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The association between breastfeeding and type 2/gestational diabetes
Based off of the systematic review of the current literature discussing this topic, the authors found that breastfeeding children for at least 2 months can lower their risk of developing diabetes. Infants that were breastfed as opposed to bottle-fed had less instances of experiencing low blood glucose and less of a need for supplementation. One longitudinal study that surveyed participants found out that Type 2 diabetes was 59% less common people who were exclusively breastfed versus subjects who were exclusively bottle-fed. One author found that even after controlling for other risk factors that may contribute to the development of diabetes, a minimum of 2 months of exclusive breastfeeding was associated with lower rates of the disease. Critics of the essential benefits of breast milk suggest that alternative reasons for lower rates of diabetes among breastfed babies is due to a predisposition for bottle-fed infants to become sick possibly due to unhygienic bottle preparation. One case control study found that breastfeeding may have a protective effect against the development of type 2 diabetes in infants. Specifically, whether a child was exclusively breastfeed for a minimum of 6 months or a minimum of a year could significantly predict the likelihood of the child developing type 2 diabetes.

The strengths of this study is that this systematic review is that it incorporates the results obtained from 9 different studies on the basis of relevance to the topic, whether the sample sizes were large enough, and whether there was adequate data reporting and collection on breastfeeding. The weaknesses of this review is that all of the evidence it contains is observational and based on surveys as opposed to testing what exactly is in breast milk that could provide a protective effect on infants against type 1 and type 2 diabetes. Because of this, even if there is a clear association between breastfeeding and prevention of diabetes, it's difficult to claim causation without more scientific evidence. In addition, this article doesn't make that many suggestions as to why breastfeeding and breast milk may have this positive effect. Overall, it's clear that this study supports the controversy that feeding children breast milk could prevent the onset of diabetes later on in life.

The long-term impact of breastfeeding on childhood obesity
This study looked at the effects of breastfeeding on children that were exposed to diabetes in utero and those that were not. The findings showed an association between breastfed for at least 6 months and having a significantly lower BMI, smaller waist circumference, and less subcutaneous abdominal fat (SAT)/visceral abdominal fat (VAT) during the ages of 6-13 years. For the subjects that were breastfeed for less than 6 months, their exposure to diabetes in utero was associated with higher BMI, larger waist circumference, and higher SAT/VAT. When the study looked at infants who received adequate breastfeeding during infancy, prenatal exposure to diabetes and childhood obesity outcomes was insignificant. This suggests that breastfeeding may have a protective effect against childhood obesity for infants born from mothers who have diabetes. The article suggests that the breast milk's levels of protein, fat carbohydrate, and bioactive substances not provided in formula may be a factor in affecting a child's metabolism, growth, and accumulation of body fat. In addition it states that higher insulin level and low leptin levels are seen in formula-fed infants as opposed to breast-fed infants.

The strengths of this study include its suggestions as to why breastfeeding may have a protective effects against diabetes, its focus on infants who were exposed to diabetes in utero, and the multiple proxies is uses to measure risk for obesity and diabetes. The weaknesses of this study are that it only looks at infants who were born at a single hospital in Colorado and therefore could use a larger sample size, and that it at best can only establish an association or correlation between exclusively feeding infant breast milk and lowered risk of diabetes risk factors. Overall, it's clear that this study supports the controversy that feeding children breast milk could prevent the development of diabetes related risk factors.

The influence of breastfeeding on development of childhood diabetes
This article was a review on the existing literature about the influence that breastfeeding has on protecting infants against developing diabetes later on in life. This non-systematic review found that the length and exclusivity of breastfeeding were important risk factors in protecting against diabetes. It suggests that human breast milk contains substances that promote infants' immune system development and thus protects against type 1 diabetes. The article also states that human breast milk contains bioactive ingredients that protect against the development of type 2 diabetes. It suggests that these substancse work to promote fullness and energy which in turn could prevent excess weight gain during childhood.

Strengths of this study include its ability to distinguish the effects that breastfeeding may have on type 1 and type 2 diabetes development and its attempt to explain why there is an association between breastfeeding and lower rates of diabetes as opposed as to just making the statistical association between them. The weaknesses of this study are that not all of the research articles that this one was based off of had the consensus of the benefits of breast feeding mentioned above, there seemed to be some inaccuracies on the reports of childhood dietary habit reports, and there may have been other variables that affected some infants from achieving some of the protective effects of breastfeeding. Overall, this study supports the controversy that feeding children breast milk could prevent the onset of diabetes later on in life.

Early infant feeding and the risk of type 1 diabetes in pre-school children
This case control study found that the length of breastfeeding an infant and the timing of when bottle-feeding was introduced was inversely associated with the risk of developing type 1 diabetes. Long breastfeeding periods were those characterized as being longer than 5 months.

A strength of this study was that is had a very large sample of subjects since it was a national wide study that included 760 different cases. The weaknesses of this article included the fact that it did not primarily focus on breastfeeding, but rather this factor was included among a mix of other variables such as social status, maternal age, low birth weight, and family size as possible risk factors for the development of diabetes in children. Overall, this study supports the controversy that feeding children breast milk could prevent the onset of diabetes later on in life.

Got Milk? Sharing Human Milk Via the Internet
This article describes some of the ways human milk has become a valued commodity and highlight some of the potential dangers of sharing raw, unpasteurized human milk. This article supports findings like multiple medications appear in breast milk and make it contraindicated for feeding to infants, and drugs of abuse can be present. Although breast milk is considered a healthier option to feed an infant, international health organizations state that only under exceptional circumstances should a mother's milk be considered unsuitable for her own infant and a “healthy wet-nurse” act as a potential alternative. This article supports the side of the controversy that cautions the public to be wary about milk sharing since it may inflict dangerous complications upon the infant, rather than provide him or her with boosted health benefits. The strength of this article is that it provides an understandable background of what milk sharing is and how feeding an infant with breast milk at whatever cost is not necessarily the best option. The weakness of this article was that it's written as a commentary and doesn't rely on an abundance of epidemiological data and scientific studies to make its claim.

Public opinions about infant feeding in the United States
This paper examines public opinions about the benefits of breastfeeding and the infant health risks associated with formula feeding. This information was obtained via a national public opinion survey that was conducted in 2013. The results showed that although the nutritional value of breast milk is fairly well known, fewer people believe that breastfeeding protects against childhood overweight or that formula feeding increases the chance of infant illness. Specifically, 78% of study participants agreed that breast milk was nutritionally designed for infants, whereas only 12% believed that it protected against infants becoming overweight. Participants who were less likely to believe that bottled milk increases the risk of infant illness were typically older, less‐educated, unmarried, and non‐Hispanic black people. One barrier to successful breastfeeding was related to the social norms within a mother's living environment, which can be seen by the "best of both" attitude often found among African American women. The strength of this article was the sample size of study participants was in the thousands so the results were less likely to be a product of randomly selecting atypical public opinions. The weaknesses of this study were that the demographics of the study didn't bother to include/categorize Asians and that participants had to complete many sets of surveys which may select for people with stronger opinions.

What predicts intent to breastfeed exclusively? Breastfeeding knowledge, attitudes, and beliefs in a diverse urban population
The researchers in this study measured the association between intentions to exclusively breastfeed and knowledge of infant health benefits, feeding guidelines, and comfort related to breastfeeding in social settings. Participants were lower-income, ethnically diverse women in two randomized, controlled trials of breastfeeding support. The study showed that women who disagreed that ‘Infant formula is as good as breast milk were more likely to intend exclusive breastfeeding versus exclusive formula feeding compared with women who agreed with this statement. Increasing levels of agreement that breastfed infants were less likely to develop ear infections, respiratory infections, diarrhea, and obesity were positively associated with intentions to exclusively breastfeed. Women who felt comfortable breastfeeding in public intended to exclusive breastfeed for 0.84 month longer as well. In conclusion, maternal knowledge about infant health benefits, as well as comfort with breastfeeding in social settings, was directly related to intention to exclusively breastfeed. Prenatal interventions that address these issues may increase exclusive breastfeeding intention and duration. This study supports the side of the controversy that deems breast milk superior to formula when it comes to health outcomes and nutritional benefits that it has on the infant. The strength of the article was that it focused on a vulnerable demographic (low SES, women of color) that is heavily impacted by this debate regarding infant feeding. The weakness of this article was that intentions to exclusively breastfeed doesn't account for the barriers that prevent women from doing so.

Breast Milk of HIV-Positive Mothers Has Potent and Species-Specific In Vivo HIV-Inhibitory Activity
Despite the nutritional and health benefits of breast milk, breast milk can serve as a vector for mother-to-child HIV transmission. Most HIV-infected infants acquire HIV through breastfeeding. Paradoxically, most infants breastfed by HIV-positive women do not become infected. This is potentially attributed to anti-HIV factors in breast milk. Breast milk of HIV-negative women can inhibit HIV infection. However, the HIV-inhibitory activity of breast milk from HIV-positive mothers has not been evaluated. In addition, while significant differences in breast milk composition between transmitting and nontransmitting HIV-positive mothers have been correlated with transmission risk, the HIV-inhibitory activity of their breast milk has not been compared. This knowledge may significantly impact the design of prevention approaches in resource-limited settings that do not deny infants of HIV-positive women the health benefits of breast milk. Here, we utilized bone marrow/liver/thymus humanized mice to evaluate the in vivo HIV-inhibitory activity of breast milk obtained from HIV-positive transmitting and nontransmitting mothers. We also assessed the species specificity and biochemical characteristics of milk's in vivo HIV-inhibitory activity and its ability to inhibit other modes of HIV infection. Our results demonstrate that breast milk of HIV-positive mothers has potent HIV-inhibitory activity and indicate that breast milk can prevent multiple routes of infection. Most importantly, this activity is unique to human milk. Our results also suggest multiple factors in breast milk may contribute to its HIV-inhibitory activity. Collectively, our results support current recommendations that HIV-positive mothers in resource-limited settings exclusively breastfeed in combination with antiretroviral therapy.

Approximately 240,000 children become infected with HIV annually, the majority via breastfeeding. Despite daily exposure to virus in breast milk, most infants breastfed by HIV-positive women do not acquire HIV. The low risk of breastfeeding-associated HIV transmission is likely due to antiviral factors in breast milk. It is well documented that breast milk of HIV-negative women can inhibit HIV infection. Here, we demonstrate, for the first time, that breast milk of HIV-positive mothers (nontransmitters and transmitters) inhibits HIV transmission. We also demonstrate that breast milk can prevent multiple routes of HIV acquisition and that this activity is unique to human milk. Collectively, our results support current guidelines which recommend that HIV-positive women in resource-limited settings exclusively breastfeed in combination with infant or maternal antiretroviral therapy.

Breastfeeding: some strategies used to market infant formula may discourage breastfeeding; state contracts should better protect against misuse of WIC name
This paper reviews the potential impact of infant formula marketing on breastfeeding rates. This is especially the case for infants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that serves almost half of infants born in the United States. Breastfeeding rates are substantially lower for WIC infants, and it was recommended that the Secretary of Agriculture educate all states about the USDA's Food and Nutrition Service policy that restricts the use of the WIC acronym and logo on formula promotional materials. This study supports the side of the controversy that supports the promotions of breast milk over infant formula via preventing promotional materials from.

The human milk oligosaccharide 2'-fucosyllactose attenuates the severity of experimental necrotising enterocolitis by enhancing mesenteric perfusion in the neonatal intestine
Necrotising enterocolitis (NEC) is a common disease in premature infants characterised by intestinal ischaemia and necrosis. The only effective preventative strategy against NEC is the administration of breast milk, although the protective mechanisms remain unknown. We hypothesise that an abundant human milk oligosaccharide (HMO) in breast milk, 2'-fucosyllactose (2'FL), protects against NEC by enhancing intestinal mucosal blood flow, and we sought to determine the mechanisms underlying this protection. Administration of HMO-2'FL protected against NEC in neonatal wild-type mice, resulted in a decrease in pro-inflammatory markers and preserved the small intestinal mucosal architecture. These protective effects occurred via restoration of intestinal perfusion through up-regulation of the vasodilatory molecule endothelial nitric oxide synthase (eNOS), as administration of HMO-2'FL to eNOS-deficient mice or to mice that received eNOS inhibitors did not protect against NEC, and by 16S analysis HMO-2'FL affected the microbiota of the neonatal mouse gut, although these changes do not seem to be the primary mechanism of protection. Induction of eNOS by HMO-2'FL was also observed in cultured endothelial cells, providing a link between eNOS and HMO in the endothelium. These data demonstrate that HMO-2'FL protects against NEC in part through maintaining mesenteric perfusion via increased eNOS expression, and suggest that the 2'FL found in human milk may be mediating some of the protective benefits of breast milk in the clinical setting against NEC.

Clinical Benefits of Milk Fat Globule Membranes for Infants and Children
The milk fat globule membrane (MFGM) in breast milk contains many bioactive components. Infant formulas traditionally have been devoid of the MFGM fraction, but dairy technology now has made the addition of bovine MFGM technically feasible. We identified 6 double-blinded randomized controlled trials exploring the effects of MFGM supplementation on the diets of infants or children. Results suggest that supplementation is safe and indicate positive effects on both neurodevelopment and defense against infections. MFGM supplementation of infant formula may narrow the gap in cognitive performance and infection rates between breastfed and formula-fed infants. Because of the small number of studies and the heterogeneity of interventions, more high-quality double-blinded randomized controlled trials are needed, with well characterized and clearly defined MFGM fractions, before firm conclusions on the effects of MFGM supplementation on the health and development of infants can be drawn.

Breast Milk Article Additions

 * Benefits (subheading)
 * In addition, feeding an infant breast milk is associated with lower insulin levels and higher leptin levels compared feeding an infant via powdered-formula.
 * A lower risk of child-onset diabetes may more applicable to infants who were born from diabetic mothers. The reason is because while breastfeeding for at least the first 6 months of life minimizes the risk of Type 1 diabetes from occurring in the infant, inadequate breastfeeding in an infant prenatally exposed to diabetes was associated with a higher risk of the child developing diabetes later on.
 * Lactation may protect the infant from specifically developing Type 2 diabetes because studies have shown that bioactive ingredients in human breast milk could prevent excess weight gain during childhood via contributing to a feeling of energy and satiety.
 * However, it can be argued that human breastfeeding may contribute to protective effects against the development of Type 1 diabetes due to the fact that the alternative of bottle-feeding may expose infants to unhygienic feeding conditions.
 * Composition (subheading)
 * Even though most infants infected with HIV contract the disease from breastfeeding, most infants that are breastfed by their HIV positive mothers never contract the disease. While this paradoxical phenomenon suggests that the risk of HIV transmission between an HIV positive mother and her child via breastfeeding is small, studies have also shown that feeding infants with breast milk of HIV-positive mothers can actually have a preventative effect against HIV transmission between the mother and child. This inhibitory effect against the infant contracting HIV is likely due to unspecified factors exclusively present in breast milk of HIV-positive mothers.
 * In addition, research has shown that women who rely on infant formula could minimize the gap between the level of immunity protection and cognitive abilities a breastfed child benefits from versus the degree to which a bottle-fed child benefits from them. This can be done by supplementing formula-fed infants with bovine milk fat globule membranes (MFGM) meant to mimic the positive effects of the MFGMs which are present in human breast milk.
 * Market (subheading)
 * Breast milk is considered to be healthier than cow's milk and infant formula when it comes to feeding an infant in the first 6 months of life, but only under extreme situations do international health organizations support feeding an infant breast milk from a healthy wet nurse rather than that of its biological mother. One reason is because the unregulated breast milk market is fraught with risks such as drugs of abuse and prescription medications being present in donated breast milk. The transmission of these substances through breast milk can do more harm than good when it comes to the health outcomes of the infant recipient.