Oral Aversion in the Breastfed Neonate

Linda Killion Healow, BSN, IBCLC and Rebecca Sliter Hugh, IBCLC
Breastfeeding Abstracts, August 2000, Volume 20, Number 1, pp. 3-4.

Infants are incredibly oral creatures. Not only is the mouth the preferred route of caloric nourishment, but it is also the way newborns most acutely sense and come to know their new environment.


The oral experience is also an integral part of how the newborn learns to recognize his or her mother. As Ruth Lawrence observes, “Comfort sucking and formation of nipple preference are genetically determined behaviors for imprinting to the mother’s nipple. The recognition of the mother is at first through the distinctive features of the nipple.
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Modulation of the Gastrointestinal Tract of Infants by Human Milk. Interfaces and Interactions. An Evolutionary Perspective

Armond S. Goldman

Journal of Nutrition. 2000;130:426S-431S


Human milk contains agents that affect the growth, development and functions of the epithelium, immune system or nervous system of the gastrointestinal tract. Some human and animal studies indicate that human milk affects the growth of intestinal villi, the development of intestinal disaccharidases, the permeability of the gastrointestinal tract and resistance to certain inflammatory/immune-mediated diseases. Moreover, one cytokine in human milk, interleukin (IL)-10, protects infant mice genetically deficient in IL-10 against an enterocolitis that resembles necrotizing enterocolitis (NEC) in human premature infants. There are seven overlapping evolutionary strategies regarding the relationships between the functions of the mammary gland and the infant’s gastrointestinal tract as follows: 1) certain immunologic agents in human milk compensate directly for developmental delays in those same agents in the recipient infant; 2) other agents in human milk do not compensate directly for developmental delays in the production of those same agents, but nevertheless protect the recipient; 3) agents in human milk enhance functions that are poorly expressed in the recipient; 4) agents in human milk change the physiologic state of the intestines from one adapted to intrauterine life to one suited to extrauterine life; 5) some agents in human milk prevent inflammation in the recipient’s gastrointestinal tract; 6) survival of human milk agents in the gastrointestinal tract is enhanced because of delayed production of pancreatic proteases and gastric acid by newborn infants, antiproteases and inhibitors of gastric acid production in human milk, inherent resistance of some human milk agents to proteolysis, and protective binding of other factors in human milk; and 7) growth factors in human milk aid in establishing a commensal enteric microflora.
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Összefüggés az anyatejes táplálás és a gyermekek hatéves korában észlelhető asthma között

W. H. Oddy, P. G. Holt, P. D. Sly, A. W. Read, L. I. Landau, F. J. Stanley, G. E. Kendall, P. R. Burton

BMJ Magyar Kiadás 2000;1:17-22.


Célkitűzés: Annak a vizsgálata, hogy van-e összefüggés a csak anyatejes táplálás időtartama és a gyermek állapotának alakulása között az asthma szempontjából, hatéves korban vizsgálva.

Módszer: Prospektív csoportvizsgálat.

A vizsgálat helyszíne: Nyugat-Ausztrália.

A vizsgálat alanyai: 2187 gyermek, akikhez Perth központi szülészeti kórházának a terhesrendelése révén jutottunk el, és akiket hatéves korukig követtünk.

Az értékelés fő szempontjai: Feltétlen logisztikus regresszió a kizárólagos anyatejes táplálás tartama és a hatéves korban már fennálló asthma vagy atópia közötti összefüggés modellezésére; több fontos zavaró tényező – nem, gesztációs kor, dohányzás a háztartásban, kora gyermekkori gondozás – számításba vételével.
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Breast-feeding and cognitive development: a meta-analysis.

Anderson JW, Johnstone BM, Remley DT.
Am J Clin Nutr. 1999 Oct;70(4):525-35.


BACKGROUND: Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education.

OBJECTIVE: Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children.

DESIGN: In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models.
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Breastfeeding Patterns in Relation to Thumb Sucking and Pacifier Use

Clara Aarts, MSc, Agneta Hörnell, Elisabeth Kylberg, PhD, Yngve Hofvander, MD, PhD, and Mehari Gebre-Medhin, MD, MPH, PhD

PEDIATRICS Vol. 104 No. 4 October 1999, p. e50


Objectives. To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration.

Study Design. Descriptive, longitudinal, prospective study.

Setting. The subjects were recruited from a population of 15 189 infants born in the maternity ward at the University Hospital, Uppsala, Sweden between May 1989 and December 1992.

Study Population. 506 mother-infant pairs.

Methods. Daily recordings by the mothers on infant feeding from the first week after delivery through the duration of the study.
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Impact of breast feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study

Juraci A César, Cesar G Victora, Fernando C Barros, Iná S Santos, José A Flores
BMJ 1999;318:1316-1320 ( 15 May )


Objective: To determine whether breast feeding protects infants against pneumonia and whether the protection varies with age.

Design: Nested case-control study.

Setting: Pelotas, southern Brazil.

Subjects: Cases were 152 infants aged 28-364 days who had been admitted to hospital for pneumonia. Controls were 2391 cases in a population based case-control study.

Main outcome measure: Odds ratio of admission for pneumonia according to type of milk consumed (breast milk alone, breast and formula milk, or formula milk and other fluids only), use of fluid supplements apart from formula milk, and use of solid supplements.
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Age of introduction of complementary foods and growth of term, low-birth-weight, breast-fed infants

Kathryn G Dewey, Roberta J Cohen, Kenneth H Brown and Leonardo Landa Rivera

American Journal of Clinical Nutrition, Vol. 69, No. 4, 679-686, April 1999


Background: The optimal age at which to introduce complementary foods is a topic of considerable debate.

This study was designed to evaluate this issue in a nutritionally vulnerable population in Honduras.

Design: Mothers of low-birth-weight (1500–2500 g) term (ie, small-for-gestational-age) infants were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, mothers were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or to feed complementary solid foods (jarred rice cereal, chicken, and fruit and vegetables) twice daily from 4 to 6 mo while continuing to breast-feed at their initial frequency (SF; n = 60).

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Health Care Costs of Formula-feeding in the First Year of Life

Thomas M. Ball, Anne L. Wright
PEDIATRICS Vol. 103 No. 4 April 1999, pp. 870-876


Objective. To determine the excess cost of health care services for three illnesses in formula-fed infants in the first year of life, after adjusting for potential confounders.

Methods. Frequency of health service utilization for three illnesses (lower respiratory tract illnesses, otitis media, and gastrointestinal illness) in the first year of life was assessed in relation to duration of exclusive breastfeeding in the Tucson Children’s Respiratory Study (n = 944) and the Dundee Community Study (Scottish study, n = 644). Infants in both studies were healthy at birth and represented nonselected, population-based samples.
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Investigation of the role of human breast milk in caries development.

Erickson PR, Mazhari E.
Pediatr Dent. 1999 Mar-Apr;21(2):86-90.


PURPOSE: The objective of this study was to determine the caries-related risk associated with human breast milk (HBM).

METHODS: First, the plaque pH of 18 children (12-24 months) was monitored before and after a five-minute feeding with HBM to determine the pH drop and minimum pH obtained. Second, Streptococcus sobrinus 6715 was cultured for 3 hr in HBM, and the increase in the number of colony forming units (cfus) and the culture pH was measured. Third, HBM was incubated for 24 hr with powdered enamel to determine the solubility of mineral in the absence of bacteria.
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The Effects of Early Pacifier Use on Breastfeeding Duration

Cynthia R. Howard, Fred M. Howard, Bruce Lanphear, Elisabeth A. deBlieck, Shirley Eberly and Ruth A. Lawrence

PEDIATRICS Vol. 103 No. 3 March 1999, p. e33


Objective. To evaluate the effects of pacifier use and the timing of pacifier introduction on breastfeeding duration, problems, and frequency.

Methods. A cohort of 265 breastfeeding mother-infant dyads was followed prospectively. Maternal interviews were conducted at delivery, 2, 6, 12, and 24 weeks, and thereafter every 90 days until breastfeeding ended. Information was obtained regarding pacifier use, infant feeding, use of supplemental foods and breastfeeding frequency, duration, and problems. The effect of pacifier introduction by 6 weeks of age on breastfeeding duration was evaluated with Kaplan-Meier and Cox proportional hazards models.
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