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Breastfeeding - if it reduced the risk of childhood leukemia would more people support it?

6/5/2015

3 Comments

 
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It’s pretty old news that breast feeding is associated with numerous health benefits, in fact it’s increasingly difficult to find any important outcome that isn’t made better by breast feeding. Whether its brain growth, avoiding hip fractures or dying from cardiovascular disease, let alone all the benefits for preterm infants in reducing NEC, mothers own breast milk is always good for you. However, the effects on childhood cancer have always been uncertain.

In this recent study, Amitay et al. (JAMA Pediatr 2015: 169(6) ) conducted a meta-analysis of published studies. This means they carefully searched every published study that examined the association between breast feeding and leukaemia (which represents 30% of all childhood cancer) and analysed them to find the overall (average) result. They found 18 separate studies: these showed that compared with no breast feeding or shorter breast feeding, breast feeding for 6 months or more was associated with a 19% lower risk of leukaemia. This is a large study – in total 10292 leukaemia cases and 17517 control cases were examined. That’s quite a lot and far more than you could ever study in a single country.  In a further analysis in just 15 studies they showed that ever breast fed, compared with never breast fed, was associated with a 11% reduction.

Observational studies, and meta-analyses (like this), can never prove direct causation and there are methodological flaws in every study. No study gives you the perfect correct answer. But the size of this reduction for such a serious condition is important -  maybe prospective mothers need to know.  http://archpedi.jamanetwork.com/journal.aspx

3 Comments

Antibiotics - are they making our children fat?

6/5/2015

2 Comments

 
You are what you eat.
And swallow.

It will come as no surprise that taking antibiotics alters the gut flora of infants, however a recent study confirms the findings of several other studies in suggesting that antibiotics may have more profound longer term effects on infants, and probably children (and then adults). One way of thinking about this, is to appreciate that in farming, antibiotics were widely used as growth promoting agents.

In this current study by Saari et al (Pediatrics 2015 135:617-626) they followed up a large group (6114 boys and 5984 girls) and looked at their growth and obesity (BMI) over the first 2 years, and examined these changes in relation to antibiotic exposure before 6 months of age. BMI is not a very accurate measure of the amount of fat you have: think of a body builder – they have lots of muscles and almost no fat, but still have a high BMI. But BMI is the only thing you can really measure when you follow up thousands of children (you can't do expensive MRI scans on them all). The study found that children who had received antibiotics were heavier (more so in boys, than girls) and this was particularly strong for certain types of antibiotics (macrolides). The authors suggest that antibiotic exposure may play a role in the growing [sic] epidemic of obesity . Of course, a study like this doesn’t prove that antibiotics cause obesity, just that there is an association. Maybe families who have obese children have a different approach to use of antibiotics i.e. maybe they attend GPs more often? Either way, it emphasises that we should be cautious of the unnecessary use of antibiotics, and especially in infancy. http://pediatrics.aappublications.org/content/135/4/617.abstract

2 Comments

Evidenced based neonatology - exclusive human milk based diets?

6/2/2015

1 Comment

 
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Nutrition for extremely preterm infants is critical to growth and development. In this review we discuss a  randomized controlled trial that examined the short-term outcomes of feeding these infants on an exclusively bovine or exclusively human milk diet. The study found that an exclusive fortified human milk diet resulted in improved short-term outcomes, including a reduction in NEC and days on PN. However, this intervention is expensive and needs testing in other situations. Read the full review here https://ebneo.org/2015/06/randomized-trial-of-exclusive-human-milk-versus-preterm-formula-diets-in-extremely-premature-infants/
1 Comment
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    Author

    Nick Embleton is a neonatologist from Newcastle UK.

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The Neonatal Research Network @www.neonatalresearch.net  - improving care, improving quality. Dedicated to promoting neonatal research and improving outcomes for sick and preterm infants, and their parents.

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Disclaimer. This website is independently owned and operated and is not affiliated to any specific institution. Opinions expressed are our individual ones and not those of our employers or the professional organisations with which we work and collaborate. Some of the photos we have used were taken from the internet - if they belong to you and want them removed just drop us a line. In some of our presentations we may have used diagrams, photos or figures from other peoples work; in addition many of our ideas build on those from others. If you think we used your figures or ideas without referencing you appropriately just drop us a line.  No copyright infringement intended. We are here to spread the word and collaborate. Everything we know in some way builds on the work of others. Thanks!