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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 June 2015) | Viewed by 115874

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Special Issue Editors

Prof. Dr. Jane A. Scott

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Guest Editor

Discipline of Nutrition and Dietetics, School of Population Health, Curtin University, Perth, WA 6102, Australia
Interests: breastfeeding; complementary feeding; early childhood nutrition
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Colin W. Binns

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Guest Editor

School of Public Health, Curtin University, Perth 6845, Australia
Interests: public health nutrition; development of dietary guidelines; breastfeeding policy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The risks of not being breastfed are well substantiated and apply to infants in both developed and developing countries. Breastmilk is uniquely suited to an infant’s nutritional needs and offers a host of important immunological and anti-inflammatory properties that protect against a variety of illnesses in infancy. The World Health Organization estimates that about 800,000 child lives would be saved annually, if every child was breastfed within an hour of birth, given breastmilk only for the first six months of life, and continued breastfeeding up to the age of two years.

This Special Issue is open to any subject area of public health, health promotion, economics, and policy related to breastfeeding and health outcomes in infancy. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Jane Scott
Prof. Dr. Colin Binns
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

infants
breastfeeding
breastmilk
gastrointestinal illness
respiratory illness
allergy
eczema
asthma
otitis media
necrotizing enterocolitis
sudden infant death
hiv/aids
dental health
growth
iron
iodine
vitamin

Published Papers (11 papers)

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Research

629 KiB

Open AccessArticle

MicroRNAs in Breastmilk and the Lactating Breast: Potential Immunoprotectors and Developmental Regulators for the Infant and the Mother

by Mohammed Alsaweed, Peter E. Hartmann, Donna T. Geddes and Foteini Kakulas

Int. J. Environ. Res. Public Health 2015, 12(11), 13981-14020; https://doi.org/10.3390/ijerph121113981 - 30 Oct 2015

Cited by 166 | Viewed by 14813

Abstract

Human milk (HM) is the optimal source of nutrition, protection and developmental programming for infants. It is species-specific and consists of various bioactive components, including microRNAs, small non-coding RNAs regulating gene expression at the post-transcriptional level. microRNAs are both intra- and extra-cellular and are present in body fluids of humans and animals. Of these body fluids, HM appears to be one of the richest sources of microRNA, which are highly conserved in its different fractions, with milk cells containing more microRNAs than milk lipids, followed by skim milk. Potential effects of exogenous food-derived microRNAs on gene expression have been demonstrated, together with the stability of milk-derived microRNAs in the gastrointestinal tract. Taken together, these strongly support the notion that milk microRNAs enter the systemic circulation of the HM fed infant and exert tissue-specific immunoprotective and developmental functions. This has initiated intensive research on the origin, fate and functional significance of milk microRNAs. Importantly, recent studies have provided evidence of endogenous synthesis of HM microRNA within the human lactating mammary epithelium. These findings will now form the basis for investigations of the role of microRNA in the epigenetic control of normal and aberrant mammary development, and particularly lactation performance. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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866 KiB

Open AccessArticle

The Effects of Leptin on Breastfeeding Behaviour

by Anna M. Cannon, Foteini Kakulas, Anna R. Hepworth, Ching Tat Lai, Peter E. Hartmann and Donna T. Geddes

Int. J. Environ. Res. Public Health 2015, 12(10), 12340-12355; https://doi.org/10.3390/ijerph121012340 - 30 Sep 2015

Cited by 30 | Viewed by 7269

Abstract

Breastfed infants have a reduced risk of becoming overweight and/or obese later in life. This protective effect has been partly attributed to leptin present in breastmilk. This study investigated 24-h variations of skim milk leptin and its relationship with breastmilk macronutrients and infant breastfeeding patterns. Exclusive breastfeeding mothers of term singletons (n = 19; age 10 ± 5 weeks) collected pre- and post-feed breastmilk samples for every breastfeed over a 24-h period and test-weighed their infants to determine milk intake at every breastfeed over a 24-h period. Samples (n = 454) were analysed for leptin, protein, lactose and fat content. Skim milk leptin concentration did not change with feeding (p = 0.184). However, larger feed volumes (>105 g) were associated with a decrease in post-feed leptin levels (p = 0.009). There was no relationship between the change in leptin levels and change in protein (p = 0.313) or lactose levels (p = 0.587) between pre- and post-feed milk, but there was a trend for a positive association with changes in milk fat content (p = 0.056). Leptin concentration significantly increased at night (p < 0.001) indicating a possible 24-h pattern. Leptin dose (ng) was not associated with the time between feeds (p = 0.232). Further research should include analysis of whole breastmilk and other breastmilk fractions to extend these findings. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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679 KiB

Open AccessArticle

Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments

by Jacqueline C. Kent, Elizabeth Ashton, Catherine M. Hardwick, Marnie K. Rowan, Elisa S. Chia, Kyle A. Fairclough, Lalitha L. Menon, Courtney Scott, Georgia Mather-McCaw, Katherine Navarro and Donna T. Geddes

Int. J. Environ. Res. Public Health 2015, 12(10), 12247-12263; https://doi.org/10.3390/ijerph121012247 - 29 Sep 2015

Cited by 112 | Viewed by 29430

Abstract

Background: Persistent nipple pain is one of the most common reasons given by mothers for ceasing exclusive breastfeeding. We aimed to determine the frequency of nipple pain as a reason for consultation, the most common attributed aetiologies, and the effectiveness of the advice and treatment given. Methods: All consultations at the Breast Feeding Centre of Western Australia (WA) were audited over two six-month periods in 2011 (n = 469) and 2014 (n = 708). Attributed cause(s) of nipple pain, microbiology results, treatment(s) advised, and resolution of pain were recorded. Results: Nipple pain was one of the reasons for consultation in 36% of cases. The most common attributed cause of nipple pain was incorrect positioning and attachment, followed by tongue tie, infection, palatal anomaly, flat or inverted nipples, mastitis, and vasospasm. Advice included correction of positioning and attachment, use of a nipple shield, resting the nipples and expressing breastmilk, frenotomy, oral antibiotics, topical treatments, and cold or warm compresses. Pain was resolving or resolved in 57% of cases after 18 days (range 2–110). Conclusion: The multiple attributed causes of nipple pain, possibly as a result of a cascade of events, suggests that effective early lactation management for prevention of nipple pain and early diagnosis and effective treatment are crucial to avoid early weaning. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

717 KiB

Open AccessArticle

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates

by Hazel Gardner, Katherine Green and Andrew Gardner

Int. J. Environ. Res. Public Health 2015, 12(9), 10923-10940; https://doi.org/10.3390/ijerph120910923 - 02 Sep 2015

Cited by 21 | Viewed by 7490

Abstract

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother’s education level, employment status and early introduction of complementary foods. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

971 KiB

Open AccessArticle

Persistent Nipple Pain in Breastfeeding Mothers Associated with Abnormal Infant Tongue Movement

by Holly L. McClellan, Jacqueline C. Kent, Anna R. Hepworth, Peter E. Hartmann and Donna T. Geddes

Int. J. Environ. Res. Public Health 2015, 12(9), 10833-10845; https://doi.org/10.3390/ijerph120910833 - 02 Sep 2015

Cited by 17 | Viewed by 8992

Abstract

Background: Infants of breastfeeding mothers with persistent nipple pain have been shown to apply stronger vacuums to the breast and transfer less milk during one monitored feed. This may be associated with differences in the movement of the tongue. The aim was to analyse the intra-oral nipple shape and movement of the tongue of infants of mothers with and without nipple pain. Methods: Breastfeeding infants of mothers with or without nipple pain were monitored using ultrasound and intra-oral vacuum during one breastfeed. From cine clips of the ultrasound scans measurements were made of the depth of the intra-oral space between the hard-soft palate junction (HSPJ) and the mid-tongue; the distance of the tip of the nipple to the HSPJ; and nipple diameters from the tip to the base. Results: During nutritive sucking, tongue movements of infants of mothers with nipple pain resulted in a smaller intra-oral space (p = 0.040) and restricted nipple expansion compared to controls (p < 0.012). Stronger baseline and peak vacuums compared to controls were confirmed (p = 0.002). Conclusion: In these mothers, nipple pain was associated with restricted infant tongue movement. Ultrasound may complement measurement of intra-oral vacuum in monitoring treatment strategies in breastfeeding women experiencing nipple pain. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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766 KiB

Open AccessArticle

An IBCLC in the Maternity Ward of a Mother and Child Hospital: A Pre- and Post-Intervention Study

by Antonella Chiurco, Marcella Montico, Pierpaolo Brovedani, Lorenzo Monasta and Riccardo Davanzo

Int. J. Environ. Res. Public Health 2015, 12(8), 9938-9951; https://doi.org/10.3390/ijerph120809938 - 20 Aug 2015

Cited by 8 | Viewed by 6153

Abstract

Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs) for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II) was preceded (Phase I) by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III). In Phase III, a significantly higher percentage of mothers: (a) received help to breastfeed, and also received correct information on breastfeeding and community support, (b) started breastfeeding within two hours from delivery, (c) reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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679 KiB

Open AccessArticle

Factors associated with Early Initiation of Breastfeeding in Western Nepal

by Vishnu Khanal, Jane A. Scott, Andy H. Lee, Rajendra Karkee and Colin W. Binns

Int. J. Environ. Res. Public Health 2015, 12(8), 9562-9574; https://doi.org/10.3390/ijerph120809562 - 14 Aug 2015

Cited by 61 | Viewed by 9629

Abstract

The initiation of breastfeeding within one hour of birth has numerous nutritional and immunological benefits and has been found to reduce neonatal mortality. This community-based prospective cohort study aimed to report the rate of, and factors associated with, early initiation of breastfeeding in Western Nepal. The rate of early initiation of breastfeeding was reported, and associations between early initiation and independent variables were tested by Chi-square test, followed by multiple logistic regression. Of the 735 mother-infant pairs, a total of 310 (42.2%) reported early initiation. Mothers who were assisted by traditional attendants during childbirth, delivered by caesarean section, from ethnically disadvantaged families and had delivered low birth weight infants, were less likely to initiate breastfeeding early whereas the mothers who were from the poorest families and did not introduce prelacteal feeds to their infants were more likely to initiate breastfeeding within the first hour. Skills-training to support breastfeeding as part of the training of skilled birth attendants and other health workers is likely to promote recommended infant feeding practices. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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704 KiB

Open AccessArticle

Breastfeeding Rates and Growth Charts—the Zhejiang Infant Feeding Trial

by Bingquan Zhu, Jian Zhang, Liqian Qiu, Colin Binns, Jie Shao, Yun Zhao and Zhengyan Zhao

Int. J. Environ. Res. Public Health 2015, 12(7), 7337-7347; https://doi.org/10.3390/ijerph120707337 - 30 Jun 2015

Cited by 2 | Viewed by 5208

Abstract

A randomised control trial was undertaken in Hangzhou, China, to study the influence of the growth chart used on breastfeeding rates. Mothers with infants who were being fully breastfed at 6 weeks after birth (n = 1602) were invited to participate in the [...] Read more.

A randomised control trial was undertaken in Hangzhou, China, to study the influence of the growth chart used on breastfeeding rates. Mothers with infants who were being fully breastfed at 6 weeks after birth (n = 1602) were invited to participate in the trial; 1415 agreed to participate and 1295 completed the study. Two growth charts were used, one that was heavier for the first six months of life (Chart A, n = 686) and a lighter growth chart (Chart B, n = 609). Mothers were interviewed and infants measured at 6 weeks and 3, 4, 5 and 6 months after delivery. At 6 months the full breastfeeding rates were 18.1% in the group using the heavier growth chart compared to 22.8% in the lighter growth chart group. After adjusting for potential confounders this difference remained significant (aOR 1.41, 95% confidence intervals 1.02, 1.93). These results suggest that breastfeeding rates may be influenced by the type of growth chart used. Mothers who perceive that their infants are not growing adequately (i.e., using the heavier charts) may introduce other foods to their infants earlier than mothers using the lighter chart. While a larger trial is required to confirm the results, in the interim it is suggested that if heavier growth charts are used, a lower percentile line could be used to assess adequacy of growth. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

747 KiB

Open AccessArticle

Estimating the Dietary Intake of Breastfeeding Preterm Infants

by Sarah Greenslade, Jacqueline Miller, Emma Tonkin, Peter Marshall and Carmel T. Collins

Int. J. Environ. Res. Public Health 2015, 12(5), 5408-5419; https://doi.org/10.3390/ijerph120505408 - 20 May 2015

Cited by 4 | Viewed by 5649

Abstract

Aim: To determine how accurately the daily prescribed feed volume (mL/day) estimates the actual intake of breastfeeding preterm infants and to characterise the volume taken during a breastfeed at differing gestational and postmenstrual ages. Methods: A cross sectional study was conducted on preterm infants born <37 weeks gestation from two Australian neonatal units. To determine the volume taken in a 24-h period infants were weighed before and after each breastfeed. This volume was added to the charted intake to determine the total intake and then compared to the prescribed feed volume. Bland Altman analyses were used to assess the level of agreement between the two methods. Results: Fifty six infants were studied on 206 breastfeeding occasions. There was a small bias (27 mLs/day) but large 95% limits of agreement (–76 to 130 mL/day). The volume taken during a single breastfeed ranged from 0 to 101 mL (median 23 mL, IQR 9 to 31 mL) and was greater in more mature infants. Conclusions: Using the prescribed feed volume to estimate total intake has limited clinical utility for the individual infant, however the relatively small bias means that it may be useful within a population or for comparison between groups in which population means are compared. There was a large variation in volume taken during a breastfeed across all gestational and postmenstrual ages. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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270 KiB

Open AccessArticle

Why Do Mothers of Young Infants Choose to Formula Feed in China? Perceptions of Mothers and Hospital Staff

by Ke Zhang, Li Tang, Hong Wang, Li-Qian Qiu, Colin W. Binns and Andy H. Lee

Int. J. Environ. Res. Public Health 2015, 12(5), 4520-4532; https://doi.org/10.3390/ijerph120504520 - 24 Apr 2015

Cited by 50 | Viewed by 9293

Abstract

In China the exclusive breastfeeding rate remains low and infant formula is widely used. This study aimed to elicit and compare mothers’ and hospital staff perceptions of the reasons that shaped mothers’ decision to formula feed. In-depth interviews with 50 mothers, and four focus group discussions with 33 hospital staff, were conducted in Hangzhou and Shenzhen in November 2014. Responses given by the mothers and hospital staff showed a number of commonalities. The perception of “insufficient breast milk” was cited by the majority of women (n = 37, 74%) as the reason for formula feeding. Mothers’ confidence in breastfeeding appears to be further reduced by maternal mothers or mothers-in-law’s and “confinement ladies” misconceptions about infant feeding. Inadequate breastfeeding facilities and limited flexibility at their workplace was another common reason given for switching to formula feeding. A substantial proportion of mothers (n = 27, 54%) lacked an understanding of the health benefits of breastfeeding. Antenatal education on breastfeeding benefits for expectant mothers and their families is recommended. Moreover, mothers should be provided with breastfeeding support while in hospital and be encouraged to seek professional assistance to deal with breastfeeding problems after discharge. Employers should also make work environments more breastfeeding-friendly. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

448 KiB

Open AccessArticle

Breastfeeding, Bottle Feeding Practices and Malocclusion in the Primary Dentition: A Systematic Review of Cohort Studies

by Ana Paula Hermont, Carolina C. Martins, Lívia G. Zina, Sheyla M. Auad, Saul M. Paiva and Isabela A. Pordeus

Int. J. Environ. Res. Public Health 2015, 12(3), 3133-3151; https://doi.org/10.3390/ijerph120303133 - 16 Mar 2015

Cited by 33 | Viewed by 10786

Abstract

The World Health Organization recommends exclusive breast feeding for at least six months. However, there is no scientific evidence of the benefits of breast feeding for oral health in children under primary dentition. This study aimed to search for scientific evidence regarding the following question: is bottle feeding associated with malocclusion in the primary dentition compared to children that are breastfed? An electronic search was performed in seven databases. The systematic review included 10 cohort studies. It was not possible to conduct meta-analysis; therefore a qualitative analysis was assessed. The majority of studies evaluated feeding habits by means of questionnaires and conducted a single examination. Three studies observed that bottle feeding was significantly associated with overjet and posterior crossbite. Studies reported several cut-off times for breastfeeding (varying from 1 month up to 3 years of age) and several types of malocclusion. Controlling for non-nutritive sucking habits was reported for only half of the studies and this may have led to biased results. The scientific evidence could not confirm a specific type of malocclusion associated with the feeding habits or an adequate time of breastfeeding to benefit the children against malocclusion. Further cohort studies are needed to confirm this evidence. Full article

(This article belongs to the Special Issue Breastfeeding and Infant Health)

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