Search Results (346)

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, 26, 39, and 52 weeks post-birth. Sleep and feeding questionnaires were answered at each visit. A multilevel growth model estimated infant night sleep duration trajectories by feeding mode (ordinal: exclusive formula, mixed, exclusive breastfeeding), night-weaning, and bedsharing as time-variant predictors. Maternal education and household income were covariates to account for differences in study attrition. Results: Infant night sleep duration followed a curvilinear trajectory, starting at 7.92 h (95% CI: 5.78, 10.06) and increasing by 0.40 h/month (95% CI: 0.21, 0.60), with a deceleration over time (0.02 h/month², p < 0.001). Each increase in levels of breast milk consumption was associated with an increase in infant night sleep duration (B = 0.87 h, p < 0.001), but the association weakened as the infant aged (B = −0.07 h/month, p < 0.001). Despite 59.7% of bedsharing infants being exclusively breastfed, bedsharing was not significantly associated with infant night sleep duration. Similarly, night-weaning was not significantly associated with infant night sleep duration. Conclusions: Breastfeeding is associated with longer infant night sleep duration, whereas bedsharing showed no association despite its correlation with breastfeeding. This research highlights the importance of breastfeeding in early life, not only for its developmental benefits but also for its relationship with infant night sleep duration, an essential component of healthy infant growth. Full article

Background/Objectives: Breast Milk Feeding (BMF) benefits mother and infant. However, women with select risk factors report shorter breastfeeding durations. Our previous prospective cohort observational study of a lactation-consultant-led telephone-based support program in the first month postpartum increased BMF rates up to 6 months. This post hoc study further evaluated the program for mothers at increased risk of early breastfeeding cessation. Methods: We performed secondary analysis involving 762 mothers (control, n = 378; intervention, n = 384), recruited between 2018 and 2019. Infant feeding types, including BMF, were recorded at 1, 3 and 6 months. Feeding outcomes were analyzed in association with maternal risk factors. p-values, odds ratios and 95% confidence intervals were reported via both univariate (UVA) and multivariate regression analysis (MVA). Results: Via MVA, the intervention was associated with increased 6-month BMF rates in these groupings [OR (95%CI), p-value]: European [1.80 (1.07–2.96), p = 0.027]; South Asian [1.93 (1.19–3.13), p = 0.008]; employed [1.47 (1.02–2.12), p = 0.038]; unemployed [2.15 (1.33–3.50), p = 0.002]; married [1.71 (1.22–2.39), p = 0.002]; social support present [1.51 (1.05–2.16), p = 0.026]; chronic illness [1.93 (1.35–2.75), p = 0.001]; gestational diabetes mellitus [2.17 (1.19–3.95), p = 0.11]; overweight and obese [1.48 (1.03–2.12), p = 0.034]. A derived success score across the study period indicated via UVA associated increases in BMF rates with history of depression and anxiety (MI) [p = 0.044] and ongoing MI [p = 0.033], but these increases were smaller than that for no history of MI [p < 0.001]. No effect was observed in East/Southeast Asian mothers, Middle Eastern mothers, single or de facto mothers, older mothers, mothers without social support and mothers of any skill level. Conclusions: Although early postpartum telephone support was associated with a number of positive findings of improved BMF at 6 months and over the course of the study, the results were mixed. This suggests that future breastfeeding telephone-based initiatives need to be multifaceted in order to target mothers at risk of early breastfeeding cessation. Full article

The recently published German evidence-based guideline on “Breastfeeding Duration” recommends that infants in Germany should be exclusively or predominantly breastfed for 6 months, with a total breastfeeding duration of 12 months. These recommendations rely exclusively on low- and very low-certainty evidence, and fall short of what would be expected for an evidence-based guideline. The guideline has been criticized by a large number of eight professional organizations, which is very unusual. As delegates or deputy delegates of our respective medical-scientific societies participating in the six-year guideline development process, we disagree with the published guideline recommendations and present here our key methodological and content-related concerns. In our view, there is no sufficient evidence that would demonstrate superiority of the proposed recommendation with respect to benefits and harms compared to the long-standing recommendation of exclusive breastfeeding for 4–6 months and continued breastfeeding for as long as mother and child desire for healthy populations in Germany and Western Europe. Full article

Background/Objectives: Skin-to-skin contact (SSC) between mother and infant is known to promote breastfeeding initiation and early bonding. However, evidence regarding the sustained effects of daily SSC during the postpartum period on breastfeeding outcomes and maternal mental health remains limited. This study aimed to evaluate the effects of structured daily SSC on breastfeeding outcomes, lactation status, and maternal postnatal mental health in a real-world clinical setting. Methods: A quasi-experimental design was used to compare mothers who performed daily SSC (SSC group) with those receiving care as usual (control group). Data were collected on postpartum Day 1, Day 3, Week 2, and Week 4. Primary outcomes included exclusive breastfeeding duration, continued breastfeeding duration, and lactation status. Multiple linear regression analyses adjusted for baseline breastfeeding intention and maternal age. Results: A total of 50 mother–infant dyads were included (SSC: n = 40; control: n = 10). The SSC group was associated with longer exclusive and continued breastfeeding durations and better lactation status (p < 0.05). Depressive symptoms did not differ significantly between groups, although both groups showed decreasing trends over time. After adjustment, daily SSC remained significantly associated with longer exclusive breastfeeding duration (adjusted β = 9.18 days, p = 0.034) and continued breastfeeding duration (adjusted β = 10.57 days, p = 0.001). Conclusions: Daily SSC is a simple and feasible intervention that may be associated with improved breastfeeding outcomes and lactation performance. Incorporating structured SSC into routine postpartum care may support breastfeeding sustainability and maternal recovery. Full article

Background/Objectives: Children and adolescents exposed to criminal victimization are at increased risk for depression; however, the contribution of nutritional status to depressive symptom severity in this vulnerable population remains poorly understood. Therefore, we aimed to examine the associations between depression severity and nutritional parameters in child and adolescent victims of crime. Methods: This cross-sectional study included 72 children and adolescents (aged 10–16 years) referred to a forensic medicine department in Türkiye. Nutritional status was assessed using anthropometric measurements (body weight, body mass index [BMI], BMI-Z score, and body fat percentage), three-day dietary records, and the Mediterranean Diet Quality Index (KIDMED). Depression severity was evaluated using the Kutcher Adolescent Depression Scale (KADS). The associations were analyzed using Pearson’s rho correlation and forward stepwise linear regression. Potential confounding variables, including age, gender, socioeconomic status, and trauma-related characteristics, were recorded and considered during the analysis; however, due to the limited sample size and to avoid model overparameterization, they were not fully adjusted for in the final model. Results: Depression severity was positively correlated with the body weight, BMI, BMI-Z score, body fat percentage, and dietary energy, carbohydrate, protein, and fat intakes (all p < 0.05). In contrast, the vitamin C and dietary fiber intakes, breastfeeding duration, and KIDMED scores were negatively correlated with the KADS scores (p < 0.05). Regression analysis revealed that the lower KIDMED scores, higher body fat percentage, and greater body weight were significantly associated with depression severity, collectively explaining 82.2% of the variance in the KADS scores. Conclusions: Poor diet quality and adverse body composition are strongly associated with depression severity in child and adolescent victims of crime. These findings suggest that nutritional factors may be associated with depression severity in child and adolescent victims of crime; however, the results should be interpreted as preliminary and hypothesis-generating. Full article

Background/Objectives: Sufficient sleep quantity/quality in infancy is crucial for healthy development, so it is important to identify early associated predictive factors. Research findings highlight salient endogenous (infant temperament) and exogenous (breastfeeding) influences, though no known studies have examined nuanced and interactive relations among these variables from early to late infancy/toddlerhood. Thus, the current study examined the main and interaction effects of these variables on infant sleep at 6 and 14 months while controlling for prenatal cortisol exposure. Methods: Data from a subsample (n = 79) of the Infant Development and Healthy Outcomes in Mothers Study were used, including prenatal maternal saliva samples assayed for cortisol and maternal questionnaires that included retrospective reporting of infant temperament, sleep quality and quantity, and breastfeeding frequency. Results: Multiple linear regression results include a statistically significant negative relation between prenatal maternal cortisol area under the curve and 6-month infant sleep quantity. A greater breastfeeding frequency at 6 months was associated with decreased 6-month sleep quality via conditional but not interaction effects. Greater 6-month infant Surgency was associated with better sleep quality at 14 months. There were no statistically significant interaction effects. Conclusions: The findings suggest that maternal psychophysiological stress has a significant influence on infant sleep duration, while research should further investigate the role of infant temperament and breastfeeding in shaping infant sleep quality. Significant conditional effects highlight patterns that should be re-examined with a larger sample to determine whether infant temperament may buffer against negative associations between breastfeeding frequency and infant sleep quality in early and late infancy in a developmental stage-consistent manner. Future replication studies should include a multi-method, longitudinal assessment of all key study variables, as well as a larger, more sociodemographically diverse sample of maternal–infant dyads. Full article

Background/Objectives: Appetite-regulating hormones are bioactive components of human milk. We tested the associations of leptin and adiponectin with infant growth and eating behaviors to age 6 months. Methods: In a cohort of 70 healthy, full-term infants and their mothers, human milk adiponectin and leptin were assayed at age 2 months (m). At infant ages 2, 4, and 6 m, infant anthropometry was obtained, mothers reported feeding frequency, duration, and breastfeeding intensity and completed the Baby Eating Behavior Questionnaire (Enjoyment of Food, Food Responsiveness, and General Appetite), and infant sucking vigor using an artificial nipple (burst duration and sucking frequency) was measured. Mothers reported demographics, gestational diabetes and pre-pregnancy body mass index (BMI), gestational age, and infant birthweight. Multivariate models evaluated predictors of leptin and adiponectin, and associations of leptin and adiponectin with infant growth and eating behaviors. Results: Human milk leptin was predicted by maternal BMI (β = 0.02) and breastfeeding intensity (β = −0.32). Regarding infant growth, infant weight-for-age and weight-for-length z-scores at 6 m were predicted by leptin (β = 0.91 and β = 1.22, respectively) and adiponectin (β = 0.01 and β = 0.01, respectively). Regarding infant eating behaviors, feeding duration at 2 m and feeding frequency at 4 m were predicted by adiponectin (β = 0.03 and β = −0.02, respectively). Conclusions: Human milk leptin and adiponectin may contribute to weight gain in early infancy, but the effect does not appear to be mediated substantially by infant eating behaviors. Further investigation into the metabolic programming of early infant weight gain is warranted. Full article

The purpose of this study was to examine relationships between infant feeding and parenting self-efficacy. Mothers (N = 121) receiving home visiting reported on PSE and infant feeding at two times (e.g., longitudinally). Mothers were exclusively formula feeding (46.7%), exclusively breastfeeding (19.8%) or combining breastfeeding and formula (33.1%). Infant feeding was regressed on parenting self-efficacy and relevant demographics using logistic regression. Mothers with higher parenting self-efficacy were more likely to be exclusively formula feeding or combination feeding at Time 1. Continued breastfeeding was not predicted by self-efficacy but rather by working status and earlier supplementation. Results suggest higher parenting self-efficacy associated with formula feeding suggests social reinforcement or feelings of success around the enactment of or choice in infant feeding method. Lower parenting self-efficacy associated with initial breastfeeding suggests unsuccessful enactment (i.e., breastfeeding challenges) or negative social reinforcement. More research is needed to understand infant feeding norms and practices in relationship to parenting self-efficacy to best promote breastfeeding intervention and support maternal mental health. Practitioners should work to extend exclusive breastfeeding through supportive positive reinforcement, while limiting formula supplementation. The importance of parental leave for longer breastfeeding duration should be considered when establishing leave policies. Full article

Background/Objectives: In Japan, hospital births predominate, with home births comprising only 0.1% of deliveries. This study assessed how documented practices for planned home births attended by independent midwives align with national guidelines and WHO intrapartum care recommendations, and assess maternal and neonatal differences before and after the COVID-19 pandemic. Methods: Records of 430 low-risk pregnant women who received continuous care at a private midwifery home over 25 years were reviewed. After excluding 8 maternal and 22 neonatal transfers, 400 records were analyzed. Descriptive statistics were compared with WHO recommendations and between the pre-pandemic (1999–2019) and post-pandemic (2020–2024) periods. Results: All women experienced spontaneous singleton cephalic labors with intermittent fetal heart rate auscultation. The mean gestational age was 277.3 days and the median labor duration was 303.5 min. Labor onset was spontaneous in 83.5% of cases. Nearly half of the women had no perineal lacerations. Postpartum blood loss ≥500 mL occurred in 14.1% of cases. Family presence was nearly universal. Neonates had a mean birth weight of 3129.0 g and high Apgar scores. Skin-to-skin contact occurred in 52.9%; exclusive breastfeeding reached 93.8% at 1 month. Post-pandemic births showed higher maternal age and higher neonatal birth weight, although these differences should be interpreted cautiously due to the small post-pandemic sample. Conclusions: Independent midwives provided evidence-based, physiologically oriented care, partially aligning with selected WHO intrapartum recommendations during planned home births. Midwife-led home births may support positive childbirth experiences and favorable maternal/neonatal outcomes for low-risk women. Post-pandemic shifts underscore the need for continued monitoring and flexible, community-based perinatal support, while recognizing the limitations of retrospective, single-site data. Full article

Human breast milk evolves beyond simple nutrition to function as a complex signaling system that promotes neonatal development. This review analyzes the bioactive components, delineating how its specific constituents compensate for the physiological vulnerabilities of the neonate. Additionally, the distinct roles of colostral and mature milk are in fortifying the immature immune system and promoting gastrointestinal maturation. Focus is placed on the prevention of necrotizing enterocolitis, where milk oligosaccharides and microbiome function to maintain mucosal integrity and symbiosis, while preventing pathogens’ adhesion. Furthermore, how breastfeeding duration is linked to long-term metabolic and immunological programming is evaluated. MicroRNAs and bioactive lipids actively modulate gene expression and immune responses, thereby reducing the incidence of metabolic diseases and childhood malignancies. By integrating findings, this article underscores the irreplaceable role of breast milk in clinical dietetics and pediatric care. Full article

Introduction: Added sugar (AS) intake has been linked to chronic diseases, yet evidence in children under 2 years remains limited. Aim: Characterise AS intake in children ≤ 2 years with associated appetite, satiety, growth, adiposity, and breastfeeding duration. Methods: We analysed data from 248 mother-child pairs from the MAS-Lactancia birth cohort. Intake of AS and energy was estimated using data from 24 h dietary recalls. AS intake was classified in tertiles as low (0 g), medium (0.01–6.96 g), and high (>6.96 g). Major food group contributors to AS intake were identified. Appetite and satiety indicators were measured using the Child Eating Behaviour Questionnaire. Adiposity was evaluated using body mass index-for-age Z score, waist circumference, and skinfold thickness. Growth was assessed using length-for-age Z score (ZLA). Linear mixed-effects models were fitted. Results: AS intake and its contribution to total energy increased with age. Major contributors to AS intake were infant formulas, table sugars, and sweet baked goods. Longer exclusive and continued breastfeeding were associated with lower AS intake. Compared to low intake, children with high AS intake had higher scores for emotional overeating (β = 0.58, 95% CI: 0.04, 1.12) and food fussiness (β = 1.45, 95% CI: 0.38, 2.53). High AS intake was also associated with lower ZLA (β = −0.17 z, 95% CI: −0.32, −0.01) and higher waist circumference (β = 2.02 cm, 95% CI: 1.32, 2.73). Conclusions: Among children ≤ 2 years, AS intake ≥ 7 g/d was associated with suboptimal growth, central adiposity, and less favourable eating behaviours. Longer breastfeeding duration may protect against AS exposure. Full article

Background: Worldwide breastfeeding initiation and exclusive rates at 6 months remain lower than recommended. Our scoping review aimed to identify interventions to improve breastfeeding duration in primiparous women. We assessed interventions’ effectiveness during the prenatal and postnatal periods separately or combined. Methods: Eight databases and grey literature were searched in March 2023, using a keyword search strategy. Results: We identified 16,161 articles from 2013 to 2023, and 35 met our eligibility criteria. The studies were conducted mostly in low–middle income countries (62.9%), and they proposed a variety of interventions in the prenatal period (n = 8), the postnatal period (n = 11) and in a combination of both periods (n = 16). It appears that a combination of various interventions, in both the prenatal and postnatal periods, targeting young women who intended to breastfeed, with low education levels, and with a partner, showed positive effects on exclusive breastfeeding rates until 6 months. Combined approaches such as workshops or individual education and support sessions during the prenatal period with support by professionals or peers until at least 6 months also showed improvements on breastfeeding duration. Conclusions: Our scoping review was the first to have identified potentially effective interventions, alone or in combination, to improve breastfeeding duration among primiparous women. Further studies should be conducted to cover a longer period, beyond six months. They should also explore the role of sociodemographic factors, such as ethnicity, in interventions’ effects. Full article

Within the Developmental Origins of Health and Disease (DOHaD) framework, breast-feeding is a modifiable early postnatal exposure, but its long-term associations are difficult to separate from socioeconomic and family context. We conducted a structured literature search (PubMed/MEDLINE and Scopus; January 2015–December 2025) and prioritised large prospective/birth cohorts and genetic epidemiology studies reporting quantitative associations between breastfeeding in infancy (ever versus never, duration and, where available, exclusivity) and adult outcomes. Eighteen key primary studies were included in evidence tables across cardiometabolic, cancer, and neurocognitive domains. Overall, breastfeeding was associated with modestly lower all-cause and cardiovascular mortality, small reductions in cardiovascular disease and type 2 diabetes, and slightly more favour-able cardiometabolic profiles, including lower adiposity and higher HDL cholesterol. Where reported, effect sizes were generally small (e.g., hazard ratios typically close to 1.00), indicating limited clinical impact at the individual level but potential population relevance. Genetic analyses provide cautious support for a protective association with coronary outcomes, although lipid-mediated pathways appear to explain only a small proportion of the observed associations. Evidence for adult cancer outcomes remains mixed and largely inconclusive, while longer breastfeeding is associated with small ad-vantages in cognitive performance, educational attainment and selected psychological outcomes. Taken together, current evidence suggests that breastfeeding is associated with modestly more favourable adult cardiometabolic and neurobehavioural profiles, but its contribution to long-term health is small relative to the influence of later-life lifestyle and clinical risk factors and should therefore be interpreted cautiously. Full article

Background/Objectives: This study aimed to compare feeding difficulties (FDs) in Slovenian late preterm infants (LPIs) and full-term infants (FTIs), to identify factors associated with FDs, and to examine a possible association between FDs and later speech–language disorders (SLDs) among LPIs. Methods: Parents of 177 children (n_LPI = 89; n_FTI = 88) born at Ljubljana Maternity Hospital between 1 July 2021 and 30 June 2022 completed a questionnaire providing general information on their child, along with the child’s health, birth history, and development of feeding, swallowing, and speech-language skills. Additional clinical data were obtained from medical documentation. Using these data, comparisons were made between LPIs and FTIs and within the LPI group according to the presence or absence of FDs and SLDs. Results: LPIs experienced significantly more FDs than FTIs (32.6% vs. 11.4%, p < 0.001). They were breastfed less frequently (68.5% vs. 94.3%, p < 0.001) and had a shorter breastfeeding duration (13.8 months vs. 17.3 months, p = 0.038). LPIs also demonstrated more challenges in speech and language development (34.1% vs. 15.3%, p = 0.004). However, no significant association was found between FDs and later SLDs (p = 0.957). Conclusions: LPIs are at increased risk of both FDs and SLDs compared with FTIs. These findings highlight the importance of high-quality preventive care and timely multidisciplinary interventions. Full article

Background: Maternal chronotype, maternal sleep, and breastfeeding practices are separately associated with maternal mood. However, it is not known if maternal mood mediates the associations between maternal chronotype or maternal sleep and breastfeeding duration. Objective: To investigate whether maternal mood mediates the associations of maternal chronotype and maternal prenatal sleep with breastfeeding duration in a multiethnic cohort of Singaporean mothers. Methods: In a prospective cohort study, caregivers of term-born, singleton infants (N = 340) completed the Horne–Östberg Morningness–Eveningness Questionnaire (MEQ; 54 months), Pittsburgh Sleep Quality Index (PSQI; 26 weeks gestation), Edinburgh Postnatal Depression Scale (EPDS; 26–28 weeks gestation) and State–Trait Anxiety Inventory (STAI-state, STAI-trait; 26–28 weeks gestation) and reported breastfeeding practices from 3 weeks to ≥12 months. Regression and mediation analyses were adjusted for maternal age, parity, maternal education, ethnicity, pre-pregnancy BMI, and mode of delivery. Results: Morningness was significantly associated with a longer breastfeeding duration (β = 0.02, p = 0.037) and lower maternal anxiety symptoms (STAI-state: β = −0.19, p = 0.006 and STAI-trait: β = −0.18, p = 0.004). Lower maternal anxiety symptoms were significantly associated with a longer breastfeeding duration (STAI-state: β = −0.02, p = 0.003; STAI-trait: β = −0.02, p = 0.016). STAI-state, but not STAI-trait or EPDS, mediates the association between maternal chronotype and breastfeeding duration (β_indirect = 0.004 (0.0004, 0.009)). Maternal mood did not mediate the association between maternal night sleep duration and breastfeeding duration. Conclusions: Maternal state-anxiety constitutes a behavioral pathway through which maternal chronotype influences breastfeeding duration. Strategies to target maternal anxiety in pregnant women with eveningness tendencies to promote breastfeeding duration are warranted. Full article