• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.330-340
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• 2019

Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2'-FL and LNnT is a promising innovation for infant nutrition.

• 한국보건간호학회지
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• 제32권3호
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• pp.376-387
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• 2018

Purpose: This study was conducted to assess the breast feeding rate and maternal adaptation of mothers with infants and children in early childhood in a community. Methods: This descriptive study was conducted from November to December 2015, and included a total of 283 mothers of infants and children in early childhood. The data were analyzed using descriptive analysis, the ${\chi}^2-test$, and one way ANOVA. Results: The rates of breast feeding after birth were 76.3% (1 month postpartum), 69.3% (3 months postpartum), 53.4% (6 months postpartum), 32.2% (9 months postpartum), and 22.6% (12 months postpartum). The level of maternal adaptation of subjects was $3.78{\pm}0.54$. Subjects who were breastfed until 9 months postpartum had a higher level of maternal adaptation than those who stopped breast feeding at 1 month postpartum (F=3.926, p<.002). The breast feeding rate of subjects who were educated about breast feeding after childbirth was significantly higher than that of those who did not receive breast feeding education after delivery. Conclusion: To increase the breast feeding rate and maternal adaptation, community health nurses should develop and provide breast feeding programs to mothers soon after childbirth.

• 대한간호학회지
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• 제45권2호
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• pp.306-313
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• 2015

Purpose: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. Methods: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. Results: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. Conclusion: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

• 대한간호학회지
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• 제45권3호
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• pp.449-458
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• 2015

Purpose: Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet. Methods: We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated. Results: Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above. Conclusion: The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5327-5332
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• 2012

In this review, we describe the patterns of known immunological components in breast milk and examine the relationship between breastfeeding and reduced risk of breast cancer. The top risk factors for breast cancer are a woman's age and family history, specifically having a first-degree relative with breast cancer. Women that have a history of breastfeeding have been shown to have reduced rates of breast cancer. Although the specific cause has not been elucidated, previous studies have suggested that breastfeeding reduces the risk of breast cancer primarily through two mechanisms: the differentiation of breast tissue and reduction in the lifetime number of ovulatory cycles. In this context, one of the primary components of human milk that is postulated to affect cancer risk is alpha-lactalbumin. Tumour cell death can be induced by HAMLET (a human milk complex of alpha-lactalbumin and oleic acid). HAMLET induces apoptosis only in tumour cells, while normal differentiated cells are resistant to its effects. Therefore, HAMLET may provide safe and effective protection against the development of breast cancer. Mothers should be encouraged to breastfeed their babies because the complex components of human milk secretion make it an ideal food source for babies and clinical evidence has shown that there is a lower risk of breast cancer in women who breastfed their babies.

• Journal of Preventive Medicine and Public Health
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• 제50권4호
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• pp.278-281
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• 2017

Since 2006, type 1 diabetes in Finland has plateaued and then decreased after the authorities' decision to fortify dietary milk products with cholecalciferol. The role of vitamin D in innate and adaptive immunity is critical. A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ${\geq}50nmol/L$. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels. Since all-disease mortality is reduced to 1.0 with serum vitamin D levels ${\geq}100nmol/L$, we call public health authorities to consider designating as the RDA at least three-fourths of the levels proposed by the Endocrine Society Expert Committee as safe upper tolerable daily intake doses. This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.

• Clinical and Experimental Pediatrics
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• 제45권6호
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• pp.790-795
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• 2002

모유 수유아에 발생하는 고나트륨혈성 탈수는 드물기는 하나 지난 30년 동안 꾸준히 보고되어 왔다. 저자들은 모유 수유 부족에 의한 고나트륨혈성 탈수를 보인 생후 14일된 여아를 경험하였다. 내원시 환아는 17%의 체중 감소가 있었고, 혈청 나트륨농도는 179 mEq/L였으며, 전신성 요독증, 고혈당증, 범발성 혈관내 응고증, 심부전 소견있었으나 치료 후 교정되었으며, 탈수 교정 중 경련을 보였으나 두부 초음파 및 뇌자기공명영상 검사에 뇌부종, 출혈 등 이상 소견은 없었고, 환아 현재 정상적인 발달을 하고 있기에 문헌 고찰상 이 증례는 모유 수유 중 발생한 고나트륨혈성 탈수의 첫 증례로 생각되어 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.563-568
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• 2016

Background: Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. Purpose: The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. Materials and Methods: A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Results: Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (${\leq}46$) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

• Journal of Microbiology and Biotechnology
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• 제26권4호
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• pp.659-665
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• 2016

The oligosaccharides in human milk constitute a major innate immunological mechanism by which breastfed infants gain protection against infectious diarrhea. Clostridium difficile is the most important cause of nosocomial diarrhea, and the C-terminus of toxin A with its carbohydrate binding site, TcdA-f2, demonstrates specific abolishment of cytotoxicity and receptor binding activity upon diethylpyrocarbonate modification of the histidine residues in TcdA. TcdA-f2 was cloned and expressed in E. coli BL21 (DE3). A human milk oligosaccharide (HMO) mixture displayed binding with TcdA-f2 at 38.2 respond units (RU) at the concentration of 20 μg/ml, whereas the eight purified HMOs showed binding with the carbohydrate binding site of TcdA-f2 at 3.3 to 14 RU depending on their structures via a surface plasma resonance biosensor. Among them, Lacto-N-fucopentaose V (LNFPV) and Lacto-N-neohexaose (LNnH) demonstrated tight binding to TcdA-f2 with docking energy of −9.48 kcal/mol and −12.81 kcal/mol, respectively. It displayed numerous hydrogen bonding and hydrophobic interactions with amino acid residues of TcdA-f2.

• Clinical and Experimental Pediatrics
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• 제59권1호
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• pp.30-34
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• 2016

Purpose: Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae. Methods: Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters were analyzed; sex, gestational age, birth weight, mode of delivery, and perinatal problems. A physical examination was carried out during the next outpatient visit to examine the healing process and check for the existence of scars or complications. Results: Initial presentation included changes in feeding habits (n=10), longer feeding time, reduced intake, and increased irritability. In 6 patients, Bednar's aphthae were discovered incidentally, without prior symptoms. Feeding posture and method of feeding are important causes of Bednar's aphthae. Eleven patients were fed in a horizontal position, whereas 5 patients were fed in a semiseated position. Fifteen patients were bottle-fed, whereas 1 patient was exclusively breastfed. After correcting the feeding position, the ulcerative lesions disappeared within 1 month of diagnosis. During the follow-up period, lesions did not recur in any of the patients. Conclusion: This study suggests that Bednar's aphthae are caused by mechanical pressure. A diagnosis of Bednar's aphthae should be considered when lesions are found on the palate of infants and when symptoms seem to be feeding related. Proper education of parents can both treat Bednar's aphthae and easily prevent its recurrence.