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Peer Reviewed

Title: Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding.
Author: Ahmed T; Svennerholm AM; Al Tarique A; Sultana GN; Qadri F
Source: Vaccine. 2009 Feb 25;27(9):1433-9.
Abstract: The killed oral cholera vaccine Dukoral is recommended for adults and only children over 2 years of age, although cholera is seen frequently in younger children and there is an urgent need for a vaccine for them. Since decreased immunogenicity of oral vaccines in children in developing countries is a critical problem, we tested interventions to enhance responses to Dukoral. We evaluated the effect on the immune responses by temporarily withholding breast-feeding or by giving zinc supplementation. Two doses of Dukoral consisting of killed cholera vibrios and cholera B subunit were given to 6-18 months old Bangladeshi children (n=340) and safety and immunogenicity studied. Our results showed that two doses of the vaccine were safe and induced antibacterial (vibriocidal) antibody responses in 57% and antitoxin responses in 85% of the children. Immune responses were comparable after intake of one and two doses. Temporary withholding breast-feeding for 3 h before immunization or supplementation with 20 mg of zinc per day for 42 days resulted in increased magnitude of vibriocidal antibodies (77% and 79% responders, respectively). Administration of vaccines without buffer or in water did not result in reduction of vibriocidal responses. This study demonstrates that the vaccine is safe and immunogenic in children under 2 years of age and that simple interventions can enhance immune responses in young children.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | INFANT | CHOLERA | ZINC | HUMAN MILK | VACCINES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | AUTOIMMUNE RESPONSE | SAFETY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Contraceptive Effectiveness | Contraception | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Public Health
Document Number: 341051

Peer Reviewed

Title: Comparison of HIV type 1 sequences from plasma, cell-free breast milk, and cell-associated breast milk viral populations in treated and untreated women in Mozambique.
Author: Andreotti M; Galluzzo CM; Guidotti G; Germano P; Altan AD; Pirillo MF; Marazzi MC; Vella S; Palombi L; Giuliano M
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):707-11.
Abstract: We analyzed the sequences of the HIV viral populations obtained from plasma, cell-free breast milk, and breast milk cells of HAART-treated (23) and untreated (30) HIV-infected women to obtain information about the origin of the breast milk virus. Sequence analyses of viruses were performed using the TruGene HIV-1 assay. Direct sequences of the reverse transcriptase (RT) and protease (PR) genes were analyzed using the Phylip 3.68 suite of sequence analysis program and pairwise evolutionary distances were calculated with the Kimura two parameter model for estimation of distances. We found that the genetic distances between the plasma and the cell-free breast milk viruses and between the cell-free and cell-associated breast milk viruses for RT were higher in HAART-receiving women than in untreated women, suggesting viral evolution under selective drug pressure in breast milk. Our data support the hypothesis of the presence of an actively replicating viral population in the breast milk compartment, distinct from that present in plasma.
Language: English
Keywords:
MOZAMBIQUE | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | HUMAN MILK | HIV | HIV TESTING | LABORATORY PROCEDURES | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342889

Title: Breast milk as the "water that supports and preserves life"--socio-cultural constructions of breastfeeding and their implications for the prevention of mother to child transmission of HIV in sub-Saharan Africa.
Author: Hofmann J; De Allegri M; Sarker M; Sanon M; Bohler T
Source: Health Policy. 2009 Mar;89(3):322-8.
Abstract: OBJECTIVES: Complementary breastfeeding represents an important source of risk of HIV infection for infants born to HIV positive mothers. The World Health Organisation recommends that infants born to HIV positive mothers receive either replacement feeding or exclusive breastfeeding (EBF) followed by early weaning. Beyond the clinical and epidemiological debate, it remains unclear how acceptable and feasible the two options are for rural populations in sub-Saharan Africa. This qualitative study aims to fill this gap in knowledge by exploring both the socio-cultural construction and the practice of breastfeeding in the Nouna Health District, rural Burkina Faso. METHODS: Information was collected through 32 individual interviews and 3 focus group discussions with women of all ages, and 6 interviews with local guerisseurs. RESULTS: The findings highlight that breastfeeding is perceived as central to motherhood, but that women practice complementary, rather than exclusive, breastfeeding. The findings also indicate that women recognise both the nutritional value of breast milk and its potential to act as a source of disease transmission. CONCLUSIONS: The findings suggest that given the socio-cultural importance attributed to breastfeeding and the prevailing poverty, it may be more acceptable and more feasible to promote EBF followed by early weaning than replacement feeding. A set of operational strategies are proposed to favour the prevention of mother to child transmission of HIV in the respect of the local socio-cultural setting.
Language: English
Keywords:
BURKINA FASO | RESEARCH REPORT | QUALITATIVE RESEARCH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV PREVENTION | BREASTFEEDING | HUMAN MILK | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Disease Transmission Control | Prevention and Control | Diseases | HIV Infections | Viral Diseases | Infant Nutrition | Nutrition | Health | Lactation | Maternal Physiology | Physiology | Biology
Document Number: 341367

Title: Maternal weight and lean body mass may influence the lactation-related bone changes in young undernourished Indian women.
Author: Kulkarni B; Shatrugna V; Nagalla B; Ajeya Kumar P; Usha Rani K; Chandrakala Omkar A
Source: British Journal of Nutrition. 2009 May;101(10):1527-33.
Abstract: Lactation is known to be associated with a transient loss of bone mineral density (BMD) during 3-6 months post-partum. Bone changes during lactation in women consuming low dietary calcium are not sufficiently studied. The present longitudinal study examined the BMD changes during lactation in undernourished women and the relationship of bone changes to the nutritional status. Whole-body bone mineral content and BMD at hip, lumbar spine and forearm were assessed using dual-energy X-ray absorptiometry in thirty-six lactating women from the low socio-economic group at four time points -- within 1 month after delivery (baseline), and at 6, 12 and 18 months after delivery. Maternal body composition and biochemical parameters of bone metabolism were estimated at the same time. It was observed that femoral neck BMD reduced by 4.6 % at 6 months, but recovery to the baseline was incomplete at 18 months with a deficit of 2 %. Hip BMD reduction at 6 months was transient. Lumbar spine BMD did not show significant loss at 6 months and BMD increased by 3.6 and 6.3 % at 12 and 18 months, respectively. Regression analyses indicated that baseline lean mass was the most important determinant of bone preservation at femoral neck, hip as well as whole body, whereas baseline body weight was the most important determinant of per cent gain in lumbar spine. Maternal nutritional status as indicated by body weight and lean mass appears to influence the lactation-related BMD changes in undernourished women from the low socio-economic group in India.
Language: English
Keywords:
INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | LOW INCOME POPULATION | POSTPARTUM WOMEN | BODY WEIGHT | LACTATION | MALNUTRITION | DIET | SKELETAL EFFECTS | SERUM CALCIUM LEVEL | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Puerperium | Reproduction | Physiology | Biology | Maternal Physiology | Nutrition Disorders | Diseases | Nutrition | Health | Hemic System
Document Number: 342007

Title: Persistence of nevirapine in breast milk and plasma of mothers and their children after single-dose administration.
Author: Kunz A; Frank M; Mugenyi K; Kabasinguzi R; Weidenhammer A; Kurowski M; Kloft C; Harms G
Source: Journal of Antimicrobial Chemotherapy. 2009 Jan;63(1):170-7.
Abstract: OBJECTIVES: Nevirapine is widely used in the developing world for the prevention of mother-to-child transmission (PMTCT) of HIV. A single mutation in the HIV genome is sufficient to lead to significant nevirapine resistance. Persistence of low-level drug concentrations in body compartments can foster resistance formation. In this study, concentration-time courses of nevirapine after single-dose administration were analysed over an extended post-partum period. PATIENTS AND METHODS: Breast milk and plasma samples of 62 HIV-positive Ugandan mother-child pairs who had received single-dose nevirapine were collected at delivery and 1, 2 and 6 weeks post-partum. Nevirapine concentrations were quantified by LC/tandem-mass-spectrometry using a quantification limit of 15 ng/mL, and a population pharmacokinetic (PK) analysis was performed. RESULTS: Concentration-time profiles in breast milk, maternal plasma and child plasma showed similar shapes. At week 1, median nevirapine concentrations were 164 ng/mL in maternal plasma, 114 ng/mL in breast milk and 183 ng/mL in child plasma. The population PK model predicted nevirapine concentrations>10 ng/mL (IC50 for nevirapine) for 13 days in breast milk, 14 days in maternal plasma and 18 days in child plasma in 80% of the samples. CONCLUSIONS: Nevirapine concentrations were present for 2-3 weeks in the three compartments. The concentrations are probably sufficiently high to protect most breastfed children from HIV transmission during the first 2 weeks. The long presence of slowly decreasing levels of nevirapine is likely to induce resistance formation. Post-natal addition of antiretrovirals for 1 week only, as recommended in the current PMTCT guidelines, will not suffice to avoid nevirapine resistance formation.
Language: English
Keywords:
GERMANY | RESEARCH REPORT | MOTHERS | INFANT | POSTPARTUM | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | DRUGS | BREASTFEEDING | HUMAN MILK | ADMINISTRATION AND DOSAGE | TREATMENT | Europe, Central | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Nutrition | Nutrition | Lactation | Maternal Physiology | Physiology | Biology
Document Number: 329752

Title: Pharmacotherapeutic options for the treatment of preeclampsia.
Author: McCoy S; Baldwin K
Source: American Journal of Health System Pharmacy. 2009 Feb 15;66:337-344.
Abstract: Purpose. Pharmacotherapeutic options for the treatment of preeclampsia are reviewed. Summary. Risk factors for the development of preeclampsia include microvascular diseases, such as diabetes mellitus; vascular and connective tissue disorders; hypertension; antiphospholipid antibody syndrome; and nephropathy. Several pathophysiological factors contribute to the development of the preeclamptic state, including vasospasm onset, coagulation system activation, increased inflammatory response, and ischemia. The specific agents used for the treatment of preeclampsia are dependent on a number of factors including symptom severity, maternal or fetal compromise, the progression to eclampsia, gestational period, and cervical status. The diagnosis of preeclampsia beyond the gestation period of 38 weeks requires delivery. The presence of maternal compromise or eclampsia at gestation greater than 20 weeks also necessitates delivery. In cases of chronic or mild hypertension, oral methyldopa may be administered on an outpatient basis. Intravenous hydralazine is a commonly administered arteriolar vasodilator that is effective for hypertensive emergencies associated with pregnancies. The most common adverse effect of hydralazine administration is unpredictable hypotension. Labetalol decreases heart rate and may be preferred because of a lack of reflex tachycardia, hypotension, or increased intracranial pressure. However, the drug of choice for the prevention and control of maternal seizures in patients with severe preeclampsia or eclampsia during the peripartum period is i.v. magnesium sulfate. Therapeutic serum magnesium levels cause cerebral vasodilation, thereby reversing the ischemia produced by cerebral vasospasm during an eclamptic episode. The results of one study indicated that women receiving magnesium sulfate therapy had a 58% lower risk of eclampsia than placebo. Conclusion. Magnesium sulfate remains the drug of choice for the prevention and treatment of preeclampsia. Alternative antihypertensive agents mayprovide additional benefit in the management of hypertension for preeclamptic patients.
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | PREECLAMPSIA | HYPERTENSION | RISK FACTORS | RENAL EFFECTS | SIGNS AND SYMPTOMS | DRUGS | ADMINISTRATION AND DOSAGE | SAFETY | LACTATION | PREVENTION AND CONTROL | Developed Countries | North America | Americas | Pregnancy Complications | Diseases | Vascular Diseases | Health | Urogenital Effects | Urogenital System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Public Health | Maternal Physiology
Document Number: 340210

Title: Trans fatty acids and fatty acid composition of mature breast milk in turkish women and their association with maternal diet's.
Author: Samur G; Topcu A; Turan S
Source: Lipids. 2009 May;44(5):405-13.
Abstract: The aim of this study was to determine the fatty acid composition and trans fatty acid and fatty acid contents of breast milk in Turkish women and to find the effect of breastfeeding mothers' diet on trans fatty acid and fatty acid composition. Mature milk samples obtained from 50 Turkish nursing women were analyzed. Total milk lipids extracts were transmethylated and analyzed by using gas liquid chromatography to determine fatty acids contents. A questionnaire was applied to observe eating habits and 3 days dietary records from mothers were obtained. Daily dietary intake of total energy and nutrients were estimated by using nutrient database. The mean total trans fatty acids contents was 2.13 +/- 1.03%. The major sources of trans fatty acids in mothers' diets were margarines-butter (37.0%), bakery products and confectionery (29.6%). Mothers who had high level of trans isomers in their milk consumed significantly higher amounts of these products. Saturated fatty acids, polyunsaturated fatty acids and monounsaturated fatty acids of human milk constituted 40.7 +/- 4.7%, 26.9 +/- 4.2% and 30.8 +/- 0.6% of the total fatty acids, respectively. The levels of fatty acids in human milk may reflect the current diet of the mother as well as the diet consumed early in pregnancy. Margarines, bakery products and confectionery are a major source of trans fatty acids in maternal diet in Turkey.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | STATISTICAL STUDIES | MOTHERS | BREASTFEEDING, EXCLUSIVE | LIPIDS | DIET | HUMAN MILK | LABORATORY PROCEDURES | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Physiology | Biology | Lactation | Maternal Physiology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 342185

8.
Title: Vitamin D nutritional status of exclusively breast fed infants and their mothers.
Author: Seth A; Marwaha RK; Singla B; Aneja S; Mehrotra P; Sastry A; Khurana ML; Mani K; Sharma B; Tandon N
Source: Journal of Pediatric Endocrinology and Metabolism. 2009 Mar;22(3):241-6.
Abstract: BACKGROUND: Vitamin D nutrition has a profound effect on the development of an infant. Vitamin D status of mothers and their infants are closely correlated. While hypovitaminosis D has emerged as a significant public health problem across all age groups, there is limited information of this condition in lactating mothers and their breast fed infants. AIM: To evaluate the vitamin D status of lactating mothers and their breast fed infants. SUBJECTS AND METHODS: 180 healthy lactating mothers and exclusively breast fed infants, 2-24 weeks old, were recruited for the study. The mother-infant pairs underwent concurrent clinical, biochemical and hormonal evaluation for calcium-vitamin D-PTH axis. RESULTS: The mean serum 25(OH)D values in lactating mothers was 27.2 +/- 14.6 nmol/l (10.9 +/- 5.8 ng/ml), while that of their infants was 28.9 +/- 20.8 nmol/l (11.6 +/- 8.3 ng/ml). Serum 25(OH)D levels <25 nmol/l (10 ng/ml) were found in 47.8% of the mothers and 43.2% of the infants. Among these, elevated PTH levels (>54 pg/ml) were seen in 59.3% of the mothers and 69.6% of the infants. A highly significant negative correlation was found between serum 25(OH)D and PTH in mothers (r = -0.480, p = 0.01) and their infants (r = -0.431, p = 0.01). A strong positive correlation was seen of 25(OH)D levels in mother-infant pairs (r = 0.324, p = 0.001). CONCLUSIONS: A high prevalence of vitamin D deficiency was found in lactating mothers and their exclusively breast fed infants. Infants born to mothers with hypovitaminosis D had 3.8 times higher risk of developing hypovitaminosis D as compared to those born to mothers with normal vitamin D levels.
Language: English
Keywords:
INDIA | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | VITAMIN D | DEFICIENCY DISEASES | LACTATION | Asia, Southern | Asia | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Diseases | Maternal Physiology
Document Number: 341670

Peer Reviewed

Title: Breastfeeding duration related to practised contraception in the Netherlands.
Author: van Wouwe JP; Lanting CI; van Dommelen P; Treffers PE; van Buuren S
Source: Acta Paediatrica. 2009 Jan;98(1):86-90.
Abstract: AIM: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. METHODS: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. RESULTS: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3-27.0), the adjusted OR 14.5 (9.3-22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6-19.9) and 11.7 (7.6-17.9). Of all breastfeeding women, 20-27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. CONCLUSION: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | QUESTIONNAIRES | MOTHERS | INFANT | BREASTFEEDING | BOTTLE FEEDING | TIME FACTORS | CONTRACEPTION CONTINUATION | LACTATION | Europe, Western | Europe | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Contraceptive Usage | Contraception | Family Planning | Maternal Physiology | Physiology | Biology
Document Number: 330861

10.
Title: Iodine status and thyroid function of pregnant, lactating women and infants (0-1 yr) residing in areas with an effective Universal Salt Iodization program.
Author: Wang Y; Zhang Z; Ge P; Wang Y; Wang S
Source: Asia Pacific Journal of Clinical Nutrition. 2009;18(1):34-40.
Abstract: OBJECTIVE: To assess the iodine nutrition and thyroid function of pregnant women, lactating women and infants residing in areas where the Universal Salt Iodization program is in place. METHODS: Pregnant women, lactating women and infants were selected randomly in the regions where iodized salt coverage rate is more than 90% since 2000. Urine iodine levels of pregnant woman, lactating woman and infants, milk iodine of lactating woman, thyroid-stimulating hormone (TSH) and free T4 of women were tested respectively. RESULTS: Median Urinary Iodine (MUI) of infants, three groups of pregnant women (first, second and third trimester) and two groups lactating women (breastfeeding less than or more than six months) were 233, 174, 180, 147, 126 and 145 microg/L, respectively. Median milk iodine of lactating women was 163 microg/L. Percentage of milk iodine < 150 microg/L of early lactating women was 40% less than that of late lactating women (p < 0.01).There was a positive correlation between urine iodine of infants and milk iodine of lactating women (r = 0.526, p = 0.000). T4 of two women were above or below the reference range. Total 15.4% women's TSH were abnormal. Most of these women's urinary iodine were lower than 150 microg/L. CONCLUSION: Iodine status of most of the target population for Universal Salt Iodization program is adequate, but iodine deficiency still existed in some. To assure every new life's brain not be damaged by iodine deficiency, iodine status of targeted populations should be monitored and supplements provided according to the monitoring outcomes.
Language: English
Keywords:
CHINA | RESEARCH REPORT | WOMEN | PREGNANT WOMEN | THYROID EFFECTS | PROTEIN BOUND IODINE ALTERATIONS | NUTRITION | DIET | LACTATION | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Population Characteristics | Endocrine Effects | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System | Health | Maternal Physiology
Document Number: 342000

11.

Title: Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women.
Author: Webb AL; Aboud S; Furtado J; Murrin C; Campos H; Fawzi WW; Villamor E
Source: European Journal of Clinical Nutrition. 2009 Mar;63(3):332-9.
Abstract: BACKGROUND/OBJECTIVE: The effect of daily prenatal and postnatal vitamin supplementation on concentrations of breast milk nutrients is not well characterized in HIV-infected women. We examined the impact of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, carotenoids and tocopherols during the first year postpartum among 626 HIV-infected Tanzanian women. SUBJECTS/METHODS: We conducted a randomized, double-blind, placebo-controlled trial. Women were assigned to one of four daily oral supplements: vitamin A+beta-carotene (VA+BC); multivitamins (MV; B, C and E); MV+VA+BC or placebo. Concentrations of breast milk nutrients were determined by high-performance liquid chromatography at birth and every 3 months thereafter. RESULTS: Supplementation with VA+BC increased concentrations of retinol, beta-carotene and alpha-carotene at delivery by 4799, 1791 and 84 nmol l(-1), respectively, compared to no VA+BC (all P<0.0001). MV supplementation did not increase concentrations of alpha-tocopherol or delta-tocopherol at delivery but significantly decreased concentrations of breast milk gamma-tocopherol and retinol. Although concentrations of all nutrients decreased significantly by 3 months postpartum, retinol, alpha-carotene and beta-carotene concentrations were significantly higher among those receiving VA+BC at 3, 6 and 12 months compared to no VA+BC. alpha-Tocopherol was significantly higher, while gamma-tocopherol concentrations were significantly lower, among women receiving MV compared to no MV at 3, 6 and 12 months postpartum. CONCLUSIONS: Sustained supplementation of HIV-infected breastfeeding mothers with MV could be a safe and effective intervention to improve vitamin E concentrations in breast milk. VA+BC supplementation increases concentrations of breast milk retinol but it is not recommended in HIV-infected mothers due to the elevated risk of vertical transmission.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | WOMEN | PERSONS LIVING WITH HIV/AIDS | PREGNANCY | VITAMINS AND MINERALS | BREASTFEEDING | VITAMIN A | HUMAN MILK | FOOD SUPPLEMENTATION | HIV | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Reproduction | Physiology | Biology | Infant Nutrition | Nutrition | Health | Lactation | Maternal Physiology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341043

12.

13.

Title: Subclinical mastitis is common among Ghanaian women lactating 3 to 4 months postpartum.
Author: Aryeetey RN; Marquis GS; Timms L; Lartey A; Brakohiapa L
Source: Journal of Human Lactation. 2008 Aug;24(3):263-267.
Abstract: Subclinical mastitis (SCM) is an asymptomatic inflammation of mammary tissue and has been associated with lactation failure, suboptimal growth in early infancy, and increased risk of mother-to-child transmission of HIV via breast milk. A rapid survey was carried out to determine the prevalence of SCM among lactating Ghanaian women between 3 and 4 months postpartum. Bilateral breast milk samples were obtained from 117 lactating women in Manya Krobo, Ghana and analyzed for sodium (Na) and potassium (K). An elevated sodium/potassium ratio (Na/K) above 1.0 was considered indicative of SCM. Overall, SCM prevalence was observed among 45.3% of the women. About 30% of the women had unilateral SCM. Na/K was associated with maternal age. The high SCM prevalence in Manya Krobo suggests the need for lactation support to reduce SCM and the risk of poor infant outcomes.
Language: English
Keywords:
GHANA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | HIV TRANSMISSION | MOTHER-TO-CHILD TRANSMISSION | HUMAN MILK | LACTATION | MAMMARY GLAND EFFECTS | MATERNAL AGE | INFECTIONS | PREVALENCE | BREASTFEEDING | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | HIV Infections | Viral Diseases | Diseases | Transmission | Maternal Physiology | Physiology | Biology | Parental Age | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Infant Nutrition | Nutrition | Health
Document Number: 308024

14.

Peer Reviewed

Title: Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia.
Author: Breymann C; Gliga F; Bejenariu C; Strizhova N
Source: International Journal of Gynecology and Obstetrics. 2008 Apr;101(1):67-73.
Abstract: The objectives were to compare the safety and efficacy of iron carboxymaltose with ferrous sulfate to treat iron deficiency anemia in the post partum. Patients were randomized (2:1 ratio) to receive iron carboxymaltose (up to 3 weekly doses of 1000 mg maximum, applied in 15 min; n = 227) or ferrous sulfate (100 mg twice daily, 12 weeks; n = 117). Changes in hemoglobin and iron stores up to week 12 were analyzed. Iron carboxymaltose was as effective as oral iron sulfate in changing hemoglobin, despite the much shorter treatment period (2 weeks vs 12 weeks). Ferritin levels were significantly higher. Except for injection site burning, iron carboxymaltose was better tolerated than ferrous sulfate, mainly concerning gastrointestinal side effects. There were no safety concerns identified in breast-fed infants. Parenteral iron carboxymaltose is a safe and effective treatment option for postpartum anemia, with advantages of a shorter treatment period, better compliance, rapid normalization of iron storages, and lower incidence of gastrointestinal side effects. (author's)
Language: English
Keywords:
SWITZERLAND | RESEARCH REPORT | COMPARATIVE STUDIES | POSTPARTUM WOMEN | ANEMIA | IRON | HUMAN MILK | BLOOD | TREATMENT | Europe, Central | Europe | Developed Countries | Studies | Research Methodology | Puerperium | Reproduction | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Hemic System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 325542

15.

16.

Title: Breast-feeding protects against arsenic exposure in Bangladeshi infants.
Author: Fangstrom B; Moore S; Nermell B; Kuenstl L; Goessler W
Source: Environmental Health Perspectives. 2008 Jul;116(7):963-9.
Abstract: BACKGROUND: Chronic arsenic exposure causes a wide range of health effects, but little is known about critical windows of exposure. Arsenic readily crosses the placenta, but the few available data on postnatal exposure to arsenic via breast milk are not conclusive. AIM: Our goal was to assess the arsenic exposure through breast milk in Bangladeshi infants, living in an area with high prevalence of arsenic-rich tube-well water. METHODS: We analyzed metabolites of inorganic arsenic in breast milk and infant urine at 3 months of age and compared them with detailed information on breast-feeding practices and maternal arsenic exposure, as measured by concentrations in blood, urine, and saliva. RESULTS: Arsenic concentrations in breast-milk samples were low (median, 1 microg/kg; range, 0.25-19 microg/kg), despite high arsenic exposures via drinking water (10-1,100 microg/L in urine and 2-40 microg/L in red blood cells). Accordingly, the arsenic concentrations in urine of infants whose mothers reported exclusive breast-feeding were low (median, 1.1 microg/L; range, 0.3-29 microg/L), whereas concentrations for those whose mothers reported partial breast-feeding ranged from 0.4 to 1,520 microg/L (median 1.9 microg/L). The major part of arsenic in milk was inorganic. Still, the infants had a high fraction (median, 87%) of the dimethylated arsenic metabolite in urine. Arsenic in breast milk was associated with arsenic in maternal blood, urine, and saliva. CONCLUSION: Very little arsenic is excreted in breast milk, even in women with high exposure from drinking water. Thus, exclusive breast-feeding protects the infant from exposure to arsenic.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | HUMAN MILK | EXPOSURE | TOXICITY | WATER QUALITY | PREVENTION AND CONTROL | Developing Countries | Asia, Southern | Asia | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Lactation | Maternal Physiology | Physiology | Biology | Risk Factors | Water | Natural Resources | Environment | Diseases
Document Number: 328397

17.

Title: Risk for postpartum depression, breastfeeding practices, and mammary gland permeability.
Author: Flores-Quijano ME; Cordova A; Contreras-Ramirez V; Farias-Hernandez L; Tolentino MC
Source: Journal of Human Lactation. 2008;24(1):50-57.
Abstract: In a cross-sectional study, 163 breastfeeding women completed the Edinburgh Postnatal Depression Scale (EPDS), a questionnaire on demographics and infant feeding and hand-expressed breast milk for Na and K quantification, between 2 and 12 weeks postpartum. Forty women (24.5%) had an EPDS score compatible with the risk of a depressive episode, and 63 (41%) did not feel confident about breastfeeding. These 2 variables were significantly correlated to each other and individually correlated to breastfeeding exclusiveness. Weeks postpartum was correlated to breastfeeding exclusiveness and Na:K in milk (all P less than .001). A logistic regression model showed that supplementation increased the risk of high Na:K in milk by 209%, whereas a longer time postpartum lowered the risk for mammary gland permeability. This study suggests that postpartum depression and low breastfeeding confidence, which may be present concomitantly, are associated with increased mammary gland permeability, only to the extent in which depression dissuades the mother from exclusive breastfeeding. (author's)
Language: English
Keywords:
SCOTLAND | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | POSTPARTUM WOMEN | BREASTFEEDING, EXCLUSIVE | DEPRESSION | HUMAN MILK | MAMMARY GLAND EFFECTS | LACTATION | Developed Countries | United Kingdom | Europe, Western | Europe | Research Methodology | Puerperium | Reproduction | Breastfeeding | Infant Nutrition | Nutrition | Health | Mental Disorders | Diseases | Maternal Physiology | Physiology | Biology
Document Number: 324668

18.

Peer Reviewed

Title: Cord blood and breast milk iron status in maternal anemia.
Author: Kumar A; Rai AK; Basu S; Dash D; Singh JS
Source: Pediatrics. 2008 Mar;121(3):e673-e677.
Abstract: The purpose of this work was to assess the effect of severe maternal iron-deficiency anemia and nutritional status on cord blood and breast milk iron status. We conducted a prospective observational study over a 6-month period in a teaching hospital in central India. The study population consisted of 55 anemic (hemoglobin: less than 110 g/L) and 20 healthy nonanemic (hemoglobin: greater than or equal to 110 g/L) pregnant women who delivered singleton live births at term gestation. We measured hemoglobin, iron, and ferritin levels in paired maternal and cord blood and iron levels in early (day 3 plus or minus 1) and late (day 15 plus or minus 3) transitional milk. Maternal anthropometry, including weight, height, midarm circumference, triceps skinfold thickness, and placental weight, were recorded. The main outcome measure of the study was to find out the relationship of maternal hemoglobin, iron, ferritin, and anthropometry with hemoglobin, iron, and ferritin in cord blood and iron levels in breast milk. Concentrations of hemoglobin, iron, and ferritin were significantly lower in the cord blood of anemic mothers and showed linear relationships with maternal hemoglobin and ferritin levels. Breast milk iron content was significantly reduced in severely anemic mothers but not in those with mild-to-moderate anemia. Breast milk iron level correlated with maternal hemoglobin and iron levels but not with ferritin levels. Maternal anthropometry had significant correlations with indices of iron nutriture in maternal and cord blood but showed no relationship with breast milk iron content. Placental weight was comparable between anemic and nonanemic mothers. Maternal anemia, particularly the severe type, adversely affects cord blood and breast milk iron status. Maternal nutritional status exerts a significant influence on fetal iron status but has little influence on breast milk iron content. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | ANEMIA | HUMAN MILK | SERUM IRON LEVEL | PREGNANCY COMPLICATIONS | HEMOGLOBIN LEVEL | ANTHROPOMETRY | Developing Countries | Asia, Southern | Asia | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Lactation | Maternal Physiology | Physiology | Biology | Hemic System | Measurement
Document Number: 324977

19.

Title: The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment.
Author: Kvist LJ; Larsson BW; Hall-Lord ML; Steen A; Schalen C
Source: International Breastfeeding Journal. 2008 Apr 7;3:6.
Abstract: The role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts. In this descriptive study, breast milk from 192 women with mastitis (referred to as cases) and 466 breast milk donors (referred to as controls) was examined bacteriologically and compared using analytical statistics. Statistical analyses were also carried out to test for relationships between bacteriological content and clinical symptoms as measured on scales, prescription of antibiotics, the number of care contacts, occurrence of breast abscess and recurring symptoms. Five main bacterial species were found in both cases and controls: coagulase negative staphylococci (CNS), viridans streptococci, Staphylococcus aureus (S. aureus), Group B streptococci (GBS) and Enterococcus faecalis. More women with mastitis had S. aureus and GBS in their breast milk than those without symptoms, although 31% of healthy women harboured S. aureus and 10% had GBS. There were no significant correlations between bacterial counts and the symptoms of mastitis as measured on scales. There were no differences in bacterial counts between those prescribed and not prescribed antibiotics or those with and without breast abscess. GBS in breast milk was associated with increased health care contacts (p = 0.02). Women with greater than or equal to 10/7 cfu/L CNS or viridans streptococci in their breast milk had increased odds for damaged nipples (p = 0.003). Many healthy breastfeeding women have potentially pathogenic bacteria in their breast milk. Increasing bacterial counts did not affect the clinical manifestation of mastitis; thus bacterial counts in breast milk may be of limited value in the decision to treat with antibiotics as results from bacterial culture of breast milk may be difficult to interpret. These results suggest that the division of mastitis into infective or non-infective forms may not be practically feasible. Daily follow-up to measure the subsidence of symptoms can help detect those in need of antibiotics. (author's)
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | COMPARATIVE STUDIES | STATISTICAL STUDIES | WOMEN | HUMAN MILK | BACTERIAL AND FUNGAL DISEASES | ANTIBIOTICS | SIGNS AND SYMPTOMS | TREATMENT | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | Infections | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 325925

20.

21.

Title: Adequacy of vitamin A and fat in the breast milk of lactating women in south Sri Lanka.
Author: Liyanage C; Hettiarachchi M; Mangalajeewa P; Malawipathirana S
Source: Public Health Nutrition. 2008 Jul;11(7):747-50.
Abstract: OBJECTIVE: To determine vitamin A (retinol) and fat concentrations in breast milk during early lactation. METHODS: Healthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method. RESULTS: Subjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0.10 to 2.46 micromol/l, with a mean of 0.50 micromol/l, and correlated positively with parity (Pearson correlation coefficient, r = 0.307; P = 0.01) and negatively with period of lactation (r = -0.209; P = 0.05). The fat content of breast milk ranged between 5.09 and 56.46 g/l with a mean of 26.95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r = 0.274; P = 0.01) and height (r = 0.328; P < 0.001) of the mothers. CONCLUSIONS: In this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92.0%) were not providing the minimum daily requirement (1.05 micromol/l) of retinol to their babies.
Language: English
Keywords:
SRI LANKA | RESEARCH REPORT | ANTHROPOMETRY | WOMEN | HUMAN MILK | LACTATION | VITAMIN A | LIPIDS | TIME FACTORS | Developing Countries | Asia, Southern | Asia | Measurement | Research Methodology | Demographic Factors | Population | Maternal Physiology | Physiology | Biology | Vitamins and Minerals | Population Dynamics
Document Number: 328817

22.

Peer Reviewed

Title: Maternal HLA homozygosity and mother-child HLA concordance increase the risk of vertical transmission of HIV-1.
Author: Mackelprang RD; John-Stewart G; Carrington M; Richardson B; Rowland-Jones S
Source: Journal of Infectious Diseases. 2008;197:1156-1161.
Abstract: Mother-child human leukocyte antigen (HLA) concordance and maternal HLA homozygosity may increase the risk of vertical transmission of human immunodeficiency virus type 1 (HIV-1) risk by reducing infant immune responses. We analyzed mother-child HLA concordance and maternal HLA homozygosity in a Kenyan perinatal cohort receiving antenatal zidovudine. HLA concordance was scored as the number of shared class I alleles, and relative risk estimates were adjusted for maternal HIV-1 load. Among 277 mother-infant pairs, HIV-1 transmission occurred in 58 infants (21%), with in utero transmission in 21 (36%), peripartum transmission in 26 (45%), and transmission via breast-feeding in 11 (19%). With increased concordance, we observed a significant increase in the risk of transmission overall (adjusted hazard ratio [aHR], 1.3 [95% confidence interval {CI}, 1.0 -1.7]; P = .04), in utero (adjusted odds ratio, 1.72 [95% CI, 1.0 -1.7]; P = .04), and via breast-feeding (aHR, 1.6 [95% CI, 1.0 -2.5]; P = .04). Women with homozygosity had higher plasma HIV-1 RNA levels at 32 weeks of gestation (5.1 vs. 4.8 log10 copies/mL; P = .03) and an increased risk of transmission overall (aHR, 1.7 [95% CI, 1.1-2.7]; P = .03) and via breast-feeding (aHR, 5.8 [95% CI, 1.9 -17.7]; P = .002). The risks of overall, in utero, and breast milk HIV-1 transmission increased with HLA concordance and homozygosity. The increased risk may be due to reduced alloimmunity or less diverse protective immune responses. (author's)
Language: English
Keywords:
KENYA | RESEARCH REPORT | COHORT ANALYSIS | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | RISK FACTORS | AUTOIMMUNE RESPONSE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | EXPOSURE | HUMAN MILK | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Transmission | Infections | Diseases | Viral Diseases | Biology | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Disease Transmission Control | Prevention and Control | Lactation | Maternal Physiology
Document Number: 325945

24.

Title: Non-puerperal induced lactation: An infant feeding option in paediatric HIV / AIDS in tropical Africa.
Author: Ogunlesi TA; Adekanmbi FA; Fetuga BM; Ogundeyi MM
Source: Journal of Child Health Care. 2008 Sep;12(3):241-248.
Abstract: A major problem in the management of infants exposed to HIV is the issue of feeding, which stems from the need to avoid transmission of the virus via breast milk. Other important issues in the nutrition of infants exposed to the virus include severe maternal illness, which makes suckling extremely difficult, and feeding orphans. Wet nursing is one of the recommended steps in addressing the feeding problems of such infants but for reasons of sociocultural disapproval, it appears not to be popular in traditional African settings. Non-puerperal induced lactation or re-lactation of a close relation, usually a grandmother, which hitherto has been used to rehabilitate severely malnourished motherless infants, may be equally useful. The procedure of re-lactation and the limitations of the method are highlighted. Also, the need to employ information, education and communication in improving the sociocultural acceptability of this veritable infant feeding method in tropical Africa is discussed. (author's)
Language: English
Keywords:
NIGERIA | AFRICA, SUB SAHARAN | CRITIQUE | HIV | AIDS | BREASTFEEDING | LACTATION | INFANT NUTRITION | INFANT HEALTH | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PROGRAM ACCEPTABILITY | Africa, Western | Africa | Developing Countries | HIV Infections | Viral Diseases | Diseases | Nutrition | Health | Maternal Physiology | Physiology | Biology | Child Health | Disease Transmission Control | Prevention and Control | Program Evaluation | Programs | Organization and Administration
Document Number: 327934

25.

Title: Prevalence ratio of HTLV-1 in nursing mothers from the state of Paraiba, northeastern Brazil.
Author: Pimenta FC; Haddad SK; de Medeiros Filho JG; Costa MJ; Diniz MF
Source: Journal of Human Lactation. 2008 Aug;24(3):289-292.
Abstract: The human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus known as a direct causal agent of a malignant disease. The vertical route of HTLV transmission is the most frequent pathway of the virus contamination. This study was performed to determine the prevalence ratio of HTLV-1 infection among nursing women. From January 2004 to January 2005, blood samples from 1033 nursing mothers from Paraiba, Brazil were evaluated for HTLV antibodies by ELISA and HTLV-1 viral particles confirmed by polymerase chain reaction (PCR). HTLV antibodies were detected in 7 women. The overall seroprevalence ratio was 0.68% and HTLV-1 viral sequences were confirmed by PCR in 2 women. These preliminary data suggest that HTLV screening should be introduced as a mandatory test before breastfeeding and breast milk donation in Paraiba, Brazil. Additionally, counseling programs would help reduce the prevalence ratio of HTLV-1 infected individuals in this Brazilian region.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MOTHERS | WOMEN IN DEVELOPMENT | PREVALENCE | LACTATION | VIRAL DISEASES | SCREENING | HUMAN MILK | BREASTFEEDING | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Economic Development | Economic Factors | Measurement | Maternal Physiology | Physiology | Biology | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Nutrition | Nutrition
Document Number: 308025

26.

Peer Reviewed

Title: Forty days and forty nights: a biocultural perspective on postpartum practices in the Amazon.
Author: Piperata BA
Source: Social Science and Medicine. 2008 Oct;67(7):1094-1103.
Abstract: The immediate postpartum period is recognized as a special time in many societies and is commonly associated with food and work restrictions. The logic of food restrictions during a period of increased energy and protein needs has been challenged, but few data are available to test the impact of these practices on the diets of lactating women. In the eastern Amazon the immediate postpartum period is referred to as resguardo, lasts for 40-41 days and includes food taboos and work restrictions. Taking a biocultural perspective, this paper combines data on the beliefs and attitudes surrounding the practice of resguardo with quantitative data on the actual dietary intakes and activity patterns of a cohort of 23 lactating women followed from birth through 15 months postpartum. This paper addresses three topics: (1) shared ideals regarding resguardo; (2) adherence to food and work restrictions; and (3) the impact of these practices on women's dietary intakes and energy expenditure. The results show that the majority of women adhered to food taboos and work restrictions. During resguardo energy expenditure in physical activity was lower, reducing women's energy needs and allowing them to devote more time to infant care. However, energy intakes were also lower. The reduction in dietary intake was impacted more by work restrictions and the loss of women in subsistence tasks during resguardo than by adherence to food taboos. In addition to altering maternal energetic strategies, resguardo served an important social function by reinforcing bonds and, for young women, marking the transition to womanhood.
Language: English
Keywords:
SOUTH AMERICA | RESEARCH REPORT | MOTHERS | POSTPARTUM | DIET | NUTRITION | CALORIC INTAKE | TABOO | LACTATION | BELIEFS | ATTITUDES | Latin America | Americas | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Health | Culture | Maternal Physiology | Physiology | Biology | Psychological Factors | Behavior
Document Number: 308017

27.

Title: Pregnancy and lactation hinder growth and nutritional status of adolescent girls in rural Bangladesh.
Author: Rah JH; Christian P; Shamim AA; Arju UT; Labrique AB
Source: Journal of Nutrition. 2008 Aug;138(8):1505-1511.
Abstract: Adolescent pregnancy is associated with adverse birth outcomes. Less is known about its influence on maternal growth and nutritional status. We determined how pregnancy and lactation during adolescence affects postmenarcheal linear and ponderal growth and body composition of 12-19 y olds in rural Bangladesh. In a prospective cohort study, anthropometric measurements were taken among primigravidae (n = 229) in the early first trimester of pregnancy and at 6 mo postpartum. Randomly selected never-pregnant adolescents (n = 458) of the same age and time since menarche were measured within 1wk of these assessments. Annual changes in anthropometric measurements were compared between the 2 groups adjusting for confounders using mixed effects regression models. The mean + or - SD age and age at menarche of adolescents were 16.3 + or - 1.6 y and 12.7 + or - 1.2 y, respectively. Unlike pregnant girls who did not grow in height (-0.09 + or - 0.08 cm/y), never-pregnant girls increased in stature by 0.35 + or - 0.05 cm/y. The adjusted mean difference between the 2 groups was 0.43 + or - 0.1cm (P < 0.001). Similarly, whereas never-pregnant girls gained BMI, mid-upper arm circumference, and percent body fat, pregnant girls declined in every measurement by 6 mo postpartum, resulting in adjusted mean + or - SD differences in annual changes of 0.62 + or - 0.11 kg/m2, 0.89 + or - 0.12 cm, and 1.54 + or - 0.25%, respectively (all P < 0.001). Differences in changes in all anthropometric measurements except height were greater among adolescents whose first pregnancy occurred <24 mo vs. > or = 24 mo since menarche (BMI, -1.40 + or - 0.18 vs. -0.60 + or - 0.11 kg/m2; all interaction terms, P < 0.05). Pregnancy and lactation during adolescence ceased linear growth and resulted in weight loss and depletion of fat and lean body mass of young girls. (author's)
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | PROSPECTIVE STUDIES | COHORT ANALYSIS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | LACTATION | GROWTH | NUTRITION | NUTRITION INDEXES | BODY WEIGHT | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Maternal Physiology | Physiology | Biology | Child Development | Health
Document Number: 327807

28.

Title: A prospective study of iron status in exclusively breastfed term infants up to 6 months of age.
Author: Raj S; Faridi M; Rusia U; Singh O
Source: International Breastfeeding Journal. 2008 Mar 1;3:3.
Abstract: Can exclusive breastfeeding until six months of age maintain optimum iron status in term babies? We evaluated iron status of exclusively breastfed term infants in relation to breast milk iron and lactoferrin. In this prospective study in Delhi, India, during the period 2003-2004 normally delivered babies of non-anemic [(Hemoglobin (Hb) greater than or equal to 11 g/dl, n = 68] and anemic (Hb 7 - 10.9 g/dl, n = 61) mothers were followed until 6 months of age. Iron parameters were measured in the cord blood at 14 weeks and 6 months. Breast milk iron and lactoferrin were measured at the same intervals. Iron parameters in babies of both groups were within normal limits at birth, 14 weeks and 6 months. Mean breast milk iron and lactoferrin in non-anemic (day 1: 0.89, 6 months: 0.26 mg/l; day 1: 12.02, 6 months: 5.85 mg/ml) and anemic mothers (day 1: 0.86, 6 months: 0.27 mg/l; day 1: 12.91, 6 months: 6.37 mg/ml) were not different on day one or at other times. No relationship was found between breast milk iron, lactoferrin and iron status of the babies. Exclusively breastfed infants of non-anemic and anemic mothers did not develop iron deficiency or iron deficiency anemia by six months of age. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | MOTHERS | BREASTFEEDING, EXCLUSIVE | ANEMIA | HUMAN MILK | IRON | MEASUREMENT | DEFICIENCY DISEASES | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Diseases | Lactation | Maternal Physiology | Physiology | Biology | Metals | Vitamins and Minerals | Nutrition Disorders
Document Number: 325076

29.

Peer Reviewed

Title: Temporal and lateral dynamics of HIV shedding and elevated sodium in breast milk among HIV-positive mothers during the first 4 months of breast-feeding.
Author: Semrau K; Ghosh M; Kankasa C; Sinkala M; Kasonde P
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Mar;47(3):320-328.
Abstract: The objective was to better understand the dynamics of breast milk HIV shedding and its relation to postnatal HIV transmission, we investigated the temporal and lateral relations of breast milk viral shedding and sodium concentrations in HIV-positive women. This was a longitudinal cohort study in Lusaka, Zambia. We examined patterns of HIV shedding in breast milk over the first 4 months of breast-feeding and their correlations with postnatal HIV transmission among 138 breast-feeding mothers. Sodium concentration in breast milk was also examined in the same samples and in breast milk from 23 HIV-negative controls. Higher breast milk viral load at 1 week, 1 month, and 4 months and consistent viral shedding in breast milk were significantly associated with increased risk of HIV transmission. Elevated breast milk sodium concentration (greater than or equal to 13 mmol/L) at 4 months was associated with HIV transmission, low maternal CD4 cell count, and high maternal plasma viral load. Elevated sodium concentration at 1 week postpartum was common and was not associated with any of these parameters. Consistent viral shedding and high breast milk viral load are strong predictors of mother-to-child HIV transmission. Although sodium concentrations later in breast-feeding correlate with breast milk viral load, increased breast milk sodium is normal in early lactation and does not predict HIV transmission. (author's)
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | LONGITUDINAL STUDIES | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | MOTHERS | BREASTFEEDING | HUMAN MILK | SODIUM | EVALUATION | HIV INFECTIONS | MOTHER-TO-CHILD TRANSMISSION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Lactation | Maternal Physiology | Physiology | Biology | Metals | Vitamins and Minerals | Transmission | Infections
Document Number: 325081

30.

Title: Co-factors for abnormal lactate levels among persons with HIV disease at a tertiary HIV care setting in South India.
Author: Sundaram M; Srinivas CN; Shankar EM; Deepak M; Murugavel KG
Source: Food and Chemical Toxicology. 2008 Aug;46(8):2823-5.
Abstract: BACKGROUND: The co-factors underlying abnormal lactate level remains to be determined in resource-limited settings. In a cross-sectional study conducted between January 2004 and July 2006, we determined the proportion of HIV-infected persons with abnormal lactate levels and correlated the association of certain co-factors of abnormal lactate levels at a tertiary HIV care centre in Chennai, Southern India. METHODS: Lactate was estimated by the enzymatic method using an Olympus AU 400 autoanalyzer. Absolute CD4+T lymphocyte count was determined by the Guava personal cell analyser (Guava Technologies Inc., Hayward, CA, USA). Subjects were classified to have normal or abnormal values of lactate based on the reference interval (0.3-2.2 mmol/L). A p value 0.05 was considered statistically significant. RESULTS: A total of 225 HIV-infected individuals (HAART experienced 213 (95%) and HAART naive (5%)) were included in the analysis. Mean age was 34+/-8 and 36+/-9 years for the individuals with normal and abnormal lactate levels respectively. Of these 185 (82%) had normal (0.3-2.2 mmol/L) and 40 (18%) had abnormal (>2.2 mmol/L) lactate levels. Significant difference in relation to female gender was observed between the normal and abnormal groups (p=0.03). Among the abnormal group, 39 (97.5%) subjects were HAART experienced compared to 174 (94.1%) normal group. Among the abnormal group, 24 (60%) individuals had a CD4 count of <200 cells/microL as compared to 76 (41.1%) normal subjects. CONCLUSION: Female gender should be carefully monitored with respect to their clinical, laboratory and biological data to diminish the occurrence of lactic acidosis.
Language: English
Keywords:
INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | WOMEN | TERTIARY SECTOR | LACTATION | ANTIRETROVIRAL THERAPY | <