Azad Meghan B, Nickel Nathan C, Bode Lars, Brockway Meredith, Brown Amy, Chambers Christina, Goldhammer Camie, Hinde Katie, McGuire Michelle, Munblit Daniel, Patel Aloka L, Pérez-Escamilla Rafael, Rasmussen Kathleen M, Shenker Natalie, Young Bridget E, Zuccolo Luisa
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Matern Child Nutr. 2021 Apr;17(2):e13109. doi: 10.1111/mcn.13109. Epub 2020 Nov 19.
Breastfeeding and human milk (HM) are critically important to maternal, infant and population health. This paper summarizes the proceedings of a workshop that convened a multidisciplinary panel of researchers to identify key priorities and anticipated breakthroughs in breastfeeding and HM research, discuss perceived barriers and challenges to achieving these breakthroughs and propose a constructive action plan to maximize the impact of future research in this field. Priority research areas identified were as follows: (1) addressing low breastfeeding rates and inequities using mixed methods, community partnerships and implementation science approaches; (2) improving awareness of evidence-based benefits, challenges and complexities of breastfeeding and HM among health practitioners and the public; (3) identifying differential impacts of alternative modes of HM feeding including expressed/pumped milk, donor milk and shared milk; and (4) developing a mechanistic understanding of the health effects of breastfeeding and the contributors to HM composition and variability. Key barriers and challenges included (1) overcoming methodological limitations of epidemiological breastfeeding research and mechanistic HM research; (2) counteracting 'breastfeeding denialism' arising from negative personal breastfeeding experiences; (3) distinguishing and aligning research and advocacy efforts; and (4) managing real and perceived conflicts of interest. To advance research on breastfeeding and HM and maximize the reach and impact of this research, larger investments are needed, interdisciplinary collaboration is essential, and the scientific community must engage families and other stakeholders in research planning and knowledge translation.
母乳喂养及母乳对母亲、婴儿及群体健康至关重要。本文总结了一场研讨会的会议记录，该研讨会召集了一个多学科研究小组，以确定母乳喂养及母乳研究的关键优先事项和预期突破，讨论实现这些突破所面临的已知障碍和挑战，并提出一项建设性行动计划，以最大限度地扩大该领域未来研究的影响。确定的优先研究领域如下：（1）采用混合方法、社区伙伴关系和实施科学方法解决母乳喂养率低和不平等问题；（2）提高卫生从业人员和公众对母乳喂养及母乳基于证据的益处、挑战和复杂性的认识；（3）确定母乳喂养替代方式（包括挤出/泵出的母乳、捐赠母乳和共享母乳）的不同影响；（4）对母乳喂养的健康影响以及母乳成分和变异性的影响因素形成机制性理解。主要障碍和挑战包括：（1）克服流行病学母乳喂养研究和母乳机制研究的方法局限性；（2）应对因负面个人母乳喂养经历而产生的“母乳喂养否定论”；（3）区分并协调研究与宣传工作；（4）处理实际和感知到的利益冲突。为推进母乳喂养及母乳研究并最大限度地扩大该研究的范围和影响，需要加大投资，跨学科合作至关重要，科学界必须让家庭和其他利益相关者参与研究规划和知识转化。
