Greetings All,

Some new studies: 

Title:  Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners.

In:   BMC Pediatrics 2020 Apr 14;20(1):159. doi: 10.1186/s12887-020-02065-1.

Authors:  Grandahl M, Stern J, Funkquist EL.

Abstract
"Background:  Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90 days; additionally, a further 300 days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding.  Aim:  To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12 months after birth. An additional aim was to describe infants’ and parents’ characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding.  Methods:  This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012–2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding.  Results:  Infants were exclusively breastfed for, on average, 2.5 months (range 0–12 months) and partially breastfed, on average, 7 months (range 0–12 months). Most of the parental leave was taken by the mother (mean = 10.9 months) during the infant’s first 12 months, while the partner took 3 months, on average. The parental leave (used and planned) during the infant’s first 24 months were, on average, 21 months. In the multivariate linear regression analysis, mothers’ and partners’ high level of education (p < 0.001, p = 0.044, respectively), mothers’ higher age (p = 0.049), non-instrumental vaginal birth (p = 0.004) and longer parental leave for the first 24 months (p < 0.001) were associated with longer duration of partial breastfeeding.  Conclusion:  The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave."

Open access:  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02065-1



Title:  A detailed exploration of early infant milk feeding in a prospective birth cohort study in Ireland: combination feeding of breastmilk and infant formula and early breastfeeding cessation.

In:  British Journal of Nutrition 2020 Apr 14:1-28. doi: 10.1017/S0007114520001324. [Epub ahead of print]

Authors:  Hemmingway A, Fisher D, Berkery T, Dempsey E, Murray DM, Kiely ME.

Abstract
Breastfeeding initiation and continuation rates in the United Kingdom and Ireland are low relative to many European countries. As a core outcome of the prospective COMBINE birth cohort study (Cork, Ireland), we aimed to describe infant milk feeding practices in detail and examine the prevalence and impact of combination feeding of breastmilk and infant formula on breastfeeding duration. COMBINE recruited 456 nulliparous mothers (2015-2017) for maternal-infant follow-up via interview at hospital discharge (median [IQR] 3 [2, 4] days, n=453), 1 (n=418), 2 (n=392), 4 (n=366), 6 (n=362) and 9 (n=345) months of age. Median (IQR) maternal age was 32 (29, 34) years, 97% of mothers were of white ethnicity, 79% were Irish-born and 75% were college educated. Overall, 75% breastfed to any extent at discharge and 44% breastfed solely. At 1, 2, 4, 6 and 9 months respectively, 40%, 36%, 33%, 24% and 19% breastfed solely. Combination feeding of breastmilk and infant formula was common at discharge (31%) and 1 month (20%). Reasons for combination feeding at 1 month included perceived/actual hunger (30%), healthcare professional advice (31%) and breastfeeding difficulties (13%). Of mothers who breastfed to any extent at discharge, 45% stopped within 4 months. Mothers who combination fed were more likely to cease breastfeeding than those who breastfed solely (relative risk 2.3 by 1 month and 12.0 by 2 months). These granular data provide valuable insight to early milk feeding practices and indicate that supporting early breastfeeding without formula use may be key to the successful continuation of breastfeeding.

Full text of accepted manuscript:  https://www.cambridge.org/core/services/aop-cambridge-core/content/view/187EE6966FDE01532C8F2326A2DFDADE/S0007114520001324a.pdf/detailed_exploration_of_early_infant_milk_feeding_in_a_prospective_birth_cohort_study_in_ireland_combination_feeding_of_breastmilk_and_infant_formula_and_early_breastfeeding_cessation.pdf



Title:  Late weaning and maternal closeness, associated with advanced motor and visual maturation, reinforce autonomy in healthy, 2-year-old children.

In:  Scientific Reports 2020 Mar 23;10(1):5251. doi: 10.1038/s41598-020-61917-z.

Authors:  Villar J, Ochieng R, Staines-Urias E, Fernandes M, Ratcliff M, Purwar M, Barros F, Horta B, Cheikh Ismail L, Albernaz E, Kunnawar N, Temple S, Giuliani F, Sandells T, Carvalho M, Ohuma E, Jaffer Y, Alison Noble J, Gravett M, Pang R, Lambert A, Bertino E, Di Nicola P, Papageorghiou A, Stein A, Bhutta Z, Kennedy S.

Abstract
"We studied neurodevelopmental outcomes and behaviours in healthy 2-year old children (N = 1306) from Brazil, India, Italy, Kenya and the UK participating in the INTERGROWTH-21st Project. There was a positive independent relationship of duration of exclusive breastfeeding (EBF) and age at weaning with gross motor development, vision and autonomic physical activities, most evident if children were exclusively breastfed for ≥7 months or weaned at ≥7 months. There was no association with cognition, language or behaviour. Children exclusively breastfed from birth to <5 months or weaned at >6 months had, in a dose-effect pattern, adjusting for confounding factors, higher scores for "emotional reactivity". The positive effect of EBF and age at weaning on gross motor, running and climbing scores was strongest among children with the highest scores in maternal closeness proxy indicators. EBF, late weaning and maternal closeness, associated with advanced motor and vision maturation, independently influence autonomous behaviours in healthy children."

Open access:  https://www.nature.com/articles/s41598-020-61917-z.pdf



Title:  Satisfaction of mothers regarding human milk donation.

In:  Archives de Pédiatrie 2020 Apr 10. pii: S0929-693X(20)30024-5. doi: 10.1016/j.arcped.2020.02.002. [Epub ahead of print]

Authors:  2020 Apr 8. pii: S0929-693X(20)30082-8. doi: 10.1016/j.arcped.2020.03.005. [Epub ahead of print]

Abstract
"In France, human milk banks are in charge of the collection, analysis, processing, and distribution of human milk to neonatology centers for preterm infants. Knowledge of what motivates mothers to donate their milk could lead to better communication regarding human milk donation. A satisfaction survey was conducted among mothers who were donating their milk to a human milk bank. In total, 214 mothers answered a questionnaire in the presence of the collector during a home visit. The median age of the mothers was 31 years (18–46), mainly high school (19%) or university (65%) graduates, and the median duration of donation was 3 months (0.5–22). At the time of the study, the median age of infants was 3 months (0.5–25), and 88% of infants were exclusively breastfed. About three quarters of mothers were motivated by willingness to help others, a quarter of them being especially sensitive to premature neonatal care; 30% of mothers were motivated by having a high supply of milk. Around 25% of mothers were given information on human milk donation during pregnancy, and two thirds after delivery, mainly by the maternity ward midwives (53.4%) or by collectors during their visit (14.1%). Most mothers (72%) found the human milk donation process easy and most of them (92.5%) were willing to donate their milk again after their next pregnancy. This survey shows that more than 90% of mothers are satisfied with donation to human milk banks. However, efforts should be made to provide information on breastfeeding and human milk donation to the general population and health professionals."

Abstract only:  https://www.sciencedirect.com/science/article/pii/S0929693X20300828?via%3Dihub



Title:  No long‐term effect of oral stimulation on the intra‐oral vacuum in healthy premature infants.

In:  Acta Paediatrica 2020 Apr 7. doi: 10.1111/apa.15289. [Epub ahead of print]

Authors:  Skaaning D, Kronborg H, Brødsgaard A, Solmer R, Pryds O, Carlsen EM.

Abstract  
"AIM:  Exclusive breastfeeding is recommended for the first 6 months of life, but the breastfeeding rate in premature infants is low. We examined the effect of oral stimulation on infant's strength of suction and the relation between this intra-oral vacuum and breastfeeding duration.  METHOD:  Between 2016 and 2018, 211 infants in a Danish neonatal unit were randomised 1:1 and of these 108 to oral stimulation intervention and 103 to control. Suction was measured as peak vacuum at enrolment and a corrected age of 6 weeks. Breastfeeding duration was registered.  RESULTS:  Vacuum increased from enrolment to a corrected age of 6 weeks in all infants, and no effect of oral stimulation intervention was demonstrated P = .08. Infants born ≤32 gestational weeks had lower vacuum compared with infants born after, 350 vs 398 mbar P < .001. For infants born after 32 gestational weeks, the odds ratio for exclusive breastfeeding at 6 months was 1.99 per 100 mbar increase in vacuum P = .01.  CONCLUSION:  In our study, infant's intra-oral vacuum increased with age and was not affected by the oral stimulation intervention. For infants born after 32 gestational weeks, the exclusive breastfeeding rate was positively associated with a strong vacuum."

Abstract only:  https://onlinelibrary.wiley.com/doi/abs/10.1111/apa.15289



Title:  Association Between Breastfeeding and Ovarian Cancer Risk.

In:  JAMA Oncology 2020 Apr 2:e200421. doi: 10.1001/jamaoncol.2020.0421. [Epub ahead of print]

Authors:  Babic A, Sasamoto N, Rosner BA, Tworoger SS, Jordan SJ, Risch HA, Harris HR, Rossing MA, Doherty JA, Fortner RT, Chang-Claude J, Goodman MT, Thompson PJ, Moysich KB, Ness RB, Kjaer SK, Jensen A, Schildkraut JM, Titus LJ, Cramer DW, Bandera EV, Qin B, Sieh W, McGuire V, Sutphen R, Pearce CL, Wu AH, Pike M, Webb PM, Modugno F, Terry KL.

Abstract
"Importance:  Breastfeeding has been associated with a reduced risk of epithelial ovarian cancer in multiple studies, but others showed no association. Whether risk reduction extends beyond that provided by pregnancy alone or differs by histotype is unclear. Furthermore, the observed associations between duration and timing of breastfeeding with ovarian cancer risk have been inconsistent.  Objective:  To determine the association between breastfeeding (ie, ever/never, duration, timing) and ovarian cancer risk overall and by histotype.  Design, Setting, and Participants:  A pooled analysis of parous women with ovarian cancer and controls from 13 case-control studies participating in the Ovarian Cancer Association Consortium was performed. Odds ratios (ORs) and 95% CIs of the overall association were calculated using multivariable logistic regression and polytomous logistic regression for histotype-specific associations. All data were collected from individual sites from November 1989 to December 2009, and analysis took place from September 2017 to July 2019.  Exposures:  Data on breastfeeding history, including duration per child breastfed, age at first and last breastfeeding, and years since last breastfeeding were collected by questionnaire or interview and was harmonized across studies.  Main Outcomes and Measures  Diagnosis of epithelial ovarian cancer.  Results:  A total of 9973 women with ovarian cancer (mean [SD] age, 57.4 [11.1] years) and 13 843 controls (mean [SD] age, 56.4 [11.7] years) were included.  Breastfeeding was associated with a 24% lower risk of invasive ovarian cancer (odds ratio [OR], 0.76; 95% CI, 0.71-0.80). Independent of parity, ever having breastfed was associated with reduction in risk of all invasive ovarian cancers, particularly high-grade serous and endometrioid cancers.  For a single breastfeeding episode, mean breastfeeding duration of 1 to 3 months was associated with 18% lower risk (OR, 0.82; 95% CI, 0.76-0.88), and breastfeeding for 12 or more months was associated with a 34% lower risk (OR, 0.66; 95% CI, 0.58-0.75).  More recent breastfeeding was associated with a reduction in risk (OR, 0.56; 95% CI, 0.47-0.66 for <10 years) that persisted for decades (OR, 0.83; 95% CI, 0.77-0.90 for ≥30 years; P for trend = .02).  Conclusions and Relevance:  Breastfeeding is associated with a significant decrease in risk of ovarian cancer overall and for the high-grade serous subtype, the most lethal type of ovarian cancer. The findings suggest that breastfeeding is a potentially modifiable factor that may lower risk of ovarian cancer independent of pregnancy alone."

Abstract only:  https://jamanetwork.com/journals/jamaoncology/article-abstract/2763398


With warm regards,

Debbie

Debra Swank, RN BSN IBCLC
Program Director
More Than Reflexes Education
Elkins, West Virginia USA
http://www.MoreThanReflexes.org

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