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Because breastfeeding provides optimal nutrition and other benefits for infants (e.g., lower risk of infectious disease) and benefits for mothers (e.g., less postpartum bleeding), many organizations recommend that healthy infants be exclusively breastfed for 4 to 6 months in the United States and 6 months internationally. Recommendations related to how long breastfeeding should continue, however, are inconsistent. The objective of this article is to review the literature related to evidence for benefits of breastfeeding beyond 1 year for mothers and infants. In summary, human milk represents a good source of nutrients and immune components beyond 1 year. Some studies point toward lower infant mortality in undernourished children breastfed for >1 year, and prolonged breastfeeding increases interbirth intervals. Data on other outcomes (e.g., growth, diarrhea, obesity, and maternal weight loss) are inconsistent, often lacking sufficient control for confounding variables. There is a substantial need for rigorous, prospective, mixed-methods, cross-cultural research on this topic.

Breastfeeding provides defense against infectious disease during early life. The mechanisms underlying this protection are complex but likely include the vast array of immune cells and components, such as immunoglobulins, in milk. Simply characterizing the concentrations of these bioactives, however, provides only limited information regarding their potential relationships with disease risk in the recipient infant. Rather, understanding pathogen and antigen specificity profiles of milk-borne immunoglobulins might lead to a more complete understanding of how maternal immunity impacts infant health and wellbeing. Milk produced by women living in 11 geographically dispersed populations was applied to a protein microarray containing antigens from 16 pathogens, including diarrheagenic E. coli , Shigella spp. , Salmonella enterica serovar Typhi, Staphylococcus aureus , Streptococcus pneumoniae, Mycobacterium tuberculosis and other pathogens of global health concern, and specific IgA and IgG binding was measured. Our analysis identified novel disease-specific antigen responses and suggests that some IgA and IgG responses vary substantially within and among populations. Patterns of antibody reactivity analyzed by principal component analysis and differential reactivity analysis were associated with either lower-to-middle-income countries (LMICs) or high-income countries (HICs). Antibody levels were generally higher in LMICs than HICs, particularly for Shigella and diarrheagenic E. coli antigens, although sets of S. aureus , S. pneumoniae , and some M. tuberculosis antigens were more reactive in HICs. Differential responses were typically specific to canonical immunodominant antigens, but a set of nondifferential but highly reactive antibodies were specific to antigens possibly universally recognized by antibodies in human milk. This approach provides a promising means to understand how breastfeeding and human milk protect (or do not protect) infants from environmentally relevant pathogens. Furthermore, this approach might lead to interventions to boost population-specific immunity in at-risk breastfeeding mothers and their infants., Competing Interests: AR and JC are employees of Antigen Discovery Incorporated, a company that carries patents related to the protein array analyses used here and the location where the arrays were conducted. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 McGuire, Randall, Seppo, Järvinen, Meehan, Gindola, Williams, Sellen, Kamau-Mbuthia, Kamundia, Mbugua, Moore, Prentice, Foster, Otoo, Rodríguez, Pareja, Bode, McGuire and Campo.)

Conjugated linoleic acids (CLA) are conjugated isomers of linoleic acid, which may promote health with regard to cancer, heart disease, diabetes, bone formation, growth modulation and immunity. The c9,t11 isomer of CLA, rumenic acid (RA), is the major isomer present in the diet. However, dietary intakes of CLA and RA by humans have not been examined rigorously, nor has the relationship between dietary CLA or RA and health (e.g., body composition). Three-day dietary records (DR) were collected from adult men (n = 46) and women (n = 47) and analyzed using a nutrient database modified to contain total CLA and RA. Simultaneously, 3-d food duplicates (FD) were collected to determine analytically individual fatty acid intakes, including those of total CLA and RA. Chronic total CLA and RA intakes were estimated using a semiquantitative food-frequency questionnaire (FFQ). Body composition was estimated using body mass index and percentage of body fat. Total CLA intake was estimated from FD to be 212 +/- 14 and 151 +/- 14 mg/d (mean +/- SEM) for men and women, respectively; RA intake was estimated to be 193 +/- 13 and 140 +/- 14 mg/d for men and women, respectively. In general, CLA and RA intakes estimated by DR and FFQ were significantly lower than those estimated by FD. Body composition was not significantly related to dietary total CLA or RA intake. In conclusion, results suggest that DR and FFQ methodologies are not reliable estimators of individual total CLA and RA intakes and may underestimate total CLA and RA intakes of groups. Intake of total CLA and RA was found to be significantly lower than that suggested previously by others.