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JAMA Pediatrics Jun 2024Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Human milk feeding is a key public health goal to optimize infant and maternal/parental health, but global lactation outcomes do not meet recommended duration and exclusivity. There are connections between lactation and mental health.
OBJECTIVE
To appraise all available evidence on whether the provision of relaxation interventions to lactating individuals improves lactation and well-being.
DATA SOURCES
Embase, MEDLINE, CINAHL, Allied and Complementary Medicine Database, Web of Science, and the Cochrane Library were searched on September 30, 2023, and topic experts were consulted.
STUDY SELECTION
Two independent reviewers screened for eligibility. Inclusion criteria were full-text, peer-reviewed publications with a randomized clinical trial design. Techniques that were entirely physical (eg, massage) were excluded. A total of 7% of initially identified studies met selection criteria.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers extracted data and assessed risk of bias with the Cochrane Risk of Bias 2 tool. Fixed-effects meta-analysis and Grading of Recommendations, Assessment, Development, and Evaluations guidelines were used to synthesize and present evidence.
MAIN OUTCOMES AND MEASURES
Prespecified primary outcomes were human milk quantity, length and exclusivity of human milk feeding, milk macronutrients/cortisol, and infant growth and behavior.
RESULTS
A total of 16 studies were included with 1871 participants (pooled mean [SD] age for 1656 participants, 29.6 [6.1] years). Interventions were music, guided relaxation, mindfulness, and breathing exercises/muscle relaxation. Provision of relaxation was not associated with a change in human milk protein (mean difference [MD], 0 g/100 mL; 95% CI, 0; 205 participants). Provision of relaxation was associated with an increase in human milk quantity (standardized mean difference [SMD], 0.73; 95% CI, 0.57-0.89; 464 participants), increased infant weight gain in breastfeeding infants (MD, z score change = 0.51; 95% CI, 0.30-0.72; 226 participants), and a slight reduction in stress and anxiety (SMD stress score, -0.49; 95% CI, -0.70 to -0.27; 355 participants; SMD anxiety score, -0.45; 95% CI, -0.67 to -0.22; 410 participants).
CONCLUSIONS AND RELEVANCE
Results of this systematic review and meta-analysis suggest that provision of relaxation was associated with an increase in human milk quantity and infant weight gain and a slight reduction in stress and anxiety. Relaxation interventions can be offered to lactating parents who would like to increase well-being and improve milk supply or, where directly breastfeeding, increase infant weight gain.
Topics: Humans; Relaxation Therapy; Milk, Human; Breast Feeding; Lactation; Infant, Newborn; Female; Infant
PubMed: 38709505
DOI: 10.1001/jamapediatrics.2024.0814 -
Nestle Nutrition Institute Workshop... 2016Presently, hydrolyzed formulas (HF) are used primarily in infants that cannot be exclusively breastfed, those with cow's milk allergy and for primary prevention of... (Review)
Review
Presently, hydrolyzed formulas (HF) are used primarily in infants that cannot be exclusively breastfed, those with cow's milk allergy and for primary prevention of allergic disease, but HFs are increasingly being used worldwide, begging the question if they may be recommended as the optimal choice for all standard-risk, full-term, non-exclusively breastfed infants. Data regarding the nutritional adequacy of modern-day HFs are scarce and lack long-term data suggesting that growth in infants fed HF versus an intact protein formula (IPF) is different. While human breast milk is the optimal source of nutrition for multiple reasons, a 2006 systematic review determined there were no comparable long-term studies regarding prolonged use of HFs versus breastfeeding. Meta-analyses of formula consumption and risk of atopic dermatitis (AD) have found that infants fed partially HF compared to IPF had a lower risk of AD, but there are significant limitations to these studies, making conclusions about the general use of HFs problematic. Costs should be considered in decision-making regarding the choice of the formula, but global comparison of this is difficult given large cost differences in different countries. Despite the issues raised here, the desire to provide concrete recommendations of widespread HF use needs to be balanced carefully in order not to overstate claims of benefit. Long-term studies are needed to investigate the feasibility of HF as a routine feeding option for healthy, standard-risk infants. Because of the paucity of data, routine use of HF as an equivalent option to breastfeeding or IPF cannot be supported at present based on available scientific evidence.
Topics: Animals; Breast Feeding; Cattle; Child Development; Cost-Benefit Analysis; Dermatitis, Atopic; Humans; Infant; Infant Formula; Infant Nutritional Physiological Phenomena; Meta-Analysis as Topic; Milk Hypersensitivity; Milk Proteins; Protein Hydrolysates; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 27336594
DOI: 10.1159/000442956 -
International Breastfeeding Journal Jan 2021This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk. (Review)
Review
BACKGROUND
This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk.
METHODS
We systematically searched electronic databases including Medline via PubMed, Scopus and ISI Web of Science till May 24, 2018. The following terms were used systematically in all mentioned databases: ("human milk" OR "breast milk" OR "breast milk composition" OR "human breast milk composition" OR "composition breast milk" OR "mother milk" OR "human breast milk" OR "maternal milk") AND ("vitamin a" OR "retinol" OR "retinal" OR "retinoic acid" OR "beta-carotene" OR "beta carotene" OR "ascorbic acid" OR "l-ascorbic acid" OR "l ascorbic acid" OR "vitamin c" OR "vitamin d" OR "cholecalciferol" OR "ergocalciferol" OR "calciferol" OR "vitamin e" OR "tocopherol" OR "tocotrienol" OR "alpha-tocopherol" OR "alpha tocopherol" OR "α-tocopherol" OR "α tocopherol" OR "vitamin k" OR "vitamin b" OR "vitamin b complex" OR "zinc" OR "iron" OR "copper" Or "selenium" OR "manganese" OR "magnesium") and we searched Medline via Medical subject Headings (MeSH) terms. We searched Google Scholar for to increase the sensitivity of our search. The search was conducted on human studies, but it was not limited to the title and abstract. Methodological quality and risk of bias of included studies were evaluated by Jadad scale and Cochrane risk of bias tools, respectively.
RESULTS
This review included papers on three minerals (zinc, iron, selenium) and 6 vitamins (vitamin A, B, D, C, E and K) in addition to multi-vitamin supplements. Although studies had different designs, e.g. not using random allocation and/or blinding, our findings suggest that maternal use of some dietary supplements, including vitamin A, D, vitamin B1, B2 and vitamin C might be reflected in human milk. Vitamin supplements had agreater effect on breast milk composition compared to minerals. Higher doses of supplements showed higher effects and they were reflected more in colostrum than in the mature milk.
CONCLUSION
Maternal dietary vitamin and/or mineral supplementation, particularly fat- soluble vitamins, vitamin B1, B2 and C might be reflected in the breast milk composition. No difference was found between mega dose and single dose administration of minerals.
Topics: Dietary Supplements; Female; Humans; Milk, Human; Mothers; Selenium; Vitamin B Complex
PubMed: 33397426
DOI: 10.1186/s13006-020-00354-0 -
Clinics in Perinatology Mar 2017This study is a systematic review of the macronutrient and energy composition of preterm human milk to enable the practicing neonatologist to make informed nutritional... (Review)
Review
This study is a systematic review of the macronutrient and energy composition of preterm human milk to enable the practicing neonatologist to make informed nutritional decisions in preterm infants. Meta-analyses were conducted in all the studies that reported total energy, true protein, fat, and lactose. Protein content decreased massively (by one-half) and significantly from day 1 to 3 at week 10 to 12. There was a significant linear increase in fat, lactose, and energy content during the same timeframe. Theoretic calculations on energy and macronutrient intake of preterm infants must be made according to a lactation time-specific manner.
Topics: Adult; Carbohydrate Metabolism; Carbohydrates; Fats; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Lactation; Lactose; Milk Proteins; Milk, Human; Premature Birth
PubMed: 28159203
DOI: 10.1016/j.clp.2016.11.010 -
Nutrition Reviews Aug 2022Dietary carotenoid intake is associated with vitamin A status and healthy visual and cognitive function in early life. To date, however, only limited population-level...
CONTEXT
Dietary carotenoid intake is associated with vitamin A status and healthy visual and cognitive function in early life. To date, however, only limited population-level data on the concentrations of carotenoids in human milk or infant blood have been available to assess the dietary exposure of infants to carotenoids.
OBJECTIVE
This systematic review seeks to define worldwide carotenoid concentrations in human milk and infant blood.
DATA SOURCES
The PubMed, Embase, and Web of Science databases were searched for original research articles published before February 2021.
DATA EXTRACTION
Dietary carotenoid concentrations in human milk and in blood plasma or serum from healthy infants (≤1 year of age), along with study location, infant age, and lactation stage, were extracted. Means and 95%CIs were analyzed within and across variables.
DATA ANALYSIS
Publications on carotenoid concentrations in infant blood (47 publications, n = 4553 unique individuals) and human milk (65 publications, n = 2871 unique individuals) described populations from 22 and 31 countries, respectively. Carotenoid species concentrations ranged from 0.3 to 20 µg/dL in blood and from 0.1 to 30 µg/dL in human milk, with carotenoid concentrations generally decreasing in milk across lactation stages and increasing in blood with infant age.
CONCLUSION
Concentrations of the major dietary carotenoids-β-carotene, lycopene, lutein, β-cryptoxanthin, zeaxanthin, and α-carotene-have been reported in both infant blood and human milk across infant ages and lactation stages, with β-carotene, lutein, and lycopene tending to be more abundant than other carotenoids. Despite heterogeneous amounts of data available for each outcome, infants worldwide are exposed to a variety of dietary carotenoids. The estimates of dietary carotenoids in human milk and infant blood can facilitate the interpretation of future studies and the design of nutritionally relevant experiments on dietary carotenoids and infant health.
Topics: Carotenoids; Female; Humans; Infant; Lutein; Lycopene; Milk, Human; Zeaxanthins; beta Carotene
PubMed: 35389473
DOI: 10.1093/nutrit/nuac018 -
Nutrition in Clinical Practice :... Jun 2017Human milk-associated microbes are among the first to colonize the infant gut and may help to shape both short- and long-term infant health outcomes. We performed a... (Review)
Review
Human milk-associated microbes are among the first to colonize the infant gut and may help to shape both short- and long-term infant health outcomes. We performed a systematic review to characterize the microbiota of human milk. Relevant primary studies were identified through a comprehensive search of PubMed (January 1, 1964, to June 31, 2015). Included studies were conducted among healthy mothers, were written in English, identified bacteria in human milk, used culture-independent methods, and reported primary results at the genus level. Twelve studies satisfied inclusion criteria. All varied in geographic location and human milk collection/storage/analytic methods. Streptococcus was identified in human milk samples in 11 studies (91.6%) and Staphylococcus in 10 (83.3%); both were predominant genera in 6 (50%). Eight of the 12 studies used conventional ribosomal RNA (rRNA) polymerase chain reaction (PCR), of which 7 (87.5%) identified Streptococcus and 6 (80%) identified Staphylococcus as present. Of these 8 studies, 2 (25%) identified Streptococcus and Staphylococcus as predominant genera. Four of the 12 studies used next-generation sequencing (NGS), all of which identified Streptococcus and Staphylococcus as present and predominant genera. Relative to conventional rRNA PCR, NGS is a more sensitive method to identify/quantify bacterial genera in human milk, suggesting the predominance of Streptococcus and Staphylococcus may be underestimated in studies using older methods. These genera, Streptococcus and Staphylococcus, may be universally predominant in human milk, regardless of differences in geographic location or analytic methods. Primary studies designed to evaluate the effect of these 2 genera on short- and long-term infant outcomes are warranted.
Topics: Food Microbiology; Humans; Infant; Microbiota; Milk, Human; Staphylococcus; Streptococcus
PubMed: 27679525
DOI: 10.1177/0884533616670150 -
Biomolecules Feb 2022Research investigating milk-derived proteins has brought to light the potential for their use as novel anticancer agents. This paper aims to systematically review... (Meta-Analysis)
Meta-Analysis
Research investigating milk-derived proteins has brought to light the potential for their use as novel anticancer agents. This paper aims to systematically review studies examining the effectiveness of milk-derived proteins in the treatment of head and neck cancer. A systematic literature search of Medline, Evidence-Based Medicine, and Web of Science databases including papers published from all dates was completed. Inter-rater reliability was high during the title, abstract, and full-text screening phases. Inclusion criteria, exclusion criteria, and data extraction were based on the PICOS tool and research questions. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analysis criteria. Eligible in vitro and in vivo studies ( = 8/658) evaluated lactoferrin, α-lactalbumin, and its complexes, such as HAMLET, BAMLET and lactalbumin-oleic acid complexes, as well as lactoperoxidase, whey, and casein. Their effectiveness in the treatment of head and neck cancer cells lines found that these compounds can inhibit tumour growth modulate cancer gene expression, and have cytotoxic effects on cancer cells. However, the exact mechanisms by which these effects are achieved are not well understood. Systematically designed, large, optimally controlled, collaborative studies, both in vitro and in vivo, will be required to gain a better understanding of their potential role in the treatment of head and neck cancer.
Topics: Animals; Carcinoma; Head and Neck Neoplasms; Humans; Milk; Milk Proteins; Oleic Acid; Peptides; Reproducibility of Results
PubMed: 35204791
DOI: 10.3390/biom12020290 -
Advances in Nutrition (Bethesda, Md.) Jan 2024Among 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...
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.
Topics: Child; Female; Humans; Infant; Body Composition; Breast Feeding; Carbohydrates; Fatty Acids; Milk, Human; Nutrients; Proteins
PubMed: 37981047
DOI: 10.1016/j.advnut.2023.100149 -
Nutrients May 2023Human milk provides all of the elements necessary for infant growth and development. Previous studies have reported associations between breastfeeding and a reduced risk... (Review)
Review
Human milk provides all of the elements necessary for infant growth and development. Previous studies have reported associations between breastfeeding and a reduced risk of developing obesity and late-onset metabolic disorders; however, the underlying mechanisms are poorly understood. Recently, intakes of human milk components have been associated with infant body composition, which is likely partially implicated in the reduced risk of developing childhood obesity among breastfed infants. In this systematic review, we searched electronic bibliographic databases for studies that explored relationships between the 24 h intakes of human milk macronutrients and bioactive components and infant body composition and/or growth parameters. Of 13 eligible studies, 10 assessed relationships of infant body composition and growth outcomes with human milk macronutrients, while 8 studies assessed relationships with human milk bioactive components. Significant time-dependent relationships with infant anthropometrics and body composition were found for intakes and no relationships for concentrations of several human milk components, such as lactose, total protein, and human milk oligosaccharides, suggesting that measuring concentrations of human milk components without quantifying the intake by the infant may provide a limited understanding. Future studies investigating the effect of human milk components on infant growth and body composition outcomes should consider measuring the actual intake of components and employ standardised methods for measuring milk intake.
Topics: Child; Female; Infant; Humans; Breast Feeding; Milk, Human; Pediatric Obesity; Body Composition; Infant Nutritional Physiological Phenomena
PubMed: 37242254
DOI: 10.3390/nu15102370 -
Environmental Science and Pollution... Nov 2023Although veterinary antibiotics are essential in preventing and treating clinical diseases in cattle, the frequent use of antibiotics leads to antibiotic residues in... (Review)
Review
Although veterinary antibiotics are essential in preventing and treating clinical diseases in cattle, the frequent use of antibiotics leads to antibiotic residues in milk and dairy products, consequently threatening human health. The massive milk consumption makes it necessary to assess antibiotic pollution and health impact comprehensively. Hence, we conducted a systematic review to evaluate antibiotics in milk and dairy products and their potential health risk. We searched four databases using multiple keyword combinations to retrieve 1582 pieces of literature and finally included eighteen articles to analyze antibiotic residues in milk and dairy products. These studies detected seven antibiotics in different regions of China. Quinolones and β-lactam antibiotics exceeded the MRL for raw and commercial milk. The maximum levels of sulfonamides and tetracyclines were detected in the same raw milk sample, exceeding the MRL. The estimated THQ and HI values in milk and dairy products are less than 1 for adults, indicating negligible noncarcinogenic health risk of antibiotics through consuming milk and dairy products. Children face higher health risks than adults, with the HI and THQ of quinolones exceeding 1. It is worth noting that quinolones accounted for nearly 89% of health risks associated with all antibiotics. Finally, we put forward possible research directions in the future, such as specific health effects of total dietary exposure to low levels of antibiotics. In addition, policymakers should effectively improve this problem from the perspectives of antibiotic use supervision, antibiotic residue analysis in food, and continuous environmental monitoring and control.
Topics: Adult; Child; Humans; Animals; Cattle; Milk; Anti-Bacterial Agents; Dairy Products; Sulfanilamide; Quinolones; China; Drug Residues
PubMed: 37851252
DOI: 10.1007/s11356-023-30312-2