Search Results (66)

Objectives: To assess maternal readiness for newborn self-care and its associations with breastfeeding readiness and psychophysical condition in early postpartum rooming-in care. Methods: This cross-sectional study included 200 women at 48–72 h postpartum. Maternal readiness was assessed with three 0–10 self-report scales: daytime newborn care, nighttime newborn care, and breastfeeding readiness. Psychometric, pain, anxiety, obstetric, haemoglobin, and haematocrit data were analysed using stepwise ordinal regression with bootstrap sensitivity analyses. Results: Breastfeeding readiness was the strongest correlate of daytime and nighttime caregiving readiness, with a marked and partially non-linear gradient (OR ≈ 13 for linear trend, p < 0.001). Higher anxiety on day 2 was associated with lower readiness across all domains (daytime care: OR = 0.61; nighttime care: OR = 0.69; breastfeeding: OR = 0.73; all p < 0.001). Daytime readiness was associated with sleep disturbance (lower readiness; OR = 0.63, p = 0.006) and goal-directed behaviour despite low mood (higher readiness; OR = 1.47, p < 0.001). Nighttime readiness correlated with concentration under emotional strain (OR = 1.63, p < 0.001) and was reduced in women reporting suicidal ideation (OR = 0.24, p = 0.012). Breastfeeding readiness was associated with greater current engagement in breastfeeding (OR = 1.90, p < 0.001) and higher parity (OR = 2.46, p = 0.002), while sleep disturbance was associated with lower readiness (OR = 0.69, p = 0.013). Somatic factors and social support were not independent predictors, while psychological variables showed stronger associations with readiness. Conclusions: Maternal readiness for newborn self-care is related to breastfeeding readiness but remains a distinct, psychologically shaped construct. These findings question the assumption that breastfeeding readiness reflects readiness for continuous newborn care. Assessment of maternal readiness may help identify support needs and guide flexible postpartum care. Full article

Background: Vitamin B12 deficiency is a recognized but frequently under-integrated cause of global developmental delay (GDD) in infancy and early childhood. Early diagnosis is critical because neurological impairment may be partially or completely reversible with timely treatment. Objective: This narrative review aims to synthesize current evidence on the role of vitamin B12 deficiency in the diagnostic evaluation of GDD, with a focus on clinical phenotype, risk factors, biomarkers, treatment outcomes, and practical integration into contemporary diagnostic algorithms. Methods: A structured, non-systematic search of PubMed/MEDLINE, Embase, and Web of Science was performed to identify clinical studies, case series, reviews, and guideline documents addressing pediatric vitamin B12 deficiency and neurodevelopmental delay. Results: Vitamin B12 deficiency in early childhood is most commonly associated with maternal deficiency and exclusive breastfeeding without adequate supplementation. Evidence from recent clinical and observational studies indicates that vitamin B12 deficiency may present with nonspecific neurological symptoms, including developmental regression, hypotonia, and feeding difficulties. Incorporating vitamin B12 assessment—using serum vitamin B12, holotranscobalamin, methylmalonic acid, and homocysteine—into early diagnostic algorithms for GDD may facilitate timely identification of a treatable cause of neurodevelopmental impairment. The proposed diagnostic framework emphasizes early biochemical evaluation in infants with unexplained developmental delay, thereby supporting prompt treatment during a critical window of neurological reversibility. Conclusions: Targeted assessment of vitamin B12 status in children with GDD, together with evaluation of maternal status, represents a clinically relevant approach to identifying a potentially preventable and treatable cause of neurodevelopmental impairment. Integration of functional biomarkers into diagnostic pathways and the development of pediatric-specific reference standards are key priorities for future research and clinical practice. 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

Background and Objectives: Pregnancy and the postpartum period profoundly affect female sexual function, yet longitudinal data integrating obstetric and psychosocial domains are scarce. We aimed to chart sexual-function trajectories from early pregnancy to 12 months postpartum and identify predictors of persistent dysfunction. Materials and Methods: In this single-center prospective cohort, 187 pregnant women were eligible to complete the FSFI at three trimesters and at 6–8 weeks, 3 months, and 6–12 months postpartum, plus postpartum PHQ-9, WHOQOL-BREF, and body-image scales. Associations with FSFI-defined dysfunction (FSFI < 26.55) and continuous FSFI were examined, of which 90 women were included for having documented dysfunction. Results: Mean FSFI declined from 27.4 ± 3.9 (first trimester) to a nadir of 20.1 ± 4.2 at 6–8 weeks postpartum, with partial recovery to 25.5 ± 4.0 at 6–12 months (p < 0.001). Depressive symptoms were higher in women with dysfunction (PHQ-9 8.8 ± 3.3 vs. 6.7 ± 3.5; p < 0.001) and correlated inversely with FSFI (r = −0.39; p < 0.001). A multivariable model explained 19% of FSFI variance, with each 1 SD PHQ-9 increase predicting a 1.2-point FSFI decrease (p = 0.005). Body-image disturbance exerted a partially PHQ-9-mediated effect, and three FSFI trajectory clusters showed postpartum dysfunction rates from 28.6% to 89.7%. A combined psychosocial prediction model achieved an AUC of 0.9 with a sensitivity and specificity of 0.8. Conclusions: Postpartum sexual dysfunction was common and persisted in many women at one year; depressive symptoms, body image, and psychological quality of life were more influential than mode of birth, breastfeeding, or pelvic-floor symptoms. Full article

Delivery by caesarean section (CS) is increasingly common worldwide and has been associated with altered health outcomes in offspring, which can be partially mitigated with breastfeeding. Interestingly, the mode of delivery itself may influence the composition of human milk. The aim of this narrative review was to comprehensively examine current evidence on the impact of CS on breast milk composition and to discuss its potential implications for neonatal and infant health. A literature search of the MEDLINE database was conducted in July 2025. It identified 1212 studies addressing associations between mode of delivery and human milk components, of which 54 were included in the qualitative synthesis. Available evidence suggests that CS is associated with transient, lactation stage-dependent alterations in breast milk composition, most pronounced in colostrum and transitional milk. Reported changes include differences in macronutrients, mineral content, immune-related molecules, hormones, antioxidants, microbiota, microRNA profiles, and other bioactive components. Findings related to mature milk are less consistent and often influenced by confounding factors. While some CS-associated alterations may slightly reduce the beneficial effect of breastfeeding, e.g., reducing certain antimicrobial or nutritional components, other changes seem to be potentially advantageous for the neonate/infant after CS, in particular in immune-related factors. Overall, the clinical significance of these compositional differences remains unclear, as no studies have directly linked CS-related changes in milk composition to long-term infant outcomes. Further well-designed longitudinal studies are needed to clarify these associations. Regardless of delivery mode, breastfeeding remains the optimal feeding strategy and a key intervention to support infant health after CS. Full article

Background/Objective: Human milk is an irreplaceable source of nutrition and is essential for the infant’s growth and development right after birth and for early life stage survival. This study aims to characterize and compare the metabolite profiles of colostrum and transitional and mature milk using an untargeted GC-MS approach. Additionally, it explores potential correlations between the identified metabolites and maternal nutritional factors. Methods: This was a longitudinal, prospective, and observational study. We included human milk samples from 113 Mexican women who practiced exclusive breastfeeding. Partial least squares-discriminant analysis (PLS-DA) was performed to assess differences among lactation stages. Metabolites showing significant variation across lactation stages were further analyzed using Friedman tests with post hoc Wilcoxon tests and Bonferroni correction. Correlations with maternal anthropometric measures were evaluated. Results: Twenty-three metabolites were identified, including amino acids and derivatives, sugars, fatty acids, and energetic metabolites. Alanine and creatinine levels decreased during lactation, while aspartate, serine, and valine levels increased. Rhamnose level was higher in colostrum, whereas decanoic, dodecanoic, and tetradecanoic acid levels increased over time, and that of 11,14-eicosadienoic acid decreased. Lactic acid levels declined across stages. Negative correlations were found between several amino acids and maternal anthropometric variables, while glyceric acid, rhamnose and lactic acid correlated positively. Conclusions: Human milk metabolomic profiles display distinct, stage-specific variations shaped by maternal characteristics, reflecting the dynamic physiological and nutritional demands of the developing infant Full article

Background/Objectives: Zinc deficiency remains a public health concern in South Asia but is rarely studied through gestation to infancy. Methods: We identified maternal and infant factors related to plasma zinc of 3 mo old Bangladeshi infants (n = 317) in the context of a trial of a daily antenatal to 3 mo postpartum multiple micronutrient supplementation (MMS) with 15 vitamins and minerals, including 12 mg zinc, versus iron–folic acid (IFA). Factors explored included maternal age, parity, and plasma zinc in early (pre-supplementation) and late pregnancy, at 3 months postpartum, and in milk; cord blood zinc (n = 83); birth outcomes; and infant feeding and biomarkers. Consequently, infant zinc was explored with 3 mo anthropometry and growth rates. Results: Mean ± SD infant plasma zinc was 15.63 ± 6.65 µmol/L, with 10.1% deficiency (<9.9 µmol/L). In adjusted analyses, infant zinc was positively associated with maternal age [20–30 years +0.11 µmol/L (p = 0.018) and ≥30 years +0.28 µmol/L (p = 0.003) relative to <20 years], maternal early pregnancy zinc (+0.01 µmol/L per 1 µmol/L maternal zinc, p = 0.011), and infant ferritin (+0.001 µmol/L per 1 µg/L, p = 0.007); conversely, infant zinc was −0.13 µmol/L lower (p = 0.013) with maternal parity ≥2 versus 0–1 and with partial versus exclusive breastfeeding (−0.15 µmol/L, p = 0.038). Relationships with MMS, maternal later pregnancy, postpartum, milk, and cord blood zinc were absent. Length-for-age (+0.02 per µmol/L, p = 0.047) but not weight-for-length Z-scores at 3 months were associated with infant zinc. Conclusions: Thus, infant zinc was associated with pre- but not post-MMS maternal zinc, age and parity, feeding style, and infant iron status. Infant length but not weight was associated with plasma zinc. Full article

Background/Objectives: Breastmilk offers numerous benefits for the health and development of preterm infants, while prolonged hospitalization may impair neurodevelopment. At our institution, the implementation of enhanced family-centered care (FCC) has enabled earlier discharge of preterm infants. This study aimed to assess the impact of early discharge on breastfeeding and breastmilk provision. Methods: This analysis is based on data from a prospective single-center longitudinal cohort study conducted from October 2020 to November 2023, involving six consecutive cohorts (one baseline and five intervention cohorts; n = 184). FCC was progressively enhanced across cohorts. The primary outcome of the main study was postmenstrual age (PMA) at discharge. In this secondary analysis, breastfeeding and breastmilk provision were assessed at four time points: 4 weeks postnatal age, at discharge, 4 weeks post-discharge, and at 3 months PMA. Results: From baseline to intervention cohort 5, the PMA at discharge declined significantly from 37.8 ± 2.1 to 35.7 ± 0.91 weeks (p = 0.03), while the percentage of infants necessitating home nasogastric tube feeding increased from 6.3% to 66.7% (p < 0.01). The proportion of breastmilk of daily feeding volume remained unchanged at 4 weeks postnatal age (0.66 ± 0.42 vs. 0.9 ± 0.28) and at discharge (0.6 ± 0.45 vs. 0.79 ± 0.36). At 4 weeks post-discharge, 65.8% vs. 62.5% of the infants were on partial or exclusive breastmilk (p = 0.91) feeding. Similarly, the percentage of exclusively breastfed infants at 4 weeks post-discharge (23.7% vs. 19.8%) and at 3 months PMA (20% vs. 28.6%) did not differ significantly between baseline and intervention cohort 5. Conclusions: Early discharge did not reduce breastmilk supply or exclusive breastfeeding. However, the persistently low rate of exclusive breastfeeding post-discharge highlights the need for additional support strategies during and after hospitalization. Full article

Background: The Baby-Friendly Hospital Initiative (BFHI) promotes, protects, and supports optimal breastfeeding through facility-based strategies. While prior studies have examined individual BFHI components in specific contexts, global evidence on its overall impact remains limited. This systematic review and meta-analysis aimed to evaluate the BFHI’s effectiveness in improving early initiation and exclusive breastfeeding practices worldwide. Methods: A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Google for English-language studies. Eligible studies included randomized controlled trials (RCTs), cluster RCTs, and quasi-experimental designs assessing BFHI’s effect on breastfeeding outcomes. Random-effects meta-analysis models were used to estimate the pooled effects with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics and p-values. Study quality was appraised using the GRADE approach. Results: Thirty studies met the inclusion criteria. The BFHI was associated with increased early initiation of breastfeeding (pooled RR 1.43; 95% CI: 1.12–1.81; I² = 97.1%). Positive associations were also observed for exclusive breastfeeding at four months (RR 1.18, 95% CI: 1.08–1.29; I² = 61.7%) and at six months (RR 1.56, 95% CI: 1.14–2.14; I² = 82.8%). Substantial heterogeneity reflected variability in study design, BFHI implementation fidelity, and context. Conclusions: Our findings suggest that the BFHI is effective in improving breastfeeding practices globally. However, study variability and partial implementation may limit the generalizability of results. High-quality RCTs assessing full BFHI implementation are needed to strengthen evidence and guide global maternal–child health policy. Full article

Background/Objectives: Dopamine partial agonists are drugs initially developed to treat schizophrenia, seeking a double effect of increased dopaminergic transmission in the prefrontal cortex and decrease in the accumbens/striatum. Of these drugs, aripiprazole, brexpiprazole, and cariprazine are currently marketed and used in schizophrenia spectrum and mood disorders. It is debated whether patients with psychiatric disorders becoming pregnant should discontinue or continue their antipsychotic treatment despite some risks for the fetus, i.e., whether it is worse to have an untreated disorder or treating it with drugs. The safety of drugs for mother and baby extend from pregnancy to the postpartum, when breastfeeding assumes great importance. We set to investigate the use of dopamine partial agonists in pregnancy and lactation. Methods: On 23 June 2025, we used suitable strategies for identifying cases and studies of cariprazine, aripiprazole, brexpiprazole, dopamine partial agonists in pregnancy, perinatal period, and/or lactation on PubMed, CINAHL, PsycInfo/PsycArticles, Scopus, and ClinicalTrials.gov. We used the PRISMA Statement in developing our review. We included case reports and clinical studies. We excluded reports without pregnancy or focused on other drugs than the above. We reached consensus on eligibility with Delphi rounds among all authors. Results: Our searches produced 386 results on the above databases. We included 24 case reports/series and 15 studies. Most studies showed no negative pregnancy outcomes. There were serious concerns about the use of dopamine D₂/D₃ partial agonists during lactation. Conclusions: The use of dopamine partial agonists during pregnancy appears to be safe, but during breastfeeding they should be better avoided. Full article

Introduction: Childhood obesity is a growing public health problem with long-term consequences. Understanding the early contributing factors is crucial for prevention and early intervention. This study explored the influence of breastfeeding, birth weight, gestational age, parental education, and sex on body mass index (BMI) during infancy. Methods: Standardized weight and height measurements of children followed a common World Health Organization protocol. Information on sex, gestational age, birth weight, breastfeeding practices and duration, family income, and mother’s educational level, as well as other sociodemographic factors, was collected from clinical records. Linear regression models were calculated. Results: This study analyzed factors associated with overweight and obesity in 286 children under 5 years of age, using data from daycare records. Several significant associations were found. Regarding breastfeeding, while 85% of children received breast milk, only 23% did so exclusively for at least six months. Although no significant difference was observed in BMI change between exclusive and partial breastfeeding groups between birth and 5 years of age, the duration of exclusive breastfeeding, the birth BMI, and the educational level predicted 54% of the variability in BMI percentile change from birth to two years (p = 0.001). In addition, girls showed significantly longer exclusive breastfeeding. Regarding gestational age, preterm infants showed a significantly greater increase in BMI percentile compared to term infants. Gestational age also proved to be a significant factor in explaining BMI variability up to 5 years of age. Regarding sex, at age 5, boys showed a significantly higher prevalence of overweight and obesity than girls. With respect to family income, no statistically significant difference was found in BMI change between birth and 2 years of age; however, this variable warrants further investigation in future studies with greater statistical power. Finally, birth BMI was a significant predictor of BMI variability at 5 years of age. Conclusions: In this study, gestational age, sex, birth BMI, and the duration of exclusive breastfeeding were the most important determinants of BMI and the prevalence of overweight and obesity in children up to 5 years of age. Further studies are needed to thoroughly explore the role of family income and other factors. Full article

Vacuum-assisted and forceps-assisted vaginal births are associated with higher rates of formula supplementation and shorter breastfeeding duration compared to unassisted vaginal births; however, the reasons for this are unclear. Factors such as maternal knowledge, partner support, and parity significantly influence breastfeeding initiation and duration. The prevalence of perineal trauma, neonatal and maternal birth complications, and decreased birth satisfaction is higher after assisted births and may also impact breastfeeding outcomes. Given the limited research on the specific effects of different vaginal birth modes on breastfeeding, this study aimed to examine women’s experiences of establishing breastfeeding after unassisted, vacuum-assisted, and forceps-assisted vaginal birth. A mixed-methods study design was employed using an anonymous online questionnaire, which included binary, multiple choice, and open-ended questions, and Likert scale items. Using social media, we recruited Australian women who had an unassisted, vacuum-assisted, or forceps-assisted birth within the last year. Details of participant demographics, breastfeeding history, initiation and establishment, postpartum mobility, and pain ratings were recorded. Additionally, qualitative data on postpartum recovery and breastfeeding support were analysed using an inductive thematic analysis framework. A total of 565 women were recruited between May and June 2024, of which 488 responses were retained for analysis. Thematic analysis of the qualitative responses identified four central themes that defined women’s experiences of establishing breastfeeding and were similar between unassisted or assisted vaginal birth modes: Experience of Care, Environment, Expectations, and Health Complications. A range of both positive and negative experiences of breastfeeding support, environmental factors, and expectations of the realities of breastfeeding impacted women’s experiences. For many women, various maternal and/or newborn health issues, nipple pain, and latching difficulties made breastfeeding more difficult. Commercial milk formula supplementation during the hospital stay was more prevalent after a forceps-assisted birth when compared to unassisted vaginal birth (41% vs. 17%, respectively; p < 0.001). Further, during the first two weeks at home, commercial milk formula supplementation was more prevalent after both forceps-assisted (26%) and vacuum-assisted (23%) births than after unassisted vaginal birth (8%, p < 0.001). Pain ratings in the early days following birth and in the first two weeks at home were significantly higher for the forceps-assisted group than for the other vaginal birth modes (p ≤ 0.005). Women that had an unassisted vaginal birth with an intact perineum had the lowest pain ratings in the early days and weeks after birth, while pain ratings were similar between women that had a vacuum-assisted birth and those who had an unassisted vaginal birth with a perineal tear or episiotomy (p = 0.05). Early commercial milk formula supplementation is associated with shorter breastfeeding duration, while postpartum pain is known to impede maternal mobility and may partially inhibit the milk ejection reflex, potentially negatively impacting breastfeeding and increasing formula use. Therefore, women who have an instrumental assisted vaginal birth, particularly those who have a forceps-assisted birth, are at greater risk of suboptimal breastfeeding outcomes including short durations of exclusive and any breastfeeding. Improvements to early postpartum pain management, breastfeeding education, and the judicious use of commercial milk formula may improve breastfeeding and subsequent maternal and health outcomes after instrument-assisted vaginal birth. Full article

While the health advantages of postpartum physical activity are clear, fewer than 25% of Australian women engage in physical activity in the year after giving birth. Physical activity may promote weight loss and a healthier body composition in the months after birth; however, evidence of this is limited. An understanding of identified facilitators and barriers to postpartum physical activity and knowledge of changes in body composition after birth will assist healthcare providers in guiding women on their return to physical activity. The primary aim of this study was to examine Australian women’s identified facilitators and barriers to physical activity in the first 12 months postpartum. The secondary aim was to investigate maternal body composition changes between 6–8 weeks and 3–3.5 months postpartum. This study comprised an anonymous online mixed-methods questionnaire and a body composition sub-study. Participants completed an anonymous questionnaire about their pregnancy and birth and their physical activity before and during pregnancy and after birth. Qualitative responses to questions about facilitators and barriers to postpartum physical activity were analysed using content analysis. Sub-study: Women that had given birth within the last 6 weeks were invited to attend study sessions at 6–8 weeks postpartum and then 6 weeks later (3–3.5 months) for anthropometric (weight, height, BMI) and body composition measurements (fat mass, fat-free mass) using a bioelectrical impedance analyser ImpediMed SFB7 (ImpediMed, Brisbane, Queensland, Australia). Participation in physical activity in the previous 7 days and the infant feeding method were recorded at each visit. Survey data of n = 469 women were available for analysis. Content analysis of the qualitative data identified the main barriers to physical activity as infant care, timing, and physical limitations. Most survey participants (72%) were active at the time of participation, yet only 23% (n = 110) met the postpartum exercise recommendations of 150 minutes/week. The sub-study involving 30 women showed no significant changes in weight (p = 0.46), BMI (p = 0.45), fat mass (p = 0.36), or fat-free mass (p = 0.23) between 6–8 weeks and 3–3.5 months postpartum. When compared by breastfeeding status, partially breastfeeding women had a larger magnitude of change in weight (−1.15 ± 1.6 vs. 0.24 ± 1.3 kg, respectively, p = 0.015) and BMI (−0.43 ± 0.62 vs. 0.09 ± 0.50 kg/m², respectively, p = 0.016) than fully breastfeeding women, which may be partly explained by the fat-free mass increase in the latter group (−0.19 ± 2.4 vs. 2.67 ± 5.7 kg, respectively, p = 0.089). At 6–8 weeks postpartum, 45% of participants (n = 14) engaged in at least 150 minutes/week of exercise, with no significant differences in changes in maternal body composition at 3–3.5 months between those meeting the recommendations and those who were not. These findings provide valuable insights that can inform the guidance, support, and education of postpartum women when planning their return to physical activity and form the basis of future studies of exercise and body composition changes in breastfeeding women. Full article

Background/Objectives: After birth, mothers provide the best nutrition for the healthy growth and development of their infants and the developing gut microbiota through breastfeeding. When breastfeeding is not or insufficiently available, infant formula is the only safe alternative. The production of infant formula includes heat-processing, which may induce protein glycation. Protein glycation has been shown to reduce protein digestion and absorption. The reduction in protein digestion and absorption because of protein glycation has been speculated to also impact gut comfort parameters as well as overnight sleep. Methods: As this could be partially due to the effect on the bacteria that reside in the infant’s gastrointestinal tract, we investigated whether protein glycation in infant formula impacts the composition and activity of infant gut microbiota by performing an in vitro study using the CoMiniGut colon model and fecal inocula obtained from a healthy six-month-old term infant. Incubations were performed for 24 h using a predigested infant formula-supplemented medium with varying levels of glycation (6.5–44.5%). Results: Our data indicate that high protein glycation increases microbial diversity and the relative abundance of Clostridium neonatale from 6.4% of the inoculum to around 25.5% of 20.8% glycation. Interestingly, propionate levels were inversely correlated with protein glycation levels after 24 h of incubation, with the 44.5% blocked lysine sample giving rise to 60% lower propionate levels as compared to the 6.4% sample. Higher propionate levels have been linked with longer uninterrupted sleep overnight, which could be indicative of the underlying mechanism of reduced crying/fussy time during nights for infants fed with a formula containing lower amounts of glycated protein. Full article

Background: Breastfeeding could improve a child’s health early on, but its long-term effects on childhood behavioral and emotional development remain inconclusive. We aimed to estimate the associations of feeding practice with childhood behavioral and emotional development. Methods: In this population-based birth cohort study, data on feeding patterns for the first 6 mo of life, the duration of breastfeeding, and children’s emotional and behavioral outcomes were prospectively collected from 2489 mother–child dyads. Feeding patterns for the first 6 mo included exclusive breastfeeding (EBF) and non-exclusive breastfeeding (non-EBF, including mixed feeding or formula feeding), and the duration of breastfeeding (EBF or mixed feeding) was categorized into ≤6 mo, 7–12 mo, 13–18 mo, and >18 mo. Externalizing problems and internalizing problems were assessed with the Child Behavior Checklist (CBCL) and operationalized according to recommended clinical cutoffs, corresponding to T scores ≥64. Multivariable linear regression and logistic regression were used to evaluate the association of feeding practice with CBCL outcomes. Results: The median (interquartile range) age of children at the outcome measurement was 32.0 (17.0) mo. Compared with non-EBF for the first 6 mo, EBF was associated with a lower T score of internalizing problems [adjusted mean difference (aMD): −1.31; 95% confidence interval (95% CI): −2.53, −0.10], and it was marginally associated with T scores of externalizing problems (aMD: −0.88; 95% CI: −1.92, 0.15). When dichotomized, EBF versus non-EBF was associated with a lower risk of externalizing problems (aOR: 0.54, 95% CI: 0.34, 0.87), and it was marginally associated with internalizing problems (aOR: 0.75, 95% CI: 0.54, 1.06). Regarding the duration of breastfeeding, breastfeeding for 13–18 mo versus ≤6 mo was associated with lower T scores of internalizing problems (aMD: −2.50; 95% CI: −4.43, −0.56) and externalizing problems (aMD: −2.75; 95% CI: −4.40, −1.10), and breastfeeding for >18 mo versus ≤6 mo was associated with lower T scores of externalizing problems (aMD: −1.88; 95% CI: −3.68, −0.08). When dichotomized, breastfeeding for periods of 7–12 mo, 13–18 mo, and >18 mo was associated with lower risks of externalizing problems [aOR (95% CI): 0.96 (0.92, 0.99), 0.94 (0.91, 0.98), 0.96 (0.92, 0.99), respectively]. Conclusions: Exclusive breastfeeding for the first 6 mo and a longer duration of breastfeeding, exclusively or partially, are beneficial for childhood behavioral and emotional development. Full article