Maternal and fetal responses to the stresses of lactation concurrent with pregnancy and of short recuperative intervals

Merchant, Kathleen M; Martorell, Reynaldo; Haas, Jere D.

doi:10.1093/ajcn/52.2.280

Cited by 72 publications

(44 citation statements)

References 8 publications

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“…Merchant et al 7,8 reported that an overlap was associated with a nonsignificant decrease of 57 g in birth weight; the effect increased with the overlap duration. Studies with the appropriate design to look at birth outcomes (risk of low birth weight or prematurity) have not been conducted yet.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Despite this, the practice is common. 7,8,28,29 In Bangladesh, an estimated 20% of women who were lactating and pregnant were still lactating at the beginning of the ninth month. 28 In Guatemala, 50% of pregnant women were breastfeeding an older children.…”

Section: Discussionmentioning

confidence: 99%

“…28 In Guatemala, 50% of pregnant women were breastfeeding an older children. 7,8 In Peru, 10% of women with preschoolers continued to breastfeed until the last trimester of pregnancy (G.S.M., unpublished data). Similar prevalence data for US women are not available, but the breastfeeding behavior is present.…”

Section: Discussionmentioning

confidence: 99%

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Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

et al. 2002

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ABSTRACT. Objective. Despite cultural pressure to wean when a new pregnancy occurs, some women choose to continue breastfeeding. We determined the effect of an overlap of lactation and late pregnancy on breastfeeding and growth in early infancy.Methods. We studied 133 Peruvian pregnant women who were >18 years of age, had a child <4 years old, and who then had a vaginal birth with a healthy, normal weight infant. Of the 133 women, 68 breastfed during the last trimester of pregnancy (BFP), and 65 had not breastfed during pregnancy (NBFP). On day 2 and at 1-month postpartum, 24-hour intake of breast milk and other liquids was measured. Twice weekly home surveillance documented infant morbidity and dietary intakes. Anthropometry was taken at birth and at 1 month. Maternal anthropometric, health, and socioeconomic status data were collected pre-and postpartum.Results. Pregnant BFP mothers breastfed 5.3 ؎ 4.3 times/day. BFP and NBFP infants did not differ in breastfeeding behavior or in colostrum intake on day 2. BFP infants breastfed longer per feed and per 24 hours (35.2 minutes/24 hours) than did NBFP infants; however, 1-month intakes per feed tended to be lower among the BFP infants. After controlling for confounders, BFP infants gained 125 g less than did NBFP infants (about 15% of mean weight gain). A sustained decline would result in a ؊0.7 z score change in weight-for-age by 6 months.Conclusions. A lactation-pregnancy overlap had a negative effect on early infant outcomes. Additional studies are needed to determine whether the effect continues past 1 month of age. Pediatrics 2002;109(4). URL: http://www.pediatrics.org/cgi/content/full/109/4/e56; breastfeeding, pregnancy, overlap, breast milk volume, weight gain, infant feeding, Peru.ABBREVIATIONS. BFP, breastfed during pregnancy; NBFP, did not breastfeed during pregnancy; BMI, body mass index; SES, socioeconomic status; CI, confidence interval; OR, odds ratio. M any women throughout the world breastfeed for as long as possible to give their children the nutritional, immunologic, and emotional benefits of breastfeeding. When lactation overlaps a new pregnancy, some women choose not to wean their toddlers, although there may be strong cultural taboos against continuing to breastfeed. 1,2 The practice of continuing to breastfeed during pregnancy has been reported among US women but might not be discussed with health professionals because of anticipated criticism of the practice. [3][4][5] Breastfeeding during pregnancy is more common in some low-income countries than in the United States because shorter birth intervals increase the likelihood of a pregnancy-lactation overlap.It has been suggested that an overlap could produce suboptimal outcomes for both pregnancy and subsequent lactation. 6 -8 Dairy research has demonstrated that a complete overlap of lactation during pregnancy dramatically compromises the total production of mature milk during the next lactation period. 9 -14 A dry (nonmilking) period of approximately 2 months before calving is usual in the da...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

et al. 2002

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“…For cases where overlap occurred, 41.4% continued to breast-feed into the second trimester and 3.2%, in the third trimester. The energetic stresses of overlap did not significantly affect fetal growth [7]. With increasing firsthand experience among health professionals; many wellrespected sources are asserting that even breast feeding is safe in healthy pregnancies [6].…”

Section: Discussionmentioning

confidence: 99%

Effect of Antenatal Expression of Breast Milk at Term in Reducing Breast Feeding Failures

Singh

Chouhan²,

Sidhu

2009

Medical Journal Armed Forces India

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Background: Though breast feeding is natural, during the first 2-3 days, when enough breast milk is not available with mother, she may introduce bottle feeding erroneously for improving nutrition to her baby. We studied the effect of antenatal expression of breast milk at term in reducing breast feeding failure as compared to conventional method of initiation of breast feeding. Methods: A prospective study was carried out in 180 booked cases at term. Daily expression of breast milk at least once a day after 37 weeks of pregnancy was introduced in randomly selected 90 pregnant ladies. Prior examination was done to exclude any inverted or cracked nipples and appropriate treatment instituted. Result: The study group who expressed breast milk daily after 37 weeks did not find it difficult to initiate breast feeding after vaginal or cesarean delivery. Sufficient milk started flowing within half an hour of initiation of breast feeding in most 85 (94.4%) subjects of study group as compared to 63 (70%) patients of control group, which was statistically significant.There was no increase in any delivery complication. There were two partial breast feeding failures in control group but none in study group. Conclusion: Daily antenatal breast milk expression after 37 completed weeks of pregnancy significantly reduced the time for establishing full breast feeding and reduced breast feeding failures.

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“…In addition, gestation and lactation have significant costs in terms of macro-and micronutrients, limiting their availability for maternal immune processes (Lunn, 1994;Prentice, 1994;Prentice and Prentice, 1988). In particular, progressive deterioration of maternal nutritional status from the cumulative demands of reproduction can lead to "maternal depletion," particularly when interbirth intervals are short and/or available nutritional resources are low (Merchant and Martorell, 1988;Merchant et al, 1990;Wood, 1994). Although the direct impact on immune function has not been considered, it can be assumed that low energy reserves impair maternal immunocompetence in these situations.…”

Section: Adulthoodmentioning

confidence: 99%

Life history theory and the immune system: Steps toward a human ecological immunology

McDade¹

2003

Am. J. Phys. Anthropol.

284

305

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KEY WORDSimmunology; human biology; growth and development; evolutionary theory; infectious disease ABSTRACTWithin anthropology and human biology, there is growing interest in immune function and its importance to the ecology of human health and development. Biomedical research currently dominates our understanding of immunology, and this paper seeks to highlight the potential contribution of a population-based, ecological approach to the study of human immune function. Concepts from life-history theory are applied to highlight the major challenges and demands that are likely to shape immune function in a range of ecological contexts. Immune function is a major component of maintenance effort, and since resources are limited, trade-offs are expected between investment in maintenance and other critical life-history functions involving growth and reproduction. An adaptationist, life-history perspective helps make sense of the unusual developmental trajectory of immune tissues, and emphasizes that this complex system is designed to incorporate information from the surrounding ecology to guide its development. As a result, there is substantial population variation in immune development and function that is not considered by current biomedical approaches. In an attempt to construct a framework for understanding this variation, immune development is considered in relation to the competing life-history demands that define gestation, infancy, childhood, adolescence, and adulthood. Each life stage poses a unique set of adaptive challenges, and a series of hypotheses is proposed regarding their implications for immune development and function. Research in human ecological immunology is in its earliest stages, but this is a promising area of exploration, and one in which anthropology is wellpositioned to make important contributions. Yrbk Phys Research on human immune function has proliferated in the past 25 years, leading to fundamental insights into basic physiology, as well as strategies for the prevention and treatment of a wide range of diseases. The complexity of the immune system is daunting, and current biomedical research elaborates this complexity by focusing almost exclusively on cellular-and molecular-level processes. The majority of this research uses animal models, with human research participants drawn primarily from clinical settings. Complementary population-based research in international health has observed consistent, bidirectional associations between undernutrition and infectious morbidity, sparking interest in immunocompetence as a potentially important mediator (Chandra, 1988;Gershwin et al., 2000;Hoffman-Goetz, 1986;Pelletier et al., 1995;Suskind and Tontisirin, 2001).The significance of these contributions should not be overlooked, but something is missing. Human physiological systems are products of natural selection, designed to develop and function in whole organisms that are integral components of surrounding social and physical environments (Oyama, 1985;Williams and Nesse, 1991). The immune s...

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Maternal and fetal responses to the stresses of lactation concurrent with pregnancy and of short recuperative intervals

Cited by 72 publications

References 8 publications

Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

Effect of Antenatal Expression of Breast Milk at Term in Reducing Breast Feeding Failures

Life history theory and the immune system: Steps toward a human ecological immunology

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