[Show abstract][Hide abstract] ABSTRACT: Over the past several decades, interest in using human milk as a biomonitoring matrix has increased. However, it is not always an easy matter for a new mother to provide a milk sample. In this article, guidance on facilitating collection of human milk is provided. This includes addressing the mother's ease in expressing a milk sample, and engaging with many audiences to reduce the likelihood of negatively impacting the already low breastfeeding rates in the United States. In addition, this article covers concepts regarding long-term storage and integrity of human milk samples to maximize the utility of those samples, and proposed methods for improving public access to the full spectrum of human milk biomonitoring data, with context to understand the information presented. The environmental chemicals and chemical classes for which robust analytical methods exist are enumerated, and a process for prioritizing the development of analytical methods for additional environmental chemicals is described.
Journal of Toxicology and Environmental Health Part A 11/2005; 68(20):1803-23. · 1.83 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Donor milk has been used to successfully treat a number of medical conditions in infants. This article highlights 3 such success stories describing the use of human milk in cases of velocardiofacial syndrome, very-low-birth weight, and failure to thrive. In 2002, more than 300 infants and young children and 15 adults received donor milk from 6 milk banks in the United States and I milk bank in Canada. Donor milk is often used to ensure optimal outcomes in full term or preterm infants until their own mother's milk volume is sufficient to meet their needs. However, human milk may be a lifesaving therapy for infants and young children with unusual medical conditions.
Journal of Human Lactation 03/2004; 20(1):75-7. · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This article describes issues related to the interpretation, presentation, and use of data from human milk surveillance and research studies. It is hoped that researchers conducting human milk studies in the future will consider these concepts when formulating study conclusions and presenting data. The key issues discussed are; (1) communication of information on human milk constituents to health care providers and the public; (2) complexities associated with assessing risks and benefits when comparing breast-feeding and formula-feeding; (3) use of human milk information for trends analysis and assessment of the efficacy of restrictions on use/release of chemicals in the environment; and (4) risk assessment and regulatory decision-making concepts regarding environmental chemicals in human milk. As researchers conduct surveillance and research involving human milk, it is of the utmost importance that the results of these studies are provided with information on risk and benefits that place the data in perspective, so that those involved in decision making regarding infant nutrition (e.g., expectant mothers, physicians, midwives, nurses, and lactation consultants) can appropriately interpret the research data.
Journal of Toxicology and Environmental Health Part A 12/2002; 65(22):1909-28. · 1.83 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Donor human milk is used to treat and protect the health and development of preterm and term infants, and occasionally to treat illnesses in older children and adults. When donor human milk is in short supply nationally, decisions must be made with regard to the priority of recipients. This article reviews the importance of donor human milk in the hospital setting, describes the factors that are considered by the Human Milk Banking Association of North America when prioritizing eligible recipients if there is a shortage of donor milk, and discusses how human milk should be stored and handled in the hospital setting.
Journal of Human Lactation 12/2002; 18(4):393-6. · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Breastfeeding and human milk are widely recognized as optimal for human infants. However, if donor milk is used when mother's own milk is not available, some questions arise concerning the effects of storage, handling, and heat processing on the unique components of human milk. Holder pasteurization (62.5 degrees C for 30 minutes) of banked human milk is the method of choice to eliminate potential viral contaminants such as human immunodeficiency virus, human T-lymphoma virus, and cytomegalovirus, as well as tuberculosis and other bacterial contaminants, while maintaining the greatest possible complement of its unique bioactive factors. This article reviews some of the critical components of human milk and what is currently known about the effects of Holder pasteurization on their biological activity.
Journal of Human Lactation 06/2001; 17(2):152-5. · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The first International Congress of Human Milk Banks--Excellence in Human Milk Banking: A Vision of the Future, held in Brazil in June 2000 and sponsored by the Brazilian Association of Milk Banks, had representation from milk banks in Argentina, Chile, Costa Rica, Venezuela, France, the United Kingdom, and North America as well as Brazil. A recurring theme in the discussion of donor milk banking was the role of each country's milk banks in the promotion and support of breastfeeding. The Brazilian National Reference Milk Bank and the growth of donor milk banking in Brazil over the past 15 years were described, including federal regulation that all milk bank directors be trained and certified. Milk banking systems in France, the United Kingdom, Venezuela and the Caribbean, and North America were also discussed. Similarities and differences in the donor screening process and the regulation of milk banks in the countries is presented.
Journal of Human Lactation 03/2001; 17(1):51-3. · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This descriptive study documents nurses' breastfeeding knowledge and attitudes. The nursing staffs of 27 private pediatric practices in North Carolina were surveyed. The 42-item questionnaire included questions about who was responsible for breastfeeding support, what staff nurses knew and believed about breastfeeding, and where their breastfeeding education was obtained. The response rate was 59% (134 out of 227). Only 5% responded that a breastfeeding patient experiencing problems would be referred to a physician, whereas 81% selected a lactation consultant, and 38% selected a member of the nursing staff. Knowledge scores ranged from 19 to 33 (out of 33). Attitude scores ranged from 10 to 30 (out of 30). Only 46% of respondents reported having received breastfeeding education in their training programs; 85% had received on-the-job training. The nurses surveyed were involved in breastfeeding support, yet many had incorrect information and negative attitudes toward breastfeeding.
Journal of Human Lactation 09/2000; 16(3):210-5. · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Often, mothers must express their milk so it can be fed to their babies in their absence or at a later time. Research has shown that human milk is remarkably resilient as long as good food-handling techniques are used. There are some measures that can be taken to optimize both the nutritional value and the immunologic protection if the milk is to be fed to a preterm or sick infant rather than to a healthy baby who is primarily breastfeeding. Keeping milk-handling and storage instructions simple and clear can encourage a mother to provide milk for her baby when she cannot breastfeed.
Journal of Human Lactation 06/2000; 16(2):149-51. · 1.98 Impact Factor