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1.  The Initial Maternal Cost of Providing 100 mL of Human Milk for Very Low Birth Weight Infants in the Neonatal Intensive Care Unit 
Objectives
Human milk (HM) feeding is associated with lower incidence and severity of costly prematurity-specific morbidities compared to formula feeding in very low birth weight (VLBW; <1,500 g) infants. However, the costs of providing HM are not routinely reimbursed by payers and can be a significant barrier for mothers. This study determined the initial maternal cost of providing 100 mL of HM for VLBW infants during the early neonatal intensive care unit (NICU) stay.
Methods
This secondary analysis examined data from 111 mothers who provided HM for their VLBW infants during the early NICU stay. These data were collected during a multisite, randomized clinical trial where milk output and time spent pumping were recorded for every pumping session (n = 13,273). The cost analysis examined the cost of the breast pump rental, pump kit, and maternal opportunity cost (an estimate of the cost of maternal time).
Results
Mean daily milk output and time spent pumping were 558.2 mL (SD = 320.7; range = 0–2,024) and 98.7 minutes (SD = 38.6; range = 0–295), respectively. The mean cost of providing 100 mL of HM varied from $2.60 to $6.18 when maternal opportunity cost was included and from $0.95 to $1.55 when it was excluded. The cost per 100 mL of HM declined with every additional day of pumping and was most sensitive to the costs of the breast pump rental and pump kit.
Conclusions
These findings indicate that HM is reasonably inexpensive to provide and that the maternal cost of providing milk is mitigated by increasing milk output over the early NICU stay.
doi:10.1089/bfm.2009.0063
PMCID: PMC2879042  PMID: 20113201
2.  INADEQUATE: A Metaphor for the Lives of Low-Income Women? 
Exclusive breastfeeding of infants for the first six months of life with continued breastfeeding for at least six more months occurs only 11.9% of the time in the US. Efforts of the past 30 years to promote optimal breastfeeding practices have had little impact. In order to create significant change in the way we feed infants in this country, we need to change the way we look at this public health issue and examine the cultural logic that makes bottle feeding the preferred choice of most US women. This paper analyzes the term ‘inadequate’ not just as self-description of a woman’s milk supply, but also as a metaphor for the lives of low-income women in the US, the group least likely to breastfeed. Low-income women in the US not only have inadequate incomes as compared to the general population, but inadequate child-care, education, preventive health services, and lives saturated with violence, leaving them inadequately safe even in their own homes. Here we outline a research agenda to explore the relationship between socially determined inadequacies and the cultural logic that makes bottle feeding a preferred form of infant feeding. (190 words)
doi:10.1089/bfm.2009.0035
PMCID: PMC2763322  PMID: 19827922
3.  Breastmilk from Allergic Mothers Can Protect Offspring from Allergic Airway Inflammation 
Objective
Breastfeeding is associated with a reduced risk of developing asthma in children. Using a murine model we previously demonstrated that mothers with Th1-type immunity to ovalbumin (OVA) transfer antigen-specific protection from OVA-induced allergic airway disease (AAD) to their offspring. The aim of this study was to evaluate the contribution of breastmilk and maternal B cell immunity from allergic mothers in the vertical transmission of protection from AAD.
Methods
This was investigated using an adoptive nursing strategy. Naive offspring were nursed by allergic wild-type or B cell-deficient foster mothers with histories of Th2-type immunity to OVA. Following weaning, offspring were immunized with OVA-Al(OH)3 and challenged with aerosolized OVA to induce AAD.
Results
Offspring nursed by wild-type OVA-immune foster mothers demonstrated lower levels of OVA-specific immunoglobulin E, interleukin-5, and airway eosinophilia than progeny nursed by naive control mothers. In contrast, offspring nursed by B cell-deficient OVA-immune foster mothers had similar parameters of OVA-induced AAD as progeny nursed by naive control mothers.
Conclusions
These data demonstrate the ability of breastmilk from allergic mothers to protect offspring from AAD was dependent on intact maternal B cell immunity. Nursing alone, when done by wild-type mothers with AAD, was sufficient for offspring to acquire the antigen-specific protective factor(s) from breastmilk.
doi:10.1089/bfm.2008.0130
PMCID: PMC2757118  PMID: 19301986
4.  Methadone Maintenance and Long-Term Lactation 
Breastfeeding among methadone-maintained women is frequently challenged because of unclear guidelines regarding this practice. Previous research has confirmed that concentrations of methadone in breastmilk in the neonatal period are low. Currently unknown are the concentrations of methadone in breastmilk among women who breastfeed for longer periods of time. The purpose of this research is to examine concentrations of methadone in the plasma and breastmilk of women who breastfeed their infants beyond the neonatal period. Four methadone-maintained women provided blood and breastmilk samples up to 6 months postpartum. The concentrations of methadone in blood and breastmilk were low, contributing to the recommendation of breastfeeding for some methadone-maintained women.
doi:10.1089/bfm.2007.0032
PMCID: PMC2689552  PMID: 18333767

Results 1-4 (4)