Title: Associations between exclusive breastfeeding duration and children's developmental outcomes: Evidence from Siaya county, Kenya.
In: PLoS One. 2022; 17(3): e0265366. Published online 2022 Mar 31.
doi: 10.1371/journal.pone.0265366
Authors: Silas Onyango, Elizabeth Kimani-Murage, Patricia Kitsao-Wekulo, Nelson K. Langat, Kenneth Okelo, Christopher Obong’o, Jürg Utzinger, Günther Fink.
Abstract: "Background: Exclusive breastfeeding (EBF) during the first 6 months of life is widely promoted as a key strategy to enhance child health, growth, and development. Even though a high proportion of children in Kenya are currently breastfed exclusively, there is little evidence regarding the developmental benefits during the first year of life. This paper aims to fill this gap by establishing an association between EBF and early childhood developmental outcomes among children below the age of 6 months in Kenya. Methods: We used data collected as part of a cluster-randomized controlled trial conducted in Bondo sub-county in the western part of Kenya to assess the associations between EBF and development in the first year of life. The primary exposure variable was EBF, and the outcome variable was child development as measured by the Ages and Stages Questionnaire-Third Edition (ASQ-3). Results: We analyzed data from 570 children aged below 6 months at the time of the interview. Breastfeeding children exclusively between 3 and 6 months was associated with 0.61 standard deviation (SD) higher ASQ-3 scores in the adjusted model. When specific domains were considered, in the adjusted models, EBF in the 3-6 months period was associated with 0.44 SD, 0.34 SD, and 0.36 SD higher ASQ-3 scores in communication, gross motor, and problem solving domains, respectively. There were weak associations in the fine motor and social-emotional domains. Conclusion: EBF in the 3- to 6-month age range has significant positive associations with child development, especially for communication, gross motor, and problem-solving. Programs encouraging mothers to continue EBF in this period may have substantial benefits for children."
Open access: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265366
Title: Hormones regulating energy homeostasis in breastfeeding versus formula feeding mothers.
In: Journal of Physiology and Pharmacology 2021 Oct;72(5):731-739.
doi: 10.26402/jpp.2021.5.08. Epub 2022 Feb 12.
Authors: J Nurek, O W Wisniewski, J Kupsz, H Krauss, Z Buchwald, Z Checinska-Maciejewska, M Gibas-Dorna.
Abstract: "To meet energy demands for lactogenesis and to sustain homeostatic conditions post-partum, the organism of breastfeeding mother undergoes combined endocrine and metabolic regulation. The main objective of this study was to determine basal serum concentrations of hormones involved in the maintenance and defense of energy balance in breastfeeding (BF) and formula feeding (FF) mothers. Twenty healthy exclusively breastfeeding mothers at 3rd month of lactation (EBF3), 17 healthy partially breastfeeding at 6th month of lactation (PB6) and 17 healthy FF mothers participated in this study. Fasting serum prolactin (PRL), acylated ghrelin (aGhr), total ghrelin (tGhr), leptin, adiponectin, insulin, and cortisol were determined for all study participants and correlations between studied parameters were calculated for BF women. We found significantly lower basal insulin (p = 0.0048) and cortisol (p = 0.0002) and significantly elevated basal prolactin (p = 0.0020) and leptin (p = 0.0416) in BF when compared with FF women. The differences were not associated with the duration of lactation (3 vs. 6 months), except for PRL, which was highest in EBF3. Levels of Ghr and adiponectin did not differ between study groups. In the BF group, the negative correlations were found between aGhr and insulin, aGhr and adiponectin, leptin and cortisol, leptin and adiponectin, insulin and adiponectin, cortisol and adiponectin. Positive associations were noted between: insulin and leptin, leptin and aGhr, PRL and leptin, PRL and aGhr. Leptin and insulin correlated positively, whereas adiponectin negatively with BMI. These data may suggest that EBF3 and PB6 as compared with FF mothers, exhibit hormonal regulation which tends to be more advantageous for their metabolic profile and is not related to the duration of breastfeeding within the first 6 months of lactation."
Open access: https://www.jpp.krakow.pl/journal/archive/10_21/pdf/10.26402/jpp.2021.5.08.pdf
Title: Kangaroo mother care had a protective effect on the volume of brain structures in young adults born preterm.
In: Acta Paediatrica 2022 May;111(5):1004-1014.
Authors: Nathalie Charpak, Rejean Tessier, Juan Gabriel Ruiz, Felipe Uriza, José Tiberio Hernandez, Darwin Cortes, Adriana Montealegre-Pomar.
Abstract: "Aim: The protective effects of Kangaroo mother care (KMC) on the neurodevelopment of preterm infants are well established, but we do not know whether the benefits persist beyond infancy. Our aim was to determine whether providing KMC in infancy affected brain volumes in young adulthood. Method: Standardised cognitive, memory, and motor skills tests were used to determine the brain volumes of 20-year-old adults who had formed part of a randomized controlled trial of KMC versus incubator care. Multivariate analysis of brain volumes was conducted according to KMC exposure. Results: The study comprised 178 adults born preterm: 97 had received KMC and 81 were incubator care controls. Bivariate analysis showed larger volumes of total grey matter, basal nuclei and cerebellum in those who had received KMC, and the white matter was better organised. This means that the volumes of the main brain structures associated with intelligence, attention, memory and coordination were larger in the KMC group. Multivariate linear regression analysis demonstrated the direct relationship between brain volumes and duration of KMC, after controlling for potential confounders. Conclusion: Our findings suggest that the neuroprotective effects of KMC for preterm infants persisted beyond childhood and improved their lifetime functionality and quality of life. Keywords: Kangaroo mother care; grey matter; magnetic resonance imaging; premature infants; white matter."
Open access: https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.16265
Title: Increasing the exclusive breastfeeding rate in a private hospital in UAE through quality improvement initiatives.
In: Journal of Neonatal-Perinatal Medicine 2022;15(1):179-186. doi: 10.3233/NPM-210703.
Authors: M Kaushal, K Sasidharan, A Kaushal, P Augustine, M Alex.
Abstract: "BACKGROUND: Mother’s milk is the best, and ideal method for infant feeding. We found that this practice was not being followed in our hospital. A survey was conducted in the unit with regards to breastfeeding practices which revealed that most babies who were discharged from our nursery were on formula supplements. Our goal was to improve established breastfeeding rates in the unit by increasing the number of full-term healthy babies who were discharged on exclusive Breastfeeding. METHOD: A project team was formed, and data were collected through direct observations and direct interviews with postnatal mothers. Exclusive Breastfeeding at discharge was defined as a baby being fully on breastfeed with no additional formula supplements for at least 12 hours prior to discharge. The primary outcome was to increase the percentage of babies being discharged on exclusive Breastfeeding. We used the FOCUS PDCA model to measure improvements and 8 PDCA cycles of 4 weeks duration were implemented to test the changes. RESULTS: The interventions we put in place led to a considerable nine times overall improvement in the established breastfeeding rates. Among all the interventions, the most promising results were observed during the PDCA cycles involving staff education, the introduction of antenatal classes for mothers, skin to skin contact and rooming in. CONCLUSION: Breastfeeding rates in the private sector with nursery services can be improved by reinforcing breastfeeding education for mothers in addition to training the maternal care staff, empowering them to promote and assist in breastfeeding."
Abstract only: https://pubmed.ncbi.nlm.nih.gov/34120921/
A review paper:
Title: Exclusive Breastfeeding and Vitamin D Supplementation: A Positive Synergistic Effect on Prevention of Childhood Infections?
In: International Journal of Environmental Research and Public Health 2022 Mar 3;19(5):2973. doi: 10.3390/ijerph19052973.
Authors: Raffaele Domenici, Francesco Vierucci.
Abstract: "Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health. Keywords: COVID-19; breastfeeding; human milk; infections; supplementation; vitamin D."
Open access: https://www.mdpi.com/1660-4601/19/5/2973/htm