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This case control study evaluates the association between hospitalization due to infection and feeding practices among infants aged ≥ 3 days to < 6 months. Mothers of 191 cases hospitalized for infections and 208 healthy controls were interviewed using a standardized questionnaire documenting infant-feeding history. Results given in odds ratio and 95% confidence intervals (OR, 95% CI) were adjusted for age, education, and place of delivery. Exclusively formula-fed infants were more likely to be hospitalized for any infection (3.7, 1.8-7.5), pneumonia (3.0, 1.2-7.4), and diarrhea (10.5, 2.5-41.9) compared to exclusively breastfed infants. Infants who did not receive any breast milk were more likely to be hospitalized for any infection (3.5, 2.1-5.9), neonatal sepsis (4.9, 1.3-18.3), pneumonia (2.8, 1.5-5.4), and diarrhea (19.6, 6.5-58.6) than infants who received any breast milk. This study showed a strong positive association between the intake of formula and/or nonbreast milk supplements and the risk of hospitalization for infectious causes. J Hum Lact. 26(1):19-25.

This study aimed to investigate the relative importance of the psychosocial factors underlying mother’s decision to continue exclusive breastfeeding (EBF) for 6 months using the theory of planned behavior. A cohort of EBF-mothers (N = 78) completed a questionnaire assessing theoretical constructs at baseline and phone-interviewed at follow-up. Multiple regression analyses were performed to find important predictors of intention, overall and married vs unmarried. Attitude, subjective norm, and perceived behavioral control together explained 50.2% (P < .01) of the variance in mothers’ intention to continue EBF for 6 months. Attitude and subjective norm were better predictors of the intention than perceived behavioral control. The role of subjective norm was greater in married than in unmarried women. A strong, positive correlation ( = 0.67, P < .01) was found between intended and actual EBF duration. Intervention programs designed to positively influence mother’s attitude and social support may be effective in improving intention, thereby increasing EBF maintenance for 6 months. J Hum Lact. 26(1):26-34.

When breast milk extraction and storage is required before ingestion, it is important to establish the conditions that ensure the least losses in milk quality, like the antioxidant capacity. The present study evaluates glutathione peroxidase activity and malondialdehyde concentration of breast milk when stored frozen, comparing the effects of 2 temperatures (—20°C and —80°C) and different storage times (15, 30, and 60 days). The results indicate that freezing induces losses in the antioxidant properties of breast milk and that such losses increase with the duration of storage and differ in intensity according to the temperature. It is concluded that to maximally preserve the antioxidant properties of breast milk, it is advisable to store the latter at —80°C for a period of less than 30 days, rather than for shorter time periods at the usual temperature of —20°C. J Hum Lact. 26(1):35-41.

A previous study performed in a predominately suburban population developed a breastfeeding assessment score (BAS) that was designed to predict, prior to hospital discharge, those mothers who would discontinue breastfeeding within the first 10 days of age. The purpose of the present study was to assess the BAS in a more diverse population. Patients were solicited from 3 urban hospitals serving patients primarily supported by public funding. Results of the present study with 1182 mother-infant pairs confirmed that 5 variables scored on a 0-2 scale (maternal age, previous breastfeeding experience, latching difficulty, breastfeeding interval, number bottles) remained highly significant for predicting discontinuation of breastfeeding. The data also demonstrate that the BAS is inversely related to the risk of cessation of breastfeeding at 7 to 10 days of age. Those at an early risk of cessation of breastfeeding, identified by the BAS, may benefit from early identification and a lactation consultation. J Hum Lact. 26(1):42-48.

Human milk is the preferred choice for infant feeding. When a sick or premature infant’s own mother’s milk is unavailable, donor human milk is becoming more widely used. Many potential milk donors do not live within close proximity to the 10 North American not-for-profit milk banks. Transporting milk via commercial carriers can be inconvenient and costly for recipient banks. A network of donor human milk depots is one practical way to increase the quantity of available donor human milk. This article provides guidelines and practical suggestions for establishing a donor human milk depot.

The objective of this study is to clarify use of the term mastitis in empirical studies of lactational mastitis. Eighteen articles published between 1998 and 2008 were critically analyzed, and a concept clarification of the term mastitis was carried out. Four articles suggested that mastitis was an infection, 4 made no mention of the etiology of symptoms, and 10 articles described mastitis as an inflammation or an infection. Eight studies made no use of distinctions between milk stasis, noninfectious mastitis, and infectious mastitis. Bacterial cultivation was used in 5 articles, and 1 article measured leukocytes and C-reactive protein. Several different causes were cited. Antibiotics were suggested as appropriate treatment in 4 articles. Use of the concept of mastitis in empirical studies remains inconsistent and may do so until the etiology of symptoms is understood. Understanding is also needed as to why some women who present with symptoms suggesting septic reaction recover without antibiotic therapy. J Hum Lact . 26(1):53-59.

Metyrapone, an inhibitor of corticosteroid biosynthesis, is used in the diagnosis and treatment of adrenocortical hyperfunction. The authors describe the excretion of metyrapone and its metabolite, rac-metyrapol, in milk from a lactating woman requiring metyrapone treatment (250 mg 4 times daily). At steady state, the average concentrations in milk and absolute and relative infant doses were 11 µg/L, 1.7 µg/kg/d, and 0.02%, respectively, for metyrapone, and 48.5 µg/L, 7.3 µg/kg/d, and 0.08%, respectively, for rac- metyrapol. The findings suggest that maternal metyrapone use during breastfeeding is extremely unlikely to be a significant risk for the breastfed infant. J Hum Lact. 25(4):451-454.