factors that shape its practice in poor rural Yoruba communities of Southwestern Nigeria. The study has conducted 10 focus group discussions among homogeneous groups of grandmothers, pregnant women, lactating mothers, husbands, and community health workers, and a questionnaire survey of 256 third trimester pregnant women. All women in these communities breastfeed their infants on demand, and for up to two years, because breastmilk is universally accepted as the best food for babies, and breastfeeding spaces births. Prelacteal feedings of water herbal infusions and ritual fluids are the norm, and breastmilk is supplemented, from birth, with water and teas. Exclusive breastfeeding is considered dangerous to the infant: the baby has an obligatory requirement for supplementary water to quench its thirst and promote its normal development, and for herbal teas which serve as food and medicine. Colostrum is discarded because it is dirty, "like pus", and therefore potentially harmful to the infant, although 24% of the survey sample would give it to their babies. Expressed breastmilk is suspect as it can get contaminated, poisoned or bewitched. Complementary foods are introduced as early as two months because of perceived lactation insufficiency. The commonest supplement is a watery maize porridge of low nutrient density. Breastfeeding can also be dangerous, as toxins and contaminants can be passed to the infant through breastmilk. The most serious conflict with the WHO/UNICEF recommendations is the lack of local credibility of exclusive breastfeeding. According to local knowledge, the early introduction of water, herbal teas, and of complementary foods is designed to enhance child survival, while these are supposed to do the exact opposite by the WHO/UNICEF rationale, by exposing the infant to contaminants early, thereby increasing diarrheal morbidity and mortality. Child survival interventions need to address this conflict."
AUTHOR
A A Davies-Adetugbo
PUBLISHED
1997 in Social science & medicine (1982)

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A Mother with Green Breastmilk Due to Multivitamin and Mineral Intake: A Case Report
"It is a globally accepted fact that breastfeeding reduces infant mortality and morbidity, optimizes infant growth, is superior to other forms of nutrition for infants, and has economic advantages for the family and the country. This case study reports a new mother who stopped breastfeeding her baby because her breastmilk was green. When her second child was born, her milk came in green, and a consultation was requested from pediatrics and infectious diseases. A physical examination and laboratory tests revealed that the abnormal color of her breastmilk was related to multivitamin intake. The patient was advised to continue breastfeeding despite the odd color. Although clinical specialists know that the color of breastmilk can change with the ingestion of certain medications and foods, mothers are usually unaware and may unnecessarily terminate breastfeeding."
AUTHORS
Ahmet Ruhi Toraman
Zerrin Yazgan
Mehmet Demirdöven
Ahmet Gürel
Hamza Yazgan
PUBLISHED
2012 in Breastfeeding Medicine

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La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales?
"Breastmilk is the best food for newborns and infants. The nutritional stores of a lactating woman may be more or less depleted as a result of the pregnancy and the loss of blood during childbirth. Lactation raises nutrient needs, mainly because of the loss of nutrients, first through colostrum and then through breastmilk. Breastmilk volume varies widely. The nutrients present in this milk come from the diet of the mother or from her nutrient reserves. The conversion of nutrients in food to nutrients in breastmilk is not complete. To have good nutritional status the breastfeeding woman has to increase nutrient intake. Human breastmilk has a fairly constant composition, and is only selectively affected by the diet of the mother. The fat content of breastmilk varies somewhat. The carbohydrate, protein, fat, calcium and iron contents do not change much, even if the mother is short of these in her diet. A mother whose diet is deficient in thiamine and vitamins A and D, however, produces less of these in her milk. The mother should be given advice on consuming a mixed diet. At each postnatal visit, both the mother and the baby should be examined, and advice on the diets of both mother and infant should be provided. A satisfactory gain in the infant's weight is the best way to judge the adequacy of the diet of the infant. Mothers should not receive less than 1800 calories per day. "
AUTHORS
N. Marta Díaz-Gómez
José Arena Ansótegui
Susana Ares Segura
PUBLISHED
2016 in Anales de Pediatría

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Centralized Breastmilk Handling and Bar Code Scanning Improve Safety and Reduce Breastmilk Administration Errors
"Safe handling and preparation of breastmilk within the hospital setting are often taken for granted, and the process may not be scrutinized until problems arise. Areas of concern focus on both risk of contamination of breastmilk feedings due to handling and fortification and risk of a breastmilk misadministration. In two phases, Children's Hospital of Orange County (Orange, CA) implemented centralized breastmilk handling and breastmilk bar code scanning. As a result of these process changes, reports of breastmilk administration errors decreased to zero. However, bar code scanning allowed for the tracking of near misses. During the first 6 months of breastmilk bar code scanning, 55 attempts to feed the wrong breastmilk to the wrong patient and 127 attempts to feed expired breastmilk were prevented. Our findings are consistent with current practice recommendations that support the use of centralized breastmilk handling and systems for proper identification of breastmilk."
AUTHORS
Christine Bixby
Caroline Steele
PUBLISHED
2014 in Breastfeeding Medicine

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Comparison of Physiological and Behavioral Responses to Fresh and Thawed Breastmilk in Premature Infants—A Preliminary Study
"Background: Breastmilk is usually frozen for premature infants when they are unable to feed orally. However, thawed breastmilk may have altered odor and taste from its original form. Few studies have investigated whether premature infants respond differently to fresh and thawed breastmilk. The purpose of this study was to examine the physiological and behavior responses of premature infants alternately fed fresh and thawed breastmilk.

Subjects And Methods: An experimental, crossover study using random assignment was conducted. A convenience sample of 18 premature infants less than 37 weeks gestational age at birth with the capability of oral feeding was studied. The premature infants were fed with fresh and thawed breastmilk during two consecutive meals in a random order. Infants' heart rate and oxygen saturation levels were measured baseline and during feeding, as well as observed feeding cues during the feeding period.

Results: Premature infants showed significant differences in heart rate when fed thawed, as opposed to fresh, breastmilk. Premature infants demonstrated more stress cues when fed thawed compared with fresh breastmilk (p=0.007). For infants with postmenstrual ages greater than 36 weeks gestation, feeding with thawed breastmilk showed more stress cues and greater effect on heart rate activity compared with fresh breastmilk (p<0.05).

Conclusions: Older premature infants demonstrate more stress when fed with thawed breastmilk. Preterm infants should be directly breastfed or fed with nonfrozen breastmilk, when they show stress behaviors in being fed with thawed breastmilk.

"
AUTHORS
Ying-Ju Chang
Yu-Yun Hsu
Hsiao-Ying Hung
PUBLISHED
2013 in Breastfeeding Medicine

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Feasibility and safety of setting up a donor breastmilk bank in a neonatal prem unit in a resource limited setting: An observational, longitudinal cohort study.
"Background: The beneficial effects of human milk on decreasing rates of paediatric infections such as necrotizing enterocolitis (NEC) and sepsis have been clearly demonstrated. Donor breastmilk has been encouraged as the milk of choice when a mother's own breastmilk is not available. The objectives of this study were to assess feasibility of providing donor breastmilk to infants in a resource limited Neonatal Prem Unit (NPU). In addition we sought to determine whether donor breastmilk could be safely pasteurized and administered to infants without any adverse events.

Methods: Low birth weight infants < 1800 g and under 32 weeks gestational age were followed up in the NPU over a 3 week period; feeding data and morbidity data was collected in order to determine if there were any adverse events associated with donor breastmilk. Samples of pasteurized breastmilk were cultured to check for any bacterial contamination.

Results: 191 infants met the inclusion criteria of whom 96 received their mother's own breastmilk. Of the 95 infants who were potentially eligible to receive donor milk, only 40 did in fact receive donor milk. There was no evidence of bacterial contamination in the samples analyzed, and no evidence of adverse events from feeding with donor breastmilk.

Conclusion: It is feasible to supply donor breastmilk to infants in an NPU in a resource limited setting, however staff needs to be sensitized to the importance of donor breastmilk to improve uptake rates. Secondly we showed that it is possible to supply donor breastmilk according to established guidelines with no adverse events therefore making it possible to prevent NEC and other side effects often associated with formula feeding of premature infants.

"
AUTHORS
Irene Coutsoudis
Anna Coutsoudis
Miriam Adhikari
Nadia Nair
PUBLISHED
2011 in BMC public health

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Review of the Relationships Between Maternal Characteristics and Preterm Breastmilk Immune Components
"The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant. Prematurity is one of the leading causes of infant death in the United States. Hospitalized infant outcomes associated with consumption of breastmilk are shorter length of stay and decreased incidence of nosocomial infections and necrotizing enterocolitis (NEC). The presence of nosocomial infections and necrotizing enterocolitis increases risk of preterm mortality and morbidity as well as healthcare expenditures. However, breastmilk immunological components such as secretory immunoglobulin A, lactoferrin (LFT), and cytokines provide a framework of immunity that, in conjunction with nutritional support, significantly improves neonatal health. The relationship between maternal characteristics and breastmilk immune properties is central to further the understanding of the impact of breastmilk on preterm infant morbidity and mortality. The purpose of this article is to review the numerous immune components in breastmilk, the moderators of the immune components, and the relevance of these components to preterm/infant health. Exploration of the complexity of breastmilk immune components may direct future development of interventions to improve and sustain the immunological benefits of preterm breastmilk."
AUTHORS
Karen D’Apolito
Shelley Thibeau
PUBLISHED
2012 in Biological Research for Nursing

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Methods and Strategies to Examine the Human Breastmilk Microbiome
"It has recently been discovered that breastmilk is not sterile, but contains a vast array of microbes, known collectively as the breastmilk microbiome. The breastmilk microbiome field is in its infancy, but over the last decade, our understanding of the microbial communities that inhabit the human body has increased exponentially, due in large part to novel next-generation sequencing technologies. These culture-independent, high-throughput molecular technologies have allowed biologists to investigate the entirety of microbiota present in breastmilk, which was previously poorly known. These approaches are novel and the methodologies surrounding the exploration of the breastmilk microbiota remain in flux. The objectives of this chapter are to outline what is known thus far and detail the optimal methods and strategies to conducting a breastmilk microbiome study from subject recruitment and milk collection to DNA extraction, high-throughput sequencing and bioinformatics analyses."
AUTHORS
Sharon Unger
Julia Copeland
Lauren LeMay-Nedjelski
Pauline W. Wang
Deborah L. O’Connor
James Butcher et al
PUBLISHED
2018 in Microbiome Analysis

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Variations in the rancid-flavor compounds of human breastmilk under general frozen-storage conditions.
"Background: Human breastmilk provides the best nutrition for infants. When women or infants have difficulties in breastfeeding directly, breastmilk is usually pumped and frozen for later use. However, while frozen, breastmilk may develop a rancid flavor, which induces infant feeding stress and raises the mothers' concerns about the quality of frozen breastmilk. Nevertheless, few studies have investigated the variations in the compounds that cause the rancid flavor of breastmilk during frozen storage.

Methods: A repeated-measures design was adopted to quantify the variations in rancid-flavor compounds, namely acid value (AV), total free fatty acids (FFAs), and short-and intermediate-chain FFAs of breastmilk during frozen storage. Breastmilk was obtained from ten healthy mothers of full-term infants and each milk sample was divided into three aliquots: fresh, 7-day frozen and 30-day frozen samples. The fresh samples were immediately analyzed, while the others were frozen in a domestic fridge within a temperature range of -15 to -18 °C and analyzed 7 and 30 days later.

Results: The rancid-flavor compounds of the breastmilk, namely AV, total FFAs and intermediate-chain FFAs, significantly increased with storage time, all of which reached the sensory threshold for detecting the rancid flavor of milk. In addition, the FFAs of the breastmilk samples frozen for 7 days far exceeded the detection threshold for unpleased rancid flavor, while the 30-day samples were higher than the intolerable level for most people.

Conclusions: This study revealed that the human breastmilk develops a rancid flavor during frozen storage. Therefore, we recommend that when infants refuse thawed milk, mothers can try to provide freshly expressed milk whenever possible or provide breastmilk frozen for less than 7 days. Future studies could explore the methods for slowing breastmilk lipolysis to maintain its fresh flavor.

"
AUTHORS
Ying-Ju Chang
Yu-Yun Hsu
Hsiao-Ying Hung
Pei-Fang Su
PUBLISHED
2018 in BMC Pediatrics

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Comparison of Breastmilk Odor and Vanilla Odor on Mitigating Premature Infants' Response to Pain During and After Venipuncture
"Objective: The main purpose of this study was to investigate the calming effects of breastmilk odor and vanilla odor on preterm infants during and after venipuncture.

Subjects And Methods: One hundred thirty-five preterm infants were randomly selected and divided into three groups: control, vanilla odor, and breastmilk odor. Infants in the breastmilk group were exposed to breastmilk odor, and infants in the vanilla group were exposed to vanilla odor from 5 minutes before the start of sampling until 30 seconds after sampling. The Premature Infant Pain Profile was used for calculating quality of pain in infants during and after sampling.

Results: Statistical analyses showed that both vanilla and breastmilk odors had calming effects on premature infants during sampling, but just breastmilk odor had calming effects on infants after the end of sampling. Compared with vanilla odor, breastmilk odor has more calming effects on premature infants.

Conclusions: Breastmilk odor can be used for calming premature infants during and after venipuncture.

"
AUTHORS
Aleheh Seyyedrasouli
Mahnaz Jebreili
Mohammad Bagher Hosseini
Hamed Hamishehkar
Hanieh Neshat
Morteza Ghojazade
PUBLISHED
2015 in Breastfeeding Medicine

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Literature review
Dietary intervention strategies to enhance zinc nutrition: promotion and support of breastfeeding for infants and young children.
"Breastmilk is the only dietary source of zinc for exclusively breastfed young infants, and it remains a potentially important source of zinc for older infants and young children who continue breastfeeding beyond early infancy. Therefore, we examined available information on breastmilk zinc concentration and total milk consumption to develop estimates of the amount of zinc transferred in breastmilk to children of different ages. Breastmilk zinc concentration declines rapidly during the first few months postpartum and more slowly thereafter. Breastmilk supplies all of the theoretical zinc needs for at least the first several months of life, although the period during which breastmilk alone remains sufficient is uncertain. Breastmilk continues to provide more than half of children's estimated zinc requirements after the introduction of complementary foods, even into the second year of life. Public health programs to promote and support breastfeeding should be included among the strategies to ensure adequate zinc status of young children."
AUTHORS
Nancy F Krebs
Janet M Peerson
Kenneth H Brown
Reina Engle-Stone
PUBLISHED
2009 in Food and Nutrition Bulletin

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Breastmilk cell and fat contents respond similarly to removal of breastmilk by the infant.
"Large inter- and intra-individual variations exist in breastmilk composition, yet factors associated with these variations in the short-term are not well understood. In this study, the effects of breastfeeding on breastmilk cellular and biochemical content were examined. Serial breastmilk samples (∼5 mL) were collected from both breasts of breastfeeding women before and immediately after the first morning breastfeed, and then at 30-minute intervals for up to 3 hours post-feed on 2-4 mornings per participant. The infant fed from one breast only at each feed. Effects of pump versus hand expression for samples were evaluated. A consistent response pattern of breastmilk cell and fat contents to breastmilk removal was observed. Maximum fat and cell levels were obtained 30 minutes post-feed (P<0.01), with up to 8-fold increase in fat and 12-fold increase in cell content compared to the pre-feed values, and then they gradually decreased. Breastmilk cell viability and protein concentration did not change with feeding (P>0.05), although large intra-individual variability was noted for protein. Expression mode for samples did not influence breastmilk composition (P>0.05). It is concluded that breastmilk fat content, and thus breast fullness, is closely associated with breastmilk cell content. This will now form the basis for standardization of sampling protocols in lactation studies and investigation of the mechanisms of milk synthesis and cell movement into breastmilk. Moreover, these findings generate new avenues for clinical interventions exploring growth and survival benefits conferred to preterm infants by providing the highest in fat and cells milk obtained at 30 min post-expression. "
AUTHORS
Sharon Perrella
Alecia-Jane Twigger
Foteini Hassiotou
Donna T Geddes
Luis Filgueira
Tracey M Williams et al
PUBLISHED
2013 in PLoS ONE

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Longitudinal analysis of mature breastmilk and serum immune composition among mixed HIV-status mothers and their infants
FUNDERS
National Science Foundation
"Background & Aims: Understanding mature breastmilk immunology may benefit infants chronically exposed to infectious pathogens in resource-limited regions.

Methods: This prospective rural/semi-rural Tanzanian cohort of women (n = 102 at delivery; 38% HIV-positive) and their infants (n = 102) investigated breastmilk, maternal and infant serum immunoglobulins (IgA/IgG1-4/IgM) and cytokines (IL-1β/IL-2/IL-6/IL-10/IL-12p70/IL-13/IL-15/TNF-α/IFN-γ) at 1, 2, 3, 6-months postpartum.

Results: Milk immunoglobulins followed an inverse U-shaped pattern, while cytokine patterns were mixed. Exclusive breastfeeding duration and feeding intensity were associated with greater breastmilk total immunoglobulin and IgA, IgG1-3 and IL-12p70 concentrations. Maternal mastitis, fever or cough was associated with higher breastmilk total cytokine concentrations, while infant fever was associated with lower milk immunoglobulins or cytokines. Strong (r ≥ 0.40) to weak (r = 0.20-0.29) positive correlations between maternal serum-breastmilk or breastmilk-infant serum immunoglobulins were evident. Breastmilk cytokines were moderate to weakly negatively correlated with infant serum. Breastmilk immunology did not differ by maternal malnutrition or HIV-seropositivity.

Conclusions: Mature breastmilk is a dynamic source of many specific and non-specific immune factors associated with maternal and infant health and infant nutrition. Breastfeeding practices are associated with differential breastmilk immunological composition providing immunological support for universal recommendations to exclusively breastfeed for 6-months.

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AUTHORS
Jim Todd
Sarah H. Pedersen
Amanda L. Wilkinson
Safari M. Kinung'hi
John Changalucha
Aura Andreasen et al
PUBLISHED
2016 in Clinical Nutrition

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Association between Total Antioxidant Capacity in Breast Milk and Postnatal Age in Days in Premature Infants.
"This study aimed to consider the significance of breast milk in preventing oxidative stress by comparing total antioxidant capacity (TAC) in breast milk and formula milk for premature infants, demonstrating the relationship between TAC in breast milk and postnatal age in days. We used the biological anti-oxidant potential test, a new method to measure TAC in breast milk. Breast milk for premature infants were stored at -20 degrees C and thawed within 48 h of collection. We measured TAC in two types of formula milk in the same way. TAC was clearly higher in breast milk than formula milk. Although a negative correlation was observed between TAC in breast milk and age when collected, TAC was always higher than the average TAC in formula milk. TAC in breast milk is higher than TAC in formula milk. We suggest the importance of breast milk for preventing oxidative stress and starting breastfeeding early."
AUTHORS
Tomoo Ito
Shoichi Ezaki
Keiji Suzuki
Masanori Tamura
PUBLISHED
2008 in Journal of Clinical Biochemistry and Nutrition

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Chlorella(Chlorella pyrenoidosa) Supplementation Decreases Dioxin and Increases Immunoglobulin A Concentrations in Breast Milk
"In addition to meeting nutritional requirements, breast milk plays important roles in biodefense for nursing infants. Dioxins have been detected at high concentrations in breast milk, raising concerns about disorders in nursing infants caused by breast milk containing dioxins in Japan. We analyzed dioxin levels in breast milk and maternal blood samples from 35 pregnant women in Japan. We also measured immunoglobulin (Ig) A concentrations in breast milk and investigated correlations with dioxin concentrations. In addition, 18 of the 35 women took Chlorella pyrenoidosa (Chlorella) supplements during pregnancy, and the effects on dioxin and IgA concentrations in breast milk were investigated. Toxic equivalents were significantly lower in the breast milk of women taking Chlorella tablets than in the Control group (P = .003). These results suggest that Chlorella supplementation by the mother may reduce transfer of dioxins to the child through breast milk. No significant correlation was identified between dioxin and IgA concentrations in breast milk in the Control group. It is unlikely that normal levels of dioxin exposure via food have a remarkable influence on IgA in breast milk. IgA concentrations in breast milk in the Chlorella group were significantly higher than in the Control group (P = .03). Increasing IgA levels in breast milk is considered to be effective for reducing the risk of infection in nursing infants. The present results suggest that Chlorella supplementation not only reduces dioxin levels in breast milk, but may also have beneficial effects on nursing infants by increasing IgA levels in breast milk."
AUTHORS
Hideo Takekoshi
Masuo Nakano
Shiro Nakano
PUBLISHED
2007 in Journal of Medicinal Food

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Role of milk whey in the transmission of human cytomegalovirus infection by breast milk.
"Breast-fed infants are susceptible to human cytomegalovirus (HCMV) infection via breast milk. In our previous study, HCMV was isolated more frequently from breast milk at later than one month after delivery than from colostrum or early breast milk. To clarify the role of milk cells and whey in vertical infection by breast feeding, we separated breast milk into milk cells and whey and examined each fraction for the presence of HCMV. We collected breast milk from mothers who breast-fed their infants (aged from 3 days to 2 months). The breast milk was centrifuged and separated into the middle layer (layer of milk whey) and the pellet (containing milk cells). We attempted to isolate HCMV from whey and to detect HCMV immediate early (IE) DNA in both milk whey and cells. HCMV was isolated from 7 out of 35 (20.0%) whey samples and HCMV IE DNA was detected from 15 out of 35 (42.9%) whey and/or milk cells. Detection rates of HCMV IE DNA in the whey layer and milk cells were 39.1% (25 out of 64) and 17.2% (11 out of 64), respectively. HCMV IE DNA was not detected in colostrum, but was detected in breast milk samples one month after delivery. Therefore, cell-free HCMV shed into milk whey may have a more important role in vertical infection by breast milk than cell-associated HCMV in the milk."
AUTHORS
T Hotsubo
K Numazaki
K Horino
N Nagata
H Asanuma
S Chiba
PUBLISHED
1996 in Microbiology and Immunology

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[Changes in epidermal growth factor concentrations in neonates with late-onset breast milk jaundice after stopping breast feeding].
"Objective: To investigate the changes in epidermal growth factor (EGF) concentrations in infants' serum and breast milk in neonates with late-onset breast milk jaundice after stopping breast feeding.

Methods: Thirty full-term infants with late-onset breast milk jaundice were included in the study. Infants' serum and breast milk were collected before and 72 hours after stopping breast feeding, and the total bilirubin and EGF concentrations in infants' serum and EGF concentration in breast milk were measured respectively.

Results: At 72 hours after stopping breast feeding, the total bilirubin and EGF concentrations in infants' serum were significantly decreased (P<0.05), but the EGF concentration in breast milk did not show significant change (P>0.05).

Conclusions: After stopping breast feeding, the neonates with late-onset breast milk jaundice show significant decreases in serum EGF concentration, but the EGF concentration in breast milk shows no significant change. The role and action mechanism of EGF in late-onset breast milk jaundice need further study.

"
AUTHORS
Xue-Feng Zhang
Xin-Yu Wang
Ling-Ling Xiao
PUBLISHED
2013 in Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics

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Highly regarded source
Trends in breastfeeding: it is not only at the breast anymore.
"The past characterisations of breastfeeding as being only at the breast of the mother may no longer be applicable in the United States as mothers now frequently express their milk. We conducted a retrospective cohort study with women who visited the Cincinnati Children's Breastfeeding Medicine Clinic to understand breast milk feeding behaviours of healthy mothers and infants, which included questions specifically about breast milk expression. All 40 mothers in the cohort expressed their milk and all 40 infants were fed expressed milk. One infant was fed another mother's milk for 30 days. Two-thirds (13/40) of infants received their mother's expressed milk at least a week after it was first expressed and 25% (10/40) of infants continued to be fed expressed breast milk after mothers had stopped expressing milk. There were 14 sequences of breast milk production by the mothers and 16 sequences of consumption by the infants. Early in the post-partum period, mothers started expressing milk even though their infants were consuming all of the breast milk that they needed at the breast. As a result of breast milk expression by all mothers in this cohort, we observed highly variable patterns of maternal breast milk production and infant breast milk consumption, which were not necessarily synchronous within a dyad. It is now time to develop appropriate ways to characterise the production and consumption of breast milk more accurately and investigate whether these behaviours have consequences for the health of mothers and infants."
AUTHORS
Sheela R Geraghty
Kathleen M Rasmussen
Heidi Sucharew
PUBLISHED
2013 in Maternal & Child Nutrition

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Human breast milk provides better antioxidant capacity than infant formula.
"Human milk contains all of the constituents that are required for the optimal growth and development of a neonate. It supports the development of brain, immune, and physiological systems. This study aimed to consider the significance of breast milk in preventing oxidative stress by comparing total antioxidant capacity (TAC) in breast and formula milk for premature infants, demonstrating the relationship between TAC in breast milk and postnatal age in days. The Ferric reducing antioxidant power assay (FRAP) method was used to spectophotometrically measure of TAC in breast and formula milk. One hundred and fourty (n = 140) lactating mothers agreed to participate in the study. TAC was also measured in two brands of formula milk (n = 80). The Range of TAC in human breast milk was 234.27-1442.31 μM and in two formula was 160.04-630.92 μM. The average TAC was significantly higher in breast milk (642.94 ± 241.23 μM) compared to formula milk (280.986 ± 100.34 μM) p < 0.0001. The TAC of breast milk was increased with some nutritional parameter such as increased consumption of cheese, vegetables, fruits, bread and nuts. Infants' height at the birthday was directly correlated with antioxidant capacity of breast milk, whilst a reversed correlation was observed between TAC in breast milk and infant age. Based on our results, it is concluded that the TAC of breast milk is varied and affected by nutrition. It is alo observed that TAC is significantly higher in breast milk than formula, which means that breast milk provides better antioxidant potency than infant formula. "
AUTHORS
Naficeh Sadeghi
Mohammad Reza Oveisi
Fariba Mokhtarinasab
Abd-Ol-Azim Behfar
Behrooz Jannat
Forouzandeh Jannat et al
PUBLISHED
2010 in Iranian journal of pharmaceutical research : IJPR

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Temporal and lateral dynamics of HIV shedding and elevated sodium in breast milk among HIV-positive mothers during the first 4 months of breast-feeding.
"Objective: To better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women.

Design: This was a longitudinal cohort study in Lusaka, Zambia.

Method: We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls.

Results: Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration (> or =13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters.

Conclusions: Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission.

"
AUTHORS
Louise Kuhn
Donald M Thea
Mwiya Mwiya
Prisca Kasonde
Chipepo Kankasa
Mrinal Ghosh et al
PUBLISHED
2008 in Journal of acquired immune deficiency syndromes (1999)

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An Intervention to Promote Breast Milk Production in Mothers of Preterm Infants
"A pilot study was conducted to estimate the effects of a breast milk expression education and support intervention on breast milk production outcomes in mothers of very and extremely preterm infants. Forty mothers of hospitalized preterm infants (<30 weeks of gestation) were randomized to the experimental intervention or standard care for 6 weeks. Duration and frequency of breast milk expressions and volume of expressed breast milk were measured daily. Samples of breast milk were collected thrice during the study and analyzed for their lipid concentration. Mothers in the experimental group had a statistically significant higher duration of breast milk expression in min/day (p= .043). Differences observed between the two groups regarding the frequency of breast milk expression, volume of breast milk, and lipid concentration were not statistically significant. Results suggest that the experimental intervention may promote breast milk production in mothers of very and extremely preterm infants. "
AUTHORS
Emile Levy
Anne Monique Nuyt
Carole Garofalo
Céline Goulet
Marjolaine Héon
PUBLISHED
2014 in Western Journal of Nursing Research

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Potent simian immunodeficiency virus-specific cellular immune responses in the breast milk of simian immunodeficiency virus-infected, lactating rhesus monkeys.
"Breast milk transmission of HIV is a leading cause of infant HIV/AIDS in the developing world. Remarkably, only a small minority of breastfeeding infants born to HIV-infected mothers contract HIV via breast milk exposure, raising the possibility that immune factors in the breast milk confer protection to the infants who remain uninfected. To model HIV-specific immunity in breast milk, lactation was pharmacologically induced in Mamu-A*01(+) female rhesus monkeys. The composition of lymphocyte subsets in hormone-induced lactation breast milk was found to be similar to that in natural lactation breast milk. Hormone-induced lactating monkeys were inoculated i.v. with SIVmac251 and CD8(+) T lymphocytes specific for two immunodominant SIV epitopes, Gag p11C and Tat TL8, and SIV viral load were monitored in peripheral blood and breast milk during acute infection. The breast milk viral load was 1-2 logs lower than plasma viral load through peak and set point of viremia. Surprisingly, whereas the kinetics of the SIV-specific cellular immunity in breast milk mirrored that of the blood, the peak magnitude of the SIV-specific CD8(+) T lymphocyte response in breast milk was more than twice as high as the cellular immune response in the blood. Furthermore, the appearance of the SIV-specific CD8(+) T lymphocyte response in breast milk was associated with a reduction in breast milk viral load, and this response remained higher than that in the blood after viral set point. This robust viral-specific cellular immune response in breast milk may contribute to control of breast milk virus replication."
AUTHORS
Srinivas S Rao
James B Whitney
Sallie R Permar
Norman L Letvin
Angela Carville
Rebecca S Gelman et al
PUBLISHED
2008 in Journal of immunology (Baltimore, Md. : 1950)

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Literature review
Human milk: Defense against infection.
"The neonate is deficient in the main antibody that protects mucosal membranes, the secretory IgA. While developing this immune system the breast-fed baby is provided with 0.25-0.5 grams per day of secretory IgA antibodies via the milk. These antibodies which function in concert with other defense factors in milk such as lactoferrin are directed against a number of micro-organisms that threaten the neonate. Recent studies suggest that it may be possible by vaccination of the mother to increase the immunity provided the breast-fed infant via the milk secretory IgA antibodies. Breast-feeding results in a lower frequency of infections in the infant, not only developing countries, but also in societies like Canada and USA. In developing countries the most dangerous period of a child's life begins with weaning when the protection of the breast milk vanishes and often heavily contaminated food is introduced. The large number of infections, especially diarrhea, that follow may be a major factor impairing growth and development with accompanying undernutrition. Utilization of available nutrients is much improved if these infections can be prevented."
AUTHORS
T Söderström
L A Hanson
PUBLISHED
1981 in Progress in Clinical and Biological Research

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