Breastfeeding Medicine最新文献

{"title":"Resilience of Breastmilk Composition to Maternal Nutritional Stress in Mothers with Preterm Infants.","authors":"Rubí Viveros-Contreras, Cesar Huerta-Canseco, Elvia Cruz-Huerta, Astrid Contreras-Domínguez, Juan Gerardo Neme Kuri, David Huerta Morales, Ana María Rivas-Estilla, Mario Daniel Caba-Flores","doi":"10.1177/15568253251379478","DOIUrl":"https://doi.org/10.1177/15568253251379478","url":null,"abstract":"<p><p><b><i>Background:</i></b> Preterm infants experience increased oxidative stress and possess limited endogenous antioxidant reserves. Breastmilk provides critical protection, but its composition under maternal nutritional stress remains poorly characterized. <b><i>Objectives:</i></b> To evaluate the nutritional and antioxidant profile of colostrum and mature milk from mothers with preterm births and under nutritional stress. <b><i>Methods:</i></b> Breastfeeding mothers from Veracruz, México, who delivered preterm infants were recruited. Dietary intake was evaluated using a food frequency questionnaire. From the total cohort (<i>n</i> = 42), a subset of mothers (<i>n</i> = 32) provided colostrum and mature milk samples which were analyzed for total proteins, total polyphenols, and antioxidant capacity using 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assays. Associations with maternal body mass index, dietary intake, gestational age, and socioeconomic status were examined. <b><i>Results:</i></b> Mothers experienced nutritional stress, with low diversity, energy dense, and nutrient-poor dietary pattern dominated by consumption of ultra-processed foods. Despite this, breastmilk retained adequate levels of protein, polyphenols, and antioxidant capacity in both colostrum and mature milk. <b><i>Conclusion:</i></b> Even under maternal nutritional stress, breastmilk composition remained functionally resilient, delivering adequate levels of nutritional and antioxidant components, sufficient to meet the elevated demands of preterm infants.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding and Lactation Medicine-From Newborn to Adult.","authors":"Elien Rouw","doi":"10.1177/15568253251379465","DOIUrl":"https://doi.org/10.1177/15568253251379465","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood and Prenatal Stressors Shape Breastfeeding Behavior in Individuals with Opioid Use Disorder: A Prospective Investigation of Stress Effects.","authors":"Linnea B Linde-Krieger, C J Ryan, Lela Rankin, Stacey Tecot, Alicia M Allen","doi":"10.1177/15568253251377776","DOIUrl":"https://doi.org/10.1177/15568253251377776","url":null,"abstract":"<p><p><b><i>Background:</i></b> Perinatal opioid use disorder (OUD) remains prevalent in the United States and is associated with unfavorable breastfeeding outcomes, including low likelihood of initiation and decreased duration. Individuals with OUD face heightened risk for traumatic events across the life course, though we know little about how life stress impacts breastfeeding in those with OUD. <b><i>Method:</i></b> We investigated the differential and sequential impacts of adverse childhood experiences (ACEs) and past-year stressful life events (SLEs) on breastfeeding outcomes in a prospective cohort study of 50 pregnant individuals (100% identified as female, 42% non-Hispanic White, 42% Hispanic/Latina) in treatment for OUD, followed through 5 months postpartum. <b><i>Results:</i></b> Out of 50 participants, 37 (74.0%) initiated breastfeeding, 16 (32.0%) reported continued breastfeeding in any capacity at 2 months, and 5 (10%) reported exclusive breastfeeding at 2 months. Higher ACE scores were associated with increased odds of breastfeeding initiation (odds ratio [OR] = 3.48, 95% confidence interval [CI]: 1.11-16.34) and longer duration (B = 0.33, 95% CI: 0.04-0.60), suggesting resilience to early childhood adversity. Mediation analyses adjusted for demographic covariates revealed a significant indirect effect from higher ACEs to reduced likelihood of exclusive breastfeeding (β = -0.09, 95% CI: -0.09, -0.001, <i>p</i> = 0.04) via greater SLEs in the year prior to birth (β = 0.33, 95% CI: 0.06, 0.68, <i>p</i> = 0.01). <b><i>Conclusions:</i></b> Results highlight the importance of addressing both lifetime and recent trauma in clinical settings to improve breastfeeding outcomes in higher-risk populations. Interventions that incorporate social and behavioral support may be particularly beneficial to mitigate the negative impacts of stress on breastfeeding.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Core Indicators of a Breastfeeding-Friendly City: A Delphi Study.","authors":"May Loong Tan, Siew Cheng Foong, Wai Cheng Foong, Grace Y W Tay, Jacqueline J Ho, Amal Omer-Salim, Elizabeth J O'Sullivan, Fionnuala M McAuliffe","doi":"10.1177/15568253251376671","DOIUrl":"https://doi.org/10.1177/15568253251376671","url":null,"abstract":"<p><p><b><i>Background:</i></b> A breastfeeding-friendly city is one with a synchronous and enabling environment for breastfeeding. A scoping review and interviews with breastfeeding mothers identified numerous potential indicators of a breastfeeding-friendly city. <b><i>Objective:</i></b> To determine a set of indicators of a breastfeeding-friendly city through consensus. <b><i>Methods:</i></b> A modified two-round online Delphi survey was conducted with three stakeholder groups-experts, policymakers, and families. In Round 1, participants rated 52 potential indicators identified from earlier studies. They were asked to also suggest additional indicators. In Round 2, participants were shown the ratings of the other participants from Round 1 and asked to rate the items again with the choice of changing their original ratings. Consensus was defined as more than 70% of participants rating an item as critical (rating of 7-9) or not important (rating of 1-3). Items without consensus were discussed in a final consensus meeting. <b><i>Results:</i></b> A total of 107 participants from 14 countries completed the survey. After both rounds, 50 of 56 items reached consensus. Following the consensus meeting, a final list of 52 indicators was agreed upon. These were grouped into five sectors: city administration (e.g., policy, leadership, budget), community (e.g., peer support, breastfeeding rooms), health care (e.g., hospital, clinic, pharmacy), workplace (e.g., time, space), and collaboration. <b><i>Conclusion:</i></b> Using a systematic approach, we identified a comprehensive list of indicators that reflect the warm chain. These indicators offer cities a practical framework for evaluating and strengthening breastfeeding-friendly environments, with the potential to improve global breastfeeding outcomes.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Survey of U.S. Prescribing Clinicians Who Practice Breastfeeding and Lactation Medicine in Outpatient and Inpatient Healthcare Settings.","authors":"Deanna Nardella, Casey Rosen-Carole, Mariana Colmenares Castaño, María-Teresa Hernández-Aguilar, Meredith Young, Emily Swisher Rosa, Mona Sharifi, Veronika Shabanova, Katherine Standish","doi":"10.1177/15568253251371711","DOIUrl":"https://doi.org/10.1177/15568253251371711","url":null,"abstract":"<p><p><b><i>Background:</i></b> The field of breastfeeding and lactation medicine (BFLM) is a developing area of clinical expertise among physicians and advanced practice providers, though it remains poorly described in the literature. We aimed to (1) characterize the workforce of U.S. prescribing clinicians who deliver BFLM and the clinical care they provide and (2) explore clinicians' perceived barriers, facilitators, and attitudes related to BFLM care. <b><i>Methods:</i></b> We performed a descriptive, cross-sectional study of U.S. clinicians who self-identify as BFLM clinicians. Inclusion was limited to medical clinicians who (1) hold a license to prescribe medication (physicians, advanced practice providers) and (2) independently diagnose and manage breastfeeding-related concerns or complications. <b><i>Results:</i></b> Our sample of 138 U.S. clinicians had a median of 8 years of BFLM clinical experience and included physicians (81%), nurse practitioners (13.0%), midwives (3.6%), and physician assistants (2.2%). Among clinicians within large healthcare organizations, 20% held BFLM-related positions/titles. Of clinicians who delivered dedicated outpatient BFLM care, 64.5% offered telehealth, 67.4% billed for mother and infant, and 43% offered outpatient frenotomy. A median wait time of 5 days for initial BFLM outpatient evaluation was reported. Few participants provided inpatient and electronic consultation services (i.e., \"e-consult\") dedicated to BFLM. Most agreed that BFLM care addresses critical gaps in U.S. healthcare (95%). <b><i>Conclusions:</i></b> We present the first description of a national sample of U.S. prescribing clinicians who practice BFLM. These findings may assist clinicians and organizations in implementing BFLM care and underscore a need for future research around the integration and impact of BFLM care within U.S. health systems.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Breastfeeding Support: The Need to Be Available and Timely.","authors":"Jennifer A Ross","doi":"10.1089/bfm.2025.0120","DOIUrl":"10.1089/bfm.2025.0120","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"681-682"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational Study on the Pharmacokinetics of Levofloxacin in Lactating Atypical Pneumonia Patients.","authors":"Jiahai Shang, Liangfang Pang, Jiaojiao Long, Yarui Liu, Yuanyuan Lu","doi":"10.1177/15568253251361911","DOIUrl":"10.1177/15568253251361911","url":null,"abstract":"<p><p><b><i>Importance:</i></b> Atypical pneumonia in postpartum women may alter drug pharmacokinetics (PK) through cytokine-mediated changes in vascular permeability, yet the breast milk disposition of levofloxacin in this population remains uncharacterized. <b><i>Objective:</i></b> This observational study aimed to compare levofloxacin PK in lactating atypical pneumonia patients (<i>n</i> = 10) receiving 400 mg once daily for 3 days with historical healthy controls and to assess infant exposure risks. <b><i>Methods:</i></b> Breast milk samples from subjects 6-10 were collected at predetermined time points (0.5, 1, 2, 4, 6, 8, 10, 12, and 24 hours) following the last dose of 3 days. Subjects 1-5 had random daytime sampling. The concentration of levofloxacin in breast milk was measured using a validated high-performance liquid chromatography method with ultraviolet detection (correlation coefficient: 0.9997; limit of detection: 0.15 μg/mL; recovery: 91.36-102.28%; RSD <5%). PK parameters were derived using noncompartmental analysis in Phoenix WinNonlin (version 8.35). <b><i>Results:</i></b> Key milk PK parameters included C_max of subjects 1-5 was 15.74 ± 6.55 μg/mL, and in subjects 6-10 was 14.55 ± 2.56 μg/mL. The elimination half-life (t_1/2β) in subjects 1-5 was 7.46 ± 3.39 hours and in subjects 6-10 was 4.57 ± 1.14 hours. The AUC_0-24 in subjects 1-5 was 84.31 ± 22.60 mg·h/L and in subjects 6-10 was 63.99 ± 11.78 mg·h/L. <b><i>Conclusions:</i></b> Based on a 150 mL/kg/day milk intake, the estimated infant daily exposure in subjects 1-5 and 6-10 was 0.53 ± 0.14 and 0.40 ± 0.07 μg/kg/day, respectively, which was below 10% of the therapeutic dose (10 mg/kg once daily) for infants aged 0-12 months. This study first quantified levofloxacin in atypical pneumonia patients' breast milk using a validated method. Results suggest that breastfeeding can continue cautiously during maternal levofloxacin therapy. Avoid breastfeeding at peak drug concentration and monitor the infant for potential reactions.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"666-671"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on the Association of Breastfeeding's Protective Effect on Postpartum Depression: A Comparative Analysis of Prepandemic and Pandemic Cohorts.","authors":"Amanda Vozzola, David E Vozzola, Dikea Roussos-Ross","doi":"10.1089/bfm.2024.0109","DOIUrl":"10.1089/bfm.2024.0109","url":null,"abstract":"<p><p><b><i>Background:</i></b> Before the COVID-19 pandemic, research studies indicated that breastfeeding was protective against postpartum depression (PPD). This study aimed to evaluate the impact of the COVID-19 pandemic on the protective association between breastfeeding and PPD. <b><i>Methods:</i></b> We performed a retrospective cohort study by comparing the Edinburgh Postnatal Depression Scale (EPDS) scores for patients in two cohorts, pre-COVID-19 (April 2019 to February 2020) and COVID-19 (April 2020 to February 2021). A cross-sectional design using descriptive statistics, Pearson correlations, analysis of variance (ANOVA), and stepwise multiple regression analysis (MRA) analyzed the EPDS scores of a prepandemic cohort (<i>N</i> = 448) and a pandemic cohort (<i>N</i> = 468) of women seen at a tertiary academic medical center for their first postpartum visit. <b><i>Results:</i></b> In the prepandemic cohort, 77.3% of breastfeeding women exhibited an unlikely risk for PPD compared with 78.5% in the pandemic cohort. Pearson correlations showed that the breastfeeding group in both cohorts had significantly lower EPDS scores, was less likely to exhibit PPD, and had a lower risk of severe PPD. ANOVA showed that nonbreastfeeding women had significantly higher EPDS scores in both cohorts. Stepwise MRA showed that the EPDS item Q8 (\"I have felt sad or miserable\") was the most significant predictor of PPD in breastfeeding women (both cohorts) and nonbreastfeeding women (prepandemic cohort) but had escalated to Q9 (\"I have been so unhappy that I have been crying\") for nonbreastfeeding women in the pandemic cohort. <b><i>Conclusion:</i></b> In both the prepandemic and pandemic cohorts, breastfeeding women had significantly lower EPDS scores.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"650-657"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors that Are Associated with Increased Lactic Acid Bacteria Presence in Donated Human Milk.","authors":"Jurjana Novoselac, Katarina Butorac, Andreja Leboš Pavunc, Davor Ježek","doi":"10.1089/bfm.2025.0077","DOIUrl":"10.1089/bfm.2025.0077","url":null,"abstract":"<p><p><b><i>Background:</i></b> Probiotic bacteria isolated from human milk can have a preventive effect against necrotizing enterocolitis and other risks of prematurity. The aim of the study is to identify the possible factors that can influence the presence of lactic acid bacteria (LAB) in donated human milk (DHM). <b><i>Methods:</i></b> Next-generation sequencing and selective microbiological culturing of samples from pools of raw DHM were performed. Data on the donors, their children, and the milk are correlated with the microbiological findings. A regression model is performed, to predict the probability of the presence of the genera <i>Lactobacillus</i> and <i>Bifidobacterium</i>. <b><i>Results:</i></b> The abundance of the genus <i>Bifidobacterium</i> positively correlated with the donor's body mass index (<i>p</i> = 0.050). The abundance of the <i>Lactobacillus</i> positively correlated with the lactation age (<i>p</i> = 0.007) and negatively with the total bacterial count on blood agar (<i>p</i> = 0.001). The abundance of the <i>Bifidobacterium</i> positively correlated with the growth on selective transgalactosylated oligosaccharides-propionate agar media (<i>p</i> = 0.036). In the regression model for predicting the probability of the presence of LAB, the feeding mode and the length of storage in the milk bank proved to be statistically significant predictors. <b><i>Conclusion:</i></b> The results of this study indicate that mature DHM, that has a lower bacterial count, that was stored in the milk bank for a shorter time after pool formation and that is donated from a mother exclusively breastfeeding her infant is assumed to have both LAB.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"628-634"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pump Matters: An Educational Bundle to Promote a Predominant Mother's-Own-Milk Diet in Very Low Birthweight Infants.","authors":"Johnae D Snell, Laura A Gollins, Joseph L Hagan, Kristina Tucker, Gina Marrinucci, Anne Debuyserie, Amy B Hair","doi":"10.1089/bfm.2025.0008","DOIUrl":"10.1089/bfm.2025.0008","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Mothers of very low birthweight (VLBW) infants rely on frequent, effective pumping for breast milk production. While hospital-grade breast pumps aid in mother's-own-milk (MOM) provision, accessing them after maternal discharge can be difficult. <b><i>Methods:</i></b> This quasi-experimental study assessed the impact of a bundled intervention on percentages of MOM and oral immune therapy (OIT) intake in the first 28 days of life (DOL) of VLBW infants admitted to a tertiary neonatal intensive care unit. The bundle included breastfeeding education, neonatal provider support, and a free 1-month hospital-grade breast pump rental for home use. <b><i>Results:</i></b> There were 102 infants enrolled, split into retrospective (<i>n</i> = 50) and prospective (<i>n</i> = 52) groups. While median %OIT intake was significantly higher in the prospective group (71.9% [interquartile range-IQR: 56, 78.2] versus 41.1% [IQR: 9.1, 60.7]; <i>p</i> ≤ 0.001), %MOM was not significantly increased after adjusting for race. More prospective infants received higher doses (≥90%) of MOM (71% versus 50%; <i>p</i> = 0.042), while more retrospective infants received lower doses (<5%) of MOM (18% versus 4%; <i>p</i> = 0.027). Black infants in the retrospective group received a lower median %MOM (69.1% [IQR: 3, 98.2] versus 93.9% [IQR: 68, 98.8] in non-Black infants; <i>p</i> = 0.388), but a significantly higher median %MOM in the prospective group (99.1% [IQR: 98, 100] versus 97.5% [IQR: 51, 99.5] in non-Black infants; <i>p</i> = 0.041). <b><i>Conclusion:</i></b> Bundled interventions including providing free hospital-grade breast pumps for home use may result in increased %OIT received and more VLBW infants receiving higher doses of MOM in the first 28 DOL. It may also help diminish existing racial disparities in %MOM intake.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"635-644"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}