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Human milk (HM) contains macronutrients, micronutrients, and a multitude of other bioactive factors, which can have a long-term impact on infant growth and development. We systematically searched MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born infants. From 9992 abstracts screened, 141 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Bioactives including hormones, HM oligosaccharides (HMOs), and immunomodulatory components are reported here, based on 75 articles from 69 unique studies reporting observations from 9980 dyads. Research designs, milk collection strategies, sampling times, geographic and socioeconomic settings, reporting practices, and outcomes varied considerably. Meta-analyses were not possible because data collection times and reporting were inconsistent among the studies included. Few measured infant HM intake, adjusted for confounders, precisely captured breastfeeding exclusivity, or adequately described HM collection protocols. Only 5 studies (6%) had high overall quality scores. Hormones were the most extensively examined bioactive with 46 articles (n = 6773 dyads), compared with 13 (n = 2640 dyads) for HMOs and 12 (n = 1422 dyads) for immunomodulatory components. Two studies conducted untargeted metabolomics. Leptin and adiponectin demonstrated inverse associations with infant growth, although several studies found no associations. No consistent associations were found between individual HMOs and infant growth outcomes. Among immunomodulatory components in HM, IL-6 demonstrated inverse relationships with infant growth. Current research on HM bioactives is largely inconclusive and is insufficient to address the complex composition of HM. Future research should ideally capture HM intake, use biologically relevant anthropometrics, and integrate components across categories, embracing a systems biology approach to better understand how HM components work independently and synergistically to influence infant growth.

Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.

One in three females with multiple sclerosis (MS) becomes pregnant after diagnosis. In the postpartum period, there is a risk of rebound inflammatory activity. This risk can likely be reduced with breastfeeding, as well as with early initiation of effective therapies that have low therapeutic lag. To guide patients in their choices surrounding breastfeeding and MS therapies, clinicians must be familiar with how best to protect against relapses, to ensure infant safety, and to support breastfeeding choices. This topical review provides a broad framework on lactation in women with MS. It seeks to reframe guidelines around caring for the maternal–infant dyad, and for diverse populations living with MS. It also provides updated data on the effects of lactation in women with MS and the limited data on transfer of disease-modifying therapies (DMTs) into breastmilk. The ultimate goal is to support informed shared decision-making between clinicians and patients regarding breastfeeding during the high-risk postpartum period. [ABSTRACT FROM AUTHOR]

Pregnant and breastfeeding women are often under-represented in clinical research, including pharmacokinetic studies, due to ethical and logistical challenges. This paper examines strategies to improve the recruitment and retention of this demographic in pharmacokinetic research, drawing on experiences from five studies conducted at the Infectious Diseases Institute, Makerere University, Uganda. Key strategies implemented include Community Advisory Board meetings, the involvement of Peer Mothers as Co-Investigators, established recruitment sites, the use of safety protocols, and the utilization of diverse communication platforms, including social media and stakeholder meetings. Despite these efforts, substantial barriers, such as scheduling conflicts and frequent staff turnover at recruitment sites, continue to threaten progress. The paper recommends flexible scheduling, strengthening public engagement, and transparent demonstration of adherence to ethical principles; justice, non-maleficence, respect, and beneficence to ensure the safety and inclusivity of pregnant and breastfeeding women. The inclusion of this population in pharmacokinetic studies is essential for providing evidence-based care that meets their unique health needs. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) has negative impact on human health. This study aims to explore the association between the levels of BPA and 25(OH) vitamin D in breastmilk. BPA exposure and vitamin D sources were recorded on the study form. Breastmilk 25(OH) vitamin D was measured by the competitive enzyme-linked immunosorbent assay method, and BPA was analyzed by fluorescence detector high pressure liquid chromatography technique. Multiple logistic regression analysis were performed for association. Among 70 lactating mothers, the median 25(OH) vitamin D level was 12.6 ng/mL. In 92.9% of breastmilk samples, detectable levels of BPA were found, with a median BPA concentration of 2.56 ng/mL. However, both univariate and multivariate analyses failed to reveal any association between breastmilk BPA and 25(OH) vitamin D levels. This lack of association in healthy lactating mothers, highlighting the need for further research to comprehensively understand the intricate dynamics of these factors. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal linear immunoglobulin A (IgA) bullous dermatosis (NLABD) is a rare, life-threatening, mucocutaneous bullous disorder. The pathogenesis and optimal treatment remain poorly defined and raise critical clinical challenges. Case Presentation: We present a case of a full-term female infant with severe cutaneous and respiratory symptoms due to NLABD. Diagnosis was confirmed by immunofluorescence on the infant’s skin biopsy, while IgAs directed against the basement membrane of the skin and mucosa were identified in the mother’s milk. The infant fully recovered after nearly 8 weeks of intensive multidisciplinary care, including non-invasive ventilation, nutritional support, wound care, systemic corticoid treatment, and breastfeeding discontinuation. Conclusion: This case underscores the importance of timely adequate diagnosis and management of this rare and serious condition. Moreover, it adds novel evidence documenting the presence of pathogenic IgAs in breastmilk. [ABSTRACT FROM AUTHOR]

Summary: In this review, we will highlight infants' immune responses to food, emphasizing the unique aspects of early‐life immunity and the critical role of breast milk as a food dedicated to infants. Infants are susceptible to inflammatory responses rather than immune tolerance at the mucosal and skin barriers, necessitating strategies to promote oral tolerance that consider this susceptibility. Breast milk provides nutrients for growth and cell metabolism, including immune cells. The content of breast milk, influenced by maternal genetics and environmental exposures, prepares the infant's immune system for the outside world, including solid foods. To do this, breast milk promotes immune system development through antigen‐specific and non‐antigen‐specific immune education by exposing the newborn to food and respiratory allergens and acting on three key targets for food allergy prevention: the gut microbiota, epithelial cells, and immune cells. Building knowledge of how the maternal exposome and human milk composition influence offspring's healthy immune development will lead to recommendations that meet the specific needs of the developing immune system and increase the chances of promoting an appropriate immune response to food in the long term. [ABSTRACT FROM AUTHOR]

Abstract Pregnant and breastfeeding women are often under-represented in clinical research, including pharmacokinetic studies, due to ethical and logistical challenges. This paper examines strategies to improve the recruitment and retention of this demographic in pharmacokinetic research, drawing on experiences from five studies conducted at the Infectious Diseases Institute, Makerere University, Uganda. Key strategies implemented include Community Advisory Board meetings, the involvement of Peer Mothers as Co-Investigators, established recruitment sites, the use of safety protocols, and the utilization of diverse communication platforms, including social media and stakeholder meetings. Despite these efforts, substantial barriers, such as scheduling conflicts and frequent staff turnover at recruitment sites, continue to threaten progress. The paper recommends flexible scheduling, strengthening public engagement, and transparent demonstration of adherence to ethical principles; justice, non-maleficence, respect, and beneficence to ensure the safety and inclusivity of pregnant and breastfeeding women. The inclusion of this population in pharmacokinetic studies is essential for providing evidence-based care that meets their unique health needs.

Background: Limited research has addressed breastfeeding practices and challenges faced by mothers during the coronavirus disease 2019 (COVID-19) pandemic in the United Arab Emirates. The recommendation on whether to continue or initiate breastfeeding among mothers with suspected or confirmed COVID-19 was contradictory. This study aimed to explore breastfeeding practices and challenges faced by mothers during the COVID-19 pandemic. Methods: In this online, cross-sectional study, 249 mothers who delivered during the COVID-19 pandemic were recruited. The questionnaire included sociodemographic and anthropometric questions related to delivery experience and infant health, attitudes toward breastfeeding practices, breastfeeding knowledge, behaviors during COVID-19, and concerns and challenges related to COVID-19. Results: Most participants (90.8%) breastfed their infants, of whom only 28.5% exclusively breastfed for the first 6 months. Among mothers who were infected with COVID-19, approximately 90.7% were not given precautionary instructions by the health-care professionals during breastfeeding, 67.6% had breastfed their infants, 27% were isolated from their infants, and 50% were not able to visit their infants during infection. Moreover, exclusive breastfeeding was inversely associated with infant separation by more than six-fold higher (B = −1.89; odds ratio = 6.6, 95% confidence interval: 2.90–16.26; P

Human breastmilk is composed of many well researched bioactive components crucial for infant nutrition and priming of the neonatal microbiome and immune system. Understanding these components gives us crucial insight to the health and wellbeing of infants. Research surrounding glycosaminoglycans (GAGs) previously focused on those produced endogenously; however, recent efforts have shifted to understanding GAGs in human breastmilk. The structural complexity of GAGs makes detection and analysis complicated therefore, research is time consuming and limited to highly specialised teams experienced in carbohydrate analysis. In breastmilk, GAGs are present in varying quantities in four forms; chondroitin sulphate, heparin/heparan sulphate, dermatan sulphate and hyaluronic acid, and are hypothesised to behave similar to other bioactive components with suspected roles in pathogen defense and proliferation of beneficial gut bacteria. Chondroitin sulphate and heparin, being the most abundant, are expected to have the most impact on infant health. Their decreasing concentration over lactation further indicates their role and potential importance during early life.

Breast milk (BM) is a unique food due to its nutritional composition and anti-inflammatory characteristics. Evidence has emerged on the role of Presepsin (PSEP) as a reliable marker of early sepsis diagnosis. In the present study, we aimed to investigate the measurability of PSEP in BM according to different maturation stages (colostrum, C; transition, Tr; and mature milks, Mt) and corrected for delivery mode and gender. We conducted a multicenter prospective case–control study in women who had delivered 22 term (T) and 22 preterm (PT) infants. A total of 44 human milk samples were collected and stored at −80 °C. BM PSEP (pg/mL) levels were measured by using a rapid chemiluminescent enzyme immunoassay. PSEP was detected in all samples analyzed. Higher (p < 0.05) BM PSEP concentrations were observed in the PT compared to the T infants. According to the grade of maturation, higher (p < 0.05) levels of PSEP in C compared to Tr and Mt milks were observed in the whole study population. The BM subtypes' degrees of maturation were delivery mode and gender dependent. We found that PSEP at high concentrations supports its antimicrobial action both in PT and T infants. These results open the door to further studies investigating the role of PSEP. [ABSTRACT FROM AUTHOR]

Lactoferrin (LF) is a major component of human milk. LF supplementation (currently bovine) supports the immune system and helps maintain iron homeostasis in adults. No recombinant human lactoferrin (rhLF) is available for commercial food use. To determine the extent to which rhLF (Effera™) produced by Komagataella phaffii digests similarly to hmLF, a validated in vitro digestion protocol was carried out. Bovine LF (bLF) was used as an additional control, as it is approved for use in various food categories. This study compared the extent of intact protein retention and the profile of peptides released in hmLF, bLF and rhLF (each with low and high iron saturation) across simulated adult gastric and intestinal digestion using gel electrophoresis, ELISA and LC-MS. Intact LF retention across digestion was similar across LF types, but the highest iron-saturated hmLF had greater retention in the simulated gastric fluid than all other sample types. Peptides identified in digested hmLF samples strongly correlated with digested rhLF samples (0.86 < r < 0.92 in the gastric phase and 0.63 < r < 0.70 in the intestinal phase), whereas digested bLF samples were significantly different. These findings support the potential for rhLF as a food ingredient for human consumption. [ABSTRACT FROM AUTHOR]

Introduction: Women worldwide have been practising milk expression for various reasons through different methods and tools. Nevertheless, references on milk expression among working Malaysian women are limited. Materials and methods: The present study explored working Malaysian women's views and experiences on breastmilk expression practices using a feminist phenomenological approach. This study conducted in-depth interviews with 19 working mothers of infants between three and 12 months old who were practising milk expression. Purposive and snowball sampling were employed during data collection. The information obtained was analysed systematically to establish themes and subthemes. Results: The participants employed hand, breast pumps, and suction cups to express their milk. The principal themes that emerged from the data obtained were reasons for practising milk expression, factors influencing milk expression method selection, and milk expression experiences. Conclusion: The reasons for breastmilk expression demonstrated the participants' determination to continue providing breastmilk despite facing various challenges. The conditions influencing the milk expression method selected and the participants' experiences in expressing breastmilk could assist practitioners in providing guidelines for breastfeeding mothers when choosing a milk expression approach. [ABSTRACT FROM AUTHOR]

Aim: Few studies investigate factors that might influence the content of expressed breastmilk. This study aims to investigate the influence of the intervals between breastmilk pumping and the time of the day on protein and fat concentration in breastmilk. Methods: Mothers of very preterm infants in a neonatal ward who expressed more than 400 mL per day were included. Expressed breastmilk was obtained from each mother over 30 h who were pumping at strictly planned and varying intervals: 2, 3, 4 and 6 h. All samples were analysed using infrared transmission spectroscopy. Results: Ten mothers participated at a median of 22 days postpartum. A total of 176 milk samples were analysed, and the average protein and fat concentrations in g/100 mL were 1.1 ± 0.23 and 4.2 ± 1.3, respectively. The time intervals between breast pumping sessions did not impact protein content, but fat content decreased by longer intervals (p < 0.01). The time of the day for milk pumping did not influence the protein or fat content. Conclusion: A single milk sample collected after any 2–6 h interval, at any time during the day, represents the protein content in the breastmilk, but not the fat content which decreased with longer intervals. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study was conducted descriptively to evaluate the impact of the COVID-19 pandemic on the breastfeeding status of mothers with infants aged 0-24 months. Methods: The study was conducted at the Ankara City Hospital in the breastfeeding support/relactation clinic and mother-infant bonding service between December 2021 and May 2022. A sample of 511 mothers who applied to the clinics mentioned during the study period, agreed to participate in the research, and met the research criteria was formed. Research data were collected using a Descriptive Data Form. Results: The average age of the mothers was 28±4.7 (18-44), and 51.66% had a caesarian delivery. Approximately 54.41% of the mothers were university graduates. During the pandemic, it was determined that 13.0% of the mothers experienced breastfeeding-related problems, and all mothers who experienced problems hesitated to go to the hospital. It was found that 12.14% of the mothers had COVID-19 during pregnancy, and 69.70% of the mothers who had COVID-19 did not continue to breastfeed. The rate of mothers who stated that they did not receive any information about breastfeeding during the COVID-19 period was 57.6%, and the rate of mothers who had breastfeeding problems after quarantine was 17.50%. During their hospital stay due to COVID-19, it was determined that 48.7% of the mothers breastfed their babies, 41.0% fed expressed breast milk and formula, and 10.3% fed only formula. Conclusions: It was observed that mothers needed breastfeeding counselling during the pandemic. [ABSTRACT FROM AUTHOR]

Lack of data on drug secretion in human milk is a concern for safe use of drugs during postpartum. Clinical studies are often difficult to perform; despite substantial improvements in computational methodologies such as physiologically based pharmacokinetic modelling, there is limited clinical data to validate such models for many drugs. Various factors that are likely to impact milk to plasma ratio were identified. A literature search was performed to gather available data on milk composition, total volume of milk produced per day, milk pH, haematocrit, and renal blood flow and glomerular filtration rate in various animal models. BLAST nucleotide and protein tools were used to evaluate the similarities between humans and animals in the expression and predominance of selected drug transporters, metabolic enzymes, and blood proteins. A multistep analysis of all the potential variables affecting drug secretion was considered to identify most appropriate animal model. The practicality of using the animal in a lab setting was also considered. Donkeys and goats were identified as the most suitable animals for studying drug secretion in milk and future studies should be performed in goats and donkeys to validate the preliminary observations. [ABSTRACT FROM AUTHOR]

Aim: We developed the Promotion of Breastfeeding (PROBREAST) programme and evaluated what effect it had on the breastfeeding rate in infants born at less than 32 weeks of gestation or weighing ≤1500 grams. Methods: We compared the breastfeeding rate in two cohorts of patients who were born before (n = 72; January 2017 to June 2018) and after (n = 80; July 2018 to December 2019) the application of the programme. Moreover, we compared the correlation between type of feeding at discharge and post-discharge breastfeeding rate, between exclusive breastfeeding, postnatal growth and neurodevelopment. Results: Infants in the PROBREAST group had an exclusive breastfeeding rate at discharge higher (42 vs. 16%, p < 0.001) than that in the historical control group. Exclusive breastfeeding was negatively correlated with weight z-score at discharge, but not at 12 and 24 months corrected age, and was positively correlated with cognitive score at 24 months corrected age. Conclusion: The application of a structured programme for the promotion of breastfeeding improved the breastfeeding rate in very preterm infants. We demonstrated that exclusive breastfeeding at discharge improved their neurodevelopment without impairing growth. [ABSTRACT FROM AUTHOR]

Maternal breast milk plays a key role in providing newborns with passive immunity and stimulating the maturation of an infant's immune system, protecting them from many diseases. It is known that diet can influence the immune system of lactating mothers and the composition of their breast milk. The aim of this study was to establish if a supplementation during the gestation and lactation of Lewis rats with extra virgin olive oil (EVOO), due to the high proportion of antioxidant components in its composition, has an impact on the mother's immune system and on the breast milk's immune composition. For this, 10 mL/kg of either EVOO, refined oil (control oil) or water (REF group) were orally administered once a day to rats during gestation and lactation periods. Immunoglobulin (Ig) concentrations and gene expressions of immune molecules were quantified in several compartments of the mothers. The EVOO group showed higher IgA levels in both the breast milk and the mammary glands than the REF group. In addition, the gene expression of IgA in mammary glands was also boosted by EVOO consumption. Overall, EVOO supplementation during gestation and lactation is safe and does not negatively affect the mother's immune system while improving breast milk immune composition by increasing the presence of IgA, which could be critical for an offspring's immune health. [ABSTRACT FROM AUTHOR]

IntroductionDonor human milk (DHM) is recommended as the second-best alternative form of supplementation when a mother is unable to breastfeed directly. However, little is known about the experience of mothers and families in the communities regarding accessing and donating expressed breastmilk in Indonesia. This study aimed to identify the experience related to donor human milk in the society in Indonesia.MethodA search was conducted through six main online news portals. The keywords used included “donor human milk,” “expressed breastmilk,” and “wet nursing” in the Indonesian language, Bahasa Indonesia. A total of 107 articles were found, but only 20 articles were included for analysis using a qualitative media content analysis approach.ResultsIn the study, the following five themes were identified: (1) the whys and wherefores of donor human milk, (2) national and religious-based regulations, (3) recommendations from authorized organizations, healthcare professionals, and Islamic scholars, (4) the negative impact from the lack of national regulations, and (5) contradictory feelings among mothers.ConclusionWith the lack of detailed information on how to access or donate expressed human milk and the absence of a human milk bank in place, informal human milk sharing is inevitably occurring in the community. This has also raised concerns among authorized organizations, healthcare professionals, and Islamic scholars. Consequently, mothers, both donors and recipients, experienced negative impacts, which included contradictory feelings. Engaging with Islamic scholars and healthcare professionals to develop clear guidelines and regulations to enable mothers' and families' access and/or make contributions to DHM in a safe and accountable way is critical to prevent further problems from occurring in Indonesian society.

Antibiotics are an essential tool for perinatal care. While antibiotics can play a life-saving role for both parents and infants, they also cause collateral damage to the beneficial bacteria that make up the host gut microbiota. This is especially true for infants, whose developing gut microbiota is uniquely sensitive to antibiotic perturbation. Emerging evidence suggests that disruption of these bacterial populations during this crucial developmental window can have long-term effects on infant health and development. Although most current studies have focused on microbial disruptions caused by direct antibiotic administration to infants or prenatal exposure to antibiotics administered to the mother, little is known about whether antibiotics in human milk may pose similar risks to the infant. This review surveys current data on antibiotic transfer during lactation and highlights new methodologies to assess drug transfer in human milk. Finally, we provide recommendations for future work to ensure antibiotic use in lactating parents is safe and effective for both parents and infants.

Abstract Background Bronchopulmonary dysplasia (BPD) is a major complication affecting the survival rate and long-term outcomes of preterm infants. A large, prospective, multicenter cohort study was conducted to evaluate early nutritional support during the first week of life for preterm infants with a gestational age 4 were enrolled. Antenatal and postnatal information focusing on nutritional parameters was collected through medical systems. Statistical analyses were also performed to identify BPD risk factors. Results The primary outcomes were BPD and severity at 36 weeks postmenstrual age. A total of 1410 preterm infants were enrolled in this study. After applying the exclusion criteria, the remaining 1286 infants were included in this analysis; 614 (47.7%) infants were in the BPD group, and 672 (52.3%) were in the non-BPD group. In multivariate logistic regression model, the following six factors were identified of BPD: birth weight (OR 0.99, 95% CI 0.99–0.99; p = 0.039), day of full enteral nutrition (OR 1.03, 95% CI 1.02–1.04; p 3.5 g/kg/d during the first week (OR 1.65, 95% CI 1.25–2.17; p

Breastmilk is the optimal source of nutrition for infants and should ideally be provided exclusively for the first 6 months of life, and alongside complementary food until 2 years of life. However, there are circumstances where a breastmilk substitute (BMS) may be required. This includes maternal and/or child conditions or personal preference. Whilst these circumstances should never be used as an opportunity to promote BMS, healthcare professionals (HCPs) need to have the knowledge of suitable alternatives and should always be guided by scientific and health motives when recommending a BMS. The Task Force 'Milk Formula Industry Sponsorship' from the European Academy of Allergy and Clinical Immunology (EAACI), provides with this publication recommendations for EAACI interactions with the BMS manufacturers and how this will be supervised. [ABSTRACT FROM AUTHOR]

In the inquisitorial archive of Pedro Onofre Cortés, alias Moixina, we see fellow practitioner protesting his son's marriage to Clara Sureda because she was an Old Christian. The poor match was blamed on the breast milk that was ingested as an infant, "andaba con cristianos porque había mamado leche de una mujer cristiana" (he went with Christians because of the milk drunk milk from a Christian woman) (Picazo y Muntaner). In early modern Spain, breastmilk was seen as responsible for transmitting virtues and vices, religious expressions of faith and moral traits. Following Galenic medical understanding equating milk with blood, it was women who were responsible for the transmission of purity, impurity (Alexandre-Bidon 175), for contamination and difference (Martínez 47). This brief citation reflects the hybrid environment and the dual practices that deeply informed the lives of the converso Jews. Moreover, the understanding of the hereditary nature of these traits, and the traditions of Judaism and Christianity, so often mixed in unique combinations are clearly demonstrated in the Inquisition trials of Cortés and his Chueta brethren. As regulation over the mother and the female body became increasingly important in controlling Iberian subjects and its empire, conversos complicate the feminization of impurity. This article explores how the conversos known as the Chuetas of Mallorca understood their religiosity and difference as seen through the lens of hybridity, breast milk and maternal care. [ABSTRACT FROM AUTHOR]

Regarding neonates and infants, the videofluoroscopy swallowing study is always conducted with liquids impregnated with a radiopaque material in varied proportions and thickenings. Variations in thickening and barium concentration are known to change the swallowing function. The present study aimed to analyze the rheological and macroscopic properties of barium contrast and liquids commonly used in Brazil with infants under six months old. This study was approved by the Ethics Committee under certificate number 63361616.2.0000.5482. Rheological measurements were performed on samples of breast milk and infant formulas, pure, with thickener, impregnated with liquid barium sulfate, as well as a pure barium sulfate sample. The data collected showed similar viscosity rates between breast milk and the infant formulas Aptamil and Enfamil. Impregnating them with 20% and 33% liquid barium sulfate increased their viscosity. However, they remained in the same classification, despite the quantitative differences in their apparent viscosity. The regular products, in formulation with thickener and thickener plus 20% barium, showed an increase in apparent viscosity close or twice to that of Enfamil A.R. impregnated with 33% barium sulfate. The study allowed a more in-depth understanding of how the products behave at strain rates consistent with the conditions when swallowing. The results indicated in this study confirm the need for knowledge and care in preparing liquids to be offered in videofluoroscopy swallowing studies with neonates and infants. They also emphasize the importance of objectively measuring the viscosities of videofluoroscopic fluids, matching them with the liquids to be prescribed in their diets. [ABSTRACT FROM AUTHOR]

This paper makes visible austerity-based infant food exchange as a contemporary food acquisition practice outside of commercial and regulated foodscapes. It presents results from a netnography conducted within two popular online platforms in Canada between April 2017 and February 2018: the Kijiji classified advertising site, and Facebook. Qualitative analysis of over 2000 user generated secondhand exchange ads show practices from selling, trading, sharing, and seeking whereby infant foods works as a form of currency to acquire either economic capital when sold, an alternative food capital when traded, or are gifts in the moral economy of exchange. While infant food exchange is often collaborative in nature, it is austerity-driven involving different forms of capital parents have or seek to accomplish the responsibility of feeding. As excluded consumers, posters are motivated by a complex mixture of desperation, innovation, ecological concerns, and morality to care for others when mainstream food access is out of reach within the current political and economic system. [ABSTRACT FROM AUTHOR]

Background: Bronchopulmonary dysplasia (BPD) is a major complication affecting the survival rate and long-term outcomes of preterm infants. A large, prospective, multicenter cohort study was conducted to evaluate early nutritional support during the first week of life for preterm infants with a gestational age < 32 weeks and to verify nutritional risk factors related to BPD development. Methods: A prospective multicenter cohort study of very preterm infants was conducted in 40 tertiary neonatal intensive care units across mainland China between January 1, 2020, and December 31, 2021. Preterm infants who were born at a gestational age < 32 weeks, < 72 h after birth and had a respiratory score > 4 were enrolled. Antenatal and postnatal information focusing on nutritional parameters was collected through medical systems. Statistical analyses were also performed to identify BPD risk factors. Results: The primary outcomes were BPD and severity at 36 weeks postmenstrual age. A total of 1410 preterm infants were enrolled in this study. After applying the exclusion criteria, the remaining 1286 infants were included in this analysis; 614 (47.7%) infants were in the BPD group, and 672 (52.3%) were in the non-BPD group. In multivariate logistic regression model, the following six factors were identified of BPD: birth weight (OR 0.99, 95% CI 0.99–0.99; p = 0.039), day of full enteral nutrition (OR 1.03, 95% CI 1.02–1.04; p < 0.001), parenteral protein > 3.5 g/kg/d during the first week (OR 1.65, 95% CI 1.25–2.17; p < 0.001), feeding type (formula: OR 3.48, 95% CI 2.21–5.49; p < 0.001, mixed feed: OR 1.92, 95% CI 1.36–2.70; p < 0.001; breast milk as reference), hsPDA (OR 1.98, 95% CI 1.44–2.73; p < 0.001), and EUGR ats 36 weeks (OR 1.40, 95% CI 1.02–1.91; p = 0.035). Conclusions: A longer duration to achieve full enteral nutrition in very preterm infants was associated with increased BPD development. Breastfeeding was demonstrated to have a protective effect against BPD. Early and rapidly progressive enteral nutrition and breastfeeding should be promoted in very preterm infants. Trial registration: The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2000030125 on 24/02/2020) and in www.ncrcch.org (No. ISRCTN84167642 on 25/02/2020). [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Current Nursing Research / Güncel Hemşirelik Araştırmaları Dergisi is the property of Journal of Current Nursing Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The immune system of neonates is immature and therefore knowledge of possible early-life protection against SARS-CoV-2 infection, such as breastfeeding, is of great importance. Few studies have investigated the presence and duration of SARS-CoV-2 antibodies in breastmilk in relation to the trimester of maternal infection during pregnancy, and none with successful participation from all three trimesters. This study has dual objectives (1) in relation to the trimester of infection to examine the frequency, concentration and duration of IgA and IgG antibodies in breastmilk and blood serum in the third and sixth month post-partum in former SARS-CoV-2-infected mothers and (2) to examine the association in pediatric emergency admission of children within the first six months of life compared to children of non-SARS-CoV-2-infected women. The first objective is based on a prospective cohort and the second is based on a nested case–control design. The study participants are women with a former SARS-CoV-2 infection during pregnancy, whose serology IgG tests at delivery were still positive. Maternal blood and breastmilk samples were collected at three and six months postpartum. Serum IgA frequency three months pp was 72.7% (50%, 90% and 60% in the first, second and third trimester) and 82% six months pp (67%, 91% and 82% in the first, second and third trimester). Breastmilk IgA frequency three months pp was 27% (16.6%, 36% and 20% in first, second and third trimester) and 28% six months pp (0%, 38% and 28% in the first, second and third trimester). The highest IgA concentration in breastmilk was found six months post-partum with infection in the third trimester. Serum IgA was detectable more than 400 days post infection, and serum IgG above threshold was found 430 days after date of infection. We found no correlation between serum IgA and breastmilk IgA, nor between serum IgG and breastmilk IgA regardless of the trimester of infection. [ABSTRACT FROM AUTHOR]

From a medical standpoint, breastmilk is the optimal option for feeding a baby, relegating the cultural, social, and material determinants to breastfeeding. Worldwide, breastfeeding rates are low, especially among working mothers. Healthcare providers have low breastfeeding rates due to several barriers to lactation, i.e. work schedule andlack of private places for pumping. A descriptive qualitative methodology was applied to examine the breastfeeding experiences of Ecuadorian mothers who are healthcare professionals. Twenty healthcare professionals who breastfed their babies took part in the research. Data gathering employed synchronous semi-structured interviews in Spanish. The data analysis followed the Phronetic Iterative Approach. Women shifted the preconceived idea of the ideal breastfeeding scenario concerning duration, promotion, and support, ideals which are constructed in their training as healthcare professionals. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted with the experience of motherhood. Although they had that clash between the ideal and the external reality, they continued breastfeeding their babies, and those experiences resulted in them improving their professional practice. This study demonstrated that breastfeeding for this group of women appears to be a unique relational and identity negotiation process. The findings emphasize that experiencing breastfeeding for this group of healthcare providers positively shifted how they communicate breastfeeding with their patients in the clinical encounter. Ensuring that healthcare professionals acquire a different approach for educating and communicating about lactation is an essential determinant in efforts to improve breastfeeding rates in Ecuador. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding is one of the major requirements for a balanced child’s health and brain development. It provides essential nutrients, antibodies, and other bioactive components that shield infants from infections and diseases. Despite the numerous benefits, the practice remains sub-optimal in many parts of Nigeria, including Enugu urban. Objective: This study investigated how radio advocacy programmes influence the knowledge and practice of exclusive breastfeeding among working-class nursing mothers in Enugu, Nigeria. Method: Adopting descriptive survey research design, 380 working-class nursing mothers residing in Enugu urban were sampled using a multistage sampling technique. The participants were selected from the three local government areas that make up the urban area of Enugu State. The LGAs were Enugu-North, Enugu-South, and Enugu-East. Data were collected using a structured questionnaire with a consistency coefficient of 0.95, while analysis was done using descriptive statistics and presented using frequency tables. Results: There was high level of exposed to radio programmes on exclusive breastfeeding among participants, but could not yield the desired attitude and behaviour changes for adherence to the practice due to other variables such as culture, modernisation, and peer influence. Conclusion: The study concludes that the majority of working-class nursing mothers in the Enugu urban area do not practise exclusive breastfeeding, despite the high level of exposure to radio advocacy programmes on the subject matter. This could be attributed to the nuanced interplay of influences of other key stakeholders in infants’ breastfeeding decisions and some socio-cultural inhibitors, such as modernisation, pre-existing misconceptions and the quest to retain breast aesthetics. Unique Contribution: This study has offered new insight into the increasing influence of intervening variables on the effects of media on the audience. Hopefully, policymakers, healthcare practitioners, and communication experts will find this fresh insight useful in planning future advocacy programmes on exclusive breastfeeding among urban-based nursing mothers. Key Recommendation: Comprehensive community-based policies and cohesive intervention programmes that involve regular (re)orientation of not just nursing mothers but all key stakeholders in infants’ breastfeeding decisions, such as mothers, grandmothers, husbands, caregivers, traditional birth attendants (TBAs), mothers-in-law, and religious leaders, are required to implement EBF among working-class nursing mothers.

Abstract Background The Mothers’ Milk Tool, developed and launched by the Australian National University and Alive & Thrive in 2022, allows to estimate the volume and value of breastmilk using prevalence rates of breastfeeding by month of age from birth to 36 months. The objective of this study was to obtain these estimates for three cohort studies conducted in a region of Italy. Methods Breastfeeding data from three cohort studies carried out in 1999, 2007 and 2016, with follow-up to 12, 24 and 36 months of 842, 400 and 265 children, respectively, were entered into the downloadable version of the tool. Breastfeeding rates charts and tables with estimates of breastmilk production and value for breastfeeding of children aged 0–36 months were produced. Results The rates of initiation of breastfeeding were similar in the three cohorts, while the rates of any breastfeeding at subsequent ages increased over the years. The volumes and values of breastmilk per child increased accordingly, from around 130 L (13,000 USD) in 1999, to 200 L (20,000 USD) in 2007, to 226 L (22,600 USD) in 2016. The percentage of lost breastmilk decreased from 67.7% to 55.4% to 43.7%, respectively. Overall, the 1507 mothers of the three cohorts produced an estimated 250,000 L of breastmilk for their children aged 0–36 months. At 100 USD per litre, this would add up to around 25 million USD. Conclusions Our study shows that the Mothers’ Milk Tool can be used to estimate per child volumes and values of breastmilk produced and lost at local levels, and to provide simple indicators of the effects of breastfeeding interventions using the percentage of lost breastmilk, where datasets on rates of breastfeeding by month of age are available. The results of such studies can be used to advocate for better and adequately funded programmes for the protection, promotion and support of breastfeeding.

The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0–12 months but also considers parts both before and beyond the first year, as the concept of ‘the first 1000 days’ emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the infant should be fed infant formula, and, when possible, breastfeeding should be continued alongside the formula feeding. If the infant is 4 months or older, starting with solids together with continued breastfeeding and/or formula feeding is an option. Infant formulas have been developed for infants who are not breastfed or do not get enough breastmilk. Home-made formula should not be given.

Background: Lactation is associated with long-term reduced risk of breast cancer. However, there is a transient increased risk of breast cancer in the 5 to 10 years postpartum and this is associated with a high incidence of metastasis and mortality. Breastmilk is a physiological fluid secreted by the mammary glands intimately connected with breast cells and the microenvironment that may affect postpartum breast cancer development and progression. This study aims to investigate the effect of breastmilk on interactions between breast cancer cells and macrophages in vitro. Methods: Human breastmilk from healthy donors (n = 7) was pooled and incubated with breast cancer (MCF-7 and MDA-MB-231) and macrophage (RAW264.7) cell lines to assess cell proliferation, viability, migration, and expression of key genes associated with epithelial-mesenchymal transition (EMT) and macrophage phenotype. Indirect co-culture studies assessed the effect of breastmilk on interactions between breast cancer cells and macrophages. Results: Breastmilk increased the proliferation and viability of breast cancer cells, reduced EMT markers, and reduced cell migration in MDA-MB-231 cells. Breastmilk decreased mRNA expression of interleukin 1B (IL1B) and interleukin 10 (IL10) in macrophages. Reduced EMT marker expression was observed in breast cancer cells co-cultured with macrophages pre-treated with breastmilk. Macrophages co-cultured with breast cancer cells pre-treated with breastmilk exhibited increased expression of a pro-inflammatory cytokine tumor necrosis factor A (TNFA) and pro-inflammatory nitric oxide synthase 2 (NOS2), and reduced expression of cytokines IL10 and transforming growth factor B1 (TGFB1) which are associated with the alternatively-activated macrophage phenotype. Conclusions: Breastmilk has the potential to promote breast cancer proliferation, however, it can also reduce breast cancer progression through inhibition of breast cancer cell migration and regulation of macrophage polarisation. These findings suggest that breastmilk has potential to shape the tumour microenvironment in postpartum breast cancer.

Background: The Mothers' Milk Tool, developed and launched by the Australian National University and Alive & Thrive in 2022, allows to estimate the volume and value of breastmilk using prevalence rates of breastfeeding by month of age from birth to 36 months. The objective of this study was to obtain these estimates for three cohort studies conducted in a region of Italy. Methods: Breastfeeding data from three cohort studies carried out in 1999, 2007 and 2016, with follow-up to 12, 24 and 36 months of 842, 400 and 265 children, respectively, were entered into the downloadable version of the tool. Breastfeeding rates charts and tables with estimates of breastmilk production and value for breastfeeding of children aged 0–36 months were produced. Results: The rates of initiation of breastfeeding were similar in the three cohorts, while the rates of any breastfeeding at subsequent ages increased over the years. The volumes and values of breastmilk per child increased accordingly, from around 130 L (13,000 USD) in 1999, to 200 L (20,000 USD) in 2007, to 226 L (22,600 USD) in 2016. The percentage of lost breastmilk decreased from 67.7% to 55.4% to 43.7%, respectively. Overall, the 1507 mothers of the three cohorts produced an estimated 250,000 L of breastmilk for their children aged 0–36 months. At 100 USD per litre, this would add up to around 25 million USD. Conclusions: Our study shows that the Mothers' Milk Tool can be used to estimate per child volumes and values of breastmilk produced and lost at local levels, and to provide simple indicators of the effects of breastfeeding interventions using the percentage of lost breastmilk, where datasets on rates of breastfeeding by month of age are available. The results of such studies can be used to advocate for better and adequately funded programmes for the protection, promotion and support of breastfeeding. [ABSTRACT FROM AUTHOR]

Background and Objectives: Breastfeeding during infancy is associated with healthier beverage consumption later in childhood, but little is known about this relation during infancy. This was a longitudinal study of breastfeeding and less healthy beverage consumption during the first year of life, in a birth cohort study conducted 2013–2018 in the Southeastern United States (n = 666). Methods: We estimated monthly rates of 100% juice and sugar‐sweetened beverage (SSB) consumption comparing infants who were exclusively or partially breastfed, versus those who were not, in multivariable adjusted models. Results: Mothers had a median age of 26.5 years, 71% identified as Black/African‐American, and 61% reported household incomes <$20 000/year. The prevalence of any breastfeeding during the first month was 78.2% and 18.7% at month 12. By age 12 months, infants consumed juice a mean (SD) 9.1 (10.1) times per week and SSBs 3.6 (9.5) times per week. Breastfed infants had a 38% lower incidence rate of weekly juice consumption (95% CI 52%, 15%, p = 0.003) and a 57% lower incidence rate of weekly SSB consumption (95% CI 76%, 22%, p = 0.006), compared with infants who were not breastfed. Conclusions: Research on early‐life correlates of dietary health should focus on the earliest beverages, given evidence that consumption of obesogenic beverages may begin prior to age 1 year. [ABSTRACT FROM AUTHOR]

Background. The composition of breast milk depends on the lactation period, the phase of single breastfeeding, time of day, and frequency of breastfeeding throughout the day, alongside other maternal and infant variables. This study aimed to assess the macronutrient and energy content of breastmilk during the first six months of lactation and evaluation of maternal determinants and association with infant anthropometric development. Material and methods. Breast milk samples were collected from 47 mothers from Warsaw in the first, third, and sixth month of lactation. Breast milk macronutrient composition was assessed using the MIRIS Human Milk Analyzer. Maternal diet was assessed using 3-day food records in the third and sixth months of lactation. At each study visit, we assessed maternal and infant anthropometric parameters. Results. Protein content declined consistently from 1.3 g/100 ml in the first month to 1.0 g/100 ml in the sixth month (p < 0.001). However, fat, lactose content, and energy values showed no significant changes throughout lactation. Fat content and milk energy value varied over time of the day in the 1st and 3rd month of lactation. There were no significant differences in the protein and lactose content according to the time of the day. Breastmilk fat adversely correlated with pre-pregnancy BMI, but not current BMI. The energy values of the diet were 2180 ±614 and 2046 ±503 kcal (p > 0.05), respectively, in the third and sixth month of lactation. The majority of mothers had lower than recommended intakes of vitamin D, folate, vitamins B1, B2, B3, B6, B12, C, A, E, magnesium, zinc, and calcium for at least one of the study periods. However, maternal dietary intake and anthropometric parameters showed a limited correlation with breastmilk macronutrient composition. We did not observe any significant correlations between breastmilk macronutrient composition and infants' body mass, length, or BMI to age z-score, nor changes in these parameters between the third and sixth month of life. Conclusion. Our findings support the assumption that breastmilk offers chrononutrition to infants. It is important to consider diurnal changes in its composition, especially when the infant is fed expressed breastmilk. Furthermore, it is necessary to implement educational programs targeting maternal nutrition, as many women do not maintain adequate dietary intake. [ABSTRACT FROM AUTHOR]

Background: Breast milk is essential for premature infants. It contains a variety of functional and protective nutrients that help to create a suitable microenvironment for intestinal development and maturation. This prospective and observational study was planned to examine the effects of feeding premature infants with fresh or frozen breastmilk on their gut microbiota. Materials and Methods: The study was carried out with a total of 40 infants, with a gestational age of 28–326 weeks, fed fresh (n = 20) or frozen (n = 20) breastmilk. Stool samples were stored at −80°C until analysis. Infants were included in groups based on the feed type, which accounted for more than 70% of their 10-day feeding. The Mann-Whitney U, Chi-square, and t-tests were used to evaluate the demographic data. Stool samples were analyzed by sequencing the V3–-V4 region of the 16S rRNA gene from the extracted DNA for microbiota analysis. Results: Streptococcus and Enterobacteriales, the majority of which are considered human pathogens, in infants receiving frozen breastmilk (Streptococcus 69%, Enterobacteriales 79%) was higher than that in infants receiving fresh breastmilk (Streptococcus 16%, Enterobacteriales 49%). Further, the Lactobacillus and Bifidobacterium species were more abundant in infants who received fresh breastmilk (Lactobacillus 17%, Bifidobacterium 12%) than in infants who received frozen breastmilk (Lactobacillus 3%, Bifidobacterium 1%). Conclusion: Thus, compared to frozen breast milk, fresh breastmilk has an effect on the diversity of preterm infants' gut microbiota. [ABSTRACT FROM AUTHOR]

Quality improvement is paramount in the nursing profession today, and there is increased awareness and focus on implementing evidence-based practices into nursing care. The Baby-Friendly Hospital Initiative (BFHI) is an evidence-based program that promotes and protects exclusive breastfeeding by encouraging breast milk feeds to infants from the time of birth. This article will discuss the history and current state of breastfeeding in the United States as well as an evidence-based change model that can be used to implement the BFHI to change the status quo and future of breastfeeding in the United States. Physical benefits to the infant and mother as well as financial benefits to the mother, hospital, and global economy will also be addressed. [ABSTRACT FROM AUTHOR]

The ability of gut commensals to adhere to the intestinal epithelium can play a key role in influencing the composition of the gut microbiota. Bifidobacteria are associated with a multitude of health benefits and are one of the most widely used probiotics for humans. Enhanced bifidobacterial adhesion may increase host-microbe, microbe-nutrient, and/or microbe-microbe interactions, thereby enabling consolidated health benefits to the host. The objective of this study was to determine the ability of human milk oligosaccharides (HMOs) to enhance bifidobacterial intestinal adhesion in vitro. This study assessed the colonisationpromoting effects of HMOs on four commercial infant-associated Bifidobacterium strains (two B. longum subsp. infantis strains, B. breve and B. bifidum). HT29-MTX cells were used as an in vitro intestinal model for bacterial adhesion. Short-term exposure of four commercial infant-associated Bifidobacterium strains to HMOs derived from breastmilk substantially increased the adherence (up to 47%) of these probiotic strains. Interestingly, when strains were incubated with HMOs as a four-strain combination, the number of viable bacteria adhering to intestinal cells increased by >90%. Proteomic analysis of this multi-strain bifidobacterial mixture revealed that the increased adherence resulting from exposure to HMOs was associated with notable increases in the abundance of sortase-dependent pili and glycosyl hydrolases matched to Bifidobacterium bifidum. This study suggests that HMOs may prime infant gut-associated Bifidobacterium for colonisation to intestinal epithelial cells by influencing the expression of various colonization factors. [ABSTRACT FROM AUTHOR]

Regarding neonates and infants, the videofluoroscopy swallowing study is always conducted with liquids impregnated with a radiopaque material in varied proportions and thickenings. Variations in thickening and barium concentration are known to change the swallowing function. The present study aimed to analyze the rheological and macroscopic properties of barium contrast and liquids commonly used in Brazil with infants under six months old. This study was approved by the Ethics Committee under certificate number 63361616.2.0000.5482. Rheological measurements were performed on samples of breast milk and infant formulas, pure, with thickener, impregnated with liquid barium sulfate, as well as a pure barium sulfate sample. The data collected showed similar viscosity rates between breast milk and the infant formulas Aptamil and Enfamil. Impregnating them with 20% and 33% liquid barium sulfate increased their viscosity. However, they remained in the same classification, despite the quantitative differences in their apparent viscosity. The regular products, in formulation with thickener and thickener plus 20% barium, showed an increase in apparent viscosity close or twice to that of Enfamil A.R. impregnated with 33% barium sulfate. The study allowed a more in-depth understanding of how the products behave at strain rates consistent with the conditions when swallowing. The results indicated in this study confirm the need for knowledge and care in preparing liquids to be offered in videofluoroscopy swallowing studies with neonates and infants. They also emphasize the importance of objectively measuring the viscosities of videofluoroscopic fluids, matching them with the liquids to be prescribed in their diets.

BackgroundMaternal stress is pervasive in the neonatal intensive care unit (NICU). Maternal stress is associated with changes in human milk (HM) immunomodulatory agents, which may impact neonatal health. We sought to determine the association between maternal stress, HM immunoglobulin A (IgA) and cortisol, and to assess how these milk components correlate with infant immune and neurodevelopmental outcomes. We then compared how these associations persist over time.MethodsThe study design involved a cohort study of exclusively breastfeeding mothers and their singleton moderately preterm (28–34 weeks) infants admitted to the NICU. We collected maternal serum, maternal saliva, and first-morning whole milk samples, and administered maternal stress questionnaires at 1 and 5 weeks postpartum. We analyzed the samples for HM IgA (using a customized immunoassay in skim milk) and for HM and salivary cortisol (using a chemiluminescent immunoassay). Infant illness was assessed using the Score for Neonatal Acute Physiology II (SNAP II) and SNAP II with Perinatal Extension (SNAPPE II), and infant neurodevelopment were assessed using the Test of Infant Motor Performance. We analyzed changes in HM IgA and cortisol over time using paired t-tests. Furthermore, we performed correlation and regression analyses after adjusting for gestational age (GA), corrected GA, and infant days of life.ResultsIn our study, we enrolled 26 dyads, with a mean maternal age of 28.1 years, consisting of 69% white, 19% Black, and 8% Hispanic. Cortisol: Salivary and HM cortisol were closely associated in week 1 but not in week 5. Though mean salivary cortisol remained stable over time [2.41 ng/mL (SD 2.43) to 2.32 (SD 1.77), p = 0.17], mean HM cortisol increased [1.96 ng/mL (SD 1.93) to 5.93 ng/mL (SD 3.83), p

Abstract Aims The aims are to describe the key components of family integrated care intervention for preterm infants in the neonatal intensive care unit (NICU) and assess the impact on breastfeeding outcomes for those infants. Design A scoping review. Methods We conducted a systematic study search based on the databases, including PubMed, Scopus, Cochrane, Web of Science, MEDLINE, CINAHL, CNKI and Wanfang Database in December 2022. The search time ranged from database establishment to 31 December 2022. Papers by manual searching were also listed on the references. We adopted Joanna Briggs Institute Reviewer's Manual methodology and followed the PRISMA guidelines for Scoping Reviews (PRISMA‐ScR) to conduct the review. Two independent reviewers filtered the papers, extracted data and synthesized the findings. A table was used to extract data and synthesize results. Results After systematic searching, 11 articles that implemented family integrated care (FIcare) were finally included in this scoping review. By analysing the implementation of this nursing model, we identified seven main components: NICU staff training, parent education, parent participation in infants' care, parent involvement in medical plans, peer support, NICU environmental support and mobile app for parents. Based on the extracted breastfeeding data, this scoping review concludes that family integrated care shows a positive effect on increasing breastfeeding rates at discharge. Through this scoping review, we find that family integrated care is feasible and it can support breastfeeding of preterm infants. Further studies will be needed to provide more evidence that family integrated care could facilitate breastfeeding of preterm infants. Impact This scoping review provides evidence for the positive role of family integrated care on breastfeeding outcomes. The analysis may contribute to the implementation of family integrated care. No patient or public contribution No further public or patient contribution was made in view of the review‐based nature of the research.