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Background/Objectives: The causes of low milk supply are multifactorial, including factors such as gene mutations, endocrine disorders, and infrequent milk removal. These factors affect the functional capacity of the mammary gland and, potentially, the concentrations of milk components. This study aimed to investigate the differences in milk composition between mothers with low and normal milk supply and develop predictive machine learning models for identifying low milk supply. Methods: Twenty-four-hour milk production measurements were conducted using the test-weigh method. An array of milk components was measured in 58 women with low milk supply (<600 mL/24 h) and 106 with normal milk supply (≥600 mL/24 h). Machine learning algorithms were employed to develop prediction models integrating milk composition and maternal and infant characteristics. Results: Among the six machine learning algorithms tested, deep learning and gradient boosting machines methods had the best performance metrics. The best-performing model, incorporating 14 milk components and maternal and infant characteristics, achieved an accuracy of 87.9%, an area under the precision-recall curve (AUPRC) of 0.893, and an area under the receiver operating characteristic curve (AUC) of 0.917. Additionally, a simplified model, optimised for clinical applicability, maintained a reasonable accuracy of 78.8%, an AUPRC of 0.776, and an AUC of 0.794. Conclusions: These findings demonstrate the potential of machine learning models to predict low milk supply with high accuracy. Integrating milk composition and maternal and infant characteristics offers a practical approach to identify women at risk of low milk supply, facilitating timely interventions to support breastfeeding and ensure adequate infant nutrition. [ABSTRACT FROM AUTHOR]

Background: Whilst it is inconvenient and time-intensive, predominantly (PP) and exclusively pumping (EP) mothers rely on breast expression to provide milk for their infants and to ensure continued milk supply, yet these populations are poorly understood. Methods: We assessed and characterised Western Australian PP mothers (n = 93) regarding 24 h milk production (MP) and infant milk intake and demographics, perinatal complications and breastfeeding difficulties, the frequencies of which were compared with published general population frequencies. Pumping efficacy and milk flow parameters during a pumping session in PP mothers (n = 32) were compared with those that pump occasionally (reference group, n = 60). Results: PP mothers had a higher frequency of pregnancy complications and breastfeeding difficulties than the general population. Exclusive pumping did not impact the 24 h MP and the amount of milk available to the infant. PP mothers had more milk ejections, longer active flow duration and lower milk removal efficacy ratios; however, responsiveness to pump (time to first milk ejection), total flow duration, time to stop pumping, percentage of available milk removed and comfort parameters were not different to the reference group. Conclusions: Despite the reported challenges, when an effective pump is used, predominant or exclusive pumping does not negatively affect the 24 h MP and the amount of milk available to the infant. Increasing awareness of the impacts of perinatal and breastfeeding complications on women may assist health professionals in early identification of mothers at high risk for early cessation of breastfeeding, escalating early postpartum intervention and targeted breastfeeding support. [ABSTRACT FROM AUTHOR]

Background: Infant growth trajectories reflect current health status and may predict future obesity and metabolic diseases. Human milk is tailored to support optimal infant growth. However, nutrient intake rather than milk composition more accurately predicts growth outcomes. Although the role of protein leverage in infant growth is unclear, protein intake is important for early infancy growth. Materials and methods: This study of exclusively breastfeeding mothers with allergies (n = 161) from the Infant Fish Oil Supplementation Study assessed relationships between intake of human milk macronutrients and infant growth. Human milk fat, protein and lactose concentrations were measured at 3 months postpartum, and infant daily intakes were estimated using an average milk intake of 800 mL/day. Results: Higher human milk protein:energy ratio was associated with higher weight-for-age z-score at 2.5 years compared to 3 months and higher body mass index-for-age z-score change (6 months to 1 year compared to 3–6 months). Maternal atopy and birth season (summer) were negatively associated with human milk lactose concentration. Passive smoke exposure was associated with reduced energy and fat concentrations and increased lactose:energy ratio. Conclusions: Our results indicate that intake of human milk macronutrients may impact early childhood growth. [ABSTRACT FROM AUTHOR]

Background: Maternal breast volume is determined by the quantity of glandular and adipose tissue, and it undergoes significant changes during pregnancy. These changes are intricately linked to the development of glandular tissue, which most likely reflects lactation capacity. Evidence indicates that women with overweight or obesity exhibit larger breast volume compared to those with a normal body mass index (BMI), emphasizing the close relationship between breast volume and maternal adiposity. Hence, we aim to investigate breast volume growth and maternal BMI as potential risk factors for low milk production. Methods: Lactating women (n = 609) from the Perth metropolitan area in Western Australia between 2011 and 2023 were included in the analysis. Twenty-four-hour milk production measurements were conducted using the test weighing method, and milk removal frequencies were recorded. Mothers completed questionnaires regarding demographic, obstetric and infant details. Linear and logistic regression models were used to determine maternal and infant factors associated with milk production. Results: Here we show that increasing maternal age and BMI are associated with low milk production. Moreover, larger pre-pregnancy breast volume and breast growth are associated with both higher BMI and milk production. Conclusions: Women who are older, have an obese BMI and who have minimal pre-pregnancy breast volume and breast growth should be provided with antenatal screening and breastfeeding support as they are more likely to experience low milk production. [ABSTRACT FROM AUTHOR]

The study explores the association between the human milk microbiome (HMM) of allergic mothers and early childhood allergic diseases. The research, conducted on 230 mother-infant dyads, found multiple associations between specific bacterial taxa in human milk and allergy outcomes in infants at 1 and 2.5 years of age. The study suggests that the HMM may play a role in early allergy development, highlighting the importance of microbial exposure in early life for immune system development. The findings contribute to understanding the complex interactions between the HMM, infant gut microbiome, and childhood allergies. [Extracted from the article]

Human milk (HM) composition, including metabolic hormones and lipids, is influenced by various factors, including lactation stage and, potentially, infant sex, which may affect infant body composition (BC) development. We aimed to: (a) characterize the longitudinal concentration and intake profiles of HM leptin, adiponectin, insulin, and total lipids; (b) determine if their concentrations and intakes differ by infant sex; and (c) explore the intakes relationships with the development of infant BC. Milk samples (n = 501) were collected from 82 mother–infant dyads during the first 6 months postpartum. Infant 24 h HM intake was measured, and the average cumulative HM component intakes were calculated. The statistical analysis used linear mixed modeling. Intakes of HM leptin, adiponectin, insulin, and total lipids increased to 1 month postpartum and then remained stable. HM intake and total lipids intake but not hormone intakes were positively associated with infant BC (fat-free mass, fat-free mass index, fat mass, fat mass index, percentage fat mass, and fat mass to fat-free mass ratio). HM component concentrations and intakes did not differ by sex. These findings advance our understanding of the temporal nature of HM components, emphasizing the role of infant 24 h HM and total lipids intake in development of infant lean and adipose tissue. [ABSTRACT FROM AUTHOR]

The ABREAST Conference, held in Perth, Australia, focused on advancing human lactation research and promoting knowledge and innovation in the field. The conference featured keynote speakers from various countries and covered a wide range of topics related to breastfeeding. A total of 161 registrations were received, and 30 manuscripts were accepted for presentation, with 23 manuscripts published. The conference was successful in fostering collaboration and the advancement of research in human lactation. [Extracted from the article]