ORCID Profile
0000-0003-3597-1360
Current Organisation
Anhui Medical University
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Publisher: Wiley
Date: 20-11-2020
Publisher: MDPI AG
Date: 10-05-2023
DOI: 10.3390/NU15102261
Abstract: Breast milk is tailored for optimal growth in all infants however, in some infants, it is related to a unique phenomenon referred to as breast milk jaundice (BMJ). BMJ is a type of prolonged unconjugated hyperbilirubinemia that is often late onset in otherwise healthy-appearing newborns, and its occurrence might be related to breast milk itself. This review aims to systematically evaluate evidence regarding breast milk composition and the development of BMJ in healthy neonates. PubMed, Scopus and Embase were searched up to 13 February 2023 with key search terms, including neonates, hyperbilirubinemia, and breastfeeding. A total of 678 unique studies were identified and 12 were ultimately included in the systematic review with narrative synthesis. These included studies covered both nutritional compositions (e.g., fats and proteins) and bioactive factors (e.g., enzymes and growth factors) of breast milk and formally assessed the difference in the concentration (or presence) of various endogenous components of breast milk collected from mothers of BMJ infants and healthy infants. The results were inconsistent and inconclusive for most of the substances of interest, and there was only a single study available (e.g., total energy and mineral content, bile salts and cytokines) conflicting or even contradictory results arose when there were two or more studies on the subject matter (e.g., fats and free fatty acids contents and epidermal growth factor). The etiology of BMJ is likely multifactorial, and no single constituent of breast milk could explain all the BMJ cases observed. Further well-designed studies are warranted to investigate the complex interaction between maternal physiology, the breast milk system and infant physiology before this field could be progressed to uncover the etiology of BMJ.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.PLEFA.2018.08.003
Abstract: Long chain polyunsaturated fatty acid (LCPUFA) intake during infancy has been associated with many health benefits, and the LCPUFA intake of breastfed infants is largely dependent on the composition of breast milk. The conventional method for breast milk fatty acid profiling is complicated by the need for cold-chain transportation and storage, and the newly developed dried milk spot (DMS) technology overcomes these difficulties. This study aimed to determine the accuracy, sensitivity and applicability of the DMS method developed based on the PUFAcoat™ technology. Two hundred breast milk s les were analyzed using the conventional method and compared with the DMS method. In order to evaluate the usefulness of DMS for large scale international studies, we analyzed another 786 breast milk s les collected from mothers of preterm infants who participated in a large clinical trial conducted in Australia, New Zealand and Singapore. Fatty acids were measured using capillary gas chromatography and results were reported as weight percentage of total fatty acids. Strong correlations and tight variation were observed in total saturated, monounsaturated, n-6 and n-3 PUFAs between the conventional and DMS methods. The DMS method proved to be sensitive in differentiating the breast milk fatty acid profiles of women consuming different habitual diets as evidenced by the differences between the breast milk fatty acid composition between Australian and Singaporean population. This study demonstrates that the DMS and the conventional method provide interchangeable results, and the DMS method is a particularly useful tool for large-scale studies.
Publisher: Wiley
Date: 28-11-2021
DOI: 10.1111/PAI.13703
Abstract: Maternal pre‐pregnancy body mass index (BMI) and gestational weight gain (GWG) have been linked to offspring allergic disorders. However, associations observed in previous studies were inconsistent and might be confounded by unmeasured familial factors. We aimed to examine the associations of maternal weight with offspring allergic disorders by using paternal BMI as a negative control exposure. We included the data of 10,522 children from the Born in Guangzhou Cohort Study, 2012–2017. Data on maternal weight were obtained from questionnaires and obstetric records, and paternal weight was collected from questionnaires. Atopic dermatitis (AD) and wheezing at the age of 1 year were defined according to parent‐reported physician diagnosis. Risk ratios (RRs) were estimated by log‐binominal regression with mutual adjustment for maternal and paternal weight status. By the age of 1 year, 16.2% and 7.9% of children were diagnosed with AD and wheezing, respectively. While maternal pre‐pregnancy BMI as a continuous variable was not associated with offspring AD, infants of pre‐pregnancy overweight/obese women had a higher risk of AD than those born to normal weight women no such associations were observed for paternal BMI. Both maternal pre‐pregnancy BMI and paternal BMI were positively associated with the risk of offspring wheezing. Maternal GWG was not associated with AD or wheezing. Our findings suggest that maternal pre‐pregnancy overweight/obesity might increase the risk of infant AD via intrauterine mechanisms, whereas the association with wheezing might be confounded by uncontrolled familial factors. These findings may be valuable in early‐life prevention for offspring allergic diseases.
Publisher: Mary Ann Liebert Inc
Date: 11-2020
Publisher: Elsevier BV
Date: 07-2020
DOI: 10.1016/J.PLEFA.2019.102035
Abstract: Breast milk dried on filter paper is a useful collection device for the study of breast milk because it avoids the costs associated with cold-chain storage and transportation. Although the fatty acid profile of breast milks as dried spots is stable, changes to the composition of lipid classes of breast milk due to lipase activity have been reported and are best reflected by its free fatty acid (FFA) concentration. This study aimed to develop a robust dried milk spot (DMS) system where fats in the breast milk are stable at room temperature, and the FFA concentration of the milk can be accurately measured without interference by the high level of triglyceride, which normally constitutes around 98% of the fats in fresh milk. Our system involves applying a small amount breast milk (20 µL) on silica gel impregnated filter paper and microwaving at high power to denature lipases. At the time of analysis, the milk fats are eluted with acetone, re-constituted in heptane and injected directly into a gas chromatograph equipped with an acid modified polyethylene glycol column. This DMS method was validated against the conventional TLC method across a range of FFA concentrations. The breast milk fats collected using this DMS system are stable at room temperature for at least eight weeks which allows for transportation by post and has the potential for use in multi-centred international clinical trials.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.PLEFA.2019.04.008
Abstract: This review evaluated the effect of various storage and handling conditions on the fat composition of expressed breast milk (EBM). Three databases PubMed, Embase and Scopus were searched in April 2019 with words from the three key components: human milk, handling process (i.e. storage and/or pasteurization), and fatty acid composition. The comparisons were EBM subjected to handling processes versus fresh EBM or versus EBM subjected to another handling processes. Both intervention and observational studies were included, and the outcomes measured included total fat and lipid classes of the EBM. We included 42 studies (43 reports), 41 of which were assessed to be of good quality. Relative changes to the fat composition of EBM subjected to handling processes were calculated based on the data provided in the included studies, and the results were synthesized narratively. The total fat content and total fatty acid composition of EBM was not generally influenced by storage and handling process, with most changes less than 10%, which is likely a result of methodological variation. A reduction in EBM triglyceride concentration and concomitant increase in free fatty acid concentration were seen after exposing to various conditions, probably due to endogenous lipase.
Publisher: SAGE Publications
Date: 14-05-2018
Abstract: Human milk is a rich source of omega-3 long-chain polyunsaturated fatty acids, which are postulated to be important for brain development. There is a lack of data on the human milk fatty acid composition of Cambodian women compared with data from Western women. The aim of this study was to determine the human milk fatty acid composition of women living in Cambodia and compare it with that of women living in Australia. Human milk s les from Cambodian ( n = 67) and Australian ( n = 200) mothers were collected at 3 to 4 months postpartum. Fatty acid composition was analyzed using capillary gas chromatography followed by Folch extraction with chloroform/methanol (2:1 v/v), and fat content was measured gravimetrically. Compared with Australian participants, human milk from Cambodian participants contained a significantly lower level of total fat (2.90 vs. 3.45 g/dL, p = .028), lower percentages of linoleic acid (9.30% vs. 10.66%, p .0001) and α-linolenic acid (0.42% vs. 0.95%, p .0001), but higher percentages of arachidonic acid (0.68% vs. 0.38%, p .0001) and docosahexaenoic acid (0.40% vs. 0.23%, p .0001). Differences in human milk fatty acid composition between Cambodian and Australian participants may be explained by differences in the dietary patterns between the two populations.
Publisher: Elsevier BV
Date: 07-2023
Publisher: MDPI AG
Date: 06-06-2022
Abstract: We aimed to examine the associations between cord blood lipids and childhood adiposity and to investigate whether these associations vary across birth weight categories (small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA)) in 1306 infants in the Born in Guangzhou Cohort Study, China. Adiposity outcomes at the age of three years included z-scores of weight-for-length/height (WFLZ), body mass index (BMIZ), subscapular (SSTZ) and triceps skinfold thickness (TSTZ), and the sum of skinfold thicknesses (SSFTZ). Cord blood triglycerides (TG) levels were negatively associated with WFLZ and BMIZ, whereas high density lipoprotein (HDL) levels were positively associated with WFLZ, BMIZ, TSTZ and SSFTZ. These associations were attenuated after adjustment for birth weight. Stratified analyses revealed that total cholesterol (TC) and low-density lipoprotein (LDL) levels were positively associated with childhood adiposity indicators among AGA infants but tended to be negatively associated with the adiposity indicators among LGA infants (p values for interaction .05). Furthermore, TG levels appeared to be positively associated with adiposity indicators among SGA infants but negatively associated with the outcomes among LGA infants (p values for interaction .05). Cord blood lipids levels might be associated with childhood adiposity, and these associations appear to differ across different birth weight categories. If confirmed in future studies, our findings suggest that in idualized management plans might be warranted in preventing obesity.
No related grants have been discovered for Chang Gao.