This systematic review and meta-analysis synthesised the post-1990 literature examining the effect of human milk on morbidity, specifically necrotising enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and neurodevelopment in infants born ≤28 weeks’ gestation and/or publications with reported infant mean birth weight of ≤1500 g. Online databases including Medline, PubMed, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched, and comparisons were grouped as follows: exclusive human milk (EHM) versus exclusive preterm formula (EPTF), any human milk (HM) versus EPTF, higher versus lower dose HM, and unpasteurised versus pasteurised HM. Experimental and observational studies were pooled separately in meta-analyses. Risk of bias was assessed for each individual study and the GRADE system used to judge the certainty of the findings. Forty-nine studies (with 56 reports) were included, of which 44 could be included in meta-analyses. HM provided a clear protective effect against NEC, with an approximate 4% reduction in incidence. HM also provided a possible reduction in LOS, severe ROP and severe NEC. Particularly for NEC, any volume of HM is better than EPTF, and the higher the dose the greater the protection. Evidence regarding pasteurisation is inconclusive, but it appears to have no effect on some outcomes. Improving the intake of mother’s own milk (MOM) and/or donor HM results in small improvements in morbidity in this population.
Objective: As numerous factors in the home environment have been related to children’s fruit and vegetable (F&V) consumption as a component of a healthy diet, the purpose of the present systematic review was to examine these factors specifically for children aged 6–12 years.Design: Relevant observational studies published in English between January 2007 and December 2015 were obtained through electronic database searches. Studies were included if the researchers reported on a potentially modifiable measure of the home physical, political and sociocultural environment related to child F&V consumption.Results: Of the thirty-three articles reviewed, overall methodological quality was poor with twenty studies rated as weak, mainly due to cross-sectional design (majority of studies), selection bias, convenience sampling and voluntary participation. Half of the studies had strong–moderate ratings for using valid and/or reliable tools while for the other half, psychometric properties were either not reported or weak. The most consistent evidence for children’s combined F&V consumption was found for availability and accessibility of F&V, parental role modelling of F&V and maternal intake of F&V.Conclusions: A vast array of home environment components and their influence on children’s consumption of fruits and/or vegetables have been studied in recent years. Specific components of the home environment may have more influence than others, but more compelling evidence is needed to draw strong conclusions. Recommendations are made for future studies to be based upon conceptual/theoretical models to provide consistency in defining the home environment and investigation of potential moderators, such as personal or contextual factors.
1 March 2012 in The American Journal of Clinical Nutrition
Sufficient information and support for breastfeeding mothers is vital to encourage optimal infant feeding practices. Infant feeding apps give breastfeeding instructions and access to information however, little is known about mothers’ perceptions about these resources. This study investigated mothers’ use and experiences of infant feeding apps with a feeding tracker component, including how information within these apps is used, initial reasons for downloading, the role of the app in infant feeding, and perceived benefits and disadvantages of infant feeding apps. In-depth interviews were conducted with nine Australian breastfeeding mothers who had used an infant feeding app in the last year. Interviews were recorded, transcribed verbatim and coded prior to thematic analysis. The findings revealed that infant feeding apps provide mothers with objective information to guide their breastfeeding decisions and other aspects of baby care. This objective approach to infant feeding gives mothers a perception of greater control, confidence and efficacy at a time of transition and stress in the early stages of parenting an infant. While, overall, the mothers were positive about infant feeding apps, they also expressed concerns regarding overreliance on the app, feeling overwhelmed with the data and questioning the credibility of the information.