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1.
Chemosphere ; 316: 137784, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36623597

RESUMO

As part of the pan-Canadian Maternal-Infant Research on Environmental Chemicals (MIREC) study, human milk samples were collected between 2008 and 2011, and analyzed for mirex, an organochlorine insecticide and flame retardant, in addition to dechlorane plus (syn- and anti-DDC-CO), the flame retardant replacement for mirex. Mirex was analyzed separately, using a method for the analysis of existing organochlorine insecticides, while the presence of DDC-CO isomers was determined using a method developed for the detection of emerging flame retardants. Mirex was detected in all samples analyzed (n = 298), while syn- and anti-DDC-CO were present in 61.0% and 79.5% of the samples, respectively (n = 541). Mirex concentrations have declined in human milk since the 1990s. Since this is the first pan-Canadian dataset reporting DDC-CO concentrations in human milk, no temporal comparisons can be made. Maternal age was correlated with concentrations of both compounds although parity did not impact concentrations of either analyte. Given the presence of this relatively recently identified flame retardant (DDC-CO) in human milk from women across Canada, studies to identify dominant sources of this compound are critical. Despite low concentrations of environmental chemicals in human milk from Canadian women, Health Canada supports breastfeeding of infants because of the important health benefits to both the mothers and their infants.


Assuntos
Retardadores de Chama , Hidrocarbonetos Clorados , Compostos Policíclicos , Feminino , Humanos , Mirex , Monitoramento Ambiental/métodos , Leite Humano/química , Retardadores de Chama/análise , Canadá , Hidrocarbonetos Clorados/análise , Compostos Policíclicos/análise
2.
Commun Biol ; 6(1): 100, 2023 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-36697496

RESUMO

Human milk contains SARS-CoV-2-specific antibodies after COVID-19 vaccination. These milk antibodies decrease several months post-vaccination. Whether booster immunization restores human milk antibody levels, potentially offering prolonged passive immunity for the infant, remains unknown. In this prospective follow-up study, we investigated the longitudinal SARS-CoV-2-specific antibody response in human milk of 26 lactating women who received a COVID-19 booster dose of an mRNA-based vaccine. Moreover, we evaluated whether the booster-induced human milk antibody response differs for participants who received a similar or different vaccine type in their primary vaccination series. All participants (100%) who received a homologous booster vaccination showed SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in their milk. Heterologous booster vaccination resulted in milk conversion for 9 (69%) and 13 (100%) participants for IgA and IgG respectively. Findings of this study indicate that both homologous and heterologous boosting schedules have the potential to enhance SARS-CoV-2-specific IgA and IgG in human milk.


Assuntos
COVID-19 , Leite Humano , Lactente , Humanos , Feminino , SARS-CoV-2 , Formação de Anticorpos , Vacinas contra COVID-19 , Seguimentos , Lactação , Estudos Prospectivos , COVID-19/prevenção & controle , Anticorpos Antivirais , Imunoglobulina G , Imunoglobulina A
3.
Environ Int ; 171: 107717, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36630790

RESUMO

Hundreds of xenobiotics, with very diverse origins, have been detected in human milk, including contaminants of emerging concern, personal care products and other current-use substances reflecting lifestyle. The routes of exposure to these chemicals include dermal absorption, ingestion and inhalation. Specific families of chemicals are dominant among human milk monitoring studies (e.g., organochlorine pesticides, bisphenol A, dioxins), even though other understudied families may be equally toxicologically relevant (e.g., food-processing chemicals, current-use plasticizers and flame retardants, mycotoxins). Importantly, the lack of reliable human milk monitoring data for some individual chemicals and, especially, for complex mixtures, is a major factor hindering risk assessment. Non-targeted screening can be used as an effective tool to identify unknown contaminants of concern in human milk. This approach, in combination with novel methods to conduct risk assessments on the chemical mixtures detected in human milk, will assist in elucidating exposures that may have adverse effects on the development of breastfeeding infants.


Assuntos
Leite Humano , Praguicidas , Lactente , Feminino , Humanos , Leite Humano/química , Monitoramento Ambiental/métodos , Aleitamento Materno , Praguicidas/toxicidade , Praguicidas/análise , Medição de Risco
4.
J Agric Food Chem ; 71(2): 994-1001, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36602115

RESUMO

The primary active components of breast milk are human milk oligosaccharides (HMOs). HMOs provide many benefits to infants, including regulating their metabolism, immune system, and brain development. Recent studies have emphasized that HMOs act as prebiotics by the metabolism of intestinal microorganisms to produce short-chain fatty acids, which are crucial for infant development. In addition, HMOs with different structural characteristics can form different microbial compositions. HMOs-induced predominant microbes, including Bifidobacterium infantis, B. bifidum, B. breve, and B. longum, and their metabolites demonstrated pertinent health-promoting properties. Meanwhile, HMOs could also directly reduce the occurrence of diseases through the effects of preventing pathogen infection. In this review, we address the probable function of HMOs inside the HMOs-gut microbiota-infant network, by describing the physiological functions of HMOs and the implications of diet on the HMOs-gut microbiota-infant network.


Assuntos
Bifidobacterium bifidum , Microbioma Gastrointestinal , Lactente , Feminino , Criança , Humanos , Leite Humano/química , Saúde do Lactente , Bifidobacterium/metabolismo , Oligossacarídeos/química
5.
Sci Rep ; 13(1): 216, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36604578

RESUMO

Increased exposure to greener environments has been suggested to lead to health benefits in children, but the associated mechanisms in early life, particularly via biological mediators such as altered maternal milk composition, remain largely unexplored. We investigated the associations between properties of the mother's residential green environment, measured as (1) greenness (Normalized Difference Vegetation index, NDVI), (2) Vegetation Cover Diversity (VCDI) and (3) Naturalness Index (NI), and human milk oligosaccharides (HMOs), known for their immune- and microbiota-related health effects on the infant (N = 795 mothers). We show that HMO diversity increases and concentrations of several individual HMOs and HMO groups change with increased VCDI and NI in residential green environments. This suggests that variation in residential green environments may influence the infant via maternal milk through modified HMO composition. The results emphasize the mediating role of breastfeeding between the residential green environments and health in early life.


Assuntos
Microbiota , Leite Humano , Lactente , Feminino , Criança , Humanos , Aleitamento Materno , Mães , Oligossacarídeos
6.
BMC Complement Med Ther ; 23(1): 19, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36681821

RESUMO

BACKGROUND AND AIMS: Human milk supports pre-term infants to thrive. Yet human milk production can be inhibited when infants are born prematurely. Pimpinella Anisum has been evidenced to increase milk production and infant weight gain in previous animal studies. The present study aimed to determine the effect of Pimpinella Anisum herbal tea on human milk volume and preterm infant weight in human populations for the first time. METHODS: Human milk supports pre-term infants to thrive. Yet human milk production can be inhibited when infants are born prematurely. Pimpinella Anisum has been evidenced to increase milk production and infant weight gain in previous animal studies. The present study aimed to determine the effect of Pimpinella Anisum herbal tea on human milk volume and preterm infant weight in human populations for the first time. RESULTS: There was a statistically significant difference in terms of milk volume in the first, third, fourth, fifth, sixth and seventh days between the three groups of intervention, placebo, and control (p < 0.05). On the first day, the mean volume of pumped milk in the intervention group was significantly higher than the control group (p = 0.008). On the second day, there was no statistically significant difference between groups. On the third, fourth, fifth, sixth and seventh days, the mean volume of pumped milk in the intervention group was significantly higher than the placebo and control groups (p < 0.05). There was no statistically significant difference in terms of preterm infant weight on days 0, 3 and 7 between the three groups. CONCLUSION: The use of Pimpinella Anisum or 'Anise' tea can increase the volume of human milk and since no specific side effects have been reported in its use, it may be incorporated easily, cheaply, and effectively in practice where appropriate to the benefit of preterm infant nutrition worldwide.


Assuntos
Pimpinella , Chás de Ervas , Lactente , Animais , Humanos , Recém-Nascido , Leite Humano , Recém-Nascido Prematuro , Aumento de Peso
7.
Environ Health Perspect ; 131(1): 17005, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36688826

RESUMO

BACKGROUND: Infancy perfluoroalkyl substances (PFAS) exposure from breastfeeding is partially determined by the transfer efficiencies (TEs) of PFAS from maternal serum into breast milk. However, to our knowledge there are no studies of such TEs in highly exposed populations. OBJECTIVES: We estimated the TEs of PFAS from maternal serum into colostrum and breast milk in a cohort of women with a wide range of PFAS exposures. METHODS: The Ronneby Mother-Child Cohort was established in 2015 after PFAS contamination was discovered in the public drinking water of Ronneby, Sweden. We measured seven PFAS in matched samples of maternal serum at delivery and colostrum and breast milk. We calculated the TE (in percentage) as the ratio of PFAS in colostrum or breast milk to serum multiplied by 100 and evaluated whether TEs varied by PFAS, lactation stage, or exposure level using a series of linear mixed-effects models with a random intercept for each woman. RESULTS: This study included 126 mothers. PFAS associated with firefighting foams [i.e., perfluorohexane sulfonic acid (PFHxS) and perfluorooctane sulfonic acid (PFOS)] were substantially elevated in the serum, colostrum, and breast milk samples of highly exposed women in the cohort and showed strong correlation. PFHxS and PFOS also contributed the largest fraction of total PFAS on average in colostrum and breast milk. Median TEs varied from 0.9% to 4.3% and were higher for perfluoroalkyl carboxylic acids, including perfluorooctanoic acid, than perfluoroalkane sulfonic acids, including PFHxS and PFOS. TEs varied by exposure level, but there was not a consistent pattern in this variation. DISCUSSION: PFAS concentrations in the colostrum and breast milk of highly exposed women were higher than the concentrations in low-exposed women, and TEs were of a similar magnitude across exposure categories. This implies that breastfeeding may be an important route of PFAS exposure for breastfeeding infants with highly exposed mothers, although the relative contribution of breastfeeding vs. prenatal transplacental transfer remains to be clarified. https://doi.org/10.1289/EHP11292.


Assuntos
Ácidos Alcanossulfônicos , Água Potável , Poluentes Ambientais , Fluorcarbonetos , Lactente , Gravidez , Humanos , Feminino , Leite Humano , Poluição da Água , Relações Mãe-Filho
8.
Nutrients ; 15(2)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36678154

RESUMO

Breastfeeding is the gold standard for early nutrition. Metabolites from the one-carbon metabolism pool are crucial for infant development. The aim of this study is to compare the breast-milk one-carbon metabolic profile to other biofluids where these metabolites are present, including cord and adult blood plasma as well as cerebrospinal fluid. Breast milk (n = 142), cord blood plasma (n = 23), maternal plasma (n = 28), aging adult plasma (n = 91), cerebrospinal fluid (n = 92), and infant milk formula (n = 11) samples were analyzed by LC-MS/MS to quantify choline, betaine, methionine, S-adenosylmethionine, S-adenosylhomocysteine, total homocysteine, and cystathionine. Differences between groups were visualized by principal component analysis and analyzed by Kruskal-Wallis test. Correlation analysis was performed between one-carbon metabolites in human breast milk. Principal component analysis based on these metabolites separated breast milk samples from other biofluids. The S-adenosylmethionine (SAM) concentration was significantly higher in breast milk compared to the other biofluids and was absent in infant milk formulas. Despite many significant correlations between metabolites in one-carbon metabolism, there were no significant correlations between SAM and methionine or total homocysteine. Together, our data indicate a high concentration of SAM in breast milk, which may suggest a strong demand for this metabolite during infant early growth while its absence in infant milk formulas may indicate the inadequacy of this vital metabolic nutrient.


Assuntos
Leite Humano , S-Adenosilmetionina , Adulto , Criança , Lactente , Feminino , Humanos , S-Adenosilmetionina/metabolismo , Cromatografia Líquida , Leite Humano/metabolismo , Carbono , Espectrometria de Massas em Tandem , Metionina/metabolismo , Racemetionina , S-Adenosil-Homocisteína/metabolismo , Homocisteína
9.
Nutrients ; 15(2)2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36678217

RESUMO

(1) Background: For the storage of human milk (HM), freezing, thawing, and/or pasteurization are routinely used in neonatal intensive care units. We aimed to analyze the effects of different HM processing types on the nutritional contents in HM, adipose tissue, and the neuroprotection markers leptin and adiponectin. (2) Methods: HM samples from 136 mothers of preterm and term infants (gestational age 23 + 0 to 41 + 6) were collected and divided into four groups: (i) fresh HM, (ii) fresh pasteurized HM, (iii) thawed HM, and (iv) thawed pasteurized HM. The macronutrients were analyzed by mid-infrared transmission spectroscopy and the adiponectin and leptin were analyzed by high-sensitivity adiponectin and leptin enzyme-linked immunosorbent assay (ELISA). (3) Results: No significant differences were observed in the protein, carbohydrate, or fat concentrations between the HM processing types. The leptin levels were significantly lower after pasteurization in comparison to HM without pasteurization (p < 0.001). The protein levels in extremely preterm HM were significantly lower compared to those in moderate/late preterm HM and term HM (p < 0.05). (4) Conclusions: HM processing had an impact on leptin concentrations but no effect on the protein level. These data support the use of unpasteurized human milk for preterm infants' nutrition and normal brain development. The protein levels of the milk of mothers from preterm compared to full-term infants differed, underlining the importance of individualized target fortification.


Assuntos
Recém-Nascido Prematuro , Leite Humano , Lactente , Feminino , Recém-Nascido , Humanos , Adulto Jovem , Adulto , Leite Humano/química , Adiponectina/análise , Leptina/análise , Fenômenos Fisiológicos da Nutrição do Lactente
10.
Nutrients ; 15(2)2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36678283

RESUMO

BACKGROUND: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. METHODS: Data were collected between February 2017 and January 2022 from an online HMB monitoring system. First, DHM samples were cultured, and the number of colony-forming units (CFU) were counted before (n = 708) and after pasteurization (n = 1146). The gram-staining method combined with the Vitek 2 Compact system were used to identify types of organisms at the Da Nang Hospital for Women and Children's Laboratory. Passing criteria for DHM included pre-pasteurization samples had a total colony count <105 CFU/mL and post-pasteurization was <10 CFU/mL. RESULTS: During five years of operation, Da Nang HMB had 491 donors (48.7% were hospital and the rest community donors) who donated an average amount of 14.2 L over 45 days. Of this DHM volume, 84.9% of donor samples passed the pre- and post-pasteurization microbiological tests. DHM from community donors had a higher pass rate (87.8%) compared to that from hospital donors (79.5%). Before pasteurization, 15.4% of DHM samples had a bacteria count <103 CFU/mL, 63.0% had 103-<105 CFU/mL, and 21.6% had ≥105 CFU/mL. Most of the unpasteurized DHM samples (93.0%) had microorganism growth: with one organism (16.4%), two (33.9%), three or more (43.6%). After pasteurization, 17.9% samples had a bacteria count of 1-9 CFU/mL and 7.2% had ≥10 CFU/mL. DHM samples from community donors had a lower bacterial count and number of organisms than those from hospital donors both before and after pasteurization. The highest microorganisms from unpasteurized DHM samples were Staphylococcus epidermidis (74.2%), Acinetobacter sp. (52.1%), gram-positive bacillus (51.7%), Staphylococcus coagulase-negative (15.8%), and Staphylococcus aureus (10.5%). Common microorganisms from pasteurized DHM were gram-positive bacillus (21.0%), Staphylococcus epidermidis (3.9%), and Acinetobacter sp. (0.9%). Samples from the hospital tended to have a higher contamination with those microorganisms than those from community donors. CONCLUSIONS: The majority of DHM samples in Da Nang passed microbiological testing criteria. DHM from community donors had higher pass rates than hospital donors. Corrective actions are needed to improve HMB operations and hospital microbiological quality standards, as well as general improvements in water and sanitation.


Assuntos
Bancos de Leite Humano , Leite Humano , Criança , Gravidez , Feminino , Humanos , Animais , Leite Humano/microbiologia , Vietnã , Leite/microbiologia , Pasteurização/métodos , Colostro
11.
Nutrients ; 15(2)2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36678304

RESUMO

(1) Background: Adequate protein intake plays an essential role in growth and neurodevelopment, especially in preterm infants. We investigated the effects of maternal diet and body mass index (BMI) on human milk (HM) composition. (2) Methods: HM samples were obtained from 136 lactating mothers (BMI: 18.0-36.7 kg/m2), of which 93% gave birth to preterm infants. Macronutrient content in HM was measured by mid-infrared transmission spectroscopy. Leptin and adiponectin were analyzed using appropriate ELISAs. Maternal diet was determined by 24-h recall. (3) Results: Significant positive associations were found between protein, fat, carbohydrate and energy intake, and levels of corresponding macronutrients in HM, especially in protein concentrations (p < 0.001). An increased protein intake was positively correlated with adiponectin (p < 0.001) and leptin (p = 0.035) in HM. Maternal BMI was positively associated with a higher protein level in HM (p < 0.05), as well as with a higher dietary protein intake (p < 0.05). (4) Conclusions: Knowledge of maternal diet and BMI impacting HM composition is essential to optimize the feeding of newborn infants. This is especially relevant in the nutritional management of preterm infants; it can be utilized in approaches to improve growth rates and the appropriate development of infants and to prevent obesity.


Assuntos
Leptina , Leite Humano , Lactente , Feminino , Humanos , Recém-Nascido , Leite Humano/química , Leptina/metabolismo , Recém-Nascido Prematuro , Lactação , Adiponectina/metabolismo , Proteínas na Dieta/metabolismo , Dieta , Tecido Adiposo , Proteínas do Leite/análise , Aleitamento Materno
12.
Nutrients ; 15(2)2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36678342

RESUMO

A major polymorphism in the fucosyltransferase2 (FUT2) gene influences risk of multiple gut diseases, but its impact on the microbiome of breastfed infants was unknown. In individuals with an active FUT2 enzyme ("secretors"), the intestinal mucosa is abundantly fucosylated, providing mutualist bacteria with a rich endogenous source of fucose. Non-secretors comprise approximately one-fifth of the population, and they lack the ability to create this enzyme. Similarly, maternal secretor status influences the abundance of a breastfeeding mother's fucosylated milk oligosaccharides. We compared the impact of maternal secretor status, measured by FUT2 genotype, and infant secretor status, measured by FUT2 genotype and phenotype, on early infant fecal microbiome samples collected from 2-month-old exclusively breastfed infants (n = 59). Infant secretor status (19% non-secretor, 25% low-secretor, and 56% full-secretor) was more strongly associated with the infant microbiome than it was with the maternal FUT2 genotype. Alpha diversity was greater in the full-secretors than in the low- or non-secretor infants (p = 0.049). Three distinct microbial enterotypes corresponded to infant secretor phenotype (p = 0.022) and to the dominance of Bifidobacterium breve, B. longum, or neither (p < 0.001). Infant secretor status was also associated with microbial metabolic capacity, specifically, bioenergetics pathways. We concluded that in exclusively breastfed infants, infant-but not maternal-secretor status is associated with infant microbial colonization and metabolic capacity.


Assuntos
Microbioma Gastrointestinal , Microbiota , Fucosiltransferases/genética , Genótipo , Leite Humano/metabolismo , Humanos , Feminino , Lactente
13.
PLoS One ; 18(1): e0280960, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36696407

RESUMO

Human milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.


Assuntos
Cesárea , Leite Humano , Humanos , Lactente , Feminino , Gravidez , Leite Humano/microbiologia , DNA Bacteriano/genética , Magreza , RNA Ribossômico 16S/genética , Projetos Piloto , Austrália , Bactérias/genética , Aleitamento Materno
14.
Int Breastfeed J ; 18(1): 3, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36627706

RESUMO

BACKGROUND: Our main objective was to determine the evolution of IgG and IgA antibodies directed against SARS-CoV-2 protein S in the blood of lactating women and in breast milk. METHODS: A cohort of 110 uninfected and vaccinated breastfeeding women was followed-up for 6 months at the Marqués de Valdecilla University Hospital, Spain, in 2020. An additional group of 23 breastfeeding mothers who had no previously documented infection and had not been vaccinated against SARS-CoV-2 were included as a control group. The antibodies in blood and breast milk and their evolution at 6 months post-vaccination were analysed. RESULTS: One hundred ten breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) received two doses of mRNA-1273, and 20 women (18.2%) received a single dose of ChAdOx1-S. No evidence of differences between concentrations of antibodies was found according to the type of vaccine, with the exception of serum IgA antibodies, which was higher in women vaccinated with mRNA-1273: mean [95%CI]: 0.05 AU/mL [0.03,0.06] with mRNA-1273, 0.02 AU/mL [0.01,0.03] with BNT162b2 and 0.01 AU/mL [0.00,0.03] with ChAdOx1-S, ANOVA p value = 0.03. The lack of difference between vaccines was also found when anti-S1 specific IgG in serum and breast milk were measured. CONCLUSIONS: In lactating women vaccinated against COVID-19, anti-SARS-CoV-2 antibodies can be detected in both serum and breastmilk 6 months after receiving the second dose, although their concentrations decreased when compared with concentrations reached immediately after vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Feminino , Humanos , Vacina BNT162 , Vacina de mRNA-1273 contra 2019-nCoV , Lactação , COVID-19/prevenção & controle , Aleitamento Materno , SARS-CoV-2 , Leite Humano , Anticorpos Antivirais , Imunoglobulina G , Imunoglobulina A
15.
Gut Microbes ; 15(1): 2164152, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36617628

RESUMO

The infant gut microbiota affects childhood health. This pioneer microbiota may be vulnerable to antibiotic exposures, but could be supported by prebiotic oligosaccharides found in breast milk and some infant formulas. We sought to characterize the effects of several exposures on the neonatal gut microbiota, including human milk oligosaccharides (HMOs), galacto-oligosaccharides (GOS), and infant/maternal antimicrobial exposures. We profiled the stool microbiota of 1023 one-month-old infants from the KOALA Birth Cohort using 16S rRNA gene amplicon sequencing. We quantified 15 HMOs in breast milk from the mothers of 220 infants, using high-performance liquid chromatography-mass spectrometry. Both breastfeeding and antibiotic exposure decreased gut microbial diversity, but each was associated with contrasting shifts in microbiota composition. Other factors associated with microbiota composition included C-section, homebirth, siblings, and exposure to animals. Neither infant exposure to oral antifungals nor maternal exposure to antibiotics during pregnancy were associated with infant microbiota composition. Four distinct groups of breast milk HMO compositions were evident, corresponding to maternal Secretor status and Lewis group combinations defined by the presence/absence of certain fucosylated HMOs. However, we found the strongest evidence for microbiota associations between two non-fucosylated HMOs: 6'-sialyllactose (6'-SL) and lacto-N-hexaose (LNH), which were associated with lower and higher relative abundances of Bifidobacterium, respectively. Among 111 exclusively formula-fed infants, the GOS-supplemented formula was associated with a lower relative abundance of Clostridium perfringens. In conclusion, the gut microbiota is sensitive to some prebiotic and antibiotic exposures during early infancy and understanding their effects could inform future strategies for safeguarding a health-promoting infant gut microbiota.


Assuntos
Anti-Infecciosos , Microbioma Gastrointestinal , Phascolarctidae , Lactente , Recém-Nascido , Feminino , Animais , Gravidez , Humanos , Criança , Leite Humano/química , Phascolarctidae/genética , Estudos de Coortes , RNA Ribossômico 16S/genética , Aleitamento Materno , Prebióticos/análise , Oligossacarídeos/farmacologia , Antibacterianos/farmacologia
16.
Neonatal Netw ; 42(1): 37-44, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36631259

RESUMO

Purpose: To describe the use of developmental care (DC) rounds as an initiative to ensure the implementation of bedside DC. To measure the confidence of NICU nurses with participation in DC rounds. Design: Evidence-based practice/quality improvement initiative aimed to answer the following questions: What are the implementation rates of bedside DC nursing interventions used or discussed during DC rounds? Do NICU nurses report agreement with education about DC rounds prior to DC rounds starting? Do nurses in the NICU feel confident participating in DC rounds Do nurses with more years of NICU nursing experience feel more confident than nurses with fewer years of nursing experience? Sample: 513 DC rounds and 101 nursing surveys. Main Outcome Variable: Nursing survey Likert score response and implementation rate of DC nursing interventions. Results: Implementation of bedside DC nursing interventions was strong in the NICU. Areas of opportunity include developmental bath, oral care with breast milk, use of scent clothes, kangaroo care, breastfeeding, use of head plan when appropriate, assignment of a primary baby buddy when appropriate, and use of schedule when needed. Nurses reported their confidence in participation in DC during the implementation of this project.


Assuntos
Visitas com Preceptor , Humanos , Leite Humano , Melhoria de Qualidade , Inquéritos e Questionários
17.
BMJ Open ; 13(1): e066978, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36635038

RESUMO

OBJECTIVES: There is an urgent need to improve breast feeding rates for Australian First Nations (Aboriginal and Torres Strait Islander) infants. We explored breast feeding outcomes of women having a First Nations infant at three sites that introduced a culturally specific continuity of midwife care model. DESIGN: Women having a First Nations infant booking for pregnancy care between March 2017 and November 2020 were invited to participate. Surveys at recruitment and 3 months post partum were developed with input from the First Nations Advisory Committee. We explored breast feeding intention, initiation, maintenance and reasons for stopping and factors associated with breast feeding. SETTING: Three tertiary maternity services in Melbourne, Australia. PARTICIPANTS: Of 479/926 eligible women approached, 343 (72%) completed the recruitment survey, and 213/343 (62%) the postnatal survey. OUTCOMES: Primary: breast feeding initiation and maintenance. Secondary: breast feeding intention and reasons for stopping breast feeding. RESULTS: Most women (298, 87%) received the culturally specific model. Breast feeding initiation (96%, 95% CI 0.93 to 0.98) was high. At 3 months, 71% were giving 'any' (95% CI 0.65 to 0.78) and 48% were giving 'only' breast milk (95% CI 0.41 to 0.55). Intending to breast feed 6 months (Adj OR 'any': 2.69, 95% CI 1.29 to 5.60; 'only': 2.22, 95% CI 1.20 to 4.12), and not smoking in pregnancy (Adj OR 'any': 2.48, 95% CI 1.05 to 5.86; 'only': 4.05, 95% CI 1.54 to 10.69) were associated with higher odds. Lower education (Adj OR 'any': 0.36, 95% CI 0.13 to 0.98; 'only': 0.50, 95% CI 0.26 to 0.96) and government benefits as the main household income (Adj OR 'any': 0.26, 95% CI 0.11 to 0.58) with lower odds. CONCLUSIONS: Breast feeding rates were high in the context of service-wide change. Our findings strengthen the evidence that culturally specific continuity models improve breast feeding outcomes for First Nations women and infants. We recommend implementing and upscaling First Nations specific midwifery continuity models within mainstream hospitals in Australia as a strategy to improve breast feeding.


Assuntos
Tocologia , Lactente , Feminino , Gravidez , Humanos , Vitória , Aleitamento Materno , Estudos de Coortes , Leite Humano , Hospitais
18.
Int Breastfeed J ; 18(1): 4, 2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36647140

RESUMO

BACKGROUND: Conflicting advice and non-evidence-based recommendations have a negative effect on breastfeeding. Since 2011, the National Food Agency in Sweden has informed parents that they can introduce tiny tastings (1 mL of solid food, i.e. other sources of nutrition than breastmilk/formula) to infants from four months of age. It is unknown how national recommendations, which differ from the Word Health Organisation's recommendation, affect breastfeeding. We hypothesised that introduction of tiny tastings of solid foods would shorten the duration of continued breastfeeding. METHODS: This retrospective study utilises data from the longitudinal 'Swedish Pregnancy Planning Study', in which mothers were recruited at antenatal clinics on a national level. The participants completed three questionnaires up to one year after birth (n = 1,251). Linear regression models were used to analyse the association between the introduction of solid foods and the duration of breastfeeding. RESULTS: As hypothesised, introduction of tiny tastings shortened the duration of continued breastfeeding. Half of all infants (48%) were fed with tiny tastings already in the fourth month. The correlation analysis showed that the earlier the infants started with tiny tastings, the earlier they ate larger amounts of solid food. In a multivariate linear regression analysis, five factors were identified as having a negative effect on the duration of breastfeeding: low infant age upon introduction of tiny tastings, low maternal age, low level of maternal education, high maternal BMI and twin birth. CONCLUSIONS: Early introduction of tiny tastings of solid foods shortened the duration of breastfeeding. It is difficult to influence most conditions that affect breastfeeding, for example, the mother's educational level, BMI, age and if she has given birth to twins. In contrast, national guidelines can always be updated. Recommendations from the Swedish authorities should adhere to the WHO's recommendation, which states exclusive breastfeeding for six months and continued breastfeeding for at least two years or longer.


Assuntos
Aleitamento Materno , Leite Humano , Lactente , Humanos , Feminino , Gravidez , Estudos Retrospectivos , Mães , Estudos Longitudinais
19.
Breastfeed Med ; 18(1): 74-77, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36638194

RESUMO

Background: Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory condition of the mammary gland that presents as a painful mass, and it must be distinguished from both infectious mastitis and breast cancer. When diagnosed during lactation, it can result in significant distress and early weaning. Injection of triamcinolone has been used as a successful treatment method, but safety in breastfed infants has not been established. Methods: We present a case of a lactating patient who received a direct injection of triamcinolone (dosage 40 mg) in her breast to treat IGM after failure of oral corticosteroids. Breastmilk samples were expressed by the patient 0, 1, 4, and 24 hours after the procedure, and then daily for 1 week. All the samples were analyzed using liquid chromatography mass spectrometry. The patient was supported by a breastfeeding and lactation medicine clinic. Results: After injection of triamcinolone into the granulomatous mass, breast milk samples were collected and analyzed. No samples were found to contain triamcinolone. A temporary but significant decrease in milk production was noted after injection, though only a slight decrease had been noted with 6 weeks of systemic corticosteroids. With support, the patient rebuilt milk production and continued to breastfeed from both breasts. Conclusion: Triamcinolone was not found in any milk samples (≥0.78 ng/mL) following therapeutic injection of the affected breast. The patient was able to continue breastfeeding from the affected breast with intermittent symptoms.


Assuntos
Mastite Granulomatosa , Leite Humano , Feminino , Lactente , Humanos , Leite Humano/química , Lactação , Mastite Granulomatosa/tratamento farmacológico , Aleitamento Materno , Triancinolona/análise , Triancinolona/uso terapêutico , Corticosteroides/uso terapêutico , Imunoglobulina M/análise
20.
Breastfeed Med ; 18(1): 30-36, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36638195

RESUMO

Background: Nipple fissure is a prevalent problem for breastfeeding mothers. Virgin coconut oil (VCO) is an herbal medicine that can heal microbial infections and wounds. Objective: This study aims to evaluate the efficacy of VCO and breast milk on nipple fissures in primiparous mothers. Design, Setting, Participants, and Intervention: A single-blind clinical trial was conducted with 106 breastfeeding primiparous mothers suffering from nipple fissures in health centers of Zarand, Kerman, from August 2020 to November 2020. The participants were selected randomly and allocated to two 60-member groups using block randomization. Mothers in the first group were asked to apply 0.5 mL of coconut oil on their nipples three times a day. Mothers in the second group were trained to apply three to four drops of their milk on their nipples after every breastfeeding session. The level of nipple fissures and pain intensity were examined using Storr's scale and visual analog scale, respectively. The results were analyzed using the chi-square test, repeated measures analysis of variance, and the independent samples t-test in SPSS 22. In this study, the significance level was set at p < 0.05. Results: Within-group comparisons revealed a significant difference between baseline scores and the scores on the 7th and 14th days (p < 0.001). Between-group comparison indicated no significant difference in nipple fissure (p = 0.419) and pain intensity (p = 0.405) at baseline. Nonetheless, there was a significant difference on the 7th day (pfissure = 0.002, ppain <0.001) and on the 14th day (pfissure <0.001, ppain = 0.036). Conclusion: Given its effect on nipple fissures, VCO may be used as a complementary substance to treat nipple fissures. Trial Registration: This trial is registered with the Iranian Registry of Clinical Trials with the identifier: IRCT20190724044318N1.


Assuntos
Mastodinia , Leite Humano , Feminino , Humanos , Mamilos/lesões , Óleo de Coco , Aleitamento Materno , Medição da Dor , Método Simples-Cego , Irã (Geográfico) , Mães
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