The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review

Verduci, Elvira; Giannì, Maria Lorella; Vizzari, Giulia; Vizzuso, Sara; Cerasani, Jacopo; Mosca, Fabio; Zuccotti, Gian Vincenzo

doi:10.3390/nu13020486

Cited by 28 publications

(22 citation statements)

References 161 publications

(200 reference statements)

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“…Exclusively breastfeeding improves the survival, health and development of all children. The advantages of exclusive breastfeeding have been well studied and they are universally recognized [20][21][22]. Many factors contribute to the initiation and continuation of breastfeeding.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers

et al. 2021

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Background The COVID-19 pandemic has posed several challenges to the provision of newborn nutrition and care interventions including maternal support, breastfeeding and family participatory care. Italy was the first country to be exposed to SARS-CoV-2 in Europe. One of the measures adopted by the Italian government during COVID-19 pandemic was the total lockdown of the cities with complete confinement at home. We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on exclusive breastfeeding in non-infected mothers. Methods We prospectively enrolled 204 mother-baby dyads during lockdown (9 March to 8 May 2020) that we compared to previously studied 306 mother-baby dyads admitted during the year 2018. To reduce the possible effect of confounding factors on exclusive breastfeeding, a 1:1 matching was performed by using an automatized procedure of stratification that paired 173 mother-baby dyads. Feeding modality was collected at discharge, 30 and 90 days of newborn’s life. Exclusive breastfeeding was considered when the infant received only breast milk and no other liquids or solids were given with the exception of vitamins, minerals or medicines. Results At discharge 69.4% of infants were exclusively breastfed during lockdown versus 97.7% of control group, 54.3% at 30 days vs 76.3 and 31.8% vs 70.5% at 90 days (p < 0.001). The proportion of breastfeeding remaining exclusive from discharge to 30-day was similar between groups (about 80%), but it was lower in lockdown group than in control cohort (58.5% vs 92.4%, p < 0.001) from 30- to 90-days. Conclusions Lockdown and home confinement led to a decrease of exclusively breastfeeding in the studied population. Considering the timing to shift from exclusive to non-exclusive breastfeeding, differences between study groups were concentrated during hospital stay and from 30- to 90 days of a newborn’s life, confirming that the hospital stay period is crucial in continuing exclusive breastfeeding at least for the first 30 days, but no longer relevant at 90 days of life.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers

et al. 2021

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“…Breast milk should be thought of as a co-adapting system, in a closely connected mother-breast milk-infant triad. Every variation in one of these three components could affect maternal health or infant development [5]. Breastfeeding allows the transmission of immunomodulating factors which contribute to immediate and direct protection from infections and the development of the newborn's immune system and intestinal microbiota (Figure 1).…”

Section: Immune Healthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A considerable amount of evidence indicates that breast milk cannot be considered simple nourishment but represents a significant predictor for the future of both lactating mother and newborn [5]. Furthermore, through biochemical and immunomodulating signals, breast milk allows a specific communication between mother and child to promote human well-being and the infant's growth and development [5,6]. Breastmilk represents a link in mother-infant signaling thanks to the provision of several bioactive factors such as lactoferrin, lysozyme, leukocytes, immunoglobulins, cytokines, hormones, stem cells, human milk oligosaccharides (HMOs), microbiota, microRNAs, antioxidants and growth factors.…”

Section: Introductionmentioning

confidence: 99%

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Human Milk, More Than Simple Nourishment

et al. 2021

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Human breast milk not only has nutritional properties but also holds a functional role. It contains various bioactive factors (lactoferrin, lysozyme, leukocytes, immunoglobulins, cytokines, hormones, human milk oligosaccharides, microbiome, microRNAs and stem cells) shown to contribute to several short- and long-term health outcomes. Some of these factors appear to be involved in the infant’s neuro-cognitive development, anti-oncogenic processes, cellular communication and differentiation. Furthermore, breast milk is increasingly recognized to have dynamic characteristics and to play a fundamental role in the cross-talking mother-neonate. This narrative review aims to provide a summary and an update on these bioactive substances, exploring their functions mainly on immunomodulation, microbiome and virome development. Although the knowledge about breast milk potentiality has significantly improved, leading to discovering unexpected functions, the exact mechanisms with which breast milk exercises its bioactivity have not been completely clarified. This can represent a fertile ground for exploring and understanding the complexity behind these functional elements to develop new therapeutic strategies.

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“…Maternal milk, defined as perfect food, is the best way of feeding newborns and infants during the first six months of life [1][2]. Besides nutritional value, human milk is rich in immunological factors, including immunoglobulins, lactoferrin, and lysozyme, crucial for newborn and infant immature immune system [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Maternal Distress and Social Support are Linked to Human Milk Immune Properties

Ziomkiewicz

Apanasewicz

Danel

et al. 2021

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Possible alterations of maternal immune function due to psychological stress may reflect immunoactive factor levels in breast milk. This study aimed to assess the association between maternal distress and breast milk levels of secretory IgA (SIgA), IgM, IgG, and lactoferrin (LF). We hypothesized this association is moderated by maternal social support achieved from others during lactation. The study group included 103 lactating mothers and their healthy 5-months-old infants. Maternal distress was determined based on the State Anxiety Inventory and the level of salivary cortisol. Social support was assessed using Berlin Social Support Scales. Breast milk samples were collected to test for SIgA, IgM, IgG, and LF using the ELISA method. Milk immunoactive factors were regressed against maternal anxiety, social support, salivary cortisol, and infant gestational age using the general regression model. Maternal anxiety was negatively associated with milk levels of LF (β=-0.22, p<0.05) and SIgA (β=-0.29, p<0.01), while social support was positively associated with milk IgG (β=0.25, p<0.05). Neither anxiety nor social support was related to milk IgM. No association was found between the level of maternal salivary cortisol and immunoactive factors in milk. Our results suggest that maternal psychological well-being and social support may affect milk immune properties.

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The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review

Cited by 28 publications

References 161 publications

Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers

Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers

Human Milk, More Than Simple Nourishment

Maternal Distress and Social Support are Linked to Human Milk Immune Properties

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