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\"What happens to pregnant women when the largest country in the world implements a global health policy aimed at reorganizing hospitals and re- training health care workers to promote breastfeeding? Since 1992, the Chinese government has led the world in reorganizing more than 7,000 hospitals into \"Baby- Friendly\" hospitals. The initiative's goal, overseen by UNICEF and the World Health Organization, is to promote the practice of breastfeeding by reorganizing hospital routines, spaces, and knowledge in maternity wards and obstetrics clinics. At the same time, China's hospitals in the mid- 1990s operated as sites where the effects of economic reform and capitalism increasingly blurred the boundaries between state imperatives to produce healthy future citizens and the flexibility accorded individuals through their participation in an emerging consumer culture. Formulas for Motherhood follows a group of women over eighteen months as they visited a Beijing Baby- Friendly Hospital over the course of their pregnancies and throughout their postpartum recoveries. The book shows how the space of the hospital operates as a microcosm of the larger social, political, and economic forces that urban Chinese women navigate in the process of becoming a mother. Relations between biomedical practices, heightened expectations of femininity and sexuality demanded by a consumer culture, alongside international and national agendas to promote maternal and child health, reveal new agents of maternal governance emerging at the very moment China's economy heats up. This ethnography provides insight into how women's creative pragmatism in a rapidly changing society leads to their views and decisions about motherhood\"-- Provided by publisher.

Despite recommendations from the World Health Organization and the American Academy of Pediatrics to exclusively breastfeed infants for their first 6 months of life, 75% of women do not meet exclusive breastfeeding guidelines, and 60% do not meet their own breastfeeding goals. Numerous observational studies have linked maternal psychological distress (eg, perceived stress, anxiety, and depression) with nonoptimal breastfeeding outcomes, such as decreased proportion and duration of exclusive breastfeeding. The physiological mechanisms underlying these associations, however, remain unclear. For this narrative review, we evaluated the evidence of relationships between maternal psychological distress and lactation and breastfeeding outcomes in pregnancy and post partum and the possible physiological mechanisms that facilitate these relationships. We searched PubMed using the following terms: stress, anxiety, depression, breastfeeding, and lactation. Additional search by hand was conducted to ensure a thorough review of the literature. Among the studies examined, methods used to assess maternal psychological distress were not uniform, with some studies examining perceived distress via a variety of validated tools and others measuring biological measures of distress, such as cortisol. Evidence supports a role for psychological distress in multiple breastfeeding outcomes, including delayed secretory activation and decreased duration of exclusive breastfeeding. One physiological mechanism proposed to explain these relationships is that psychological distress may impair the release of oxytocin, a hormone that plays a critical role in milk ejection during lactation. Continued impairment of milk ejection may lead to decreased milk production because of incomplete emptying of the breast during each feed. Maternal distress may also yield elevated levels of serum cortisol and decreased insulin sensitivity, which are associated with decreased milk production. The relationship between psychological distress and breastfeeding is likely to be bidirectional, however, in that breastfeeding appears to reduce maternal distress, again possibly via effects on the pleasure or reward pathway and calming effects of oxytocin on the mother. This finding suggests that interventions to support lactation and breastfeeding goals in women who score high on measures of psychological distress would be beneficial for both maternal and infant well-being. Evidence to date suggests that maternal psychological distress may impair lactation and breastfeeding outcomes, but stronger study designs and rigorous assessment methods are needed. A better understanding of the physiological mechanisms leading to impaired lactation may assist in the development of early interventions for mothers experiencing distress. In addition, stress-reducing programs and policies should be investigated for their potential to improve breastfeeding outcomes.

\"After drawing its first breath, every newborn mammal turns his or her complete attention to obtaining milk. This primal act was once thought to stem from a basic fact: milk provides the initial source of calories and nutrients for all mammalian young. But it turns out that milk is a much more complicated biochemical cocktail and provides benefits beyond nutrition. In this fascinating book, biologists Michael L. Power and Jay Schulkin reveal this liquid's evolutionary history and show how its ingredients have changed over many millions of years to become a potent elixir. Power and Schulkin walk readers through the early origins of the mammary gland and describe the incredible diversification of milk among the various mammalian lineages. After revealing the roots of lactation, the authors describe the substances that naturally occur in milk and discuss their biological functions. They reveal that mothers pass along numerous biochemical signals to their babies through milk. The authors explain how milk boosts an infant's immune system, affects an infant's metabolism and physiology, and helps inoculate and feed the baby's gut microbiome. Throughout the book, the authors weave in stories from studies of other species, explaining how comparative research sheds light on human lactation. The authors then turn their attention to the fascinating topic of cross-species milk consumption--something only practiced by certain humans who evolved an ability to retain lactase synthesis into adulthood. The first book to discuss milk from a comparative and evolutionary perspective, Power and Schulkin's masterpiece reveals the rich biological story of the common thread that connects all mammals\"-- Provided by publisher.

One impediment to breastfeeding is the lack of information on the use of many drugs during lactation, especially newer ones. The principles of drug passage into breastmilk are well established, but have often not been optimally applied prospectively. Commonly used preclinical rodent models for determining drug excretion into milk are very unreliable because of marked differences in milk composition and transporters compared to those of humans. Measurement of drug concentrations in humans remains the gold standard, but computer modeling is promising. New FDA labeling requirements present an opportunity to apply modeling to preclinical drug development in place of conventional animal testing for drug excretion into breastmilk, which should improve the use of medications in nursing mothers.

High-lactation cows exhibit advantages in milk yield and quality compared to low-lactation cows; however, the underlying mechanisms remain unclear. Based on the demand for high-quality milk sources in the food industry, this study used single-cell sequencing technology (scRNA-seq) on the 10 × Chromium platform to analyze the milk cells of 10 Holstein cows (5 in the high-lactation group and 5 in the low-lactation group). The seven cell types included two types of epithelial cells (epithelial and secretory epithelial cells) and five types of immune cells (neutrophils, T cells, macrophages, B cells, and dendritic cells). Further sub-clustering analysis identified three epithelial cell types and nine T-cell subsets, and their differentiation paths were depicted through pseudo temporal analysis. Inter-group comparisons revealed differential genes and signaling pathways that affect lactation performance, such as lactation-related pathways (prolactin, protein export, thermogenesis) and immune-related pathways (Toll-like receptor, cytokine-receptor interaction, and NF-κB). In addition, this study elucidated the complex signaling relationships between epithelial and immune cells, especially the impact of CyPA, ICAM, and SELL signaling pathways on lactation. Moreover, additional analyses of macrophage and neutrophil subpopulations further revealed their interactions with epithelial cells, providing complementary insights into immune regulation during lactation.This study enriches the knowledge of cow lactation biology and provides a reference for the food industry to screen high-quality milk sources and optimize dairy processing technology.

Background Breastfeeding has many benefits for mothers and infants. Lactogenesis II is one of the key steps in the implementation of breastfeeding. If lactogenesis II occurs more than 72 h after delivery, it is termed delayed onset of lactation (DOL). DOL is associated with decreased milk production, shortened breastfeeding time, and pathological neonatal weight loss. A comprehensive summary of the incidence and factors influencing DOL is needed to provide a basis for improving breastfeeding practices and health outcomes. Methods Studies on the incidence and factors influencing DOL were retrieved from 13 Chinese and English databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL, etc.) from database inception to August 2023. Two researchers independently conducted the study screening, data extraction and quality evaluation. Stata 16.0 SE software was used for data analysis, and sensitivity analysis and publication bias tests were also performed. The qualitative description method was used to analyse studies that could not be combined quantitatively. Results A total of 35 studies involving 19,176 parturients, including 4,922 who had DOL, were included. The mean Newcastle‒Ottawa scale score of the included studies was ≥ 6, indicating that the quality was relatively high. Finally, the incidence of DOL was 30%, and 13 factors influencing DOL with robust results and no publication bias were obtained: prepregnancy body mass index (overweight or obesity), gestational diabetes, gestational hypertension, thyroid disease during pregnancy, serum albumin levels (< 35 g/L), parity, (unscheduled) caesarean section, caesarean section history, daily sleep duration, gestational age, birth weight (< 2.5 kg), breastfeeding guidance and daily breastfeeding frequency. However, there were still six influencing factors with undetermined associations: age, gestational weight gain, birth weight (≥ 4 kg), anxiety, time of first breastfeeding session (maternal separation) and breast massage or treatment. Conclusions The incidence of DOL is high. Clinicians should pay attention to parturients at high risk of DOL and formulate targeted prevention strategies according to the influencing factors to reduce the occurrence of DOL and promote better maternal and infant outcomes. Trial registration PROSPERO (ID: CRD42023458786), September 10, 2023.

Background Lactation is extremely important for dairy cows; however, the understanding of the underlying metabolic mechanisms is very limited. This study was conducted to investigate the inherent metabolic patterns during lactation using the overall biofluid metabolomics and the metabolic differences from non-lactation periods, as determined using partial tissue-metabolomics. We analyzed the metabolomic profiles of four biofluids (rumen fluid, serum, milk and urine) and their relationships in six mid-lactation Holstein cows and compared their mammary gland (MG) metabolomic profiles with those of six non-lactating cows by using gas chromatography-time of flight/mass spectrometry. Results In total, 33 metabolites were shared among the four biofluids, and 274 metabolites were identified in the MG tissues. The sub-clusters of the hierarchical clustering analysis revealed that the rumen fluid and serum metabolomics profiles were grouped together and highly correlated but were separate from those for milk. Urine had the most different profile compared to the other three biofluids. Creatine was identified as the most different metabolite among the four biofluids (VIP = 1.537). Five metabolic pathways, including gluconeogenesis, pyruvate metabolism, the tricarboxylic acid cycle (TCA cycle), glycerolipid metabolism, and aspartate metabolism, showed the most functional enrichment among the four biofluids (false discovery rate < 0.05, fold enrichment >2). Clear discriminations were observed in the MG metabolomics profiles between the lactating and non-lactating cows, with 54 metabolites having a significantly higher abundance ( P  < 0.05, VIP > 1) in the lactation group. Lactobionic acid, citric acid, orotic acid and oxamide were extracted by the S-plot as potential biomarkers of the metabolic difference between lactation and non-lactation. The TCA cycle, glyoxylate and dicarboxylate metabolism, glutamate metabolism and glycine metabolism were determined to be pathways that were significantly impacted ( P  < 0.01, impact value >0.1) in the lactation group. Among them, the TCA cycle was the most up-regulated pathway ( P  < 0.0001), with 7 of the 10 related metabolites increased in the MG tissues of the lactating cows. Conclusions The overall biofluid and MG tissue metabolic mechanisms in the lactating cows were interpreted in this study. Our findings are the first to provide an integrated insight and a better understanding of the metabolic mechanism of lactation, which is beneficial for developing regulated strategies to improve the metabolic status of lactating dairy cows.

Objective This study aimed to compare the characteristics and experiences of women with measured low and normal 24 h milk production. Methods We analysed data from a nested case-control study of 136 participants who measured their 24 h milk production within 1–6 months of birth and completed an online survey of lactation risk factors and experiences within 2 years of birth. The study was conducted between January 2020 and March 2024. 24 h milk production, calculated as the sum of all pre-post breastfeed and expression weights, was classified as low (< 600 mL) or normal milk production (≥ 600 mL). The prevalence of anatomical, endocrine/metabolic, pregnancy, birth complications and postpartum lactation risk factors was reported. Further, the experiences of participants that reported low milk production were described. Results Low milk production was measured in 39 out of 136 participants (29%). Breast hypoplasia was more prevalent in this group (low milk production 13%; normal milk production 3%; p  = 0.03). Of those with measured low milk production 21% perceived production was normal. In participants with measured normal production 28% had perceived low production. Formula use was more common among those with low milk production, and their infants had significantly lower weight-for-age z-scores despite similar birth weights. Qualitative data reflected the stress and effort expended in trying to increase milk production, and 10/26 (39%) rated lactation consultant support as most helpful in managing their milk production. Conclusions Low milk production is a multifactorial and common concern, affecting nearly one in three breastfeeding women. While some contributing risk factors such as breast hypoplasia were identified, over half of the affected participants had not received an explanation from their healthcare provider. This underscores that low milk production is not always fully explainable or treatable, and highlights the need for personalized supportand further research to improve clinical assessment and effective management.

Lactation persistency and milk production are among the most economically important traits in the dairy industry. In this study, we explored the association of over 6.1 million imputed whole-genome sequence variants with lactation persistency (LP), milk yield (MILK), fat yield (FAT), fat percentage (FAT%), protein yield (PROT), and protein percentage (PROT%) in North American Holstein cattle. We identified 49, 3991, 2607, 4459, 805, and 5519 SNPs significantly associated with LP, MILK, FAT, FAT%, PROT, and PROT%, respectively. Various known associations were confirmed while several novel candidate genes were also revealed, including ARHGAP35, NPAS1, TMEM160, ZC3H4, SAE1, ZMIZ1, PPIF, LDB2, ABI3, SERPINB6, and SERPINB9 for LP; NIM1K, ZNF131, GABRG1, GABRA2, DCHS1, and SPIDR for MILK; NR6A1, OLFML2A, EXT2, POLD1, GOT1, and ETV6 for FAT; DPP6, LRRC26, and the KCN gene family for FAT%; CDC14A, RTCA, HSTN, and ODAM for PROT; and HERC3, HERC5, LALBA, CCL28, and NEURL1 for PROT%. Most of these genes are involved in relevant gene ontology (GO) terms such as fatty acid homeostasis, transporter regulator activity, response to progesterone and estradiol, response to steroid hormones, and lactation. The significant genomic regions found contribute to a better understanding of the molecular mechanisms related to LP and milk production in North American Holstein cattle.

The exponential growth in knowledge has resulted in a better understanding of the lactation process in a wide variety of animals. However, the underlying genetic mechanisms are not yet clearly known. In order to identify the mechanisms involved in the lactation process, various mehods, including meta-analysis, weighted gene co-express network analysis (WGCNA), hub genes identification, gene ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment at before peak (BP), peak (P), and after peak (AP) stages of the lactation processes have been employed. A total of 104, 85, and 26 differentially expressed genes were identified based on PB vs. P, BP vs. AP, and P vs. AP comparisons, respectively. GO and KEGG pathway enrichment analysis revealed that DEGs were significantly enriched in the “ubiquitin-dependent ERAD” and the “chaperone cofactor-dependent protein refolding” in BP vs. P and P vs. P, respectively. WGCNA identified five significant functional modules related to the lactation process. Moreover, GJA1 , AP2A2 , and NPAS3 were defined as hub genes in the identified modules, highlighting the importance of their regulatory impacts on the lactation process. The findings of this study provide new insights into the complex regulatory networks of the lactation process at three distinct stages, while suggesting several candidate genes that may be useful for future animal breeding programs. Furthermore, this study supports the notion that in combination with a meta-analysis, the WGCNA represents an opportunity to achieve a higher resolution analysis that can better predict the most important functional genes that might provide a more robust bio-signature for phenotypic traits, thus providing more suitable biomarker candidates for future studies.