Karleen D. Gribble

Mental health, attachment and breastfeeding: implications for adopted children and their mothers

Breastfeeding an adopted child has previously been discussed as something that is nice to do but without potential for significant benefit. This paper reviews the evidence in physiological and behavioural research, that breastfeeding can play a significant role in developing the attachment relationship between child and mother. As illustrated in the case studies presented, in instances of adoption and particularly where the child has experienced abuse or neglect, the impact of breastfeeding can be considerable. Breastfeeding may assist attachment development via the provision of regular intimate interaction between mother and child; the calming, relaxing and analgesic impact of breastfeeding on children; and the stress relieving and maternal sensitivity promoting influence of breastfeeding on mothers. The impact of breastfeeding as observed in cases of adoption has applicability to all breastfeeding situations, but may be especially relevant to other at risk dyads, such as those families with a history of intergenerational relationship trauma; this deserves further investigation.

Peer-to-Peer Milk Donors' and Recipients' Experiences and Perceptions of Donor Milk Banks

OBJECTIVE To explore the intersection of peer-to-peer milk sharing and donor milk banks. METHODS A descriptive survey design containing closed and open-ended questions was used to examine womens perceptions of peer-to-peer milk sharing and milk banking. Closed-ended questions were analyzed using descriptive statistics and conventional qualitative content analysis was used to analyze open-ended responses. SETTING Participants were recruited via the Facebook sites of two online milk-sharing networks (Human Milk 4 Human Babies and Eats on Feet). PARTICIPANTS Ninety-eight milk donors and 41 milk recipients who had donated or received breast milk in an arrangement that was facilitated via the Internet. RESULTS One half of donor recipients could not donate to a milk bank because there were no banks local to them or they did not qualify as donors. Other respondents did not donate to a milk bank because they viewed the process as difficult, had philosophical objections to milk banking, or had a philosophical attraction to peer sharing. Most donor respondents felt it was important to know the circumstances of their milk recipients. No recipient respondents had obtained milk from a milk bank; it was recognized that they would not qualify for banked milk or that banked milk was cost prohibitive. CONCLUSION Peer-to-peer milk donors and recipients may differ from milk bank donors and recipients in significant ways. Cooperation between milk banks and peer sharing networks could benefit both groups.

Milk sharing and formula feeding: Infant feeding risks in comparative perspective?

The advent of Internet forums that facilitate peer-to-peer human milk sharing has resulted in health authorities stating that sharing human milk is dangerous. There are risks associated with all forms of infant feeding, including breastfeeding and the use of manufactured infant formulas. However, health authorities do not warn against using formula or breastfeeding; they provide guidance on how to manage risk. Cultural distaste for sharing human milk, not evidenced-based research, supports these official warnings. Regulating bodies should conduct research and disseminate information about how to mitigate possible risks of sharing human milk, rather than proscribe the practice outright.

In vitro uptake of minerals by Gypsophila paniculata and hybrid eucalypts, and relevance to media mineral formulation

Despite the importance of mineral nutrition for plantlet growth in vitro, there have been few studies on mineral uptake from growth media or on optimising the media used in tissue culture. As plants in vitro experience abnormal growth conditions and may not possess roots, they may use different mechanisms of mineral uptake than plants growing ex vitro. To examine this possibility, plantlets of Gypsophila paniculata were grown on media in which the K or Ca concentration was varied. Mineral analysis showed a linear relationship between concentrations of K or Ca in the growth medium and plantlet tissues, suggesting uptake is by passive diffusion. However, interactions occurred between K, Ca and Mg uptake; therefore, other mechanisms are also likely to be involved in regulating mineral concentrations in tissue. The study also demonstrated that critical mineral concentrations could be estimated by using tissue-culture systems, as the concentration ranges of K and Ca in vitro correlated well with data for a related species ex vitro. This knowledge of critical concentrations, in conjunction with tissue analysis and ion speciation modelling, can be used to optimise in vitro mineral formulations through cycles of culture, tissue analysis and medium reformulation. To test this proposal, plantlets of Eucalyptus europhylla × grandis were grown on a proprietary medium formulation (SEM) and one modified as a result of tissue analysis (MEM). Plantlets cultured on SEM had chlorotic leaves and serious mineral imbalances. In contrast, plantlets cultured on MEM were not chlorotic, had more uniform growth and a more balanced mineral content. However, modification of mineral concentrations in the culture medium did not always result in similar changes in plant tissues. These differences in the proportions of minerals in the medium and those in the plant indicate that there are interactions between minerals in the medium and/or between minerals and the agar matrix that influence mineral availability and uptake.

Position of water in vitrified plants visualised by NMR imaging

SummaryVitrification of plants in vitro is a physiological abnormality of tissue-cultured plants which causes significant losses in the micropropagation industry. Vitrified plants are waterlogged but the position of water within plants has not been identified. Nuclear magnetic resonance (NMR) imaging of normal tissue-cultured, vitrified tissue-cultured, and glasshouse-grown leaves ofGypsophila paniculata showed the distribution of water within the leaves. Normal tissue-cultured and glasshouse-grown leaves had a high concentration of water within leaf vascular bundles and lower concentrations elsewhere. In contrast, vitrified leaves had a relatively even distribution of high water concentration throughout the leaves. When imaging parameters were changed, so that only water associated with cell membranes was shown, the images of normal tissue-cultured and glasshouse-grown leaves did not change. However, the image of the vitrified leaves showed a general lowering of intensity across the whole of the leaf. The appearance of the NMR images, together with those obtained by light microscopy, suggest that the excess water associated with vitrified plants is located in the intercellular air spaces. The blockage of these spaces may lead to a cycle of perturbations in the plants physiology culminating in the development of vitrification.

Environmental scanning electron microscopy of the surface of normal and vitrified leaves of Gypsophila paniculata (Babies Breath) cultured in vitro.

Leaf surfaces of non-tissue-cultured, vitrified and non-vitrified plantlets of Gypsophila paniculata (Babies Breath) were examined using an environmental scanning electron microscope. Non-tissue-cultured plants had a complete epidermal surface, recessed stomata and wax present on the leaf surface. The surface of tissue-cultured plantlets appeared similar to non-tissue-cultured plants excepting stomata were slightly protruding and less wax appeared to be present. In both non-tissue-cultured and tissue-cultured plants stomata were found both opened and closed and were observed closing. In contrast vitrified plantlets had abnormal, malformed stomata which appeared non-functional. The ventral surfaces of leaves seemed more normal than the dorsal, this may be due to the former receiving more light. Additionally, discontinuities were found in the epidermis. Often epidermal holes were found in association with stomatal apertures. It is suggested that the main cause of desiccation of vitrified G. paniculata plantlets ex vitro is due to loss of water from the discontinuity in epidermis and not because of non-functional stomata. Liquid water could be seen through the epidermal holes indicating that at least some of the extra water in vitrified plantlets is contained in the intercellular spaces.

The influence of relative humidity on vitrification, growth and morphology of Gypsophila paniculata L.

A vitrification scoring system was devised that comprised a visual assessment of vitrification in vitro followed by transplanting of plantlets ex vitro and recording of plantlet survival rates. This proved to be a simple method of predicting survival of plantlets ex vitro and demonstrated that vitrification severity is more important than acclimitization procedures in promoting survival ex vitro. Growth of normal plantlets in liquid medium in an environment where plantlets are able to transpire made it clear that lack of transpiration as opposed to high water availability is the primary cause for induction of vitrified growth. Finally, small decreases in relative humidity in vitro were found to be sufficient to increase plantlet transpiration to the extent that vitrification is greatly reduced and survival ex vitro increased. Small differences in relative humidity also influenced plantlet morphology with plantlets grown at a higher relative humidity being larger and consisting of more shoots than plantlets grown at a lower relative humidity. It is suggested that in vitro relative humidity may be manipulated to produce plantlets of a particular morphology and should be measured in tissue culture experiments and included in the materials and methods sections of papers to ensure correct interpretation of results.

Infant and Young Child Feeding in Emergencies

Infants and young children are vulnerable in any emergency. It is the position of the International Lactation Consultant Association that supporting their wellbeing should be a priority of governments, aid agencies, health workers, and members of the public. Such support should include assistance for exclusive and continued breastfeeding, safe artificial feeding where breastfeeding or provision of human milk is not possible, and appropriate complementary feeding for all infants and young children.

Perception and management of risk in Internet-based peer-to-peer milk-sharing

The perception and management of the risks of peer-to-peer milk sharing was explored via a written questionnaire administered to 97 peer milk donors and 41 peer milk recipients who were recruited via Facebook. All recipients’ respondents were aware that there were risks associated with using peer-shared milk and took action to mitigate these risks; however, their knowledge and risk mitigation was incomplete. Recipient respondents were well informed as to the risks involved in artificial feeding and this contributed to their decision to prefer peer-shared milk. Many donor respondents did not follow guidelines for safe milk expression. Many respondents had not discussed milk sharing with a health provider. It is recommended that health providers be proactive in providing education to minimise the risks of peer-to-peer milk sharing. This is the first study to examine the views and practices of Internet-facilitated peer-to-peer milk sharing and provides insight that may improve the safety of the practice.

Media messages and the needs of infants and young children after Cyclone Nargis and the WenChuan Earthquake

Infants and young children are vulnerable in emergencies. The media plays an important role in aid delivery and has a positive impact when reports are accurate. However, the media has been implicated in encouraging harmful aid in the form of donations of infant formula and other milk products. Internet-based media reports were collected after Cyclone Nargis in Myanmar and the WenChuan Earthquake in China (2008) and examined for content related to infant and young child feeding. Common messages identified included that: babies are vulnerable; stress prevents breastfeeding; and providing infant formula saves lives. Messages rarely reported included that: artificial feeding is dangerous; and breastfeeding protects infants. This analysis suggests that current patterns of media reporting may encourage harmful aid and increase child morbidity and mortality. Aid organisations should encourage the media to report accurately on the needs of infant and young children in emergencies so as to improve aid delivery.