Infant health meta analyses
Infant health research
The studies below explore the wide-reaching and long-term impact of infant feeding choices with focus on the benefits that breastfeeding brings to physical and emotional wellbeing.
Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis
This meta-analysis of 45 articles aimed to quantitatively summarise the available evidence on the association of breastfeeding with the risk of childhood cancer. Of the 33 studies relating to the association between breastfeeding and risk of childhood leukemia, the pooled risk estimates were 0.77 for ever versus non/occasional breastfeeding and longest versus shortest breastfeeding duration group, respectively. There was also clear indication for non-linear dose-response relationship between breastfeeding duration and the risk of childhood leukemia (P non-linear < 0.001). The most protective effect was observed at a breastfeeding duration of 9.6 months. Conclusions support a protective role of breastfeeding on the risk of childhood leukemia, also suggesting a non-linear dose-response relationship. Further studies are warranted to confirm the association between breastfeeding and risk of childhood neuroblastoma.
The challenges of medically complex breastfed children and their families: A systematic review
Despite medically complex infants and children being a group that could benefit most from continued breastfeeding, breastfeeding duration and exclusivity are lower among more complex paediatric populations. This systematic review aimed to understand the challenges of breast/chestfeeding the medically complex child and to establish the gaps in healthcare provision that act as barriers to optimal infant and young child feeding. Findings affirm the lack of consistent high-quality care for lactation support in paediatric settings and reinforce the need for further focused research in this area.
Breastfeeding promotes early neonatal regulatory T-cell expansion and immune tolerance of non-inherited maternal antigens
Research led by the University of Birmingham and Birmingham Women’s and Children’s NHS Foundation Trust has revealed new insight into the biological mechanisms of the long-term positive health effects of breastfeeding in preventing disorders of the immune system in later life, with data showing that exposure of the neonate to maternal cells through breastfeeding acts to drive the maturation of Tregs and ‘tolerizes’ the neonate towards non-inherited maternal antigens.
January – March 2019 research round up
Infant Feeding expert and blogger Analytical Armadillo has produced a round up of 45 infant feeding-related studies, published between January and March 2019. Ranging from a meta-analysis of the effects of kangaroo care on preterm infants, to racial inequalities in breastfeeding, the document provides a concise summary of each study.
Research round up (April 2019)
Stroking modulates noxious-evoked brain activity in human infants
This study of 32 infants explored whether touch can reduce noxious-evoked brain activity, following previous studies of adults showing that touch of C fibre sensory neurons is pleasant and can reduce pain perception. Researchers found that stroking prior to an experimental noxious stimulus or clinical heel lance can attenuate noxious-evoked brain activity in infants. They conclude that C-tactile fibres may represent a biological target for non-pharmacological interventions that modulate pain in early life, and said that further research is needed to ascertain whether this simple tactile intervention is effective in modulating pain in the context of other clinical procedures and in preterm infants.
Comparison of breast milk compositions among mothers delivering small-for-gestational age, appropriate-for-gestational age, and large-for-gestational age infants
This study of 75 milk samples found that the carbohydrate (CHO) composition of breastmilk in mothers of infants who were small-for-gestational age (SGA) was significantly lower than that in mothers of appropriate-for-gestational age (AGA) infants – but this was not found to have any clinical significance. In addition, no significant correlation was found between maternal BMI, gestational age, and CHO.
Domperidone increases breast milk production in mothers of premature babies
This systematic review of five randomised controlled trials found that domperidone increased mean daily expressed milk volume by 88ml/day amongst women feeding expressed breastmilk to their premature babies. Further studies are needed to explore this and examine any other possible side effects.
Child health in 2030 in England: comparisons with other wealthy countries
This report from the Royal College of Paediatrics and Child Health (RCPCH)’s uses long-term historical data to project outcomes for children and young people’s health in 2030. It predicts that without urgent action in England by 2030: mortality rates are set to be 140% higher for infants than in comparable wealthy nations; reported mental health problems may increase by 60%; A&E attendances among children and young people likely to increase by 50%; and nearly one-third of England’s most deprived boys will be obese. The college argues that a properly funded health strategy which could transform the life chances of children and young people is needed urgently if England is to stem the predicted rises. We welcome the report’s recommendation that: “NHS England must mandate all maternity services to achieve and maintain Unicef UK Baby Friendly Initiative accreditation”, highlighting the importance of early nutrition and relationships in laying a strong foundation for future health.
RCPCH, (2018). Child health in 2030 in England: comparisons with other wealthy countries, https://www.rcpch.ac.uk/resources/child-health-england-2030-comparisons-other-wealthy-countries
International comparisons of health and wellbeing in early childhood
This report from the Nuffield Trust compares data on child health and wellbeing across 14 different countries. Whilst the UK performs well in some areas, it lags far behind on breastfeeding compared to similarly developed countries, with serious implications for child and lifelong health. The report highlights the importance of enabling health services to achieve and maintain Baby Friendly accreditation in order to better support mothers to breastfeed.
Trauma-informed care in the newborn intensive care unit: promoting safety, security and connectedness
This review applies the principles of trauma-informed care, within the framework of the Polyvagal Theory as described by Porges, to care for the NICU baby, the baby’s family and their professional caregivers, emphasizing the importance of social connectedness among all. The Polyvagal Theory explains how one’s unconscious awareness of safety, danger or life threat (neuroception) is linked through the autonomic nervous system to their behavioral responses. Using techniques of trauma-informed care, as explained by the Polyvagal Theory, with both babies and their parents in the NICU setting will help to cement a secure relationship between the parent-infant dyad, redirecting the developmental trajectory toward long-term health and well-being of the baby and all family members.
Older research
- Unicef, (2017). Early moments matter, https://www.unicef.org/publications/index_100862.html
- Batterbsy, C. et al (2017) Term admissions to neonatal units in England: a role for transitional care? A retrospective cohort study BMJ Open 2017;7:e016050. doi: 10.1136/bmjopen-2017-016050
- Bartick, M, et al (2017) Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. Maternal & Child Nutrition, Vol 13, Issue 1, DOI: 10.1111/mcn.12366
- Flint, A, et al. Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD005092. DOI: 10.1002/14651858.CD005092.pub3
- Ayonrinde, O T et al (2016), Maternal obesity and duration of breastfeeding influence the risk of nonalcoholic fatty liver disease in adolescents, EASL LiverTree, 125715
- Smith, H, et al (2016) Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD006462. DOI: 10.1002/14651858.CD006462.pub4