Browsing by Subject "Breastfeeding"

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  • DIABIMMUNE Study Grp; Miettinen, Maija E.; Honkanen, Jarno; Niinistö, Sari; Vaarala, Outi; Virtanen, Suvi M.; Knip, Mikael (2022)
    Aims/hypothesis Our aim was to study the association between duration of breastfeeding and circulating immunological markers during the first 3 years of life in children with HLA-conferred susceptibility to type 1 diabetes. Methods We performed a longitudinal analysis of 38 circulating immunological markers (cytokines, chemokines and growth factors) in serum samples from Finnish (56 individuals, 147 samples), Estonian (56 individuals 148 samples) and Russian Karelian children (62 individuals, 149 samples) at 3, 6, 12, 18, 24 and 36 months of age. We also analysed gut inflammation markers (calprotectin and human beta defensin-2) at 3 (n = 96) and 6 months (n = 153) of age. Comparisons of immunological marker medians were performed between children who were breastfed for 6 months or longer vs children who were breastfed for less than 6 months. Results Breastfeeding for 6 months or longer vs less than 6 months was associated with lower median of serum immunological markers at 6 months (granulocyte-macrophage colony-stimulating factor [GMCSF], macrophage inflammatory protein [MIP-3 alpha]), 12 months (IFN-alpha 2, vascular endothelial growth factor, GMCSF, IFN-gamma, IL-21), 18 months (FGF-2, IFN-alpha 2) and 24 months of age (CCL11 [eotaxin], monocyte chemoattractant protein-1, TGF alpha, soluble CD40 ligand, IL-13, IL-21, IL-5, MIP-1 alpha) (all p < 0.01) but not at 36 months of age. Breastfeeding was not associated with gut inflammation markers at 3 and 6 months of age. Conclusions/interpretation Children who were breastfed for 6 months or longer had lower medians for 14 immunological markers at one or more age points during the first 2 years of life compared with children who were breastfed for less than 6 months. The clinical meaning of the findings is not clear. However, the present study contributes to the understanding of immunological differences in children that have been breastfed longer, and thus provides a mechanistic suggestion for the previously observed associations between breastfeeding and risk of type 1 diabetes.
  • Eshriqui, Ilana; Viljakainen, Heli T; Ferreira, Sandra R G; Raju, Sajan C; Weiderpass, Elisabete; Figueiredo, Rejane A O (BioMed Central, 2020)
    Abstract Background Breastfeeding contributes to gastrointestinal microbiota colonization in early life, but its long-term impact is inconclusive. We aimed to evaluate whether the type of feeding during the first six months of life was associated with oral microbiota in adolescence. Methods This is a cross-sectional sub-study using baseline information of 423 adolescents from the Finnish Health in Teens (Fin-HIT) cohort. Type of feeding was recalled by parents and dichotomized as (i) No infant formula; (ii) Infant formula (breastmilk + formula or only formula). Saliva microbiota was analysed using 16S rRNA (V3–V4) sequencing. Alpha diversity and beta diversity were compared between feeding type groups using ANCOVA and PERMANOVA, respectively. Differential bacteria abundance was tested using appropriate general linear models. Results Mean age and body mass index were 11.7 years and 18.0 kg/m2, respectively. The No formula group contained 41% of the participants. Firmicutes (51.0%), Bacteroidetes (19.1%), and Proteobacteria (16.3%) were the most abundant phyla among all participants. Alpha and beta diversity indices did not differ between the two feeding groups. Three Operational Taxonomic Units (OTUs) belonging to Eubacteria and Veillonella genera (phylum Firmicutes) were more abundant in the No formula than in the Infant formula group (log2fold changes/ p - values − 0.920/ < 0.001, − 0.328/ 0.001, − 0.577/ 0.004). Conclusion Differences exist in abundances of some OTUs in adolescence according to feeding type during the first six months of life, but our findings do not support diversity and overall oral microbiota composition in adolescents being affected by early feeding type.
  • Eshriqui, Ilana; Viljakainen, Heli T.; Ferreira, Sandra; Raju, Sajan C.; Weiderpass, Elisabete; Figueiredo, Rejane A. O. (2020)
    Background Breastfeeding contributes to gastrointestinal microbiota colonization in early life, but its long-term impact is inconclusive. We aimed to evaluate whether the type of feeding during the first six months of life was associated with oral microbiota in adolescence. Methods This is a cross-sectional sub-study using baseline information of 423 adolescents from the Finnish Health in Teens (Fin-HIT) cohort. Type of feeding was recalled by parents and dichotomized as (i) No infant formula; (ii) Infant formula (breastmilk + formula or only formula). Saliva microbiota was analysed using 16S rRNA (V3-V4) sequencing. Alpha diversity and beta diversity were compared between feeding type groups using ANCOVA and PERMANOVA, respectively. Differential bacteria abundance was tested using appropriate general linear models. Results Mean age and body mass index were 11.7 years and 18.0 kg/m(2), respectively. The No formula group contained 41% of the participants. Firmicutes (51.0%), Bacteroidetes (19.1%), and Proteobacteria (16.3%) were the most abundant phyla among all participants. Alpha and beta diversity indices did not differ between the two feeding groups. Three Operational Taxonomic Units (OTUs) belonging to Eubacteria and Veillonella genera (phylum Firmicutes) were more abundant in the No formula than in the Infant formula group (log2fold changes/ p - values - 0.920/ <0.001, - 0.328/ 0.001, - 0.577/ 0.004). Conclusion Differences exist in abundances of some OTUs in adolescence according to feeding type during the first six months of life, but our findings do not support diversity and overall oral microbiota composition in adolescents being affected by early feeding type.
  • Pinto, A.; Adams, S.; Ahring, K.; Allen, H.; Almeida, M. F.; Garcia-Arenas, D.; Arslan, N.; Assoun, M.; Altinok, Y. Atik; Barrio-Carreras, D.; Belanger Quintana, A.; Bernabei, S. M.; Bontemps, C.; Boyle, F.; Bruni, G.; Bueno-Delgado, M.; Caine, G.; Carvalho, R.; Chrobot, A.; Chyz, K.; Cochrane, B.; Correia, C.; Corthouts, K.; Daly, A.; De Leo, S.; Desloovere, A.; De Meyer, A.; De Theux, A.; Didycz, B.; Dijsselhof, M. E.; Dokoupil, K.; Drabik, J.; Dunlop, C.; Eberle-Pelloth, W.; Eftring, K.; Ekengren, J.; Errekalde, I.; Evans, S.; Foucart, A.; Fokkema, L.; Francois, L.; French, M.; Forssell, E.; Gingell, C.; Goncalves, C.; Ozel, H. Gokmen; Grimsley, A.; Gugelmo, G.; Gyure, E.; Heller, C.; Hensler, R.; Jardim, I.; Joost, C.; Joerg-Streller, M.; Jouault, C.; Jung, A.; Kanthe, M.; Koc, N.; Kok, I. L.; Kozanoglu, T.; Kumru, B.; Lang, F.; Lang, K.; Liegeois, I.; Liguori, A.; Lilje, R.; Lubina, O.; Manta-Vogli, P.; Mayr, D.; Meneses, C.; Newby, C.; Meyer, U.; Mexia, S.; Nicol, C.; Och, U.; Olivas, S. M.; Pedron-Giner, C.; Pereira, R.; Plutowska-Hoffmann, K.; Purves, J.; Dionigi, A. Re; Reinson, K.; Robert, M.; Robertson, L.; Rocha, J. C.; Rohde, C.; Rosenbaum-Fabian, S.; Rossi, A.; Ruiz, M.; Saligova, J.; Gutierrez-Sanchez, A.; Schlune, A.; Schulpis, K.; Serrano-Nieto, J.; Skarpalezou, A.; Skeath, R.; Slabbert, A.; Straczek, K.; Gizewska, M.; Terry, A.; Thom, R.; Tooke, A.; Tuokkola, J.; van Dam, E.; van den Hurk, T. A. M.; van der Ploeg, E. M. C.; Vande Kerckhove, K.; Van Driessche, M.; van Wegberg, A. M. J.; van Wyk, K.; Vasconcelos, C.; Velez Garcia, V.; Wildgoose, J.; Winkler, T.; Zolkowska, J.; Zuvadelli, J.; MacDonald, A. (2018)
    Background: In infants with phenylketonuria (PKU), dietary management is based on lowering and titrating phenylalanine (Phe) intake from breast milk or standard infant formula in combination with a Phe-free infant formula in order to maintain blood Phe levels within target range. Professionals use different methods to feed infants with PKU and our survey aimed to document practices across Europe. Methods: We sent a cross sectional, survey monkey (R) questionnaire to European health professionals working in IMD. It contained 31 open and multiple-choice questions. The results were analysed according to different geographical regions. Results: Ninety-five centres from 21 countries responded. Over 60% of centres commenced diet in infants by age 10 days, with 58% of centres implementing newborn screening by day 3 post birth. At diagnosis, infant hospital admission occurred in 61% of metabolic centres, mainly in Eastern, Western and Southern Europe. Breastfeeding fell sharply following diagnosis with only 30% of women still breast feeding at 6 months. 53% of centres gave pre-measured Phe-free infant formula before each breast feed and 23% alternated breast feeds with Phe-free infant formula. With standard infant formula feeds, measured amounts were followed by Phe-free infant formula to satiety in 37% of centres (n = 35/95), whereas 44% (n = 42/95) advised mixing both formulas together. Weaning commenced between 17 and 26 weeks in 85% centres, >= 26 weeks in 12% and <17 weeks in 3%. Discussion: This is the largest European survey completed on PKU infant feeding practices. It is evident that practices varied widely across Europe, and the practicalities of infant feeding in PKU received little focus in the PKU European Guidelines (2017). There are few reports comparing different feeding techniques with blood Phe control, Phe fluctuations and growth. Controlled prospective studies are necessary to assess how different infant feeding practices may influence longer term feeding development.
  • Demir, And; Karadas, Nihal Özdemir; Karadas, Ulas (2022)
    We studied the effect of duration of breastfeeding and history of prematurity on the duration of hospitalization in infants with lower respiratory tract infections (LRTI) because these may reflect the severity of illness as well as sizable direct and indirect healthcare costs. One hundred twenty-five patients (49 girls, 76 boys; aged 1-24 months) were hospitalized for LRTI during a period of 102 days and studied prospectively. We found a significant difference (P = .045) between the durations of hospitalization of the 92 patients breastfed for at least six months, compared to the other group of 33 patients who were breastfed for less than six months. The durations of hospitalization among the groups with and without a history of prematurity were not statistically different (P = .78). A history of breastfeeding for more than six months had significant effect on the duration of hospitalization, but this was not true for children with a history of preterm birth.
  • Simre, Kart; Uibo, Oivi; Peet, Aleksandr; Tillmann, Vallo; Kool, Pille; Hämäläinen, Anu-Maaria; Harkonen, Taina; Siljander, Heli; Virtanen, Suvi; Ilonen, Jorma; Knip, Mikael; Uibo, Raivo; DIABIMMUNE Study Grp (2016)
    Background: During the last several decades the prevalence of coeliac disease (CD) has increased worldwide. Aim: To compare the cumulative incidence of CD between Estonian and Finnish children and to identify the risk factors. Materials and methods: Children were recruited as part of the DIABIMMUNE Study. In the birth cohort (BC) 258 children from Estonia and 305 from Finland, and in the young children's cohort (YCC) 1363 and 1384 children were followed up, respectively. The diagnosis of CD was made in accordance with the ESPGHAN guidelines-the presence of IgA-tTG antibodies and small bowel villous atrophy. Results: During the study period 29 children developed CD. The cumulative incidence of CD was significantly higher in Finland (0.77% vs 0.27%; P = 0.01). No difference was seen between the children with CD and the controls in the duration of breastfeeding or the age at cereal introduction. The BC children with CD had had significantly more episodes of infections with fever by the age of 12 months compared to the controls (3.4 vs 1.4; P = 0.04). Conclusion: The 5-year cumulative incidence of childhood CD is significantly higher in Finland than in Estonia. Sequential infections early in life may increase the risk for developing CD. (C) 2016 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
  • Laine, Merja K; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G. (BioMed Central, 2021)
    Abstract Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed < 6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <  0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Laine, Merja K.; Kautiainen, Hannu; Gissler, Mika; Pennanen, Pirjo; Eriksson, Johan G. (2021)
    Background The impact of gestational diabetes mellitus (GDM) on the duration of breastfeeding varies between shortening and no impact. Breastfeeding seems to reduce both maternal and offspring risk for type 2 diabetes and offspring risk for overweight or obesity later in life. The aim of our study was to evaluate in primiparous women whether GDM had an influence on the duration of breastfeeding, and further, to evaluate the factors that influenced on the duration of breastfeeding. Methods The study cohort (N = 1089) consisted of all primiparous women with a Finnish background excluding women with pre-existing diabetes mellitus who lived in the city of Vantaa, Finland, gave birth to a singleton living child between 2009 and 2015, and with valid data on breastfeeding available. The diagnosis of GDM was based on a standard 75 g 2-h oral glucose tolerance test. Data were obtained from Finnish national registers and from the medical records of the city of Vantaa. Results No differences were observed in the duration of breastfeeding between women diagnosed with GDM and without GDM, 7.5 (Standard Deviation [SD] 3.7) months versus 7.9 (SD 3.5) months (p = 0.17). Women diagnosed with GDM breastfed boys for a longer duration than girls (maternal age, pre-pregnancy body mass index, marital status, educational attainment, duration of pregnancy, and smoking habits adjusted p = 0.042). Women who breastfed <6 months were younger, were more likely smokers, had shorter education, and higher pre-pregnancy body mass index than women who breastfed over 6 months (p <0.001 for linearity). Conclusions In primiparous women GDM did not influence breastfeeding duration. The positive health effects of breastfeeding should be emphasized especially in young, overweight and less educated women in order to minimize the risk of obesity and type 2 diabetes for themselves and their offspring.
  • Lojander, Jaana; Axelin, Anna; Bergman, Paula; Niela-Vilen, Hannakaisa (2022)
    Objective: The purpose of this study was to examine maternal perceptions of postnatal breastfeeding support in the hospital before and after designation to the Baby-Friendly Hospital Initiative (BFHI). Further maternal and infant characteristics associated with the maternal perception of breastfeeding support were investigated. Our hypothesis was that mothers would perceive breastfeeding support more adherent to the standards of the BFHI after the hospital was designated to the BFHI compared with before.Design: The study had a quasi-experimental non-equivalent two-group design.Setting: The study was conducted in one postnatal ward and one neonatal intensive care unit in a public birth hospital in Finland. Participants: Postpartum mothers giving birth in the hospital before (pre-test group, n = 162) and after (post-test group, n = 163) designation to the BFHI participated. Intervention: The aim of the BFHI is to support and promote breastfeeding by implementing the Ten Steps to Successful Breastfeeding into routine care. Implementation in the study hospital required staff training and revision of current hospital practices, which took place during 2017-2018. The postnatal ward and neonatal intensive care unit were designated to the Baby-Friendly Hospital in February 2019. Measurements: Maternal perceptions of postnatal breastfeeding support were measured with a 20-item questionnaire developed for this study. Items were based on maternal self-report of the breastfeeding support in the hospital. A sum variable was created to measure the maternal perception of the support (scale 1-7), and higher scores indicated perception of breastfeeding support that is more adherent to the standards of the BFHI. Descriptive statics, nonparametric statistical tests, and multiple linear regression analysis were used to analyse data.Findings: Mothers in the post-test group (median 6.1, IQR 5.4-6.4) perceived breastfeeding support more adherent to the standards the BFHI compared with mothers in the pre-test group (median 5.0, IQR 4.25.8) (p < 0.001). Fifteen of 20 of the measured breastfeeding support practices improved after the hospital's designation to the BFHI. The largest difference between groups was observed for multipara mothers (median 4.6 vs 6.0, p < 0.001), older mothers ( > 35 years) (median 4.4 vs 5.8, p < 0.001), and mothers with a longer history of breastfeeding (6-12 months) (median 4.4 vs 6.2, p < 0.001). Before the BFHI designation, multipara mothers and mothers who gave birth to an infant with low Apgar scores ( < 7) perceived breastfeeding support less adherent to the BFHI standards than did primiparas or mothers of an infant with high Apgar scores ( >= 7). After the BFHI designation, mothers who experienced preterm birth (GA < 37 weeks) perceived breastfeeding support less adherent to the BFHI standards compared with mothers who experienced a full-term birth. Key conclusions: Designation to the BFHI had a positive impact on breastfeeding support from the maternal perspective. Designation improved particularly multiparas' perceptions of receiving breastfeeding support that is in adherence with the standards of the BFHI. However, more emphasis should be placed, and further research should be conducted to ensure that mothers giving birth to a preterm infant receive breastfeeding support that is adherent to the BFHI standards. Implications for practice: Birth hospitals are recommended to implement the BFHI as it improves breastfeeding support in the hospital and provides mothers with a good basis and continuation for breastfeeding, even after hospital discharge. Maternal perceptions about the impact of BFHI designation are important to consider because mother - infant dyads are at the centre of that support, and their viewpoint may help to assess whether the designation to the BFHI in the unit is successful. Results of this study indicate that designation to BFHI improves breastfeeding support from the maternal perspective.(c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )