bluuebunny/crossref_metadata_2025_split huggingface dataset:
Filling the Gap: Trends in and Factors Related to Infant Feeding Choice in the U.S. from 1925‐1964
Authors: Pilles K , Dong YQ , Willett WC , Michels KB , Forman MR 
Published: June 2021

Identifying infant feeding (IF) practices of the mothers of the nurse daughters in the Nurses' Health Cohort Studies provides early life data to link to the daughter's adult disease risk.The objective is to describe the rates of exclusive breastfeeding (XBR); of ever breastfeeding i.e. XBR plus breast and bottle‐feeding (Ever BR); and of exclusive bottle‐feeding (XBot) from 1925‐1964; and to identify the factors influencing IF choice by birth cohort via a retrospective cohort in the Nurses' Health Cohort Studies (N= 39,743). Multiple logistic regression analysis was used to calculate the adjusted odds ratios for Ever BR and XBR.80% of mothers in the Great Depression Ever BR and this rate steadily declined to 37% in 1964. A declining trend also appeared in XBR from 41% to 10%. Factors positively associated with Ever BR were: any maternal college education compared to <12 years of education and delivering a low or high compared to normal birth weight nurse daughter. Factors negatively associated with Ever BR were: smoking during pregnancy, C‐section delivery, pre‐term births, birth orders 2+, and nurse daughters born after 1939. Factors differed for birth cohort specific models, e.g. maternal age was associated with XBR during the Great Depression, while maternal education was associated with XBR from the 1950's on. Among the XBot, the majority used canned evaporated milk until 1959 and then switched to infant formula. Obesity prior to and weight gain during pregnancy were not related to IF choice in contrast with determinants of today.The Nurses' Mother's Cohort Study fills a gap in rates of and factors influencing IF choice in the U.S. from 1925‐1964. Our results are birth cohort era specific and differ with current determinants.
Mothers' Experiences Expressing Breastmilk for VLBW Infants: A Phenomenological Case Study
Authors: Bower K , Burnette T , Lewis D , Wright C , Kavanagh K 
Published: June 2021

The purpose of this phenomenological study was to gain an understanding of mothers' experiences expressing breastmilk for their very‐low‐birth‐weight (VLBW) infants in a Level III Neonatal Intensive Care Unit (NICU). Using purposive sampling, mothers with VLBW infants in the NICU were invited to participate if they had ever expressed breastmilk during their infant's stay. Mothers were eligible if they were English‐speaking, 18 years or older, maintaining custody post discharge, and their breastmilk was not contraindicated for any reason. In‐depth, semi‐structured interviews were conducted in person in a private room at the NICU or over the phone, per the mother's preference. Consistent with phenomenological methods, interviews began with the question: “tell me about your experience pumping breastmilk for your baby.” Additional questions prompted for further detail to better capture the mother's experiences. All interviews were audio‐recorded, transcribed verbatim, and analyzed using Colaizzi's methodology. To date, 11 mothers have consented and been interviewed. Results are based on preliminary findings from these first interviews. Emergent themes related to expressing breastmilk include: 1) breastmilk has more benefits than formula for NICU infants; 2) mothers can actively participate in infants' care; 3) pumping is time consuming; and 4) ease of formula‐feeding may influence mothers to quit pumping. Data analysis will continue until saturation has been achieved. Mothers will be re‐contacted to validate the researchers' interpretations or the results. Results will be used to inform development of a pilot intervention to promote breastmilk expression in the NICU setting.Funding: Univ. of TN, Professional Development Fund
“Las Dos Cosas” on the U.S.‐México Border
Authors: Anchondo Ines , Flores Angela , Huang Cindy , Finch Casey 
Published: June 2021

ObjectiveDetermine breastfeeding barriers on the U.S‐México border (El Paso, Texas), with high breastfeeding initiation (84%, hospital discharge), but low duration (16%, 3 months after delivery).Methods: 300 mostly Mexican‐American low‐income mothers answered a 14‐question survey about infant feeding, socio‐demographics, and health habits.Results: Breastfeeding barriers included deciding to breastfeed and formula feed (72%) or do “las dos cosas” after delivery. Only 61 mothers (20%) chose exclusive breastfeeding and 22 mothers (7%) chose exclusive formula feeding after delivery. Although new mothers were educated about breastfeeding, 32% still chose to formula feed in the immediate postpartum period. Multiple regression analysis showed barriers to breastfeeding included deciding during pregnancy not to exclusively breastfeed and not having breastfed previous children. Other barriers included not having enough breast milk (33%), planning to go back to work or school (17%), and not having a female relative to provide support. Acculturation did not play a role in breastfeeding decision. The ‘any’ breastfeeding rate was 94% and exclusive breastfeeding rate was 22%.ConclusionMexican‐American mothers who decide to breastfeed during pregnancy or have breastfed other children are more likely to choose exclusive breastfeeding after delivery. Official breastfeeding rates for Mexican‐American mothers are misleading, because although these mothers' breastfeeding initiation is high, many begin to offer formula immediately after birth. This practice of “las dos cosas” must be considered when providing breastfeeding support to these mothers.Research support: Texas Tech University Health Sciences Center ‐ Pediatrics
Obese Mothers Have a Lower Prevalence of Exclusive Breastfeeding<6 Mo as Compared to Non‐Obese Mothers: Data From the 2012 National Health and Nutrition Survey
Authors: Gonzalez de Cosío Teresita , Escobar Leticia , González‐Castell Luz Dinorah 
Published: June 2021

ObjectiveTo estimate the prevalence of exclusive breastfeeding <6 mo (EBF<6m) by level of obesity in Mexican women who participated in the 2012 National Nutrition Survey.Methods: A representative sample of 477 postpartum women 12‐49 y and their <6 mo infants were studied. EBF<6m information obtained by status quo method; EBF<6mo indicator was constructed as recommended by the WHO‐2008. Maternal weight and height were measured wearing light clothing ‐ no shoes. Maternal BMI (kg/m2) categorized in non‐obese, obese‐1 or obese‐2+ (BMI<30, 30‐< 35 and 35+ respectively). To compare proportions of EBF< 6m per BMI we used Student's t test and the Mann‐ Kendall test for trend. P < 0.05 was declared statistically significant.Results: Prevalence of EBF<6m was 17.4, 7.1 and 3.2 % in non‐obese, obese‐1 and obese‐2+ women respectively (p< 0.05 for proportions, p=0.012, test for trend). Results are similar when excluding teenage mothers from the analysis.ConclusionObesity inhibits breastfeeding through an inadequate prolactin response to suckling, which in turn associates with delayed onset lactogenesis II, hindering the establishment of successful breastfeeding in obese mothers. Results of this study derived from nationally representative data show that the risk of inadequate breastfeeding is significantly higher in obese women, and this risk increases with increasing obesity. The information is alarming given the current obesity pandemic concurrent with the declining prevalence of breastfeeding in Mexico.Funded by the National Institute of Public Health, Mexico
Milk Mineral and Cytokine Concentrations Differ in Guatemalan Mothers with Subclinical Mastitis (SCM) by Stage of Lactation
Authors: Li Chen , Wren Hilary , Solomons Noel , Scott Marilyn , Koski Kristine 
Published: June 2021

BackgroundLittle is known about the impact of SCM on the immunological and mineral concentrations of human breast milk. Our objective was to determine if minerals and cytokines differed in mothers with and without SCM during 3 stages of lactation.MethodsTransitional milk (TM: 5‐17d, n=21), early mature milk (EMM: 18‐46d, n=32) and mature milk (MM: 109‐187d, n=59) samples were collected from Mam‐Mayan women. Inductively Coupled Plasma Mass Spectrometry was used to analyze the concentration of 13 minerals (Na, K, Ca, Mg, Mn, Zn, Cu, Cr, Sr, Se, Rb, Fe, P) and immunoassay with Luminex was used to determine the concentration of 4 cytokines (IL‐1β, IL‐6, IL‐8, TNF‐α).ResultsPrevalences of SCM, using Na/K > 0.6, were 26.3% in TM, 15.6% in EMM and 8.9% in MM. Na, K, P, Cu, Fe, Rb, Zn and IL6 were higher in TM and EMM whereas Mg was higher in MM, as was IL‐8. SCM was associated with changes in P and Se and with the presence of 3 cytokines (IL‐6, IL‐8, and TNF‐α) in TM only. Regression analyses for each mineral showed that cytokines were associated with higher milk mineral concentrations: IL‐1β with P, Fe and Mn; IL‐6 with Na, K, Ca and Cu; IL‐8 with Zn; and TNF‐α with Na, Mn and Se.ConclusionMilk minerals and cytokines concentrations vary by lactation stages. The cytokines are associated with changes in milk mineral concentrations. Our finding suggests that IL‐6 is associated with elevated Na/K ratio.FundingMcGill University International Mobility Award
Effect of Breastmilk Leptin and Macronutrient Content on Gastric Emptying in Term Breastfed Infants
Authors: Geddes Donna , Gridneva Zoya , Cannon Anna , Hepworth Anna , Tie Wan , Lai Ching , Hartmann Peter 
Published: June 2021

Higher breastmilk casein concentration increases gastric emptying in preterm infants, however there are limited information regarding whether casein or other components of breastmilk affect gastric emptying in term infants. In this study we investigated associations of macronutrient and skim milk leptin concentrations with gastric emptying.Term fully breastfed infants (n=20, aged 6 to 32 weeks) were examined with ultrasound before and after one feed, and then at 10‐20 minute intervals until the next feed. Stomach volumes were calculated from transverse and sagittal ultrasound scans of the infant stomach. Milk intake was measured by the test‐weigh method. Breastmilk samples (1‐2 mL) were collected and analyzed for fat, lactose, total protein, whey and casein protein and skim milk leptin. Leptin dose was calculated as an average concentration multiplied by the feed volumeAfter accounting for the total feed volume and the time since the end of the feed post‐feed stomach volumes were not associated with leptin dose (P=0.998), leptin (P=0.91), fat (P=0.78), protein (P=0.80), whey (P=0.15), casein (P=0.37) or lactose (P=0.59) concentrations. Leptin dose was positively associated with protein (P<0.001) but not with fat (P=0.58), whey (P=0.76), casein (P=0.75) or lactose (P=0.77) concentration after accounting for the total feed volume.Gastric emptying in term infants does not appear to be affected by milk composition in the same way that it is in preterm infants.
A Longitudinal Study of Human Milk Composition Beyond One Year Postpartum
Authors: Perrin Maryanne , Fogleman April , Allen Jonathan 
Published: June 2021

ObjectivesEvaluate longitudinal changes in human milk composition during the 2nd year of lactation and compare 2nd year milk samples to unpasteurized, pooled milk collected by Human Milk Banking Association of North America (HMBANA) milk banks in order to create evidence‐based guidelines regarding donor exclusions.MethodsNineteen mothers provided sequential monthly milk samples (n = 154) between <12 months (control) and 18+ months postpartum by complete expression of one breast. Samples were analyzed for macronutrients and key bioactive compounds including lactoferrin, lysozyme and IgA. Unpasteurized, pooled milk samples (n = 33) from two HMBANA milk banks were also analyzed.ResultsA bivariate regression analysis showed that protein, lactoferrin, lysozyme, and IgA concentration increased significantly based on Month of Lactation (P < 0.05). Fat content was not impacted by Month of Lactation (P = 0.6132). Volume Expressed had a significant inverse effect on all nutrients (P < 0.0001). Longitudinal samples beyond 12 months postpartum had significantly higher concentrations of all nutrients (P < 0.05) than milk bank samples.ConclusionsHuman milk during the 2nd year of lactation has increasing levels of total protein, IgA, lactoferrin and lysozyme that were significantly greater than levels observed in pooled milk bank samples. Because protein is especially important for the preterm infant, this research suggests that milk donors beyond one year postpartum should be considered as quality donors with the potential to raise the protein composition and supply of pooled donor milk. However, the late lactation changes might not be as evident in women who are aggressively pumping to donate and are thus producing large daily volumes.
Feasibility of Post‐Hospitalization Interventions to Improve Physical Function in Older Adults
Authors: Deer Rachel , Goodlett Shawn , Fisher Steve , Dickinson Jared , Volpi Elena 
Published: June 2021

Acute hospitalization can have catastrophic consequences for physical function and independence in older adults. The inability to regain function following a hospital stay is a strong predictor of re‐hospitalization and mortality. We have shown that nutritional interventions, exercise, and anabolic steroids independently increase muscle size and function, thus representing promising therapeutic strategies.The goal of this pilot study was to test the feasibility of interventions (placebo supplement (P), nutrition supplement (N, whey protein), progressive in‐home exercise + placebo (E+P), exercise + nutrition (E+N), or single testosterone injection (T)) to improve physical function in older adults following acute hospitalization.Subjects (>65 years) were recruited during hospitalization at UTMB Acute Care for Elders unit. Demographics and short physical performance battery (SPPB) were collected at hospital discharge and 1‐month post discharge.Mean baseline SPPB score was 6.6. At 1‐mo testing, interventions tended to enhance improvement in raw SPPB score (P: 1.3, N: 3.3, E+P: 2.2, E+N: 3.2, T: 2.3) and percent of subjects with a clinically meaningful improvement (蠅1 point) (P: 50%, N: 100%, E+P: 80%, E+N: 80%, T: 88%). Gait speed was low in all groups at baseline (0.60‐ 0.71 m/s). Interventions tended to augment gait speed at 1‐mo (P: 25%, N: 50%, E+P: 45%, E+N: 44%, T: 21%).These preliminary data (n=4‐8), from an ongoing clinical trial, indicate that interventions after acute hospitalization are feasible and can improve physical function in older adults.Dairy Research Institute (1229) and UTMB Claude D. Pepper OAIC (5P30‐ AG024832).
Changing the Consistency of Animal Source and Micronutrient‐Rich Complementary Foods to Improve Acceptability and Consumption among Infants and Toddlers: Formative Research (FR) in Rural Peru
Authors: Creed‐Kanashiro Hilary , Bartolini Rosario , Goya Cecilia , Bentley Margaret 
Published: June 2021

In many parts of rural Peru and other developing countries where stunting and anemia are prevalent, caregivers culturally prefer non‐nutrient dense preparations such as soups as first complementary foods. Animal source foods (ASF) are frequently introduced towards the end of the first year. Through conducting in depth interviews (24), focus groups (6) and observations (4) with caregivers, we explored the potential acceptance of commercial infant food grinders (IFG) to facilitate giving available micronutrient‐rich family foods and ASFs to infants and young children from 6 months.Mothers considered the IFG transforms negative qualities attributed to ASF to positive: the grinding of the food made it “soft”, the ASF is transformed from “hard” to a consistency considered appropriate for eating and digesting for a 6 – 7 month old; the food is “tastier because it has meat in it and child will eat more”. Advantages for the mothers included its ease and facility to use and wash; it “saves time”, and that a baby will not choke on this food. These soft preparations can be used as a vehicle for multi‐micronutrient powders, recently being distributed by the MOH.The first phase of the FR is followed by household behavioral trials with 40 caregivers and their children 6 – 15 months to further explore the use of the IFG during a period of 2 ‐3 weeks, to learn of the types of foods used, frequency of use and changes in dietary intake, information to be used to design a community efficacy trial to explore potential dietary impact of the IFG at scale in this setting.Funding: Mathile Institute for the Advancement of Human Nutrition
Association of Dietary Intake Contribution of Prospera Supplements and Socioeconomic Level in Children in San Luis Potosi, Mexico
Authors: Gaona‐Pineda Elsa , Cuevas‐Nasu Lucia , Gomez‐Acosta Luz , Mendez Ignacio , Shamah Teresa 
Published: June 2021

ObjectiveTo estimate the contribution to dietary intake of Prospera (former Oportunidades) supplements in children and the association with socioeconomic status (SES).Methods: Within the study of “Impact evaluation of food assistance programs in San Luis Potosi, Mexico” we obtained information from 398 children (< 3y old) beneficiaries of Prospera. Through a food semicuantitative frequency questionnaire we estimated the percentage contribution to total dietary intake (PCDI) of energy, protein, zinc, iron, folate and vitamin B12 of Prospera distributed supplements. We studied the association of PCDI and SES with zero‐inflated negative binomial regression models adjusted by sex and age, interaction between SES and sex was tested.Results: Interaction between SES and sex was found for energy and protein intakes. Girls of low SES showed higher PCDI than boys (energy and protein p= 0.054 and 0.0456; respectively). Children of low SES had higher PCDI of zinc, iron, folate and vitamin B12 than children of high SES.

[Table 1]
PCDI (CI 95%)
PCDI (CI 95%)

Nutriment
Low SES
High SES

Energy (Boys)
10 (8,11.9)
4 (3, 5)

Energy (Girls)
13 (11, 14)
6 (3, 9.7)

Protein (Boys)
15 (12,17)
5 (2,8)

Protein (Girls)
17 (15, 20)
8 (4, 12)

Zinc
56 (53, 58)
39 (34, 43)

Iron
52 (49, 55)
35 (31, 39)

Folate
27 (25, 30)
17 (15, 20)

Vitamin B12
31 (28, 35)
14 (14, 21)

ConclusionsThe PCDI of supplements is higher in children of low SES. It is necessary to study dietary quality in Prospera beneficiaries and asses the program target population.Supported by FOMIX SLP. Project: FMSLP‐213‐C02‐208475
Food Insecurity and Quality of Life among Obese Latino Adolescents
Authors: Bruening Meg , Shaibi Gabriel , Williams Allison , Konopken Yolanda , Skelton Kara 
Published: June 2021

ObjectiveTo assess the relationship between quality of life and food insecurity among obese Latino adolescents participating in a diabetes prevention program.MethodsBaseline surveys including the USDA food security screener and the Youth Quality of Life scale were administered to 62 parent‐adolescent (mean age 14.8 yrs) dyads prior to the intervention. Multivariate regressions were used to assess the relationship between youth's quality of life and food insecurity (both household and adolescent's self‐report) , adjusting for parent employment status, household size, and youth's gender and age.ResultsSelf‐reported food insecurity prevalence was high among parents (54.2%) and moderate among youth (19.7%). The odds of a child reporting food insecurity was 3.8 times higher if parents reported food insecurity (p=0.07). The mean adolescent quality of life score was 81.0±11.3. There was no significant relationship between adolescents' quality of life and food insecurity status(β=‐3.67; p=0.33), or in the relationship in adolescents' quality of life and parents' food security status even after adjusting for child food insecurity status (β=‐2.01; p=0.59).ConclusionsParents may protect their children from food insecurity, given the lower relative prevalence of food insecurity in adolescents as compared to parents. Surprisingly, there was no association observed between food security and quality of life; health professionals addressing food insecurity among youth may consider capitalizing on the positive outcomes in overall quality of life when designing interventions.
Examining Trends in Meal Patterns between 1995 and 2011 Using Two National Surveys
Authors: McNaughton Sarah , Leech Rebecca , Worsley Anthony 
Published: June 2021

BackgroundWhile international research suggests that meal patterns of the population may be changing, possibly with adverse health consequences, little is known about the meal patterns of Australians. The aim of this study was to examine the changes in meal patterns of Australians between 1995 and 2011.Methods: Data from two nationally representative Australian surveys were used (1995 National Nutrition Survey, 10851 adults 蠅19 years, n=2986 children/adolescents 2‐18 years; 2011‐2013 National Nutrition and Physical Activity Survey, 8964 adults 蠅19 years, 2783 children/adolescents 2‐18 years). Dietary intake was assessed via 24‐hour recall and respondents and eating occasions (EOs) including meals and snacks were reported. Frequency of meals, snacks and all EOs, time between EOs and energy intake (EI) from meals, snacks and all EOs were compared between the two surveys using an F‐test. All results were weighted, adjusted for sample design effects and presented as means and Taylor linearized standard errors.Results: Overall, there was little change in frequency of total EOs over time. Time between EOs decreased among women but not men between 1995 and 2011‐12 (181 [1.15] vs 171 [1.29], P<0.001) and among children (164 [1.40] vs 157 [1.47], P=0.001). The proportion of total EI from meals decreased in both children and adults between 3‐7% (P<0.001) whereas the proportion of total EI from snacks increased between 3‐7% (P<0.001).ConclusionsOverall, only small changes in meal patterns have occurred between 1995 and 2011 among children and adults. However, increases in the proportion of energy from snacks warrants further investigation. Future research will examine changes in nutrient profiles of meals and snacks over time.
Near‐Infrared (NIR) Spectroscopy of Amniotic Fluid (AF) Distinguishes Between AGA and LGA Infants
Authors: Sanchez‐Galan Javier , Burns David , Koski Kristine 
Published: June 2021

BackgroundNIR of AF has been used to characterize fetal lung maturity and prematurity. However, this approach has been seldom used to classify infants according to birth weight for gestational age.ObjectivesWe explored the possibility that NIR of 2nd trimester AF could identify early metabolomic differences between appropriate‐ (AGA, n=494) and large‐ (LGA, n=51)‐for‐gestational age infants. A secondary objective explored whether these AF profiles differed by maternal pre‐pregnancy BMI: normal BMI<24.9kg/m2 (n=310) vs overweight/obese BMI>25 kg/m2 (n=168).MethodsEight NIR functional groups (1600‐2400nm) were selected (CH, SH, POH, ROH, amide, amine, lactate and glucose); their values and calculated ratios were compared among experimental groups using Mann‐Whitney U‐test and Kruskal‐Wallis one‐way ANOVA test, followed by post‐hoc comparisons.ResultsThirteen functional group ratios differed. LGA infants had higher AF glucose relative to CH, SH, POH and ROH and higher AF amines relative to POH, ROH, glucose and amides. In contrast, AGA infants had higher POH and ROH relative to glucose, amines and amides and higher CH:glucose and SH:glucose compared to AF of LGA infants. When subdivided by BMI categories, only AGA infants of overweight/obese mothers had higher AF glucose compared to normal weight mothers; surprisingly this maternal BMI‐based difference did not exist for LGA infants.ConclusionNIR spectral profiles of 2nd trimester AF differed between LGA and AGA infants but maternal BMI was not sufficient to fully explain early 2nd trimester metabolic perturbations.