Journal articles: 'Breastmilk expression'

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Kent, Jacqueline C., Leon R. Mitoulas, Mark D. Cregan, Donna T. Geddes, Michael Larsson, Dorota A. Doherty, and Peter E. Hartmann. "Importance of Vacuum for Breastmilk Expression." Breastfeeding Medicine 3, no. 1 (March 2008): 11–19. http://dx.doi.org/10.1089/bfm.2007.0028.

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EGLASH, ANNE, and MICHELE L. MALLOY. "Breastmilk Expression and Breast Pump Technology." Clinical Obstetrics and Gynecology 58, no. 4 (December 2015): 855–67. http://dx.doi.org/10.1097/grf.0000000000000141.

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Geraghty, Sheela, Barbara Davidson, Meredith Tabangin, and Ardythe Morrow. "Predictors of Breastmilk Expression by 1 Month Postpartum and Influence on Breastmilk Feeding Duration." Breastfeeding Medicine 7, no. 2 (April 2012): 112–17. http://dx.doi.org/10.1089/bfm.2011.0029.

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Glavey, Meadhbh, and Anne Fallon. "Supporting women with diabetes to breastfeed: use of antenatal breastmilk expression." British Journal of Midwifery 30, no. 6 (June 2, 2022): 316–24. http://dx.doi.org/10.12968/bjom.2022.30.6.316.

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Background Antenatal breastmilk expression is recommended in many practice settings to overcome challenges to breastfeeding for women with diabetes. Aim This narrative literature review aimed to examine how antenatal breastmilk expression supports women with diabetes to breastfeed. Methods A search was undertaken of the CINAHL database, Scopus, Medline, Excerpta Medica DataBASE and the Cochrane Library to identify quantitative and qualitative primary research studies. Eight studies met the inclusion criteria. Results Findings were examined within a framework of informational, emotional and motivational and practical aspects of antenatal breastmilk expression. Information on infant wellbeing is important, as concerns about admission to neonatal care have emerged. However, for women at low risk of complications, their infants were not at greater risk of being admitted to neonatal care following antenatal expression in comparison to standard care, and there was no evidence of increased neonatal hypoglycaemia. Emotional support is important, as although the experience is rewarding it can also be challenging. Breastfeeding rates were higher following antenatal expression, although the differences were not always statistically significant. Practical aspects, including the optimum gestation at commencement, require further research. Conclusions Although the evidence is not conclusive on how antenatal breastmilk expression can support women with diabetes to breastfeed, the results are promising.

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Qin, Wenyi, Ke Zhang, Beth Kliethermes, Ramak Amjad, Kaitlin Clarke, and Edward R. Sauter. "Differential Expression of Cancer-Associated Proteins in Breastmilk." Breastfeeding Medicine 8, no. 1 (February 2013): 120–26. http://dx.doi.org/10.1089/bfm.2011.0158.

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Amin, Ulfat. "Handling, Storage and Use of Expressed Breastmilk among Working Mothers of Infants in Anantnag, Kashmir." Nursing Journal of India CXIII, no. 03 (2022): 110–15. http://dx.doi.org/10.48029/nji.2022.cxiii303.

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Rising number of mothers are expressing their breastmilk to feed their infants when away from them, which presents new issues for infant feeding. Having sound knowledge regarding expression, storage and use of breast milk is fi rst step towards promoting practice of expressed breast milk, which in turn promotes exclusive breastfeeding. Primary concern in this is handling, storage, and warming of expressed breastmilk. So all breastfeeding mothers should be motivated to learn different techniques of expression, storage and use of expressed breastmilk. The settings chosen for present study were 18 villages of Dachnipora block of district Anantnag (J&K) with a sample size of 50 mothers of infants. This setting was selected as per feasibility & availability of study subjects. A questionnaire was used for data collection. The study revealed that 46 percent of subjects had inadequate knowledge level, 54 percent had moderate knowledge level’ and none of subjects had adequate knowledge level regarding expression, storage and use of expressed breast milk. A signifi cant association of knowledge level of mothers of infants was found with demographic variables, parity and previous experience with expression and storage at p≤0.05 level and no association was found with variables like age, educational status, nature of job and monthly family income. To conclude, mothers of infants had insignifi cant level of knowledge about expression, handling, storage and use of expressed breast milk. If they are provided and supported with adequate and appropriate information from the beginning of their motherhood, they will make exclusive breastfeeding a success

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Qin, Wenyi, Ke Zhang, Kaitlin Clarke, and Edward R. Sauter. "Family History of Breast Cancer Predicts Breastmilk Protein Expression." Breastfeeding Medicine 9, no. 4 (May 2014): 231–32. http://dx.doi.org/10.1089/bfm.2013.0097.

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Jakubek, Patrycja, Joanna Cieślewicz, and Agnieszka Bartoszek. "MicroRNAs as novel bioactive components of human breastmilk." Postępy Higieny i Medycyny Doświadczalnej 74 (May 15, 2020): 103–15. http://dx.doi.org/10.5604/01.3001.0014.1434.

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MicroRNAs are short, non-coding oligonucleotides that regulate gene expression at the post-transcriptional level. These small molecules participate in the control of various cellular processes and signalling pathways. Since 2010 microRNAs have been recognized as a new bioactive component of breastmilk, which is an exceptionally rich source of these oligonucleotides. In infants fed with breastmilk, microRNAs are involved in the growth and proper development as well as maturation of the immune system. It has been demonstrated that microRNAs are resistant to harsh conditions during in vitro digestion in simulated gastrointestinal tract of a newborn and, therefore, may be absorbed by the intestinal cells. Protection against RNase activity and low pH is provided by exosomes, which are carriers of microRNAs in skim milk or by fat globules and milk cells. It has been reported that, in contrast to human milk, infant formulas contain only a few microRNAs, which have been derived from other organisms, such as cow or soy. It may be presumed that supplementing infant formulas with microRNAs identical with those which occur naturally in breastmilk may constitute a new way of designing artificial substitutes for human breastmilk.

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Huang, Mingyang, Anying Song, Xi Chen, Sarah Ishtiaq, Chunmei Wang, Darryl L. Hadsell, Qiong A. Wang, and Yi Zhu. "Maternal Adipocyte Connexin43 Gap Junctions Affect Breastmilk Lactose Levels and Neonate Growth in Mice." Biology 11, no. 7 (July 7, 2022): 1023. http://dx.doi.org/10.3390/biology11071023.

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Breastfeeding offers a broad spectrum of health benefits for infants. However, overnutrition and a steady increase in maternal obesity in the U.S. have made it harder for many mothers to produce and express breastmilk, and the quality of milk from obese mothers is also frequently compromised. Adipocytes, the primary cell type in the non-lactating breast, display a drastic morphological and functional change during lactation in mice. Lipid-filled adipocytes undergo lipolysis, and lipid droplets disappear to provide fatty acids and energy for breastmilk production. Once the animal stops lactation, these lipid-depleted adipocytes return as lipid-laden cells. This dynamic remodeling of the tissue is likely the result of active intercellular communications. Connexin43 (Cx43) is the most abundant connexin in the mammary adipose tissue that makes up the gap junctions for direct intercellular communications. Its expression is increased during lactation and reduced in obese mammary adipose tissue, which is resistant to lactation-induced remodeling. However, whether Cx43 is required for adipocyte remodeling and breastmilk production to support neonates’ growth has not been established. In this study, we used doxycycline-inducible adipocyte-specific Cx43-deleted mice and demonstrated that adipocyte Cx43 played a vital role in determining the carbohydrate levels in breastmilk, which may subsequently affect neonates’ growth.

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Slusher, Tina M., Ida L. Slusher, Elizabeth M. Keating, Beverly A. Curtis, Eleanor A. Smith, Elizabeth Orodriyo, Sussane Awori, and Margaret K. Nakakeeto. "Comparison of Maternal Milk (Breastmilk) Expression Methods in an African Nursery." Breastfeeding Medicine 7, no. 2 (April 2012): 107–11. http://dx.doi.org/10.1089/bfm.2011.0008.

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Foudil-Bey, Imane, Malia SQ Murphy, Erin J. Keely, and Darine El-Chaâr. "Maternal and newbornnewborn outcomes of antenatal breastmilk expression: a scoping review protocol." BMJ Open 10, no. 5 (May 2020): e033101. http://dx.doi.org/10.1136/bmjopen-2019-033101.

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IntroductionMothers with diabetes face unique challenges associated with breastfeeding initiation and maintenance. Antenatal breastmilk expression (BME) may be suggested to mothers, including mothers with diabetes, to improve breastfeeding, maternal, and infant outcomes postpartum. However, there have been few evaluations of the potential harms and benefits of this practice. The objective of our scoping review will be to broadly examine the literature describing maternal and infant outcomes of antenatal BME.Methods and analysisThis scoping review will address the research question: ‘Among women who engaged in antenatal BME, what maternal and infant outcomes have been evaluated?’ A search of published and unpublished studies available in English will be conducted in February 2020 using the following databases: Medline (OVID), Embase (OVID), CINAHL (EBSCOHost), and Cochrane Database of Systematic Reviews (OVID). A search of the British Library E-Theses Online Services (EThOS) database and OpenGrey will be conducted to identify relevant grey literature. This scoping review will use a five-step framework to guide the selection, extraction, and analysis of eligible studies. Clinical consultation will be included as a sixth step to our methodology. Literature reporting on the effect of antenatal BME on maternal and infant outcomes, breastfeeding initiation and duration, and the experiences of women who have engaged in the practice will be considered. The data will be summarised with attention paid to high-risk obstetrical populations such as women with diabetes. Our results will be reported as outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.Ethics and disseminationResearch ethics board approval will not be required due to the nature of the study’s methodology. The results of this review will be disseminated through peer-reviewed publication and presentation at relevant conferences.Trail registration numberOpen Science Framework (osf.io/gfp2q).

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Janardhan, Alok M., Sandhya Alok, Leelavathi Janardhan, and Y. M. Sudhakar. "Bridging the gap-determinants of successful breastfeeding among mothers of rural India." International Journal Of Community Medicine And Public Health 7, no. 12 (November 25, 2020): 5006. http://dx.doi.org/10.18203/2394-6040.ijcmph20205177.

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Background: Breastfeeding is the most crucial intervention with exponential positive impact on the maternal and infant health, that can change the community health outcome. Although a general awareness regarding breastfeeding cannot be undermined, there is significant gap in its optimal understanding, and practice in the rural community.Methods: Questionnaire-based cross-sectional study conducted in a rural nursing home and clinic. Mothers aged 15-45 years who were actively breast feeding or have breastfed in the past, visiting for various reasons.Results: Out of 300 mothers included in the study, most mothers were aged 20-30 years (66%), stay-at-home (77%), below-poverty-line (81%) with school-level education (43%). 77% mothers knew about breastfeeding initiation within 1 hour of life, 75% knew exclusive breastfeeding must be practiced for 6 months. 74% knew that breastmilk reduces risk of allergies in baby, 58% were aware of its thermoregulatory benefits in neonates, 41% knew about its contraceptive benefits. 17% mothers felt embarrassed to breastfeed in public, 28% felt breastfeeding is a hindrance to occupation. 51% mothers fed by partial emptying of both breasts in each feed, 28% practiced burping of children for 20 minutes, 5% stored expressed breastmilk at room temperature, none knew about storage of breastmilk in fridge.Conclusions: Mothers lack awareness about thermoregulatory benefits, reduced allergy risks and lactational contraceptive benefits of breastfeeding. They lag significantly, regarding complete emptying of each breast during feeds, adequate burping of baby, expression and storage of breastmilk. Significant gap between knowledge and practice of successful breastfeeding noted.

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Rashid, Ahmed. "Yonder: Breastmilk expression, mild cognitive impairment, Ramadan, and 111 online — an ‘invisible service’." British Journal of General Practice 73, no. 727 (January 26, 2023): 80. http://dx.doi.org/10.3399/bjgp23x731937.

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Hickey, A., K. Tavener, and V. Olivera. "PO-0591 Supporting Early Breastmilk Expression On The Neonatal Unit – Are We Doing Enough?" Archives of Disease in Childhood 99, Suppl 2 (October 2014): A445.1—A445. http://dx.doi.org/10.1136/archdischild-2014-307384.1232.

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Healy, David B., Ann-Marie Brennan, Rebecca O'Donovan, Veronica Daly, Anne Doolan, and Eugene M. Dempsey. "Structured promotion of breastmilk expression is associated with shortened hospitalisation for very preterm infants." Acta Paediatrica 105, no. 6 (May 6, 2016): e252-e256. http://dx.doi.org/10.1111/apa.13399.

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Crowe, Susan Diana, Hayley Miller, Bethan Faulkner, and Henry C. Lee. "Use of Hand Expression of Breastmilk Within First Hour of Delivery to Increase Exclusive Hospital Breastfeeding Rate [40O]." Obstetrics & Gynecology 135 (May 2020): 167S. http://dx.doi.org/10.1097/01.aog.0000663984.24193.f5.

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Lussier, Mary M., Elizabeth A. Brownell, Tracey A. Proulx, Donna M. Bielecki, Kathleen A. Marinelli, Sandra L. Bellini, and James I. Hagadorn. "Daily Breastmilk Volume in Mothers of Very Low Birth Weight Neonates: A Repeated-Measures Randomized Trial of Hand Expression Versus Electric Breast Pump Expression." Breastfeeding Medicine 10, no. 6 (July 2015): 312–17. http://dx.doi.org/10.1089/bfm.2015.0014.

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Tavares, Gabriel Araujo, Amada Torres, Gwenola Le Drean, Maïwenn Queignec, Blandine Castellano, Laurent Tesson, Séverine Remy, Ignacio Anegon, Bruno Pitard, and Bertrand Kaeffer. "Oral Delivery of miR-320-3p with Lipidic Aminoglycoside Derivatives at Mid-Lactation Alters miR-320-3p Endogenous Levels in the Gut and Brain of Adult Rats According to Early or Regular Weaning." International Journal of Molecular Sciences 24, no. 1 (December 22, 2022): 191. http://dx.doi.org/10.3390/ijms24010191.

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To investigate if the artificial delivery of microRNAs naturally present in the breastmilk can impact the gut and brain of young rats according to weaning. Animals from a new transgenic rat line expressing the green-fluorescent protein in the endocrine lineage (cholecystokinin expressing cells) received a single oral bolus of miR-320-3p or miR-375-3p embedded in DiOleyl-Succinyl-Paromomycin (DOSP) on D-12. The pups were weaned early (D-15), or regularly (D-30). The expression of relevant miRNA, mRNAs, chromatin complexes, and duodenal cell density were assessed at 8 h post-inoculation and on D-45. The miR-320-3p/DOSP induced immediate effects on H3K4me3 chromatin complexes with polr3d promoter (p < 0.05). On regular weaning, on D-45, miR-320-3p and 375-3p were found to be downregulated in the stomach and upregulated in the hypothalamus (p < 0.001), whereas miR-320-3p was upregulated in the duodenum. After early weaning, miR-320-3p and miR-375-3p were downregulated in the stomach and the duodenum, but upregulated in the hypothalamus and the hippocampus. Combination of miR-320-3p/DOSP with early weaning enhanced miR-320-3p and chromogranin A expression in the duodenum. In the female brain stem, miR-320-3p, miR-504, and miR-16-5p levels were all upregulated. Investigating the oral miRNA-320-3p loads in the duodenal cell lineage paved the way for designing new therapeutics to avoid unexpected long-term impacts on the brain.

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Canale, Stephanie, Renuka Ramanathan, Matteo Pelligrini, Nicolas C. Rochette, Brian B. Nadel, and Melissa Gee. "Analysis of gene expression from human breastmilk cells: A comparison between low and high producers, and the influence of anxiety and depression on milk production, gene expression and bacterial production." Heliyon 7, no. 11 (November 2021): e08335. http://dx.doi.org/10.1016/j.heliyon.2021.e08335.

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Sewannonda, Andrew, Alvaro Medel-Herrero, Victoria Nankabirwa, and Valerie J. Flaherman. "Experiences and attitudes related to newborn feeding in central Uganda: A qualitative study." PLOS ONE 17, no. 10 (October 19, 2022): e0274010. http://dx.doi.org/10.1371/journal.pone.0274010.

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Objective Adequate infant nutrition is a critical cornerstone of population health, yet adherence to recommended breastfeeding practices is low in many countries in sub-Saharan Africa, including Uganda. This study aims to describe local attitudes, experiences and beliefs related to nutrition in early infancy in Central Uganda Design We conducted 5 focus group discussions and 12 key informant interviews to gather information on local attitudes, experiences and beliefs related to feeding in early infancy. Setting Urban areas of Central Uganda. Participants Parents and healthcare and public health professionals. Results Participants reported numerous concerns related to infant health including inadequate infant weight, premature birth, diarrhea, fever, gastrointestinal infection and malnutrition. Awareness of the infant health benefits of exclusive breastfeeding was prevalent but experienced as in balance with maternal factors that might lead to supplementation, including employment demands, physical appearance, pain, poverty and maternal health and malnutrition. Breastfeeding was highly valued, but use of unsafe breast milk supplements was common, including cow’s milk, black tea, glucose water, fruit juice, millet, maize, rice, potatoes, soy, sorghum, egg yolk, fish and ghee. Expression of breast milk was viewed as not consonant with local culture. Conclusions Participants were aware of the benefits of exclusive breastfeeding but described multiple barriers to achieving it. Supplementation with unsafe breastmilk supplements was considered to be more culturally consonant than milk expression and was reported to be the only affordable potential breast milk substitute for many families.

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Parker, Leslie A., Sandra Sullivan, Charlene Krueger, and Martina Mueller. "Association of Timing of Initiation of Breastmilk Expression on Milk Volume and Timing of Lactogenesis Stage II Among Mothers of Very Low-Birth-Weight Infants." Breastfeeding Medicine 10, no. 2 (March 2015): 84–91. http://dx.doi.org/10.1089/bfm.2014.0089.

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Strom, Kamila, Sylwia Jarzynka, Anna Minkiewicz-Zochniak, Olga Barbarska, Gabriela Olędzka, and Aleksandra Wesolowska. "Microbiological Quality of Milk Donated to the Regional Human Milk Bank in Warsaw in the First Four Years of Activity." Healthcare 10, no. 3 (February 26, 2022): 444. http://dx.doi.org/10.3390/healthcare10030444.

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As the survival rate for preterm infants increases, more emphasis is placed on improving health-related quality of life through optimal nutritional management. Human Milk Banks (HMBs) provide bioactive nutrients and probiotic microorganisms to premature newborns, especially in the first year of life. Donated milk screening and selection of potential donors ensures the quality and microbiological safety of the donated milk. Therefore we reviewed the basic characteristics of donors and the amounts and contamination of breast milk donated to the Regional Human Milk Bank (RHMB) in Warsaw. In four years, the RHMB collected 1445.59 L of milk, of which 96.60% was distributed among hospitalised infants. Additionally, breastmilk from donor candidates (139 samples from 96 women) was tested at least once in the first year of lactation. First analyses showed that 18 women’s milk samples were microbiologically pure, and 78 samples had one or more species of commensal and/or potentially pathogenic bacteria. In human milk samples from 10 women, the bacteria level was above the standard required by the RHMB; therefore, donors were re-educated, and further samples were tested. Most women followed the recommendations on hygienic expression and storage of milk before transfer to the RHMB. Our analysis will help to increase the accessibility and quality of raw donor milk and to meet the needs of more newborns.

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Woolley, Emma, and Shirley Wyver. "“How about We Give It a Go?”: A Case Study on Supporting Breastfeeding Families in an Australian Child Care Centre." Children 7, no. 11 (October 23, 2020): 195. http://dx.doi.org/10.3390/children7110195.

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The World Health Organization (WHO) recommends exclusive breastfeeding for six months and continuation of breastfeeding for up to two years. Formal child care has an important role in supporting breastfeeding, as many Australian infants commence care before two years of age. Currently, little is known about support or barriers in child care contexts. The present qualitative instrumental case study explores practices which protect, promote and support breastfeeding at a child care centre located in the Australian Capital Territory’s outer suburbs. Extending from a previously published collective case study, a cultural-institutional focus of analysis was used to explore the roles of proximity, flexibility and communication in supporting breastfeeding within a child care centre located close to an infant’s home. Interviews with centre staff and mothers, triangulated with observations of the centre environment and policy documents provide insight into the environment. Affirming the roles of flexibility in routine and staff rostering and two-way communication, findings suggest longer-term benefits may be derived from selecting a child care centre close to an infant’s home, provided mothers can overcome barriers to breastmilk expression in the workplace. The study recognises the role of non-lactating caregivers in the transition to formal child care, and of the support culture for educators who breastfeed. This study extends the knowledge base of breastfeeding support interventions in the child care setting to inform future research and policy.

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Savino, Francesco, Francesca Giuliani, Stefano Giraudi, Ilaria Galliano, Paola Montanari, Valentina Daprà, and Massimiliano Bergallo. "Analysis of Serum Th2 Cytokines in Infants with Non-IgE Mediated Food Allergy Compared to Healthy Infants." Nutrients 14, no. 8 (April 9, 2022): 1565. http://dx.doi.org/10.3390/nu14081565.

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Background: The aim of this study is to assess the serum values of IL-4, IL-5, IL-10, and IL-13 in a group of infants with non-IgE mediated food allergies treated with a hydrolyzed formula and compare them with a group of healthy peers. Methods: A total of 53 infants aged 1 to 4 months, of which 34 with non-IgE mediated food allergies and 19 healthy infants were enrolled in this study. Infants were eligible if they had gastrointestinal symptoms of food allergy and needed to switch from their initial formula to hydrolyzed formulas with an improvement of symptoms. Controls were fed with either breastmilk or standard formula. Blood samples were taken within one week of a special diet for cases. Interleukinsin in peripheral blood was detected and analyzed using the real-time PCR MAMA method. Fecal calprotectin was evaluated using a quantitative assay. Results: Values of IL-4 and IL-13 were significantly higher in the non-IgE food allergy group compared to the control group (p < 0.05), while IL-5 and IL-10 were significantly lower than the control group (p < 0.05). Fecal calprotectin in the non-IgE food allergy group was significantly higher compared to the control group (p < 0.05). Conclusion: This study provides a theoretical basis that Th2 cytokine expression in infants with a non-IgE mediated food allergy is significantly different than in healthy infants; this finding supports the use of early dietetic treatment with hydrolyzed formulas.

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Wu, R. Y., B. Li, R. Horne, A. Ghamel, S. Robinson, M. Cadette, H. Miyake, K. Johnson-Henry, A. Pierro, and P. M. Sherman. "A47 SYNTHETIC HUMAN MILK OLIGOSACCHARIDES PREVENT EXPERIMENTAL NECROTIZING ENTEROCOLITIS VIA DIVERGENT TRANSCRIPTOMIC RESPONSES." Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 272–74. http://dx.doi.org/10.1093/jcag/gwab002.045.

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Abstract Background Breastmilk reduces the risk of necrotizing enterocolitis (NEC) in preterm infants, but the bioactive components mediating this effect are not well understood. Human milk oligosaccharides (HMOs) reduce NEC both in humans and in relevant animal models. However, it is unclear if there are functional differences between individual oligosaccharides. Aims The objective of this study was to compare the intestinal transcriptome responses of individual HMOs using complementary in vitro and in vivo models of NEC. Methods RNA sequencing was performed on Caco-2Bbe1 gut epithelial cells after exposure to commercially-purified 2’-fucosyllactose (2’FL), 3-fucosyllactose, 6’-siallyllactose, lacto-N-tetraose (LNT) or lacto-N-neotetraose for 24hr at 37°C for 24 h (n=3). Signaling pathways were analyzed in murine- and human-derived NEC enteroids by qPCR. To validate these findings, five-day-old mouse pups were orally gavaged formula with or without individual HMOs, followed by NEC induction with hypoxia (5% O2, 95% N2) and lipopolysaccharide (4 mg/kg/day). Coded ileal sections (n=6–7/group) were analyzed for mucosal injury by histology, immune fluorescence, immunohistochemistry, and gene expression via qPCR. Results The HMO transcriptome clustered into divergent functional categories including metabolic process, protein processing and responses to external stimuli. Each synthetic HMO induced a unique transcriptome and exhibited varying effects on the intestinal epithelial functions and biological pathways. This was confirmed in the murine model of NEC, as both LNT and 2FL mitigated NEC injury with comparable recovery of intestinal cell proliferation (Ki67) and expression of stem cells (Lgr5+). Both qPCR and immunofluorescence staining showed differences between 2FL- and LNT-fed pups in host inflammatory and immune responses. Conclusions This study demonstrates that synthetic HMOs ameliorate intestinal injury in experimental NEC. However, the mechanisms by which individual oligosaccharides act on the intestine differ, suggesting that single synthetic HMOs may not fully recapitulate the benefits of pooled HMOs. Future studies will further delineate structure-function relationships of synthetic HMOs on host intestinal innate and adaptive immune responses. Funding Agencies CIHRFerring Canada Medical Student Research grant

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Costa, Kassandra, Laiane Ribeiro, José De Jesus, Karina Costa, Geraldo Fernandes, Jan Spilski, Thomas Lachmann, and Rosana Tristão. "Olfactory sensory evaluation in newborn children of women infected with COVID-19 during pregnancy." Journal of Human Growth and Development 31, no. 2 (August 3, 2021): 192–98. http://dx.doi.org/10.36311/jhgd.v31.11341.

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Introduction: In adults, olfactory loss is one of the earliest and most frequent acute clinical manifestations of SARS-CoV-2 infection. The number of children infected with SARS-CoV-2 is relatively small, perhaps due to the lower expression of Angiotensin Converting Enzyme 2 (ACE2) in children compared to adults. Little is known about foetal impairment in mothers infected with SARS-CoV-2. Objective: The goal of the present study is to develop and validate a behavioural evaluative scale of olfactory perception in healthy new-borns and to apply this scale to new-born children of women infected with COVID-19 during pregnancy comparing to new-born children of women without COVID-19 infection history. Methods: This is a retrospective comparative analytical cohort study of 300 new-borns exposed and unexposed to COVID-19 during pregnancy. The data collection will follow the experimental procedure in a previous study that explored odours of the maternal breastmilk, vanilla (sweet) and distilled water (neutral). A coffee smell was implemented as an addition to this previous study in order to include the acid/bitterness category to the categories of stimuli. Discussion: It is feasible to argue the hypothesis of the involvement of the foetus' olfactory bulb during intrauterine life as one of the indelible pathophysiological manifestations to the clinical diagnosis of COVID-19 with neurosensory olfactory deficit in foetuses and new-borns affected by intrauterine infection. This study aims to investigate if new-born children of women infected with COVID-19 during pregnancy have olfactory sensory changes. The clinical trial was registered in the Brazilian Registry of Clinical Trials (ReBEC- RBR-65qxs2).

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Ahmadzai, Hilai, Lisa Bg Tee, Richard Parsons, and Andrew P. Crowe. "A longitudinal study investigating changes in the expression of efflux transporters in the lactating mammary epithelial cells and their impact on the transfer of drugs from mother to breastfed infant via breastmilk." Proceedings for Annual Meeting of The Japanese Pharmacological Society WCP2018 (2018): PO4–10–10. http://dx.doi.org/10.1254/jpssuppl.wcp2018.0_po4-10-10.

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Kent, George. "Why make fake breastmilk?" World Nutrition 11, no. 3 (September 29, 2020): 2–11. http://dx.doi.org/10.26596/wn.20201132-11.

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There are efforts underway to make “breastmilk” called Biomilq through cell culture, “to produce cultured human breastmilk using patent-pending technology in order to offer families a more nutritious and more sustainable option for feeding babies.” However, Biomilq advocates have not explained their claims that the product would be better for infants’ health or for the environment. Their claim that the product would be breastmilk and not a breastmilk substitute is not convincing. They argue that until now women who cannot or choose not to breastfeed have no alternative but to feed with infant formula, but they ignore options such as mothers expressing their own milk or using wet-nurses. They do not mention the possibility of feeding with pasteurized human milk from other women, obtained through a human milk bank. The prospects for Biomilq do not look promising.

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Roy, S. K., Saria Tasnim, Ms Khurshid Jahan, Summyia Nazmeen, Sumon Chandra Debnath, and A. B. M. Muzharul Islam. "Difficulties in breastfeeding: Easy solution by Oketani breast massage." Bangladesh Medical Research Council Bulletin 45, no. 3 (December 30, 2019): 149–54. http://dx.doi.org/10.3329/bmrcb.v45i3.44644.

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Background: Breastfeeding is universally recommended feeding method for promoting child survival. Many mothers in developing countries do not practice optimum breastfeeding due to difficulties in the breast that may lead to temporary or permanent cessation of breastfeeding. Oketani breast massage approach is one such technique to overcome those difficulties for successful lactation to promote child growth. The aim of this study was to assess the difficulties in breastfeeding and mother’s expression on benefits of Oketani breast massage. Methods: A cross sectional study was conducted at lactational management center (LMC) in the Institute of Child Mother Health (ICMH), Dhaka, Bangladesh during March to August 2015. A total of 98 mothers (having 0-12 month’s old children) who had breast problems or difficulty in breastfeeding were included in the study. The mothers agreed to undertake Oketani massage. This is a breast massage that promotes breast milk production and helps the lactating mothers to overcome certain difficulties in the breast. Mothers who received Oketani massage were interviewed using a semi-structured questionnaire. Results: Ninety-eight mothers were interviewed for this study. About two-thirds (66.3%) of babies were girls of which 57.1% were less than 2 months. More than two-thirds (78.6%) mother ages were more than 25 years. Half of the mothers completed secondary school certificate (SSC) in which non-working (63.3%) mothers were more than working mother (36.7%). The proportion of exclusive breastfeeding practice was 50.0%. Most common difficulties included breast engorgement (22.4%), followed by sore nipple (17.3%) and insufficient milk (14.3%). After receiving Oketani massage mother’s perception of getting confidence improved to 80.6%. About 69% said that the baby can be fed well, 61.2% felt that there was increase in breast milk production and 56.1% mothers expressed feeling good after the massage. Study findings revealed that Breast feeding significantly improved with the Oketani breast massage (p=0.001). Conclusion: Oketani massage is considered as a useful technique to build confidence and improved milk secretion among mothers facing difficulty during lactation. A multicentre study with detailed assessment of quality, the quantity of breastmilk as well as baby’s growth and nutritional assessment is recommended.

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Tanjung, Wiwi Wardani. "PENGARUH TEKNIK ROOLING MASSAGE TERHADAP KELANCARAN PENGELUARAN ASI PADA IBU HAMIL TRIMESTER III." Jurnal Ilmiah PANNMED (Pharmacist, Analyst, Nurse, Nutrition, Midwivery, Environment, Dentist) 16, no. 1 (May 17, 2021): 220–23. http://dx.doi.org/10.36911/pannmed.v16i1.1060.

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The Exclusive Breastfeeding has been shown to have an impact better on health growth, development, and all the impacts short and long term, but there are still many mothers who do not provide exclusive breastfeeding. One of the reasons mom does not provide exclusive breastfeeding to the baby was due to the release of breast milk that was not smooth that happened due to inhibition of the hormone prolactin which produces breast milk. Rolling Massase Technique was one action which gives a relaxing sensation to the mother and smooth the flow of nerves as well as the milk duct. The purpose of this research was to know the influence of rooling massage techniques on the smooth release of breast milk in third trimester pregnant women in the work area In Public Health Center Of Batunadua 2020. This type of research was quantitative research with a quasi experimental design used the Post Test Only Design with Control Group design. The population in this study are all trimester III pregnant women who came to the Public Health Center Of Batunadua as many as 32 people. The sample in this study was 16 people in the intervention group and 16 people in the control group by used accidental sampling method. The analysis used was the Wilcoxon test. The results showed that massage rooling technique effect on smoothness expressing breastmilk in pregnant women Trimester III with p value = 0.008 (p <0.05). It was hoped that the Public Health Center Of Batunadua In Padangsdimpuan to do health education or health promotion which can be given to pregnant women to prepare for smooth operation expressing breastmilk like perform rooling massage technique.

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Yuniar Angelia Puspadewi and Jiarti Kusbandiyah. "Differences in The Effectiveness of Oxytocin Massage and Major Pectoralist Massage Towards Acceleration of Breast Milk Expenditure in Postpartum Mothers in PMB Ngadila Sobirin Malang District." EMBRIO 13, no. 1 (May 31, 2021): 56–63. http://dx.doi.org/10.36456/embrio.v13i1.3323.

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Breastmilk (ASI) is a staple food that can be given to a newborn for growth and development of the baby for his survival. Therefore, almost 80% of mothers who give birth are able to produce enough milk for the needs of their babies. Psychological factors because there is a belief from the mother that she cannot provide breast milk which will cause a decrease in the hormone oxytocin so that breast milk cannot come out immediately after birth, so the mother takes the decision to give formula milk. The research objective in this study was to analyze the difference in the effectiveness of oxytocin massage and pectoralis major muscle massage on the acceleration of breastfeeding in postpartum mothers. The number of respondents in each group was 20 people with criteria such as postpartum mothers before 2 hours, breastfeeding did not come out at all, mothers gave normal birth. Both groups were checked for the smooth release of breast milk on which day by observation. This study used a true experiment design with a postest-only control design approach. The independent variables in this study were oxytocin massage and pectoralis major muscle massage which was carried out 2 times a day massage with a massage duration of 2-3 minutes for 5 days, while the dependent variable was the speed of expressing breastmilk which occurred on what number of days postpartum. The results showed that the U value was 122 and the W value was 375. When converted to Z value, the value was -2.593. Sig value or P value 0.010 <0.05 means that there is a significant difference between the 2 groups, namely oxytocin massage is more effective in accelerating breastfeeding.

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Forster, Della A., Anita M. Moorhead, Susan E. Jacobs, Peter G. Davis, Susan P. Walker, Kerri M. McEgan, Gillian F. Opie, et al. "Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial." Lancet 389, no. 10085 (June 2017): 2204–13. http://dx.doi.org/10.1016/s0140-6736(17)31373-9.

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Ariani, Peny, Bella Agustria, Putri Ayu Yessy Ariescha, Tetty Junita Purba, Nur Mala Sari, and Kristin Natalia. "HUBUNGAN BODY IMAGE TERHADAP PERILAKU PEMBERIAN ASI EKSKLUSIF PADA IBU PEKERJA." JURNAL KEBIDANAN KESTRA (JKK) 3, no. 1 (October 31, 2020): 89–95. http://dx.doi.org/10.35451/jkk.v3i1.513.

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A negative body image after childbirth tends to have a shorter duration of exclusive breastfeeding due to postpartum diet, embarrassment at having to breastfeed in public and concerns about the impact of breastfeeding on body shape. Government policies and regulations supporting exclusive breastfeeding in the workplace are not yet maximum because there are many workplaces that do not support the exclusive breastfeeding program, including time off for maternity leave, places for expressing breastmilk. This research is an observational non-experimental study using an analytical design that is case sectional. Sampling in this study used a purposive sampling technique with 70 respondents at the Meurah Mulia Public Health Center, Meurah Mulia District, North Aceh Regency in 2020. Data collection was carried out through a questionnaire. The univariate data analysis technique used frequency distribution and bivariate analysis used the chi-square test. The results showed that the majority of body image with breastfeeding behavior supported body image with positive breastfeeding behavior as many as 56 respondents (80%). There is a relationship between body image and exclusive breastfeeding behavior for working mothers at Meurah Mulia Public Health Center, Meurah Mulia District, North Aceh Regency in 2020 with a value of p (0.002) <p value (0.05), it is hoped that respondents will continue to add information and knowledge, especially regarding behavior Exclusive breastfeeding.

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Opiela, Shannon Jacqueline, and Becky Adkins. "Exposure to NIMA-like alloantigens induces vigorous in vivo T cell responses in murine neonates (102.17)." Journal of Immunology 178, no. 1_Supplement (April 1, 2007): S207. http://dx.doi.org/10.4049/jimmunol.178.supp.102.17.

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Abstract During early life, fetuses and neonates are exposed to allogeneic non-inherited maternal antigens (NIMA), through the passage of maternal cells and/or molecules across the placenta and in the breastmilk. Currently, it is thought that this early exposure results in the development of tolerance to NIMA. This is manifest in later life as an increased acceptance of grafts expressing the NIMA antigens. However, there also is evidence that exposure to NIMA during early life can lead to priming instead. In a murine model, we have shown that priming of neonates occurs when they are exposed to low doses of NIMA-like alloantigens. As these two possibilities, tolerance or priming, are extremely important for the outcome of transplantation, our lab has been engaged in studies to understand the in vivo responses of early life exposure to low doses of NIMA-like alloantigens. Following exposure, neonates developed both primary and memory cytotoxic responses to alloantigen. These responses were accompanied by vigorous Th1 and Th2 responses that exceeded the responses of adults similarly exposed. Overall, we conclude that exposure to low doses of NIMA-like alloantigens induces the development of robust cytotoxic and cytokine responses in neonates. This suggests that under specific conditions, early exposure to NIMA may lead to highly efficient immunological priming of all arms of T cell adaptive immunity, rather than tolerance. This work was supported by NIAID grant number R01 AI44923-02 (B.A.)

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Kurniawati, Fitria Rizky. "HUBUNGAN PENGGUNAAN OBAT HERBAL (JAMU GEPYOK) DENGAN PRODUKSI ASI DI BPS DS. NGUMPAKDALEM KEC. DANDER KABUPATEN BOJONEGORO TAHUN 2017." Journal of Health Sciences 12, no. 1 (January 29, 2019): 55–59. http://dx.doi.org/10.33086/jhs.v12i1.792.

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Abstract Indonesian society's interest in complementary or traditional therapy is increasing. The frequency of utilization of complementary alternative therapies is increasing rapidly throughout the world. The result of Susenas (2007) shows Indonesians who complain of pain within the month before the 30.90% survey. Of the residents who complained of illness, the largest percentage (65.01%) chose their own treatment using traditional medicines and / or drugs. The use of traditional medicine in self-medication efforts has steadily increased from 15.2% to 38.3% over the course of 7 years from 2000-2006 (Supardi, S and Andi Leny, 2010) The purpose of this study is to determine the effect of the use of herbal medicine to facilitate the expansion of breast milk as an effort to reduce the use of conventional medicines in Bojonegoro District in 2017. This research uses Quasy experimental research design technique (quasi experiment). Based on the place of study including the type of field research design. Population is a subject that meets the criteria that have been set. The population in this study were all breastfeeding mothers in 10 Puskesmas in Bojonegoro Regency in 2016. Analysis is a very important part to achieve the goal, where the main purpose of research is to answer the research questions in expressing the phenomenon . Data analysis in this study using chi square test. The results showed p value 0.468> 0.05 which means there is no relationship between the use of herbal uyup - uyup with milk production. Keywords: Herbal Medicinal Use and Breastmilk Production

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Widayati, Wahyu Widayati. "EDUKASI TEKNIK MEMERAH, MENYIMPAN DAN MENYIAPKAN ASI YANG BENAR PADA IBU MENYUSUI YANG BEKERJA DI SMAN I PAGELARAN." Jurnal Pengabdian Masyarakat Kesehatan 7, no. 1 (March 30, 2021): 70–72. http://dx.doi.org/10.33023/jpm.v7i1.739.

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ABSTRAK Praktik ASI ekslusif masih jauh dari 90% di sebagian besar Negara berkembang, bahkan durasi menyusui sangat pendek dan data dari SDKI menunjukkan masih cakupan ASI ekslusif tahun 2012 di Indonesia baru mencapai 27%. Tingginya angka kegagalan menyusui pada ibu bekerja terjadi setelah selesai cuti bersalin terutama pada ibu menyusui yang bekerja disektor formal karena status kepegawaiannya mengikuti standar aturan hukum yang jelas bagi perkantoran atau perusahaan yang bersangkutan. Seperti pada SMA N 1 Pagelaran dimana terdapat 50% adalah pekerja ibu – ibu baik guru dan staf yang masih berada pada usia produktif dan menyusui. Pengabdian masyarakt ini bertyujuan untuk menuingkatkan pengetahuan ibu - ibu menyususi yang berkerja di SMA N 1 Pagelaran dengan tehnik demontrasi pemberian edukasi teknik memerah, menyimpan dan menyiapkan ASI yang benar. Hasil dari pelaksanaan pengabdian masyarakat ini adalah didapatkan bahwa sebagian besar peserta pengabdian masyarakat meningkat pengetahuannya tentang teknik memerah, menyimpan dan memberikan ASI kepada anaknya. Kata Kunci : Edukasi Memerah, Menyimpan dan Menyiapkan ASI ABSTRACT The practice of exclusive breastfeeding is still far from 90% in most developing countries, even the duration of breastfeeding is very short and data from the IDHS show that exclusive breastfeeding in 2012 in Indonesia only reached 27%. The high rate of failure to breastfeed in working mothers occurs after maternity leave, especially for breastfeeding mothers who work in the formal sector because their employment status follows clear legal standards for the office or company concerned. As in SMA N 1 Pagelaran where 50% are working mothers, both teachers and staff who are still at the productive and breastfeeding age. This community service aims to increase the knowledge of breastfeeding mothers who work at SMA N 1 Pagelaran with dem,onstration technique, providing education on how to express, store and prepare correct breast milk. The result of the implementation of this community service participants have increased their knowledge of techniques for expressing, storing and giving breast milk to their children. Keywords :Education Expressing, Storing and Preparing Breastmilk

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Curtis, Alan Dale, Maria Dennis, Joshua Eudailey, Kenneth Cronin, Justin Pollara, Guido Ferrari, Michael Hudgens, Koen Van Rompay, Sallie Permar, and Kristina De Paris. "Neonatal vaccination primes persistent HIV Env-specific antibodies that are augmented by a single booster immunization in late infancy." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 167.10. http://dx.doi.org/10.4049/jimmunol.204.supp.167.10.

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Abstract Breastmilk transmission of HIV remains unacceptably high. Vaccine approaches that prime robust virus-specific immune responses in infancy may prevent acquisition during the breastfeeding period. Moreover, vaccine responses that generate robust immunological memory that persists into adolescence could prevent sexual transmission later in life. The current study investigated the immunological benefit of late boosting following vaccination in infancy. Two groups of neonatal rhesus macaques were immunized with a clade C HIV Env protein adjuvanted with 3M-052 stable emulsion (SE) vaccine (Env Only) alone or together with a modified vaccinia Ankara (MVA) vector expressing HIV Env and SIV Gag (MVA/Env) at 0, 6, and 12 weeks of age. Env-specific B cells were present in blood yet absent from lymph nodes in the Env Only group by week 14. At week 32, 18 weeks following the last immunization, we could still detect Env-specific plasma IgG responses capable of autologous and heterologous HIV Env binding, Env-specific ADCC activity and CD4 blocking in both groups. A final booster immunization at week 32 enhanced avidity and function of Env-specific plasma IgG in both groups. These data confirmed previous work by our group that demonstrated HIV Env protein adjuvanted with the TLR7/8-based 3M-052-SE primed greater immune responses than Span85-Tween 80 Squalene. Our data from the Env Only vaccine regimen are consistent with the induction of Env-specific antibody responses in human infants. These results support the idea that early life vaccination is an effective means to induce persistent HIV Env-specific IgG responses that can be boosted in infancy and could be exploited to drive protective immunity against HIV acquisition prior to sexual debut.

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Leee, Ji Shin, Nah Ihm Kim, and Min Ho Park. "Abstract P4-07-22: Evaluation of human epididymis protein 4 serum and tissue expression in ductal carcinoma in situ of the breast." Cancer Research 82, no. 4_Supplement (February 15, 2022): P4–07–22—P4–07–22. http://dx.doi.org/10.1158/1538-7445.sabcs21-p4-07-22.

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Abstract Background: Human epididymis protein 4 (HE4), also known as WFDC2, is a member of whey acidic protein (WAP) family with a presumptive role in natural immunity. HE4 expression has been increased in many cancer types, particularly in gynecologic and pulmonary cancers. HE4 has been identified as an important serum biomarker in the diagnosis and monitoring of epithelial ovarian cancer. Recent researches have demonstrated that HE4 levels in serum and tissues are elevated in patients with breast cancer and HE4 is thought be involved in breast cancer progression. In contrast, expression of HE4 in ductal carcinoma in situ (DCIS) has not been well characterized yet. The present work was undertaken to evaluate serum and tissue levels of HE4 in DCIS and their correlations with clinicopathological features of DCIS. Materials and methods: Preoperative serum HE4 levels in 59 DCIS patients was analyzed using the ARCHITECT assay. Tissue microarray containing DCIS and adjacent normal tissues from the same cohort were tested for HE4 mRNA and protein by RNAscope in situ hybridization (ISH) and immunohistochemistry analysis, respectively. Tissue microarray containing only DCS tissues from 41 patients were also tested for HE4 mRNA and protein. To validate prognostic potential of HE4 in breast cancer patients, the BreastMark database was used. Results: HE4 levels in 59 DCIS patients ranged from 23.5 to 86.3 pmol/L (mean ± SD: 39.4 ± 11.9). Based on the cutoff level, there were no abnormal cases for HE4. Serum HE4 levels did not differ according to clinicopathological parameters except for menopause status. RNAscope ISH and immunohistochemistry confirmed an increase in HE4 in DCIS tissues compared with their corresponding normal tissues. Spearman’s correlation analyses revealed no significant correlation between serum and tissue levels of HE4. Among 100 DCIS tissues, there was a positive correlation between HE4 mRNA ISH scores and HE4 immunohistochemical staining scores (r = 0.771, P < 0.001). High mRNA and protein expression of HE4 were observed in 25 of 99 (25.3%) and 34 of 99 (34.3%) cases, respectively. High mRNA HE4 expression was significantly associated with low stromal tumor infiltrating lymphocyte (TIL) density scores, ER positivity, HER2 negativity, and HR+/HER2- subtype. High protein HE4 expression was also significantly associated with absence of comedo-type necrosis, low stromal TIL density scores, ER positivity, HER2 negativity, and HR+/HER2- subtype. HE4 mRNA and protein expression did not correlate with recurrence of DCIS. In breast cancer patients, high HE4 expression was significantly associated with good survival in the overall group (HR = 0.838, P = 0.003, n = 2,652) and lymph node negative group (HR = 0.791, P = 0.029, n = 1,183). Conclusions: Our study revealed that serum HE4 is not elevated in patients with DCIS. High expression of HE4 mRNA and protein in DCIS tissues are associated with good clinicopathological characteristics, which warrant. further investigations. Citation Format: Ji Shin Leee, Nah Ihm Kim, Min Ho Park. Evaluation of human epididymis protein 4 serum and tissue expression in ductal carcinoma in situ of the breast [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-07-22.

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Martin, Stephanie, Beatrice John, Esther Chung, Samantha Grounds, Margaret Bentley, Msuya Sia, and Melina Mgongo. "Facilitators and Barriers to Exclusive Breastfeeding Among Women Working in the Informal Sector: A Qualitative Exploration in Moshi, Tanzania." Current Developments in Nutrition 5, Supplement_2 (June 2021): 781. http://dx.doi.org/10.1093/cdn/nzab046_078.

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Abstract Objectives Paid work is a barrier to exclusive breastfeeding (EBF) worldwide. In Tanzania, most women work in the informal sector and cannot access paid maternity leave or other employment benefits, exacerbating these challenges. The objectives of this research were to examine barriers and facilitators to EBF among women working in the informal sector, and identify the strategies women use to meet infant care and feeding and informal work responsibilities. Methods We conducted semi-structured interviews with 20 mothers of children 1–5 months of age who work in the informal sector in Moshi Urban District, Tanzania. Recorded interviews were transcribed and translated into English. We used Atlas.ti to code transcripts, retrieve text segments, and conduct thematic analysis. Results Participants’ mean age was 31 years (range 18–43) and their children's mean age was 2.9 months. Mothers worked as vendors (i.e., food, clothes, or goods) or provided services (e.g., tailor) resulting in varied levels of flexibility and time away from home. Women had very different experiences with work, which was influenced by their job type. However, there was considerable variation between women with the same type of job. Although some women brought their baby to their worksites, most participants thought it was challenging as workplaces are unsafe, it is difficult to simultaneously meet customers’ and infants’ demands, and women are not comfortable breastfeeding in public. Some women left their worksites during the day to go home and breastfeed, but this was not an option for many women who reported long distances to their child, missing customers, and travel costs. Participants’ responses about expressing breastmilk were mixed with many voicing concerns about safety, milk quality, amount, preparation, and feeding. Conclusions While informal work may be perceived to facilitate EBF compared to formal work, our findings indicate that in this context it was highly variable and dependent on women's individual circumstances. Targeted strategies and tailored counseling are needed to support women who work in the informal sector to overcome these barriers as well as policy level changes that provide paid parental leave to informal workers. Funding Sources International Society for Research on Human Milk and Lactation (ISRHML) and the Family Larsson-Rosenquist Foundation.

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Sharon, Nehama, Nurit Rosenberg, Uri Seligsohn, Aryeh Simmonds, Yakov Shiff, Yaakov Schechter, and Hagit Hausner. "Breast Milk from Immune Thrombocytopenic Mothers Can Contain Anti Platelet Antibodies That Are Associated with Persistent Thrombocytopenia in Neonates." Blood 124, no. 21 (December 6, 2014): 4181. http://dx.doi.org/10.1182/blood.v124.21.4181.4181.

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Abstract Purpose: Maternal immune thrombocytopenic purpura (ITP) accounts for 5% of all cases of pregnancy associated thrombocytopenia and is a common cause of neonatal thrombocytopenia. One of the common mechanism involves transfer of IgG autoantibodies against platelet receptors which are found in the blood samples of affected patients. The neonatal thrombocytopenia usually subsides within 2 months. The autoantibodies are often of the IgG type and therefore can cross the placenta and cause fetal and/or neonatal thrombocytopenia. Recently we observed persistence of neonatal ITP which disappeared following discontinuation of breast feeding. The aim of our current work was to discern whether breast milk of mothers with ITP contains anti-platelet antibodies and whether these antibodies may be the cause for persistent neonatal ITP. Methods: Breast milk samples were collected from 12 women with ITP. Six of them were thrombocytopenic during pregnancy and their neonates also had thrombocytopenia. The remaining 6 mothers had a history of ITP but not during the current pregnancy, and neither did their neonates. As controls, breast milk from 8 healthy women was also examinied. The presence of anti-platelet antibodies were evaluated by incubating washed platelets from healthy donors with breast milk or extracted milk – Ig. The type of immune globulin was defined by flow cytometry using fluorescence conjugated anti-human IgA, IgG or total Ig antibodies. To prove that the antibodies were against an antigen that is platelet specific and not against HLA epitopes, we also tested the samples on cultured cells expressing the fibrinogen receptor, αIIbβ3, and compared the results to mock cells (transfected with empty vectors). Results: In the cases of women with active ITP, 3 were positive for anti-platelet antibodies, 2 were inconclusive and one was negative. In the mothers with a history of ITP, 1 was positive, 1 was inconclusive and 4 were negative. No anti-platelet antibodies were found in breast milk of healthy women. In all 6 cases of active ITP, the cell cultured assay for the fibrinogen receptor αIIbβ3 was positive, indicating that there were anti platelet specific antibodies in their milk. Of the 6 neonates of mothers with active ITP, 4 of them required treatment with oral steroids, and the average time to resolution of thrombocytopenia was 3.5 months. Conclusion: This study demonstrates that breastmilk of women with active ITP contains anti platelet specific antibodies. The presence of these antibodies demonstrated an association with persistant and prolonged neonatal thrombocytopenia. Disclosures No relevant conflicts of interest to declare.

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Foudil-Bey, Imane, Malia S. Q. Murphy, Sandra Dunn, Erin J. Keely, and Darine El-Chaâr. "Evaluating antenatal breastmilk expression outcomes: a scoping review." International Breastfeeding Journal 16, no. 1 (March 12, 2021). http://dx.doi.org/10.1186/s13006-021-00371-7.

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Abstract Background Antenatal breastmilk expression (aBME) is recommended by some healthcare providers to improve lactation, breastfeeding, and newborn outcomes, particularly for women with diabetes as they face unique challenges with breastfeeding. However, there is limited evidence of the potential harms and benefits of this practice. Our objective was to conduct a scoping review to map the literature describing maternal and newborn outcomes of aBME. Methods We searched Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, British Library E-Theses Online Services (EThOS) database, OpenGrey, and Clinical trials.gov from inception to January 2020. Studies in English that reported on the effect of aBME on maternal and newborn outcomes, and the experiences of women who have engaged in the practice were included for screening. Titles, abstracts, and full-text articles were screened by two independent reviewers. A critical appraisal and clinical consultation were conducted. Key findings were extracted and summarized. Results We screened 659 studies and 20 met the inclusion criteria. The majority of included studies (n = 11, 55.0%) were published after 2015, and seven (35.0%) originated from Australia. Ten (50.0%) studies provided data on high-risk obstetrical populations, including those with diabetes (n = 8), overweight or obesity (n = 1), and preeclampsia (n = 1). Commonly reported outcomes included breastfeeding status at discharge or follow-up, mode of delivery, newborn blood glucose, and time to establishing full lactation. Maternal experiences were related to challenges with aBME, confidence and mastery, perceived impact, security and altruism, learning and resources, and physical symptoms as a result of aBME. The critical appraisal demonstrated limited high-quality evidence surrounding aBME. Conclusions Our findings demonstrate increasing interest in the safety, efficacy, and acceptability of aBME. Existing studies are heterogenous with variable research questions, outcomes, study designs, and methodology. The recommendations made in this review can be used to help inform future studies evaluating aBME.

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Chiba, Takeshi, Aya Kooka, Kiyoko Kowatari, Megumi Yoshizawa, Naoko Chiba, Akira Takaguri, Yoshiyuki Fukushi, Fuminori Hongo, Hideki Sato, and Shinichiro Wada. "Expression profiles of hsa-miR-148a-3p and hsa-miR-125b-5p in human breast milk and infant formulae." International Breastfeeding Journal 17, no. 1 (January 3, 2022). http://dx.doi.org/10.1186/s13006-021-00436-7.

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Abstract Background Milk-derived microRNAs (miRNAs), including hsa-miR-148a-3p (miR-148a) and hsa-miR-125b-5p (miR-125b), have been shown to be beneficial to the gastrointestinal function in infants. Here, we investigated their expression during lactation in humans and determined whether the infant formulae available in Japan contain these miRNAs. Methods Healthy Japanese women (n = 16) who gave birth vaginally or by cesarean section at the Teine Keijinkai Hospital between 1 September 2020, and 31 April 2021 were included in this study. Breast milk was collected by nurses on days 4 or 5 after delivery (hereinafter, transition milk) and on day 30 of postpartum (hereinafter, mature milk). The levels of miR-148a and miR-125b in breastmilk and six commercially available infant formulae were compared and evaluated using quantitative reverse transcription-polymerase chain reaction. Results In all participants, the miR-148a level in mature breastmilk was significantly lower than that in the transition milk. The changes in miR-125b expression during lactation showed similar trends to the changes in miR-148a expression. The miR-148a and miR-125b levels in all analyzed infant formulae were lower than 1/500th and 1/100th of those in mature breastmilk, respectively. Conclusions The levels of both miR-148a and miR-125b in human breast milk decreased on day 30 postpartum compared with those in the transition milk. Additionally, the expression of these miRNAs in infant formulae available in Japan was very low. Further studies with larger populations are required to understand precisely the lactational changes in the expression of miR148a and miR-125b in breast milk.

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Alibhai, Kameela Miriam, Malia S. Q. Murphy, Sandra Dunn, Erin Keely, Paloma O’Meara, Josdalyne Anderson, and Darine El-Chaâr. "Evaluation of a breastmilk hand expression toolkit: the M.I.L.K survey study." International Breastfeeding Journal 17, no. 1 (January 15, 2022). http://dx.doi.org/10.1186/s13006-021-00448-3.

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Abstract Background Breastmilk hand expression (BMHE) is recommended to promote lactation, relieve breast engorgement, and collect milk for future infant feedings. Resources to teach this skill are limited and infrequently developed in partnership with the obstetrical population. In collaboration with maternity care experts and individuals with recent breastfeeding experience, we designed a one-page toolkit that describes the process of BMHE and includes step-by-step instructions and images to illustrate the technique. This study aimed to evaluate the readability, clarity of content, layout, and informational value of this BMHE toolkit. Methods Individuals who intended to breastfeed, were currently breastfeeding, or had recently breastfed were electronically surveyed and completed a two-part survey that consisted of radio, multi-select, Likert scale, and open-ended questions. Part one captured sociodemographic factors, obstetrical history, and breastfeeding practices. Part two collected feedback on the BMHE toolkit. Participants were recruited electronically through social media and posters were circulated in antenatal and postnatal care settings in Ottawa, Canada between November 2020 and February 2021. Results Of the 123 participants, 117 (95.1%) had heard of hand expression prior to reviewing the toolkit and 99 (80.5%) had hand expressed before. Among the 48 participants who were no longer exclusively breastfeeding at the time of the survey, 22 (45.8%) had exclusively breastfed their infant for at least six months and 7 (14.6%) had discontinued exclusive breastfeeding within the first month. When asked about the BMHE toolkit, 118 (95.9%) participants said it was informative, 115 (93.5%) said it was easy to understand, and 114 (92.7%) said it was well laid-out. When asked about information seeking behaviours, participants indicated a preference for online resources (58.5%) and video resources (22.0%). Conclusions The BMHE toolkit was well received by participants and the feedback was favourable overall. The survey feedback will be used to create a revised version of the toolkit that has been validated by the obstetrical patient population. Future research should focus on identifying implementation strategies to optimize the use of the toolkit and increase its effectiveness as an educational resource to teach participants correctly BMHE.

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Edemba, Priscillah Wanini, Grace Irimu, and Rachel Musoke. "Knowledge attitudes and practice of breastmilk expression and storage among working mothers with infants under six months of age in Kenya." International Breastfeeding Journal 17, no. 1 (May 2, 2022). http://dx.doi.org/10.1186/s13006-022-00469-6.

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Abstract Background Expression and storage of breastmilk is a strategy that ensures continued breast milk consumption in the event of temporary separation of an infant from the mother. However, many studies show that working mothers are unable to exclusively breastfeed for six months successfully. Working mothers are forced to wean early because of minimal support at the workplace, lack of knowledge on breast milk expression and lack of storage facilities. The 2017 Kenya Health Act mandates employers to provide lactation rooms for facilitation of breast milk expression in support of the lactating mother. This study analyses the knowledge attitude and practice of breast milk expression among working women in Kenya. Methods This was a cross sectional study done between December 2018 and February 2019. Study participants were 395 working women with infants aged six months and below, attending well baby clinics in two large public hospitals in Nairobi Kenya. A structured questionnaire with open and closed ended questions was used to establish the knowledge and practice while a Likert scale was used to explore attitudes of the mothers towards expression and storage of breast milk. Results Overall satisfactory knowledge on breast milk expression and storage was attained by only 34% of working mothers. Eighty four percent positively agreed that expression and storage of breast milk would help them achieve six months of exclusive breastfeeding. Challenges experienced were breast pain and cumbersome nature of expressing milk. Only 41% (161) were expressing breast milk either regularly or occasionally. The most common reason (24.7%) for expressing milk was to enable someone else feed the baby when they were at work. Most mothers (77%) expressed at home as the workplace did not seem to provide adequate equipment to facilitate breastmilk expression and storage. Conclusions There is a substantial knowledge gap on expression and storage of breast milk. Working mothers have a good attitude towards attainment of exclusive breast milk feeding through expression of breast milk. The workplace does not have adequate facilities to support expression and storage of breast milk.

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Strauch, Leah, Linda Sweet, Hayley Scott, and Amanda Müller. "Mechanisms of support for exclusive breastmilk expressers in the community: a scoping review." BMC Pregnancy and Childbirth 19, no. 1 (December 2019). http://dx.doi.org/10.1186/s12884-019-2667-y.

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Abstract Background The World Health Organization recommends that infants be exclusively breastfed until the age of six months. Breastfeeding is generally understood to mean the provision of human breastmilk to the infant by direct feeding at the breast, and interventions aimed at supporting exclusive breastfeeding are therefore targeted at this activity. However, breastfeeding is actually an umbrella term covering the provision of breastmilk to an infant by any means. Our population of interest is mothers who exclusively feed their infants indirectly using expressed breastmilk. Some research suggests that any expressing, and exclusively expressing in particular, can be a risk factor for early cessation of exclusive breastmilk provision, so we were interested to identify whether any specific support existed for exclusively expressing mothers outside of the context of premature infants and the Neonatal Intensive Care Unit setting. Methods A scoping review following the Joanna Briggs Institute approach was used to explore the phenomenon of formal and informal supports in the community for exclusively expressing mothers. Searches were run across academic databases and of government websites and infant feeding support organisations. Finally, an informal internet search was run using a simple search string. Results On analysis of results, there were no studies or articles that met the search criteria. An informal internet search linked us directly with websites and blogs that could be considered a form of support intervention. These informal results suggest that support material or programs could possibly exist in other modalities but we cannot find them in the context of this type of scoping review. Conclusions The results of the search corroborated what we had suspected – that exclusively expressing mothers are not specifically supported by usual channels for new parents and that it is also difficult to find acknowledgement that exclusive expression exists. The absence of results demonstrates the relevance of this study: exclusively expressing mothers are an under-served population. If we wish to strive towards achievement of World Health Organization breastfeeding goals, exclusively expressing mothers require targeted support to assist in their infant feeding experience, and there is little formal evidence of it currently being provided.

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Piñeiro-Salvador, Raúl, Eduardo Vazquez-Garza, José Antonio Cruz-Cardenas, Cuauhtémoc Licona-Cassani, Gerardo García-Rivas, Jorge Moreno-Vásquez, Mario René Alcorta-García, Victor Javier Lara-Diaz, and Marion E. G. Brunck. "A cross-sectional study evidences regulations of leukocytes in the colostrum of mothers with obesity." BMC Medicine 20, no. 1 (November 1, 2022). http://dx.doi.org/10.1186/s12916-022-02575-y.

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Abstract Background Breastmilk is a dynamic fluid whose initial function is to provide the most adapted nutrition to the neonate. Additional attributes have been recently ascribed to breastmilk, with the evidence of a specific microbiota and the presence of various components of the immune system, such as cytokines and leukocytes. The composition of breastmilk varies through time, according to the health status of mother and child, and altogether contributes to the future health of the infant. Obesity is a rising condition worldwide that creates a state of systemic, chronic inflammation including leukocytosis. Here, we asked whether colostrum, the milk produced within the first 48 h post-partum, would contain a distinct leukocyte composition depending on the body mass index (BMI) of the mother. Methods We collected peripheral blood and colostrum paired samples from obese (BMI > 30) and lean (BMI < 25) mothers within 48 h post-partum and applied a panel of 6 antibodies plus a viability marker to characterize 10 major leukocyte subpopulations using flow cytometry. Results The size, internal complexity, and surface expression of CD45 and CD16 of multiple leukocyte subpopulations were selectively regulated between blood and colostrum irrespective of the study groups, suggesting a generalized cell-specific phenotype alteration. In obesity, the colostrum B lymphocyte compartment was significantly reduced, and CD16+ blood monocytes had an increased CD16 expression compared to the lean group. Conclusions This is the first characterization of major leukocyte subsets in colostrum of mothers suffering from obesity and the first report of colostrum leukocyte subpopulations in Latin America. We evidence various significant alterations of most leukocyte populations between blood and colostrum and demonstrate a decreased colostrum B lymphocyte fraction in obesity. This pioneering study is a stepping stone to further investigate active immunity in human breastmilk.

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Natalia, Regina, Yeni Rustina, and Defi Efendi. "Combining breastfeeding education and support to improve breastmilk production, frequency of breastmilk expression, and partial breastfeeding in low-birth-weight infants." Journal of Neonatal Nursing, August 2021. http://dx.doi.org/10.1016/j.jnn.2021.08.015.

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Johnsen, Maren, Claus Klingenberg, Meta Brand, Arthur Revhaug, and Gunnbjørg Andreassen. "Antenatal breastmilk expression for women with diabetes in pregnancy - a feasibility study." International Breastfeeding Journal 16, no. 1 (July 23, 2021). http://dx.doi.org/10.1186/s13006-021-00393-1.

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Abstract Background Mothers with diabetes are less likely to achieve successful breastfeeding. Antenatal breastmilk expression (ABE) may facilitate earlier breastfeeding, but feasibility of introducing ABE and its acceptance among Scandinavian women have previously not been investigated. Methods This observational trial was conducted between the 1 January 2019 and the 12 March 2020 in Tromsø, Norway. We aimed to determine the feasibility of ABE in terms of practicality and acceptability among women with medically (metformin or insulin) treated diabetes. Women were invited to participate during antenatal visits from 32 weeks gestation. Participants received instruction and started ABE from gestation week 37 + 0. Participants, and their infants, were followed until 6–8 weeks after birth. We collected data on breastfeeding rates, infant hypoglycemia, transfer to the neonatal unit, and the women’s overall experience and satisfaction with antenatal breastmilk expression. Results Twenty-eight of 34 (82%) invited women consented to participate. All started ABE from week 37 + 0, and continued until hospital admission. No women reported any discomfort or side effects. Labor was induced at 38 weeks gestation. Twenty-four women brought harvested colostrum to the maternity ward, which was given to their infants during the first 24 h of life. Breastfeeding rates at discharge were 24/28 (86%) and 21/27 (78%) at 6–8 weeks after delivery. Seven (25%) infants were transferred to the neonatal unit; four because of hypoglycemia. Maternal satisfaction assessed 6–8 weeks after delivery revealed that all participants felt positive about the ABE, but one woman would not recommend it to other pregnant women. Conclusions Implementing a structured ABE guideline for women with medically treated diabetes was feasible. The intervention was associated with high level of satisfaction among study participants. No obvious side effects were observed, and breastfeeding rates at discharge and 6–8 weeks after delivery were higher than in comparable studies. Trial registration The study was registered at the research study registry at the University Hospital of North Norway (Nr 2018/7181).

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Hassiotou, Foteini, Alecia‐Jane Twigger, Pilar Blancafort, and Donna Geddes. "Gene expression in breastmilk cells changes with the stage of lactation (732.2)." FASEB Journal 28, S1 (April 2014). http://dx.doi.org/10.1096/fasebj.28.1_supplement.732.2.

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Twigger, Alecia-Jane, Anna R. Hepworth, Ching Tat Lai, Ellen Chetwynd, Alison M. Stuebe, Pilar Blancafort, Peter E. Hartmann, Donna T. Geddes, and Foteini Kakulas. "Gene expression in breastmilk cells is associated with maternal and infant characteristics." Scientific Reports 5, no. 1 (August 10, 2015). http://dx.doi.org/10.1038/srep12933.

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Journal articles on the topic 'Breastmilk expression'

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