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Author(s): Sarah M. Reyes [sup.1] , Kozeta Miliku [sup.1] [sup.2] , Deborah Chan [sup.1] [sup.3] , Meredith Brockway [sup.1] , Sarah Turner [sup.1] [sup.4] , Katherine A. Kearns [sup.1] [sup.5] [...]

Lactation is a unique period in which the maternal skeleton acts as a storehouse to provide substantial calcium to milk. Women who exclusively breastfeed lose an average of 210 mg of calcium per day, which doubles or triples with twins and triplets. Data from rodent and clinical studies are consistent with skeletal calcium being released to provide much of the calcium needed for milk production. This is programmed to occur independently of dietary calcium intake or intestinal calcium absorption, which remains at the prepregnant rate in breastfeeding women. After weaning, the skeleton is restored to its prior mineralization and strength, but the factors that regulate this remain to be elucidated., Effects of lactation on the maternal skeleton The maternal skeleton is borrowed from during lactation to provide much of the calcium that ends up in breast milk (1). Women who [...]

Author(s): Samantha Enstad [sup.1] , Sukhinder Cheema [sup.2] , Raymond Thomas [sup.3] , Raina Fichorova [sup.4] [sup.5] , Camilia R. Martin [sup.5] [sup.6] , Perrie O'Tierney-Ginn [sup.7] , Carol L. [...]

Milk supply and quality during lactation are critical for progeny survival. Maternal tissues and metabolism, influenced by hormonal changes, undergo modification during lactation to sustain breastfeeding. Two organs that suffer essential adjustment are the mammary glands and the bone; however, renal calcium conservation and calcium absorption from the intestine are also modified. Lactation leads to a transient loss of bone minerals to provide adequate amounts of minerals, including calcium for milk production. Physiological, metabolic, and molecular changes in different tissues participate in providing nutrients for milk production. After weaning, the histological, metabolic, and hormonal modifications that take place in lactation are reverted, and bone remineralization is a central function at this time. This study focuses on the hormonal, metabolic, molecular, and tissue modifications that occur in mammary glands, bone, intestine, and kidneys in the mother during lactation and post-weaning periods. Keywords: Lactation, Mammary gland, Bone, Intestine, Author(s): Gustavo Canul-Medina[sup.1] and Cristina Fernandez-Mejia[sup.1] Introduction Lactation and post-weaning are periods during which several tissues suffer morphologic, metabolic, and hormonal changes. The central function of lactation is to synthesize [...]

Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life. Keywords HIV infection * HIV positive mothers * HIV exposed infants * Breast feeding * Body composition * Anthropometry, Introduction Breastfeeding is critical for child survival [1, 2]. The intense debate surrounding breastfeeding in the presence of HIV infection has brought breastfeeding to the forefront [3]. Vertical transmission of [...]

Objectives: To evaluate the impact of maternal diet and intensive dietary counselling during pregnancy and breastfeeding on the infant's metabolic status. Subjects/Methods: At the first trimester of pregnancy, 256 women were randomized into a control/placebo group and two dietary counselling groups (diet/probiotics and diet/placebo). The counselling, with double-blind randomization to probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis) or placebo, targeted excessive saturated fat and low fibre consumption. Maternal diet was evaluated repeatedly during pregnancy and postpartum by means of 3 days' food diaries. Metabolic markers, serum 32-33 split and intact proinsulin, leptin/adiponectin ratio, skinfold thickness and waist circumference were measured of 194 healthy infants at the age of 6 months, and the high levels were taken to mirror adverse metabolic status. Results: The proportion of infants with a high 32-33 split proinsulin was significantly lower in dietary counselling with probiotics (n = 6/62, 9.7%) or placebo (n = 7/69, 10.1%) compared with the control/placebo group (n = 17/63, 27.0%). The high split proinsulin was associated with larger skinfold thickness, waist circumference and higher leptin/adiponectin ratio in the infants (P < 0.05). With respect to maternal diet during pregnancy, the highest and lowest tertiles of fat intake increased the infant's risk of high split proinsulin, whereas those of butter associated correspondingly with the infant's waist circumference. Further, breastfed infants showed a reduced risk of high split proinsulin and leptin/adiponectin ratio compared with formula-fed infants. Conclusions: Modification of maternal diet during pregnancy and breastfeeding may benefit infant metabolic health. High split proinsulin reflects adverse metabolic status in infancy, which can be improved by early dietary counselling. European Journal of Clinical Nutrition (2011) 65, 10-19; doi: 10.1038/ejcn.2010.225; published online 13 October 2010 Keywords: infant; adiposity; metabolism; pregnancy; counselling, Introduction Industrialized countries worldwide are faced with a progressive increase in metabolic conditions such as obesity, and the velocity of propagation is particularly outstanding in the paediatric population. Evidence that [...]

In mammals, the most significant maternal effect on offspring growth during lactation is the ability of females to efficiently transfer milk energy to their neonates. However, despite the importance of the transfer of milk energy to both maternal and offspring fitness, nothing is known about the extent to which variation among females may be attributed to differences in individual quality or environmental variation in natural populations. We measured repeatability over multiple lactation periods in components of lactation performance in free-ranging, multiparous gray seal (Halichoerus grypus) females to examine to what extent variation among females in pup weaning mass may be attributed to inherent differences in their physiological capacity to deliver milk energy. Levels of repeatability were high for milk composition (r = 0.38-0.50), daily milk output (r = 0.46), and the duration of lactation (r = 0.57), demonstrating that there are consistent differences among females in these characters across lactations and that the overall capacity of gray seal females to deliver milk energy to their pups is characteristic of individuals. The repeatability in pup weaning mass (r = 0.48) was consistent with the values for the components of total milk energy output and suggests that, over a large proportion of their reproductive life, individual gray seal females will consistently wean pups with greater or lesser probabilities of survival. Our results suggest that inherent differences among females in their physiological capacity to deliver milk energy may be an important component of variation in individual quality and, thus, lifetime reproductive success in mammals. High levels of repeatability also suggest that components of milk energy transfer may have a significant heritable genetic basis. Key words: gray seal; Halichoerus grypus; individual quality; lactation length; maternal effects; milk composition; milk energy output; repeatability; weaning mass.

Objective. To enhance breastfeeding practices, the World Health Organization discourages pacifiers and bottle-feeding. However, the effect of artificial nipples on breastfeeding duration is poorly defined. The effects of 2 types of artificial nipple exposure on breastfeeding duration were evaluated: 1) cupfeeding versus bottle-feeding for the provision of in-hospital supplements and 2) early (2-5 days) versus late (>4 weeks) pacifier introduction. Methods. A total of 700 breastfed newborns (36-42 weeks, birth weight [greater than or equal to] 2200 g) were randomly assigned to 1 of 4 intervention groups: bottle/early pacifier (n = 169), bottle/late pacifier (n = 167), cup/early pacifier (n = 185), or cup/late pacifier (n = 179). The cup/bottle intervention was invoked for infants who received supplemental feedings: cup (n = 251), bottle (n = 230). Data were collected at delivery and at 2, 5, 10, 16, 24, 38, and 52 weeks&apos; postpartum. Intervention effects on breastfeeding duration were evaluated with logistic regression and survival analyses. Results. Supplemental feedings, regardless of method (cup or bottle), had a detrimental effect on breastfeeding duration. There were no differences in cup versus bottle groups for breastfeeding duration. Effects were modified by the number of supplements; exclusive and full breastfeeding duration were prolonged in cupfed infants given >2 supplements. Among infants delivered by cesarean, cupfeeding significantly prolonged exclusive, full, and overall breastfeeding duration. Exclusive breastfeeding at 4 weeks was less likely among infants exposed to pacifiers (early pacifier group; odds ratio: 1.5; 95% confidence interval: 1.0-2.0). Early, as compared with late, pacifier use shortened overall duration (adjusted hazard ratio: 1.22; 95% confidence interval: 1.03-1.44) but did not affect exclusive or full duration. Conclusions. There was no advantage to cupfeeding for providing supplements to the general population of healthy breastfed infants, but it may have benefitted mother-infant dyads who required multiple supplements or were delivered by cesarean. Pacifier use in the neonatal period was detrimental to exclusive and overall breastfeeding. These findings support recommendations to avoid exposing breastfed infants to artificial nipples in the neonatal period. Pediatrics 2003;111:511-518; breastfeeding, pacifiers, bottle-feeding, cupfeeding., ABBREVIATIONS. WHO, World Health Organization; ITT, intention-to-treat; CI, confidence interval; OR, odds ratio; HR, hazard ratio. Infants must learn to attach and suckle properly at the breast during the first [...]

Iron supplements are often prescribed during infancy but their benefits and risks have not been well documented. We examined whether iron supplements affect growth or morbidity of breast-fed infants. Full-term infants in Sweden (n = 101) and Honduras (n = 131) were randomly assigned to three groups at 4 mo of age: 1) placebo from 4 to 9 mo; 2) placebo from 4 to 6 mo and iron supplements [1 mg/(kg * d)] from 6 to 9 mo; or 3) iron supplements from 4 to 9 mo. All infants were exclusively or nearly exclusively breast-fed to 6 mo and continued to be breast-fed to at least 9 mo. Growth was measured monthly and morbidity data were collected every 2 wk. Among the Swedish infants, gains in length and head circumference were significantly lower in those who received iron than in those given placebo from 4 to 9 mo. The same effect on length was seen in Honduras, but only at 4-6 mo among those with initial hemoglobin (Hb) [greater than or equal to] 110 g/L. There was no significant main effect of iron supplementation on morbidity, nor any significant interaction between iron supplementation and site, but for diarrhea (with both sites combined), there was an interaction between iron supplementation and initial Hb. Among infants with Hb < 110 g/L at 4 mo, diarrhea was less common among those given iron than in those given placebo from 4-9 mo, whereas the opposite was true among those with Hb [greater than or equal to] 110 g/L (P < 0.05). We conclude that routine iron supplementation of breast-fed infants may benefit those with low Hb but may present risks for those with normal Hb. KEY WORDS: * iron supplementation * anemia * diarrhea * breast-feeding * infant growth

An attenuated severity of infections is among the well-documented benefits of breast-feeding. The degree to which this attenuated severity extends to the amelioration of anorexia is understood incompletely,and possible underlying mechanisms have received limited evaluation. This study was designed to test whether breast-feeding attenuates reductions in energy intake associated with a mild immunologic stimulus and to assess poststimulus relationships among putative reductions in energy intake and serum interleukin (IL)-1[beta], tumor necrosis factor (TNF)-[alpha] and leptin concentrations. A quasi-experimental, hospital-based study was conducted in 23 healthy fully breast- (BF) and formula-fed (FF) infants who received the quadruple diphtheria, pertussis, tetanus and hemophilus influenza (DPTH) immunization as an immunologic challenge. Only FF infants had decreased energy intakes (12[+ or -]2%, P = 0.001) after immunization. Leptin concentrations increased after immunization only in FF infants (30[+ or -]7%, P = 0.03). Correlations between postimmunization increases in IL-[beta]and reductions in energy intake were of borderline significance (r = -0.56, P = 0.08). These findings support the view that breast-feeding protects against anorectic response to mild immunologic stimuli. Increases in leptin are associated with reductions in energy consumption in the postimmunization period in FF infants and postimmunization changes in IL-1[beta]concentrations likely are related to reductions in energy intake in response to immunologic stimuli. Key Words: * breast-feeding * infants * interleukin-1[beta] * tumor necrosis factor-[alpha] * leptin * infections * anorexia

This article examines the relationship between blood pressure levels and oxytocin responsivity in bottle and breast-feeding mothers. Results indicate that breast-feeding mothers were more likely to experience reductions in stress and blood pressure levels and increases in oxytocin during testing conditions when compared to bottle-feeding mothers.

Research shows that fecal samples from the formula-fed infants contain higher numbers of Coriobacterium group cells as compared to the breast-fed infants. Data also suggest with increasing age, the diversity of the Atopobium cluster species in the feces increases.

Objective: To examine factors associated with the physical growth of breast-fed Ghanaian infants during the first 18 months of life. Design: A community-based longitudinal study. Setting: The study was carried out in Techiman, a district capital and major food trading center in the Brong Ahafo region of Ghana. Subjects: One-month old infants (n = 216) with birth weight [greater than or equal to] 2.5 kg were recruited from Maternal and Child Health Centers. Method: From 6 to 12 months, infants were provided with one of four types of nutritionally enhanced complementary foods. Anthropometric assessments were completed monthly from 1 to 12 months and every other month from 12 to 18 months. Information was collected on household characteristics, morbidity from common infections and dietary intakes. Blood samples were collected at 6 and 12 months to assess iron, zinc, riboflavin and vitamin A status. Multiple regression analysis was used to examine factors associated with growth during the age intervals of 1-6, 4-6, 6-12 and 12-18 months as well as size attained at 12 and 18 months. Results: Prevalence of diarrhea and fever were negatively associated with growth during the first year of life. No significant relationship was found between respiratory illness (defined as cough or purulent nasal discharge) and growth. With the exception of dietary zinc intake, dietary variables were generally not significantly associated with growth. Maternal education was positively associated with growth during most of the age intervals. Conclusion: These findings suggest that interventions to reduce morbidity and improve the education of girls may benefit children&apos;s growth in this population. Sponsorship: Nestle Foundation; Rockefeller Foundation African Dissertation Internship Award; Fulbright Scholarship. Descriptors: infant growth; morbidity; complementary feeding; nutrition; maternal education; Ghana, Introduction Growth faltering among infants and children in developing countries is highly prevalent (Dewey, 1998; Wells et al, 1993). Although globally there has been a reduction in the prevalence of [...]

Measures of energy intake of lactating women in developing countries show that intakes are often lower than those recommended by international bodies, while fat-mass losses are often substantially less than the 3-4 kg used in the calculations of recommendations, suggesting that physiological adaptation must be commonplace among such women. The cost of lactation may be met by reduction in energy expenditure, including reduced physical activity, as well as by mobilization of bodily soft tissue. However, daily energy expenditure of lactating women has been shown to increase across the course of lactation among women in a rural population in the Philippines and an urban population in India, with a decline in body weight across the course of lactation in both studies. In the present study, total daily energy expenditure and anthropometric body composition were measured longitudinally in 68 mothers from a poor urban area of Dhaka, Bangladesh, at 0, 1, 2, 4, and 8 months of lactation, to determine whether the increasing energy expenditure across lactation observed elsewhere also occurs in Bangladeshi women. In addition, the extent to which an extended period of lactation was accompanied by weight and body fat change in these women was determined. Energy expenditure by heart-rate monitoring and activity report, and body composition from anthropometry was carried out four times across the 8-month period of lactation. A small decline in body fat mass and a significant increase in total energy expenditure across this period were observed, confirming similar observations elsewhere in the developing world. Am J Phys Anthropol 110:457-465, 1999. KEY WORDS: lactation; Bangladesh; energy expenditure; body composition

Previously published reports have indicated that postpartum anovulatory intervals can be markedly reduced and rebreeding performance enhanced in Bos taurus cows by eliminating nighttime suckling. We sought to confirm this hypothesis by examining the effects of day, nighttime, and ad libitum suckling on suckling behavior of calves, duration of the postpartum anovulatory interval, and pregnancy rates in 45 fall-calving Brahman x Hereford ([F.sub.1]) cows. Beginning on d 9 to 12 postpartum, calves were removed from lactating cows from 0700 to 1900 (Night-Suckled, n = 15) or from 1900 to 0700 (Day-Suckled, n = 15), or remained with their dams continuously (Ad Libitum-Suckled, n = 15). Cows in each group were maintained with fertile Angus bulls from d 10 postpartum until the first normal luteal phase or 100 d postpartum, whichever occurred first. Cows were observed for estrous behavior twice daily, and jugular blood samples were collected twice weekly for the determination of serum progesterone concentration. Mean number of suckling episodes per 24 h was greater (P < .0001) for the Ad Libitum-Suckled group than either Night- or Day-Suckled groups (5.9 [+ or -] .42 vs 3.8 [+ or -] .14, and 3.9 [+ or -] .32, respectively). Hourly analysis of suckling episodes in the Ad Libitum group indicated that they were not skewed toward a particular period, with suckling occurring at a periodicity of 4 to 6 h. Intervals to the first rise in progesterone [greater than or equal to] 1 ng/mL (32 [+ or -] 2.5, 32 [+ or -] 4.5, and 31 [+ or -] 1.7 d, respectively), first normal luteal phase (38 [+ or -] 3.1, 38 [+ or -] 3.8, and 37 [+ or -] 2.5 d, respectively), and first estrus (43 [+ or -] 3.5, 40 [+ or -] 3.9, and 36 [+ or -] 1.1 d, respectively) did not differ (P > .05) among the three groups. Similarly, cumulative pregnancy rates within 100 d after calving did not differ (P > .05). These results in Bos indicus x Bos taurus ([F.sub.1]) cattle do not support the previous conclusions in Bos taurus that eliminating nighttime suckling reduces the postpartum anovulatory interval. Key Words: Postpartum Interval, Suckling