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Importantly, the rewards of change have been tangible and impactful for mothers and their babies. This road has not been smooth, with findings that have disrupted the field requiring the reassessment of conventional dogma and change of deep-seated beliefs. These studies have provided the foundation for the development of successful interventions for those mothers experiencing lactation difficulties and have informed and reassured those women, particularly first-time mothers, that they are ‘normal’. The evolution of our research program has been in direct response to the need to fill the translation gap and has been a journey from basic research into the anatomy, function of the breast and milk composition to multidimensional translational research elucidating mechanisms by which breastfeeding confers a multitude of benefits. Evidence-based care, established from an understanding of the basic principles of lactation and mammary gland function is imperative to improve breastfeeding rates and subsequently the health and wellbeing of breastfeeding women, infants’, and their families.
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The dearth of research into the fundamentals of human lactation over the latter part of the last century, combined with the lack of translation of the limited research actually performed into the medical model, has left clinicians little scope and tools to objectively assess breastfeeding problems. In the haste to provide support and solutions, an understanding of the basic science is frequently neglected in favour of the implementation of interventional trials that promise advances in care but are themselves based on an incomplete foundational understanding. To identify and address the issues faced by the breastfeeding dyad a foundational knowledge of the ‘norm’ is required. Despite the wealth of information on the benefits to both the mother and the infant, global breastfeeding rates remain low, averaging only 41%. It also sets a foundation for improved study design for future investigations in human lactation.īreastfeeding is a major determinant of infant short- and long-term health, preventing acute infections and programming lower risk for chronic disease and is therefore considered to be a major public health focus. This approach has allowed the translation of the findings with respect to education, and clinical practice.
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Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health.