Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 165
Filtrar
1.
Science ; 384(6692): eadj9989, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38603486

RESUMO

Epoxy resin thermosets (ERTs) are an important class of polymeric materials. However, owing to their highly cross-linked nature, they suffer from poor recyclability, which contributes to an unacceptable level of environmental pollution. There is a clear need for the design of inherently recyclable ERTs that are based on renewable resources. We present the synthesis and closed-loop recycling of a fully lignocellulose-derivable epoxy resin (DGF/MBCA), prepared from dimethyl ester of 2,5-furandicarboxylic acid (DMFD), 4,4'-methylenebis(cyclohexylamine) (MBCA), and glycidol, which displays excellent thermomechanical properties (a glass transition temperature of 170°C, and a storage modulus at 25°C of 1.2 gigapascals). Notably, the material undergoes methanolysis in the absence of any catalyst, regenerating 90% of the original DMFD. The diamine MBCA and glycidol can subsequently be reformed by acetolysis. Application and recycling of DGF/MBCA in glass and plant fiber composites are demonstrated.

2.
J Voice ; 37(3): 374-381, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-33632556

RESUMO

OBJECTIVES/HYPOTHESIS: Articulation, phonation, and resonance disorders in the speech of hearing-impaired-speakers reduces intelligibility. The study focusses on (1) whether nonacoustic feedback may facilitate the adjustment of the vocal tract, leading to increased vocal tract resonance, and (2) whether training with the feedback would be helpful for the subsequent formation of vowels. STUDY DESIGN: Prospective. METHODS: Seven profoundly hearing-impaired participants used acoustic sound waves in the frequency range of the first two vocal tract resonances applied in front of the open mouth at intensities above 1 Pa. They were asked to amplify the sound via adjusting the vocal tract. The sound waves corresponded to the first and second resonance frequencies of the vowels [u], [o], and [a]. The self-assessment of the participants and a software-based/auditory analysis was reported. RESULTS: The participants were able to enhance the acoustic signal by adjusting the vocal tract shape. The self-perception of the participants, the auditory voice analysis, and the acoustic analysis of vowels were consistent with each other. While the maximum sound pressure levels were constant, the mean sound pressure levels increased. Breathiness and hoarseness declined during the exercises. Resonance/harmonic-to-noise ratio increased, especially for the vowels [u], [o], [a]. Furthermore, the positively connoted feedback from the participants indicated easier sound production. CONCLUSION: Nonauditory feedback, based on acoustic waves, could be suitable for improving the formation of vowels. The findings are in accordance with a reduction of acoustic losses within the vocal tract.


Assuntos
Distúrbios da Voz , Voz , Humanos , Qualidade da Voz , Estudos Prospectivos , Fonação , Audição , Acústica da Fala
3.
Nutrients ; 13(9)2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34578947

RESUMO

Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.


Assuntos
Aleitamento Materno/métodos , Fenômenos Fisiológicos da Nutrição do Lactente , Lactação , Leite Humano/química , Anquiloglossia/epidemiologia , Composição Corporal , Mama/anatomia & histologia , Desenvolvimento Infantil , Feminino , Microbioma Gastrointestinal , Humanos , Lactente , Recém-Nascido , Masculino
4.
Nutrients ; 13(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34579170

RESUMO

This study aimed to investigate relationships between infant abdominal visceral and subcutaneous adiposity and human milk (HM) components and maternal body composition (BC) during first year of lactation. Subcutaneous-abdominal depth (SAD), subcutaneous-abdominal fat area (SFA), visceral depth (VD) and preperitoneal fat area of 20 breastfed infants were assessed at 2, 5, 9 and 12 months using ultrasound. Maternal BC was determined with bioimpedance spectroscopy. HM macronutrients and bioactive components concentrations and infant 24-h milk intake were measured and calculated daily intakes (CDI) determined. Maternal adiposity associated with infant SFA (negatively at 2, 5, 12, positively at 9 months, all overall p < 0.05). 24-h milk intake positively associated with infant SAD (p = 0.007) and VD (p = 0.013). CDI of total protein (p = 0.013), total carbohydrates (p = 0.004) and lactose (p = 0.013) positively associated with SFA. Lactoferrin concentration associated with infant VD (negatively at 2, 12, positively at 5, 9 months, overall p = 0.003). CDI of HM components and maternal adiposity have differential effects on development of infant visceral and subcutaneous abdominal adiposity. Maintaining healthy maternal BC and continuing breastfeeding to 12 months and beyond may facilitate favourable BC development reducing risk of obesity.


Assuntos
Composição Corporal , Aleitamento Materno/métodos , Gordura Intra-Abdominal/metabolismo , Leite Humano/química , Gordura Subcutânea Abdominal/metabolismo , Adiponectina/análise , Adiposidade , Peso Corporal , Carboidratos da Dieta/análise , Feminino , Humanos , Lactente , Lactação/metabolismo , Leptina/análise , Estudos Longitudinais , Masculino , Nutrientes/análise , Obesidade/epidemiologia
5.
Adv Synth Catal ; 363(12): 3138-3143, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34413715

RESUMO

The substrate scope of the asymmetric allylation with zinc organyls catalyzed by 3,3-bis(2,4,6-triisopropylphenyl)-1,1-binaphthyl-2,2-diyl hydrogenphosphate (TRIP) has been extended to non-cyclic ester organozinc reagents and ketones. Tertiary chiral alcohols are obtained with ee's up to 94% and two stereogenic centers can be created. Compared to the previous lactone reagent the stereopreference switches almost completely, proving the fact that the nature of the organometallic compound is of immense importance for the asymmetry of the product.

6.
Phys Rev E ; 104(1-2): 015202, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34412281

RESUMO

Using data from equilibrium molecular dynamics computer simulations we have built up a catalog of response functions for the Coulomb one-component plasma over a wide range of Γ coupling values, including the strongly coupled Γ>1 liquid regime. We focus on the domain of negative compressibility (Γ>3), where the proper response displays an acausal behavior, implying a modification of the relation between its real and imaginary parts in the Kramers-Kronig relations. We give a description of the details of this acausal feature, in both the frequency and time domains. We show that the viscoelastic pole of the density response function morphs into an imaginary pole in the upper ω half-plane that is responsible for the anomalous behavior of the response in this coupling range. By examining the plasmon dispersion relation through the dielectric response function, rather than via the peaks of the dynamical structure function, we obtain a more reliable representation for the dispersion. We demonstrate that there is an intimate link between the formation of the roton minimum in the dispersion and the negative compressibility of the system. The feasibility of the extension of our analysis to systems with a short-range interaction is explored.

7.
BMC Pregnancy Childbirth ; 21(1): 322, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892640

RESUMO

BACKGROUND: Health professionals caring for women and infants experiencing difficulty with breastfeeding have reported deficiencies in evidence-based lactation knowledge. LactaMap is an online lactation care support system with more than 100 clinical practice guidelines to support breastfeeding care. Clinical practice guidelines support medical decision-making by summarising scientific evidence into systematically developed statements for specific clinical circumstances. Both common-sense and theory-based approaches have been used for guideline development and debate continues regarding which is superior. LactaMap clinical practice guidelines were created over the course of 5 years using a common-sense approach that was refined inductively. The aim of this study was to incorporate a theory-based framework approach into the methodology for ongoing update and review of LactaMap clinical practice guidelines. METHODS: The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was chosen as the framework-based approach to appraise LactaMap guideline quality. The study was conducted in two phases. The first phase appraised all 103 original LactaMap guidelines. The second phase appraised a subset of 15 updated LactaMap guidelines using improved methodology guided by phase 1, as well as 15 corresponding original (un-updated) guidelines. RESULTS: Mean Domain scores for 103 LactaMap original guidelines were above 75% in 3 of the 6 AGREE II quality Domains and no mean Domain score rated poorly. Update of guideline methodology was guided by phase 1 appraisals. Improved documentation of methods relating to questions in the Rigour of Development Domain resulted in improvement in mean Domain score from 39 to 72%. CONCLUSIONS: This study showed that a theory-based approach to guideline development methodology can be readily integrated with a common-sense approach. Factors identified by AGREE II theory-based framework provided practical guidance for changes in methodology that were integrated prior to LactaMap website publication. Demonstration of high quality in LactaMap clinical practice guideline methodology ensures clinicians and the public can have trust that the content founded on them is robust, scientific and of highest possible quality.


Assuntos
Aleitamento Materno/métodos , Cuidado do Lactente , Intervenção Baseada em Internet , Sistemas On-Line , Cuidado Pós-Natal , Guias de Prática Clínica como Assunto/normas , Adulto , Prática Clínica Baseada em Evidências , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Cuidado do Lactente/métodos , Cuidado do Lactente/normas , Recém-Nascido , Lactação , Avaliação das Necessidades , Cuidado Pós-Natal/métodos , Cuidado Pós-Natal/normas , Gravidez
8.
Pediatr Res ; 89(4): 911-921, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32438370

RESUMO

BACKGROUND: To investigate relationships between infant body composition (BC) and human milk (HM) immunomodulatory proteins (IMPs) during the first 12 months of lactation. METHODS: BC of breastfeeding dyads (n = 20) was measured with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers) at 2, 5, 9, and/or 12 months post partum. Breastfeeding frequency, 24-h milk intake, and IMP concentrations (lactoferrin, lysozyme, secretory immunoglobulin A (sIgA)) were measured, and calculated daily intakes (CDIs) were determined. We used linear regression/mixed-effects models and adjusted results for multiple comparisons. RESULTS: No associations were seen between maternal characteristics and IMP concentrations/CDIs or between IMP concentrations and infant BC. Lactoferrin CDI was negatively associated with infant fat-free mass index (P = 0.002); lysozyme CDI was positively associated with infant fat mass (P = 0.004) and fat mass index (P = 0.004) measured with ultrasound skinfolds. CONCLUSION: In this small cohort of infants breastfed on demand during first year of life, we report differential associations of HM IMPs with infant BC, showing that in addition to their critical role in shaping infant immunity, lactoferrin, and lysozyme also influence development of infant BC, highlighting the importance of breastfeeding for 12 months and beyond. IMPACT: HM IMPs (concentrations and, most importantly, daily intakes) time-dependently and differentially associate with development of infant lean mass and adiposity during first 12 months of lactation. There is no information on how intakes and concentrations of these components affect development of infant BC. HM contains IMPs-lactoferrin, lysozyme, and sIgA, which not only play a critical role in shaping infant's immunity, but also influence infant growth and development of BC, highlighting the importance of breastfeeding for 12 months and beyond and warranting careful consideration of the dose effects of supplemented formula.


Assuntos
Composição Corporal , Lactação/imunologia , Leite Humano/química , Leite Humano/imunologia , Adiposidade , Antropometria , Austrália , Índice de Massa Corporal , Aleitamento Materno , Espectroscopia Dielétrica , Feminino , Humanos , Imunoglobulina A/sangue , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Lactoferrina/sangue , Estudos Longitudinais , Muramidase/sangue , Projetos Piloto , Análise de Regressão , Fatores de Risco , Ultrassonografia
9.
Phys Rev E ; 102(4-1): 043206, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33212692

RESUMO

The equilibrium structure and the dispersion relations of collective excitations in trilayer Yukawa systems in the strongly coupled liquid regime are examined. The equilibrium correlations reveal a variety of structures in the liquid phase, reminiscent of the corresponding structures in the solid phase. At small layer separation substitutional disorder becomes the governing feature. Theoretical dispersion relations are obtained by applying the quasilocalized charge approximation (QLCA) formalism, while numerical data are generated by microcanonical molecular dynamics simulations. The dispersions and polarizations of the collective excitations obtained through both of these methods are compared and discussed in detail. We find that the QLCA method is, in general, very satisfactory, but that there are phenomena not covered by the QLCA. In particular, by analyzing the dynamical longitudinal and transverse current fluctuation spectra we discover the existence of a structure not related to the collective mode spectra. This also provides insight into the long-standing problem of the gap frequency discrepancy, observed in strongly coupled layered systems in earlier studies.

10.
Opt Express ; 28(12): 17320-17333, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32679942

RESUMO

This work presents the design and characterization of an approach for areal surface profilometry with sub-nm axial resolution. The developed approach is based on a low-coherence interferometer enhanced by an dispersive element to control the axial resolution and measurement range. Optical path differences are detected by an imaging spectrometer where equalization wavelengths are determined as a basis for fitting spectra. This enables the acquisition of surface profiles with a length of up to 1.5 mm without mechanical scanning where a minimal resolution of 0.1 nm in an axial measurement range of nearly 80 µm was achieved. The resolution calculation was based on the standard deviation of measured feature heights. In addition to the system design, its capabilities are demonstrated on samples such as height standards.

11.
J Org Chem ; 85(15): 9672-9679, 2020 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-32648755

RESUMO

3,3-Bis(2,4,6-triisopropylphenyl)-1,1-binaphthyl-2,2-diyl hydrogenphosphate (TRIP) catalyzes the asymmetric allylation of aldehydes with organozinc compounds, leading to highly valuable structural motifs, like precursors to lignan natural products. Our previously reported mechanistic proposal relies on two reaction intermediates and requires further investigation to really understand the mode of action and the origins of stereoselectivity. Detailed ab initio calculations, supported by experimental data, render a substantially different mode of action to the allyl boronate congener. Instead of a Brønsted acid-based catalytic activation, the chiral phosphate acts as a counterion for the Lewis acidic zinc ion, which provides the activation of the aldehyde.

12.
Matern Child Nutr ; 16(3): e12969, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32032481

RESUMO

During the last decade, there have been several publications highlighting the need for consistent terminology in breastfeeding research. Standard terms and definitions are essential for the comparison and interpretation of scientific studies that, in turn, support evidence-based education, consistency of health care, and breastfeeding policy. Inconsistent advice is commonly reported by mothers to contribute to early weaning. A standard language is the fundamental starting point required for the provision of consistent advice. LactaPedia (www.lactapedia.com) is a comprehensive lactation glossary of over 500 terms and definitions created during the development of LactaMap (www.lactamap.com), an online lactation care support system. This paper describes the development of LactaPedia, a website that is accessible free of charge to anyone with access to the Internet. Multiple methodological frameworks were incorporated in LactaPedia's development in order to meet the needs of a glossary to support both consistent health care and scientific research. The resulting LactaPedia methodology is a six-stage process that was developed inductively and includes framework to guide vetting and extension of its content using public feedback via discussion forums. The discussion forums support ongoing usability and refinement of the glossary. The development of LactaPedia provides a fundamental first step towards improving breastfeeding outcomes that are currently well below World Health Organisation recommendations globally.


Assuntos
Aleitamento Materno , Dicionários como Assunto , Comunicação em Saúde/métodos , Lactação , Terminologia como Assunto , Feminino , Humanos , Internet
13.
Arch Dis Child Fetal Neonatal Ed ; 105(3): 266-269, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31296697

RESUMO

AIM: To determine the impact of the pumping regimes of women with preterm infants on the daily milk production, and on the short-term rate of milk synthesis during early lactation to support evidence-based recommendations for optimising milk production. METHODS: Mothers of preterm infants (n=25) recorded start time, finish time and expression volumes from every breast expression on days 10, 15-20 postpartum. RESULTS: Expressing more often than five times per day did not result in a significant increase in daily milk production. Milk volume per expression per breast increased for intervals between expressions of between 2and6 hours then reached a plateau when the interval between expression was 7 hours or longer. The short-term rate of milk synthesis decreased as the interval between expressions increased until about 7.5 hours at which point it begun to increase (p value associated with interval between expressions^2<0.001). CONCLUSION: The strong inverse association between the short-term rate of milk synthesis and the interval between expressions for intervals up to 7 hours suggest that the maximum interval between expressions should be 7 hours. Data suggest that, on average, the mothers should express at least five times a day to maximise daily milk production. Considering inter-individual variation, determination of an individual mother's maximum interval between expressions that does not compromise the short-term rate of milk synthesis will help to optimise daily milk production while minimising the demands on the mother's time.


Assuntos
Extração de Leite/métodos , Recém-Nascido Prematuro , Lactação/metabolismo , Leite Humano/metabolismo , Mães , Adulto , Peso ao Nascer , Feminino , Idade Gestacional , Humanos
14.
Nutrients ; 11(7)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261649

RESUMO

Human milk (HM) carbohydrates may affect infant appetite regulation, breastfeeding patterns, and body composition (BC). We investigated relationships between concentrations/calculated daily intakes (CDI) of HM carbohydrates in first year postpartum and maternal/term infant BC, as well as breastfeeding parameters. BC of dyads (n = 20) was determined at 2, 5, 9, and/or 12 months postpartum using ultrasound skinfolds (infants) and bioelectrical impedance spectroscopy (infants/mothers). Breastfeeding frequency, 24-h milk intake and total carbohydrates (TCH) and lactose were measured to calculate HM oligosaccharides (HMO) concentration and CDI of carbohydrates. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Higher TCH concentrations were associated with greater infant length, weight, fat-free mass (FFM), and FFM index (FFMI), and decreased fat mass (FM), FM index (FMI), %FM and FM/FFM ratio. Higher HMO concentrations were associated with greater infant FFM and FFMI, and decreased FMI, %FM, and FM/FFM ratio. Higher TCH CDI were associated with greater FM, FMI, %FM, and FM/FFM ratio, and decreased infant FFMI. Higher lactose CDI were associated with greater FM, FMI, %FM, and FM/FFM, ratio and decreased FFMI. Concentrations and intakes of HM carbohydrates differentially influence development of infant BC in the first 12 months postpartum, and may potentially influence risk of later obesity via modulation of BC.


Assuntos
Composição Corporal , Aleitamento Materno , Desenvolvimento Infantil , Carboidratos da Dieta/metabolismo , Fenômenos Fisiológicos da Nutrição do Lactente , Lactação , Leite Humano/metabolismo , Valor Nutritivo , Adiposidade , Fatores Etários , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estado Nutricional , Projetos Piloto , Estudo de Prova de Conceito
15.
Front Plant Sci ; 10: 382, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984227

RESUMO

In response to a wide-spread decline in forest vitality associated with acid rain in the 1980s, liming of soils has been implemented in many federal states in Germany to buffer further acid deposition and improve availability of nutrients such as calcium and magnesium. As a consequence, it may also increase vitality and depth of fine-root systems and hence improve the drought tolerance of species such as Norway spruce [Picea abies (L.) Karst.], which occurs mostly on acidic forest soils. However, the influence of repeated liming on drought tolerance of trees has never been studied. Here we compared the resistance, recovery and resilience of radial growth in P. abies in relation to drought in limed and control stands and assessed how the dosage and interval between lime application and drought year influences the radial growth response of P. abies. We analyzed radial growth in 198 P. abies trees of six experimental sites in south-west Germany. An analysis of the radial increment over the last 30 years allowed the analysis of drought events shortly after the first liming (short-term effect) as well as posterior drought events (mid- to long-term effects). Generalized linear models were developed to assess the influence of drought intensity, site and period since first liming on the drought tolerance of Norway spruce. Regardless of drought intensity, there was no general increase in drought resistance of Norway spruce in response to liming. However, drought resistance of radial growth improved on a loamy site that was additionally treated with wood ash 30 years after the first lime application. Furthermore, recovery and resilience of radial growth after severe drought events were generally better in spruce trees of limed treatments. This indicates a shorter stress period in spruce trees growing on limed soil, which may reduce their susceptibility to secondary, drought-related pests and pathogens.

16.
Sensors (Basel) ; 19(5)2019 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-30866475

RESUMO

A method to characterize cross-linking differences in polymers such as waveguide polymers has been developed. The method is based on the scan-free information acquisition utilizing a low-coherence interferometer in conjunction with an imaging spectrometer. By the introduction of a novel analyzing algorithm, the recorded spectral-phase data was interpreted as wavelength-dependent optical thickness which is matchable with the refractive index and therefore with the degree of cross-linking. In the course of this work, the method was described in its hardware and algorithmic implementation as well as in its accuracy. Comparative measurements and error estimations showed an accuracy in the range of 10-6 in terms of the refractive index. Finally, photo-lithographically produced samples with laterally defined cross-linking differences have been characterized. It could be shown, that differences in the optical thickness of ±1.5 µm are distinguishable.

17.
Angew Chem Int Ed Engl ; 58(24): 8226-8230, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-30920120

RESUMO

Podophyllotoxin is probably the most prominent representative of lignan natural products. Deoxy-, epi-, and podophyllotoxin, which are all precursors to frequently used chemotherapeutic agents, were prepared by a stereodivergent biotransformation and a biocatalytic kinetic resolution of the corresponding dibenzylbutyrolactones with the same 2-oxoglutarate-dependent dioxygenase. The reaction can be conducted on 2 g scale, and the enzyme allows tailoring of the initial, "natural" structure and thus transforms various non-natural derivatives. Depending on the substitution pattern, the enzyme performs an oxidative C-C bond formation by C-H activation or hydroxylation at the benzylic position prone to ring closure.


Assuntos
Lactonas/química , Podofilotoxina/química , Biocatálise , Biotransformação
18.
J Org Chem ; 84(9): 5831-5837, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-30920215

RESUMO

The asymmetric allylation under the assistance of catalytic amounts of 3,3'-bis(2,4,6-triisopropylphenyl)-1,1'-binaphthyl-2,2'-diyl hydrogen phosphate (TRIP) allows the concise construction of the lignan scaffold from simple aldehydes and allylic bromides with full control of the two formed stereocenters. This young methodology has been employed to synthesize four naturally and pharmaceutically active lignans. Members of the dibenzylbutyrolactone, the tetraline, and the dibenzocyclooctadiene classes have been synthesized in 40-47% overall yield along four-step synthetic routes.

19.
Artigo em Inglês | MEDLINE | ID: mdl-34776750

RESUMO

Single frequency, geometrically symmetric Radio-Frequency (rf) driven atmospheric pressure plasmas exhibit temporally and spatially symmetric patterns of electron heating, and consequently, charged particle densities and fluxes. Using a combination of phase-resolved optical emission spectroscopy and kinetic plasma simulations, we demonstrate that tailored voltage waveforms consisting of multiple rf harmonics induce targeted disruption of these symmetries. This confines the electron heating to small regions of time and space and enables the electron energy distribution function to be tailored.

20.
Singapore Med J ; 60(2): 80-88, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29876577

RESUMO

INTRODUCTION: Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump. METHODS: Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein. RESULTS: Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls. CONCLUSION: LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.


Assuntos
Aleitamento Materno/métodos , Lactação/fisiologia , Leite Humano/fisiologia , Adulto , Extração de Leite/métodos , Citratos/análise , Feminino , Humanos , Fórmulas Infantis , Recém-Nascido , Leite Humano/química , Mães , Proteínas/análise , Sódio/análise , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...