Journal of Human Lactation最新文献

{"title":"Relationship Between Birthweight for Gestational Age and Colostrum Macronutrient Composition: A Comparative Analysis in Small, Appropriate, and Large for Gestational Age Infants.","authors":"Sema Arayici, Evrim Alyamac Dizdar, Gulsum Kadioglu Simsek, Fatma Nur Sari","doi":"10.1177/08903344251342561","DOIUrl":"10.1177/08903344251342561","url":null,"abstract":"<p><strong>Background: </strong>Human milk and colostrum have been well studied; however, limited data are available on the variations in macronutrient content when compared across different infant weight categories for infants with similar gestational ages.</p><p><strong>Research aims: </strong>To compare the colostrum macronutrient content of participants who delivered term infants classified as small for gestational age, appropriate for gestational age, and large for gestational age.</p><p><strong>Methods: </strong>In this exploratory cross-sectional observational study (<i>N</i> = 252), colostrum (on postpartum Day 2) was collected and categorized by gestational weight group. The protein, fat, carbohydrate, and energy levels of colostrum were measured using a mid-infrared human milk analyzer. Values were dichotomized at the median and compared using logistic regression.</p><p><strong>Results: </strong>Median colostrum protein content was significantly higher in the small for gestational age (4.8 [IQR = 3-6.4] gr/dl) and large for gestational age (4.4 [IQR = 3.5-5.3] g/dl) groups compared to the appropriate for gestational age group (2.8 [IQR = 2.1-3.7] g/dl; <i>p</i> < 0.001). Median carbohydrate content was significantly higher in the large for gestational age group (5.3 [IQR = 4.2-6] g/dl) than appropriate for gestational age group (4.5 [IQR = 3.5-5.3] g/dl; <i>p</i> = 0.002). In multivariate analysis, being SGA or LGA was independently associated with higher milk protein content (<i>OR</i> 4.68; 95% CI [2.25, 9.77; <i>p</i> < 0.001; and <i>OR</i> 6.76; 95% CI [3.30, 13.87]; <i>p</i> < 0.001, respectively). Only being LGA was associated with higher carbohydrate content (<i>OR</i> 2.74; 95% CI [1.46, 5.16]; <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>Colostrum macronutrient content varies depending on whether the birthweight is small or large for gestational age. Studies are needed to investigate these potential associations and the clinical consequences of this relationship.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"371-378"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Silver Nipple Protectors in Treating Nipple Trauma: A Non-Randomized Comparative Trial.","authors":"Maya Nakamura, Hiroyuki Sugimori, Yoko Asaka, Yasuhiko Ebina","doi":"10.1177/08903344251342564","DOIUrl":"10.1177/08903344251342564","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is crucial for infant health, but nipple trauma remains a common challenge. In particular, nipple trauma can lead to the onset of mastitis and psychological distress for mothers. Silver nipple protectors have been suggested to alleviate this issue, but detailed research is needed.</p><p><strong>Research aim: </strong>This study aims to clarify the effectiveness of silver nipple protectors in treating nipple trauma in Japanese women.</p><p><strong>Methods: </strong>A non-randomized comparative trial compared 47 participants (94 nipples) using silver nipple protectors with a control group of 50 participants (100 nipples) from historical data. The assessment included chronological changes in nipple condition, level of nipple pain, and safety, among other factors. Data collection spanned from 2023 to 2024.</p><p><strong>Results: </strong>The group using silver protectors experienced fewer instances of severe nipple trauma and showed a higher frequency of healing patterns. Many of these patterns involved a transition from mild erythema or swelling toward a healing state. Specifically, the level of nipple pain on the 4th postpartum day was significantly lower. No safety issues from the use of silver protectors were noted.</p><p><strong>Conclusion: </strong>This study suggests that silver nipple protectors may prevent the occurrence of severe nipple trauma and are safe and beneficial for Japanese women. Future research should focus on the mechanism of silver protectors, their long-term effects, regional differences, practical challenges for implementation, and comparisons with other common treatments.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"382-391"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"About Research: Clinical Versus Statistical Significance\".","authors":"","doi":"10.1177/08903344251363628","DOIUrl":"https://doi.org/10.1177/08903344251363628","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251363628"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester.","authors":"","doi":"10.1177/08903344251362775","DOIUrl":"10.1177/08903344251362775","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251362775"},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hispanic Birthing Parents' Experiences With Lactation Support Received In-Hospital: A Quality Improvement Needs Assessment.","authors":"Cati G Brown-Johnson, Samantha M R Kling, Erika A Saliba-Gustafsson, Zakiyah K Williams, Julie Najar, Anna Sophia Lessios, Sonia Rose Harris, Kate A Shaw, Lisa M Goldthwaite, Jonathan G Shaw, Susan D Crowe","doi":"10.1177/08903344251321777","DOIUrl":"10.1177/08903344251321777","url":null,"abstract":"<p><strong>Background: </strong>Human milk-feeding benefits infants and parents. Exclusive human milk (EHM) feeding is recommended for infants younger than 6 months; however, many U.S. infants do not receive this recommendation. Documented disparities exist between White and historically marginalized populations, including Hispanic/Latino parents.Quality Improvement Needs Assessment Aims:To explore Hispanic birthing parents' experiences with human milk-feeding and lactation support as part of a quality improvement needs assessment project, identifying barriers and facilitators during post-birth hospital recovery.</p><p><strong>Methods: </strong>We collected and triangulated three data sources for 37 interviews: (1) in-hospital observations that included opportunistic informal interviews, as well as telephone interviews with (2) English- and Spanish-language-preferring Hispanic birthing parents, and (3) pediatric clinician interviews (via snowball sampling recruitment). In-hospital observations were collected in March 2022 at a Northern California academic medical center. Interviews included birthing parents, physicians, nurses, clinical trainees, administrators, and lactation consultants. Telephone interviews occurred between March and May 2022. We used rapid and thematic analysis, subsequently mapping themes to the socioecological model as an organizing framework.</p><p><strong>Results: </strong>Interpersonal growth opportunities were identified: trust-building through deep listening, better communication between patients and clinicians, particularly at night, and better cross-language understanding. At the hospital level, identified needs included supportive maternity care practices, lactation staff availability, and more perinatal lactation education and resources (e.g., iPads, pumps). Spanish-language-preferring patients reported needing better interpretation services.</p><p><strong>Conclusion: </strong>This quality improvement project identified opportunities for improvement in relationships with patients, clinician communication, and training and physical resources.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"207-219"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Field - Designing Baby-Friendly Hospital Step 2 Training A Hospital Case Study.","authors":"Cassandra P Leahy","doi":"10.1177/08903344251319363","DOIUrl":"10.1177/08903344251319363","url":null,"abstract":"<p><p>Maintaining Baby-Friendly Hospital Initiative (BFHI) standards within a complex healthcare system presents unique challenges. This case study from a regional perinatal center in the northeast United States details the design and implementation of a program to address BFHI Step 2, which requires ongoing competency assessment and team member training to ensure breastfeeding support. The shift of BFHI competencies to continuous professional development introduced logistical challenges, compounded by staff turnover and budget constraints. To address these, the hospital team developed an in-house learning management system tailored to BFHI requirements. The learning management system offered modular, role-specific content, self-paced learning, and interactive assessments, ensuring adaptability, cost-effectiveness, and scalability. Administrative tools supported compliance tracking and reviews of test results, which assisted with timely resolution of knowledge gaps. A hybrid approach, including in-person training and team meetings, further reinforced staff competence. This sustainable, integrated system fostered continuous learning, and enhanced staff preparedness toward supporting breastfeeding families.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"191-195"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Breastfeeding Promotion in Maternity Hospitals Based on Specified International Recommendations-Experiences From Germany.","authors":"Merlin Blendermann, Nele Hockamp, Erika Sievers, Thomas Lücke, Mathilde Kersting","doi":"10.1177/08903344251318275","DOIUrl":"10.1177/08903344251318275","url":null,"abstract":"<p><strong>Background: </strong>The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).</p><p><strong>Research aim: </strong>To identify specific hospital practices and structures that are in compliance with the recommendations and those that still need to be improved.</p><p><strong>Method: </strong>A cross-sectional survey and descriptive analysis was conducted in 109 German hospitals. This web-based questionnaire examined the structural conditions and usual handling of breastfeeding support. Recommendations were reported using sub-criteria.</p><p><strong>Results: </strong>The implementation of the sub-criteria ranged from less than 25% to more than 90%. Hospitals were more likely to have a breastfeeding policy (85.3%, <i>n</i> = 93) than a breastfeeding coordinator (73.4%, <i>n</i> = 80). Immediate skin-to-skin contact after birth and early breastfeeding initiation were implemented more frequently after a vaginal (89.9%, <i>n</i> = 98 and 71.6%, <i>n</i> = 78) than after Cesarean delivery (45.9%, <i>n</i> = 50 and 54.1%, <i>n</i> = 59). Additional feeding of fluids was usually restricted to a medical indication (70.6%, <i>n</i> = 77), however, the decision to feed formula was rarely made by hospital staff alone (27.5%, <i>n</i> = 30). Large hospitals (> 1000 births/year) had a written breastfeeding policy and a breastfeeding coordinator more frequently than smaller hospitals (<i>p</i> < 0.01, Fisher's exact test).</p><p><strong>Conclusion: </strong>The use of sub-criteria of WHO recommendations helped identify critical parts of breastfeeding promotion in hospitals, providing concrete starting points for targeted interventions. This differentiated approach could be promising for future analyses of breastfeeding promotion.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"220-230"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Cell Isolation From Human Milk Using Immunomagnetic Beads.","authors":"Noor Radhi, Ayamita Paul, Mariana Muelbert, Gergely Toldi","doi":"10.1177/08903344251316491","DOIUrl":"10.1177/08903344251316491","url":null,"abstract":"<p><strong>Background: </strong>There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking.</p><p><strong>Research aim: </strong>Our aim was to systematically compare available cell isolation techniques to isolate T lymphocytes from human milk samples.</p><p><strong>Methods: </strong>This repeated measures study design compared three cell isolation methods using human milk samples: (1) centrifugation, (2) immunomagnetic bead isolation, and (3) a combination of both methods. We assessed the proportion and viability of CD3+, CD4+, CD25+ and regulatory T cells using flow cytometry in isolated cells to compare the performance of these isolation methods.</p><p><strong>Results: </strong>Immunomagnetic separation is a feasible method to isolate T lymphocytes in human milk, similar to blood. It improves target cell enrichment and cell viability compared to centrifugation, which may be an advantage when the goal is to characterize rare cell types or when cells are further used in functional assays. No excess cell activation (CD25 positivity) was observed with the use of magnetic beads.</p><p><strong>Conclusion: </strong>Immunomagnetic separation of human milk T lymphocytes may have advantages over centrifugation depending on the intended downstream use of cells.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"263-271"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Censorship in Science: Navigating Between Soft and Hard Constraints in Lactation Research.","authors":"Ellen Chetwynd","doi":"10.1177/08903344251325143","DOIUrl":"10.1177/08903344251325143","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"167-169"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship and Determinants of Breastfeeding Self-Efficacy Among Postpartum Mothers and Fathers in Malawi: A Cross-Sectional Study.","authors":"Roselyn Chipojola, Mega Hasanul Huda, Kaboni Whitney Gondwe, Nyanyiwe Masingi Mbeye, Shu-Yu Kuo","doi":"10.1177/08903344251318274","DOIUrl":"10.1177/08903344251318274","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding self-efficacy among both mothers and fathers is critical in enhancing exclusive breastfeeding rates. However, the interrelationship between maternal and paternal breastfeeding self-efficacy and their determinants remains unknown.</p><p><strong>Research aims: </strong>We aimed to (a) investigate the relationship between breastfeeding self-efficacy scores postpartum for mothers and fathers; (b) explore factors associated with breastfeeding self-efficacy in this group; and (c) examine determinants of combined self-efficacy scores among breastfeeding parents in Malawi.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on postpartum mother-father couples at a tertiary maternity facility in central Malawi. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression.</p><p><strong>Results: </strong>Mothers demonstrated a higher score of self-efficacy (<i>M</i> = 55.7, <i>SD</i> = 6.5) in comparison to fathers (<i>M</i> = 50.2, <i>SD</i> = 11.9). A significant moderate positive correlation was identified between mothers' and fathers' breastfeeding self-efficacy (<i>r</i> = 0.32). Age, employment status, mode of birth, and practicing exclusive breastfeeding were significantly associated with maternal and paternal breastfeeding self-efficacy. Factors including advanced age, Cesarean delivery, and depressive symptoms emerged as significant determinants of combined breastfeeding self-efficacy scores among couples.</p><p><strong>Conclusion: </strong>Breastfeeding self-efficacy is highly correlated between mothers and fathers, with a relatively higher score in mothers. Importantly, sociodemographic, obstetric, and psychological determinants play a substantial role in influencing parental breastfeeding efficacy. This highlights the necessity of incorporating both mothers and fathers into future breastfeeding promotion strategies.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"272-282"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}