Breastfeeding Medicine最新文献

{"title":"Breastfeeding Challenges Experienced by Mothers Following Multiple Births-a Systematic Review and Meta-Synthesis of Quantitative, Qualitative, and Mixed-Methods Studies.","authors":"Geeta Bhardwaj, Moonjelly Vijayan Smitha, Prasuna Jelly, Shine Stephen, Jessica Eustace- Cook, Sunita Panda","doi":"10.1089/bfm.2024.0207","DOIUrl":"10.1089/bfm.2024.0207","url":null,"abstract":"<p><p><b><i>Background:</i></b> Breastfeeding is vital for infant nutrition, especially for multiple babies (twins) born prematurely, yet breastfeeding rates among mothers of twins are lower compared with mothers of singleton babies. This review presents a synthesis of research findings on breastfeeding challenges experienced by mothers following twins' births. <b><i>Methods:</i></b> The electronic databases of CINAHL, MEDLINE, PsycINFO, EMBASE, and Web of Science were systematically searched in August 2023. All eligible quantitative, qualitative, and mixed-methods studies reported on breastfeeding challenges experienced by mothers of twins were included. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and followed Lucas et al.'s framework for thematic synthesis. Two reviewers independently screened all studies by title, abstract, and full text. The methodological quality of studies was independently assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool and mixed-methods appraisal tool based on study design. <b><i>Results:</i></b> The review included 16 studies: quantitative (<i>n</i> = 5), qualitative (<i>n</i> = 8), and mixed methods (<i>n</i> = 3), published between 1980 and 2022, involving 3,351 mothers from 16 countries. Three main themes were generated as follows: (1) transitioning to a new role, finding the balance between self and the newborns' needs; (2) the inevitability of emotional challenges; and (3) navigating support and information. <b><i>Conclusion:</i></b> The integrated findings of quantitative, qualitative, and mixed-methods studies on challenges experienced by mothers of twins will have scope for researchers to address the challenges through tailored intervention, education, and support and can help health care professionals revisit policy and practices to extend support services for mothers of twins beyond the initial postpartum and to the community for improving breastfeeding practices among mothers following multiple births.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"219-230"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920472","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":"Test Weight Validation In Preterm Infants.","authors":"Meredith Kinoshita, Martin J White, Anne Doolan","doi":"10.1089/bfm.2024.0243","DOIUrl":"10.1089/bfm.2024.0243","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Accuracy in the assessment of feed intake is important for preterm infants at risk of growth failure. Clinical observation tools are unvalidated in this population, and test weight measurement may be inaccurate in preterm infants taking small feed volumes. <b><i>Methods:</i></b> Test weights were performed to assess agreement between weights using a standardized protocol and a feed of known weight in preterm infants (born at <35 weeks gestational age [GA]) during their transition to oral feeding. Reproducibility was assessed using two repeated measurements in each participant. Agreement between test weights and known feed weights was assessed, and minimal detectable change was calculated. <b><i>Results:</i></b> Thirty-eight preterm infants (GA 30 + 5 (28-33 + 1), birth weight 1574 g (+/- 671 g)) were recruited and had test weights performed at CGA 35 + 3 (± 10 days). Each infant was weighed twice before and twice after each measured feed, and a high degree of reproducibility was found for both the paired pre-feed weights, ICC = 0.99 [0.99-0.99] and the paired post-feed weights, ICC = 0.99 [0.99-0.99]. The mean absolute difference between test weight and feed weight was 1.7 g (±2.2). We calculated the minimum detectable change as 0.96 g, representing the magnitude of change below which there is more than 95% chance that no real change occurred. <b><i>Conclusions:</i></b> During the establishment of oral feeds, a standardized protocol at the bedside for repeated pre- and post-feed weights demonstrated a high degree of reproducibility. Based on our data, test weight measurements are appropriate for use in this preterm population during the establishment of oral feeds.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"238-243"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766059","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":"Association Between Breastfeeding Intensity and Mammary Gland Involution Markers in Early Postpartum Among Women from Low-Income Households.","authors":"Diana Marcos Rosas, Maryanne Perrin, Jigna M Dharod","doi":"10.1089/bfm.2024.0148","DOIUrl":"10.1089/bfm.2024.0148","url":null,"abstract":"<p><p><b><i>Background:</i></b> The aim was to examine the associations between breastfeeding intensity and changes in concentrations of mammary gland involution markers (protein and lactose) among mothers participating in federal food assistance programs. <b><i>Methods:</i></b> Pregnant women in their third trimester who planned to breastfeed were recruited from local prenatal clinics (<i>n</i> = 25). After delivery, six weekly home visits were conducted to collect human milk samples and 24-hour infant feeding recalls. Milk protein and lactose concentrations were measured utilizing Bicinchoninic Acid and Megazyme assays, respectively. Bivariate tests were carried out using a statistical significance of <i>p</i> < 0.05. <b><i>Results:</i></b> Majority (84%) of our participants were either African American or of Latino origin. About one-fourth of our participants were primiparous and the average monthly household income was $3,150 with an average household size of 4. In week 2 postpartum, 18 mothers had a 100% breastfeeding intensity, while in week 6 it decreased to 16 mothers. A significant difference in milk protein concentration was seen between exclusive and mixed-feeding mothers from weeks 2 to 6; meanwhile, for lactose concentrations, the significant differences were seen only in weeks 3 and 4 (<i>p</i> < 0.005). Protein changes were negatively associated with breastfeeding intensity (as breastfeeding intensity went up, protein decreased), while lactose changes were positively associated with breastfeeding intensity (protein <i>r</i> = -0.5578; lactose <i>r</i> = 0.6571). <b><i>Conclusions:</i></b> Significant associations between intensity of breast milk feeding and mammary gland involution markers highlight the sensitivity of the mammary gland to mixed feedings in the early postpartum period.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"231-237"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805895","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":"Effect of Feeding Human Milk on Development of the Infant Immune System and Allergic Outcomes-An Area of Research Challenge and Need.","authors":"Kirsi M Järvinen-Seppo","doi":"10.1089/bfm.2024.0302","DOIUrl":"10.1089/bfm.2024.0302","url":null,"abstract":"<p><p>Surprisingly little is known about the effect of breastfeeding on the infant's immune system development. Systematic reviews have suggested the role of breastfeeding in the prevention against asthma, autoimmune diseases, inflammatory bowel disease, and childhood leukemia. However, studies on atopic disease suffer from reverse causation, small size, and those assessing food allergy (FA) have often relied on parent-reported outcomes. Randomized controlled trials (RCTs) are not possible for ethical reasons. In addition, epidemiological studies have not considered that there is a large interindividual variation in human milk (HM) composition and feeding at the breast versus pumped HM potentially impacting the effect of breastfeeding between mothers. While prevention strategies such as early introduction of highly allergenic food are impactful in preventing peanut and egg allergies, implementation of early introduction guidelines has been slow, and many infants are already sensitized by 4-6 months of age. To be more effective, primary prevention strategies must commence much earlier, during breastfeeding. There are studies that imply a definitive effect of breastfeeding on the gut microbiome and regulatory T cells (Tregs) as well as a higher rate of FA in populations with historically low rates of breastfeeding. These provide a strong rationale for assessing the effect of feeding HM in the context of HM composition and mode of feeding on immune development. The lack of well-conducted, large studies assessing the role of breastfeeding and HM composition in the development of immune system development is a significant gap when designing prevention strategies.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"201-204"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188110","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":"Influence of Newborns' Sex on Minor and Trace Element Concentrations in Human Milk During Early Lactation.","authors":"Banin Shakeri Jooybari, Fatemeh Nasri Nasrabadi, Abdoulreza Esteghamati","doi":"10.1089/bfm.2024.0226","DOIUrl":"10.1089/bfm.2024.0226","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> This study aimed to investigate the influence of newborns' sex on the concentrations of minor and trace elements in the human milk of lactating mothers during early lactation. The elemental analysis focused on calcium (Ca), potassium (K), sodium (Na), and chlorine (Cl) as minor elements and iodine (I), aluminum (Al), bromine (Br), and rubidium (Rb) as trace elements. <b><i>Methods:</i></b> Breast milk samples were collected from 75 lactating mothers in Tehran, Iran, during the early feeding stage. Neutron activation analysis was used to quantify elemental amounts in milk samples, and <i>t</i> tests were conducted to identify statistical differences in element levels between mothers of male and female newborns. <b><i>Results:</i></b> Statistically significant differences in the elemental composition of milk samples were found based on newborn infants' sex. Mothers of female newborns had notably higher mean levels of Br (14.8 mg/kg versus 11.3 mg/kg, <i>p</i> = 0.011), Cl (10.16 mg/g versus 7.10 mg/g, <i>p</i> = 0.009), and Na (6.18 mg/g versus 4.45 mg/g, <i>p</i> = 0.017) compared with mothers with male newborns. Although Ca, K, I, Al, and Rb did not show statistically substantial differences, there was a trend toward elevated levels of Al, I, and Ca in the milk of mothers with the females. <b><i>Conclusion:</i></b> The analysis reveals sex-based variations in human milk composition, with elevated levels of Br, Cl, and Na observed in mothers of female newborns. These findings suggest that infant sex may influence the elemental profile of maternal milk, highlighting the need for further research to uncover the mechanisms behind these differences and their potential implications for improving infant nutrition and health.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"256-260"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881238","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 Positive Effect on Preterm Infants' Feeding of Human Milk During Hospitalization and at Discharge after the Opening of a Personalized Nutrition Unit.","authors":"María Isabel Pescador-Chamorro, Sylvia Caballero-Martín, Elena Rodríguez-Corrales, Sara Vigil-Vázquez, Manuel Sánchez-Luna","doi":"10.1089/bfm.2024.0233","DOIUrl":"10.1089/bfm.2024.0233","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pasteurized donor human milk must be provided when mother's own milk (MOM) is not available for preterm infants. There are concerns that human milk banks (HMBs) and the use of donor milk may potentially reduce breastfeeding rates. <b><i>Objective:</i></b> To compare feeding during hospitalization and at discharge before and after the opening of a HMB and to evaluate the proportion of milk provided by mothers of premature babies, comparing the intake of MOM in infants born of donor and no donor mothers. <b><i>Methods:</i></b> Retrospective observational cohort study. Data on milk intake and feeding at discharge of newborns <1,500 grams and/or 32 weeks gestational age. <b><i>Results:</i></b> There were significant differences in the intake of preterm formula (PF) between the two groups in the first 28 days of life (87.8% versus 54.2%; <i>p</i> = 0.000) and at discharge (34% versus 18.2%; <i>p</i> = 0.000). The intake of MOM during hospitalization (90.5% versus 100%; <i>p</i> = 0.008) and exclusive breastfeeding at discharge (18.7% versus 61.8%; <i>p</i> = 0.000) increased and the intake of PF (71.4% versus 33.8%; <i>p</i> = 0.000) and exclusive PF (EPF) at discharge decreased (27.5% versus 7,3%; <i>p</i> = 0.000) for babies whose mothers were or were not donors. Mothers of preterm babies donated 57.6% of the total milk received by the milk bank. <b><i>Conclusion:</i></b> After the opening of a HMB, there was a decrease in PF intake during hospitalization and an increase in MOM intake at discharge in preterm babies, especially for those whose mothers were milk donors.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"277-283"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913607","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":"Comparison of Breastfeeding Behaviors of Mothers Toward Infants by Ethnic Groups: An Example of a Multicultural City.","authors":"Ahmet Butun, Vasfiye Bayram Deger","doi":"10.1089/bfm.2024.0328","DOIUrl":"10.1089/bfm.2024.0328","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Breastfeeding practices vary widely among different ethnic groups and are influenced by cultural, social, economic, and educational factors. The aim of this study was to compare the breastfeeding behaviors of mothers toward infants in different ethnic groups. <b><i>Methods:</i></b> This descriptive cross-sectional study included women of four ethnic groups (Assyrian, Turkish, Arab, and Kurdish) living in Mardin, Turkey. The study was completed with 180 Assyrian, 184 Turkish, 175 Arab, and 169 Kurdish women. In total, 708 women participated in this study. Data were collected between August 12, 2024, and September 22, 2024. <b><i>Results:</i></b> The highest rate of traditional breastfeeding practices was seen in Kurdish (99.4%), whereas this rate was 97.3% in Turkish, 96% in Arab, and 84.4% in Assyrian. The highest rate of giving breast milk immediately after birth was in Assyrian (71.7%), while this rate was 69.3% in Turkish, 61.9% in Kurdish, and 47% in Arab (<i>p</i> = 0.000). The rate of those who waited for three calls to prayer to feed the baby was 13.1% in Kurdish, 11.3% in Arab, 9.5% in Turkish, and 7.9% in Assyrian. The rate of those who did not give the first milk (colostrum) to the baby was 15.8% in Assyrian, 11.7% in Turkish, 6.5% in Kurdish, and 6% in Arab. The rate of those who give sugared water as the baby's first nutrient was 37.5% in Arab, 20.8% in Kurdish, 11.7% in Turkish, and 9.2% in Assyrian. Increased education levels were associated with decreased rates of the presence of traditional practices. <b><i>Conclusion:</i></b> This study provides novel results regarding the comparison of breastfeeding behaviors among ethnic groups living in the same city. Comparing breastfeeding practices across the four ethnic groups allowed us to better understand different breastfeeding practices, which could lead to the development of culturally sensitive interventions to improve the health of children and mothers. Educating the community about the benefits of breastfeeding and the risks associated with some traditional practices could contribute to public health.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"267-276"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188056","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":"Mother-Infant Bed-sharing Is Associated with Increased Breastfeeding: A Systematic Review.","authors":"Rebecca L Wolf, Iva Skobic, Benjamin T Pope, Angela Zhu, Hassan Chamas, Nishtha Sharma, Kayla M Larsen, Harold S Bright, Patricia L Haynes","doi":"10.1089/bfm.2024.0060","DOIUrl":"10.1089/bfm.2024.0060","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To review current knowledge of the association between bed-sharing and breastfeeding behaviors during infancy. <b><i>Methods:</i></b> A systematic review methodology was employed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses method and utilizing the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies for quality assessment. Inclusion criteria were quantitative or mixed-methods studies published between 1993 and 2022 that provided data on the association between bed-sharing and breastfeeding for postpartum mothers of infants 0-12 months. We excluded studies that utilized breastfeeding as the independent variable and bed-sharing as the dependent variable. <b><i>Results:</i></b> A total of 24 studies met the inclusion criteria, 11 of which were prospective/longitudinal and 13 of which were cross sectional. Eight of the longitudinal studies found a significant positive association between bed-sharing and breastfeeding (73%), and nine of the cross-sectional studies (69%) found a positive association. <b><i>Conclusion:</i></b> Many postpartum women bed-share with their infants. Bed-sharing is associated with an increase in breastfeeding for most women. There does not appear to be such a relationship between bed-sharing and breastfeeding in U.S. African American women, who have overall lower rates of breastfeeding. <b><i>Policy Implications:</i></b> The public health principle of risk reduction could be applied to those who plan to bed-share such as recommending that health care providers educate women about bed-sharing without hazards. Bed-sharing without hazards may be considered one strategy to promote breastfeeding.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"205-218"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920449","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 Maternal Antibiotic Consumption on the Development of Oral Thrush Infection in Breastfeeding Infants: A Quasi-Experimental Study.","authors":"Amal M H Mackawy, Basmah F Alharbi, Ahmad Almatroudi, Mohsina Huq, Amal Hussain Mohammed, Afshan Zeeshan Wasti, Manal F Elharbi, Khaled S Allemailem","doi":"10.1089/bfm.2024.0209","DOIUrl":"https://doi.org/10.1089/bfm.2024.0209","url":null,"abstract":"<p><p><b><i>Background:</i></b> Oral thrush is a common yeast infection caused by <i>Candida albicans</i> in infants during their first few weeks or months. Infant mothers' antibiotics consumption can contribute to this opportunistic fungal growth due to their weaker immune systems. <b><i>Objectives:</i></b> To investigate the relationship between maternal antibiotic consumption and oral thrush infection in breastfeeding infants, this study aims to provide insights for health care professionals regarding antibiotic prescriptions and preventive strategies for managing oral thrush. <b><i>Methods:</i></b> A quasi-experimental design with a control group was used. Eighty-two breastfeeding infants were divided into two groups: Group 1 (<i>n</i> = 40) infants of antibiotic-consuming mothers and Group 2 (<i>n</i> = 42) infants of nonantibiotic-consuming mothers. The oral samples were collected using sterile cotton swabs and cultured on Sabouraud's dextrose agar <i>C. albicans</i>, confirmed by simple staining and a germ tube test. <b><i>Results:</i></b> Infants aged 1-11 months with a mean ± standard deviation of 4.8 ± 3.51. Within all 82 oral swabs, 42.7% were positive for <i>C. albicans</i> growth and 57.3% were negative. The highest percentage was in 1-month-old infants (<i>n</i> = 9, 25.71%), and the lowest was in 11 months old (<i>n</i> = 2, 5.71%). Group 2 infants had significantly fewer positive <i>C. albicans</i> growth (<i>n</i> = 12, 28.57%) compared with group 1 (<i>n</i> = 23; 57.5%) (χ² = 7.0, <i>p</i> = 0.007; odds ratio = 3.332, 95% confidence interval = 1.35-8.46). Oral thrush clinical signs were identified in 66.6% and 33.4% of group 1 and 2 infants, respectively, while 31.4% of <i>C. albicans-</i>positive colonization showed no clinical manifestations. <b><i>Conclusion:</i></b> Maternal antibiotic consumption for more than 1 week is associated with the occurrence of oral thrush in breastfeeding infants. Differences in clinical signs in two groups of infants indicate the importance of laboratory tests for early oral thrush diagnosis. This can help health care professionals understand oral thrush causes, enable early detection, improve treatment, and enhance appropriate antibiotic use in breastfeeding mothers.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751091","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":"Feasibility of Using Point-of-Care Biomarkers of Secretory Activation to Address Early, Unplanned Weaning Among Healthy, Term Dyads in Community Settings: A Pilot Study.","authors":"Katie T Kivlighan, Jessica Long, Rebekah Martinez, Sandra Cardenas, Esther Ryan","doi":"10.1089/bfm.2024.0374","DOIUrl":"https://doi.org/10.1089/bfm.2024.0374","url":null,"abstract":"<p><p><b><i>Background:</i></b> Delayed and/or impaired secretory activation (SA) achievement is a risk factor for early unplanned lactation cessation. This pilot study (1) evaluated the feasibility of in-home daily milk collection; (2) compared daily maternal self-report of breast fullness with mother's own milk (MOM) biomarkers of SA; and (3) examined SA patterns in association with lactation outcomes through 3 months postpartum. <b><i>Methods:</i></b> Twelve mother-infant dyads were enrolled at term (median gestational age (GA) = 39.9 weeks, range = 38.3-41.1 weeks). After birth, participants self-reported breast fullness and collected milk samples daily for a week. Infant weight gain and milk intake by test-weights were assessed postpartum during a week 1 routine infant outpatient visit and again during a week 2 home visit. Milk samples were tested for sodium (Na) and potassium (K) using portable ion selective electrodes. Timing of SA achievement was denoted as the first day breast fullness was self-rated ≥ 3, Na concentration was < 12 mmol/L, or the Na/K ratio was < 0.6. Breastfeeding duration and exclusivity were measured at 1, 2, and 3 months postpartum. <b><i>Results:</i></b> By day 6, all mothers self-reported SA achievement, while only 72-82% achieved SA using MOM biomarkers. Cohen's kappa between the timing of SA by maternal self-report and MOM biomarkers showed lack of agreement (κ = 0.05 and 0.08), but was high between MOM Na and Na/K ratio (κ = 0.87). Three patterns of SA by MOM biomarkers emerged (<i>mature and stable, impermanent, and delayed)</i> with implications for infant weight loss/gain at 1 week postpartum. These patterns were not associated with breastfeeding exclusivity through 3 months postpartum in this highly motivated sample. <b><i>Conclusion:</i></b> MOM biomarkers of SA achievement are feasible and have significant potential for use in community settings.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708391","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}