Human Milk: Composition, Clinical Benefits and Future Opportunities. Группа авторов

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      ¹ Some caution is needed when generalizing from these data as they are based on a preliminary screening of ultrasound recordings; while some sections of feeding were not able to be analyzed, because of movement artefact, we regard them as substantively correct.

      State of Breastfeeding in the World

      Donovan SM, German JB, Lönnerdal B, Lucas A (eds): Human Milk: Composition, Clinical Benefits and Future Opportunities. Nestlé Nutr Inst Workshop Ser, vol 90, pp 33–34, (DOI: 10.1159/000490483)

      Nestlé Nutrition Institute, Switzerland/S. Karger AG., Basel, © 2019

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Summary on State of Breastfeeding in the World

      Alan Lucas took an overview of the scientific evidence that supports breastfeeding. He identified that three key pillars of breastfeeding science were underpinned by flawed science and thinking. That breastfeeding has evolved over millions of years of mammalian evolution, spawned the view human breast milk must be the perfect diet for human infants. But this view does not take into account the competing needs of mother and offspring, nor the current mismatch between our ancient genes and modern environment (evolutionary discordance) which may result in disease. He noted that 1,500 papers on the composition breast milk were too flawed to derive realistic values for the dietary intake of breastfed babies. The use of such data by formula manufactures resulted in overfeeding of babies contributing to the epidemic of obesity and cardiovascular disease risk in later life. And he noted that the numerous proposed beneficial outcomes of breastfeeding were mostly based on potentially confounded observational studies. He addressed these issues by showing that more modern research and understanding was resolving the flaws of past work and thinking. This newer work puts breastfeeding medicine on a sounder scientific footing – and this is in the interests of improving the care of infants and the health outcomes of populations.

      Mike Woolridge delved deeply into the mechanical aspects of suckling. He noted two long-standing principles about the way babies removed milk from the breast – one mechanism is suction, and the other, the wave-like movements of the tongue that exert pressure on the undersurface of the nipple and breast in the oral cavity. These aspects were confirmed by imaging studies from the 1950s and underpinned successful “best practice” in breastfeeding management. He explained however that more recently the process of suckling has been revisited with more sophisticated imaging techniques and the application of engineering approaches to build new mathematically complex models to explain how breastfeeding works. He critically appraised the strengths and weaknesses of the new research but gratifyingly concluded that a new consensus on the principles of suckling, whilst extending our understanding, does not in any way undermine or change well-tried and effective best practices for the management of breastfeeding – indeed more strongly reaffirms them. Such practices impact on the success