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C Cooper - One of the best experts on this subject based on the ideXlab platform.

  • Infant Milk feeding and bone health in later life findings from the hertfordshire cohort study
    Osteoporosis International, 2020
    Co-Authors: Sarah Carter, C Parsons, S M Robinson, Nicholas C Harvey, K A Ward, C Cooper
    Abstract:

    Using data from the Hertfordshire cohort study, this study examined the effect of breastfeeding and bottle feeding on adult lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD). The type of Infant Milk feeding was significantly associated with lumbar spine BMD in males. INTRODUCTION Using data from the Hertfordshire cohort study (HCS), this study aims to examine the effect of Infant Milk feeding on bone health in later life by comparing the effect of breastfeeding and bottle feeding on lumbar spine and femoral neck BMC and BMD. METHODS Information about Infant Milk feeding, birth weight (kg) and weight at 1 (kg) was collected by health visitors between 1931 and 1939 in Hertfordshire. BMC and BMD measurements were taken by DXA scan between 1998 and 2004. Linear regression models adjusted for conditional weight at 1, age at DXA scan, sex, adult BMI, smoking behaviour, alcohol consumption, physical activity, dietary calcium, and prudent diet score. RESULTS Infant Milk feeding was significantly associated with lumbar spine BMD (b = - 0.028; 95% CI, - 0.055; - 0.000; p value, 0.047) in males. On average, males who consumed breastMilk alternatives in infancy had lower lumbar spine BMD measurements than those who were fed only breastMilk. These associations remained significant in fully adjusted models. There were no significant associations between Infant Milk feeding and bone health for females. CONCLUSIONS Significant associations between Infant Milk feeding and lumbar spine BMD in males indicate that breastMilk may be protective for the bone health of male babies. The evidence presented here underscores the potential lifelong benefits of breastfeeding and may highlight the differences between osteoporotic risk factors for males and females.

  • Infant Milk feeding and bone health in later life findings from the hertfordshire cohort study
    Osteoporosis International, 2020
    Co-Authors: Sarah Carter, C Parsons, S M Robinson, Nicholas C Harvey, K A Ward, C Cooper
    Abstract:

    Using data from the Hertfordshire cohort study, this study examined the effect of breastfeeding and bottle feeding on adult lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD). The type of Infant Milk feeding was significantly associated with lumbar spine BMD in males. Using data from the Hertfordshire cohort study (HCS), this study aims to examine the effect of Infant Milk feeding on bone health in later life by comparing the effect of breastfeeding and bottle feeding on lumbar spine and femoral neck BMC and BMD. Information about Infant Milk feeding, birth weight (kg) and weight at 1 (kg) was collected by health visitors between 1931 and 1939 in Hertfordshire. BMC and BMD measurements were taken by DXA scan between 1998 and 2004. Linear regression models adjusted for conditional weight at 1, age at DXA scan, sex, adult BMI, smoking behaviour, alcohol consumption, physical activity, dietary calcium, and prudent diet score. Infant Milk feeding was significantly associated with lumbar spine BMD (b = − 0.028; 95% CI, − 0.055; − 0.000; p value, 0.047) in males. On average, males who consumed breastMilk alternatives in infancy had lower lumbar spine BMD measurements than those who were fed only breastMilk. These associations remained significant in fully adjusted models. There were no significant associations between Infant Milk feeding and bone health for females. Significant associations between Infant Milk feeding and lumbar spine BMD in males indicate that breastMilk may be protective for the bone health of male babies. The evidence presented here underscores the potential lifelong benefits of breastfeeding and may highlight the differences between osteoporotic risk factors for males and females.

A K M Masum - One of the best experts on this subject based on the ideXlab platform.

  • influence of drying temperatures and storage parameters on the physicochemical properties of spray dried Infant Milk formula powders
    International Dairy Journal, 2020
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract The influence of spray drier inlet (180 and 200 °C) and outlet (80, 90 and 100 °C) air temperatures and storage parameters (22 and 40 °C, and 11%, 23% and 54% RH, for 6 months) on the characteristics of Infant Milk formula (IMF) powders was investigated. The combination of inlet–outlet temperatures affected the moisture content, water activity, particle size and glass transition temperature (Tg) in the freshly spray-dried IMF powders, whereas, powder surface composition and morphology were not affected. Powders remained stable for 6 months at 11 and 23% RH at both storage temperatures. Storage at 54% RH (at both storage temperatures) increased the moisture uptake by powders, decreased Tg below storage temperature, induced lactose crystallisation, increased surface fat and caking of powders, and reduced powder solubility. This study shows that inlet–outlet temperature combinations used during spray drying affect the stability of powders during storage by affecting their initial moisture content.

  • physicochemical properties of spray dried model Infant Milk formula powders influence of whey protein to casein ratio
    International Dairy Journal, 2020
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract The effect of whey protein-to-casein ratio (60:40, 50:50 and 40:60) on the physicochemical properties of model Infant Milk formula (IMF) wet-mixes and powders prepared therefrom was studied. A lower whey protein-to-casein ratio lowered the zeta potential and apparent viscosity of wet-mixes and increased the particle size after evaporation. Particle size and water activity of powders decreased with decreasing whey protein-to-casein ratio. Glass transition temperature, crystallinity, surface free fat content and solubility of the powders were similar and unaffected by protein composition. Surface composition of powders was substantially different from their bulk composition irrespective of the protein ratios, with fat representing more of the powders surface (∼42–44%) followed by protein (∼30–32%) and lactose (∼24–26%). Overall, IMF powders can be prepared by varying the whey protein-to-casein ratio without affecting the physicochemical properties of the feed and the spray-dried powders.

  • effect of lactose to maltodextrin ratio on emulsion stability and physicochemical properties of spray dried Infant Milk formula powders
    Journal of Food Engineering, 2019
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract This study was conducted to investigate the effects of lactose-to-maltodextrin ratio (L:M 100:0, 85:15 and 70:30) on emulsion stability and the physicochemical properties of spray-dried Infant Milk formula. Lactose-to-maltodextrin ratio did not affect the emulsion particle size, but increasing the proportion of maltodextrin increased the apparent viscosity after evaporation and decreased the zeta potential of emulsions. Most importantly, increasing maltodextrin proportion increased the glass transition temperature (by 4 and 8 °C at 15% and 30% maltodextrin, respectively) and decreased the crystallinity and yellowness of the powders. Surface composition of powders was different to that of their bulk composition, where fat was over-represented on the powders surface (∼41–44%), followed by protein (∼30–33%) and carbohydrate (∼24–26%). This study concludes that maltodextrin can be successfully included in Infant formula blends without affecting emulsion stability in a wet mix and allows controlled modifications of certain properties in corresponding spray-dried powders.

S M Robinson - One of the best experts on this subject based on the ideXlab platform.

  • Infant Milk feeding and bone health in later life findings from the hertfordshire cohort study
    Osteoporosis International, 2020
    Co-Authors: Sarah Carter, C Parsons, S M Robinson, Nicholas C Harvey, K A Ward, C Cooper
    Abstract:

    Using data from the Hertfordshire cohort study, this study examined the effect of breastfeeding and bottle feeding on adult lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD). The type of Infant Milk feeding was significantly associated with lumbar spine BMD in males. INTRODUCTION Using data from the Hertfordshire cohort study (HCS), this study aims to examine the effect of Infant Milk feeding on bone health in later life by comparing the effect of breastfeeding and bottle feeding on lumbar spine and femoral neck BMC and BMD. METHODS Information about Infant Milk feeding, birth weight (kg) and weight at 1 (kg) was collected by health visitors between 1931 and 1939 in Hertfordshire. BMC and BMD measurements were taken by DXA scan between 1998 and 2004. Linear regression models adjusted for conditional weight at 1, age at DXA scan, sex, adult BMI, smoking behaviour, alcohol consumption, physical activity, dietary calcium, and prudent diet score. RESULTS Infant Milk feeding was significantly associated with lumbar spine BMD (b = - 0.028; 95% CI, - 0.055; - 0.000; p value, 0.047) in males. On average, males who consumed breastMilk alternatives in infancy had lower lumbar spine BMD measurements than those who were fed only breastMilk. These associations remained significant in fully adjusted models. There were no significant associations between Infant Milk feeding and bone health for females. CONCLUSIONS Significant associations between Infant Milk feeding and lumbar spine BMD in males indicate that breastMilk may be protective for the bone health of male babies. The evidence presented here underscores the potential lifelong benefits of breastfeeding and may highlight the differences between osteoporotic risk factors for males and females.

  • Infant Milk feeding and bone health in later life findings from the hertfordshire cohort study
    Osteoporosis International, 2020
    Co-Authors: Sarah Carter, C Parsons, S M Robinson, Nicholas C Harvey, K A Ward, C Cooper
    Abstract:

    Using data from the Hertfordshire cohort study, this study examined the effect of breastfeeding and bottle feeding on adult lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD). The type of Infant Milk feeding was significantly associated with lumbar spine BMD in males. Using data from the Hertfordshire cohort study (HCS), this study aims to examine the effect of Infant Milk feeding on bone health in later life by comparing the effect of breastfeeding and bottle feeding on lumbar spine and femoral neck BMC and BMD. Information about Infant Milk feeding, birth weight (kg) and weight at 1 (kg) was collected by health visitors between 1931 and 1939 in Hertfordshire. BMC and BMD measurements were taken by DXA scan between 1998 and 2004. Linear regression models adjusted for conditional weight at 1, age at DXA scan, sex, adult BMI, smoking behaviour, alcohol consumption, physical activity, dietary calcium, and prudent diet score. Infant Milk feeding was significantly associated with lumbar spine BMD (b = − 0.028; 95% CI, − 0.055; − 0.000; p value, 0.047) in males. On average, males who consumed breastMilk alternatives in infancy had lower lumbar spine BMD measurements than those who were fed only breastMilk. These associations remained significant in fully adjusted models. There were no significant associations between Infant Milk feeding and bone health for females. Significant associations between Infant Milk feeding and lumbar spine BMD in males indicate that breastMilk may be protective for the bone health of male babies. The evidence presented here underscores the potential lifelong benefits of breastfeeding and may highlight the differences between osteoporotic risk factors for males and females.

Bogdan Zisu - One of the best experts on this subject based on the ideXlab platform.

  • influence of drying temperatures and storage parameters on the physicochemical properties of spray dried Infant Milk formula powders
    International Dairy Journal, 2020
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract The influence of spray drier inlet (180 and 200 °C) and outlet (80, 90 and 100 °C) air temperatures and storage parameters (22 and 40 °C, and 11%, 23% and 54% RH, for 6 months) on the characteristics of Infant Milk formula (IMF) powders was investigated. The combination of inlet–outlet temperatures affected the moisture content, water activity, particle size and glass transition temperature (Tg) in the freshly spray-dried IMF powders, whereas, powder surface composition and morphology were not affected. Powders remained stable for 6 months at 11 and 23% RH at both storage temperatures. Storage at 54% RH (at both storage temperatures) increased the moisture uptake by powders, decreased Tg below storage temperature, induced lactose crystallisation, increased surface fat and caking of powders, and reduced powder solubility. This study shows that inlet–outlet temperature combinations used during spray drying affect the stability of powders during storage by affecting their initial moisture content.

  • physicochemical properties of spray dried model Infant Milk formula powders influence of whey protein to casein ratio
    International Dairy Journal, 2020
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract The effect of whey protein-to-casein ratio (60:40, 50:50 and 40:60) on the physicochemical properties of model Infant Milk formula (IMF) wet-mixes and powders prepared therefrom was studied. A lower whey protein-to-casein ratio lowered the zeta potential and apparent viscosity of wet-mixes and increased the particle size after evaporation. Particle size and water activity of powders decreased with decreasing whey protein-to-casein ratio. Glass transition temperature, crystallinity, surface free fat content and solubility of the powders were similar and unaffected by protein composition. Surface composition of powders was substantially different from their bulk composition irrespective of the protein ratios, with fat representing more of the powders surface (∼42–44%) followed by protein (∼30–32%) and lactose (∼24–26%). Overall, IMF powders can be prepared by varying the whey protein-to-casein ratio without affecting the physicochemical properties of the feed and the spray-dried powders.

  • effect of lactose to maltodextrin ratio on emulsion stability and physicochemical properties of spray dried Infant Milk formula powders
    Journal of Food Engineering, 2019
    Co-Authors: A K M Masum, Thom Huppertz, Jayani Chandrapala, Benu Adhikari, Bogdan Zisu
    Abstract:

    Abstract This study was conducted to investigate the effects of lactose-to-maltodextrin ratio (L:M 100:0, 85:15 and 70:30) on emulsion stability and the physicochemical properties of spray-dried Infant Milk formula. Lactose-to-maltodextrin ratio did not affect the emulsion particle size, but increasing the proportion of maltodextrin increased the apparent viscosity after evaporation and decreased the zeta potential of emulsions. Most importantly, increasing maltodextrin proportion increased the glass transition temperature (by 4 and 8 °C at 15% and 30% maltodextrin, respectively) and decreased the crystallinity and yellowness of the powders. Surface composition of powders was different to that of their bulk composition, where fat was over-represented on the powders surface (∼41–44%), followed by protein (∼30–33%) and carbohydrate (∼24–26%). This study concludes that maltodextrin can be successfully included in Infant formula blends without affecting emulsion stability in a wet mix and allows controlled modifications of certain properties in corresponding spray-dried powders.

Kirsi M Jarvinen - One of the best experts on this subject based on the ideXlab platform.

  • Infant Milk feeding practices and diabetes outcomes in offspring a systematic review
    The American Journal of Clinical Nutrition, 2019
    Co-Authors: Darcy Gungor, Perrine Nadaud, Concetta C Lapergola, Carol Dreibelbis, Yat Ping Wong, Nancy Terry, Steve A Abrams, Leila Beker, Tova Jacobovits, Kirsi M Jarvinen
    Abstract:

    Background During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations. Objectives The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human Milk, 2) shorter versus longer durations of any human Milk feeding, 3) shorter versus longer durations of exclusive human Milk feeding, and 4) feeding a lower versus higher intensity of human Milk to mixed-fed Infants with type 1 and type 2 diabetes in offspring. Methods The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. Results The 4 systematic reviews included 21, 37, 18, and 1 articles, respectively. Observational evidence suggests that never versus ever feeding human Milk (limited evidence) and shorter versus longer durations of any (moderate evidence) and exclusive (limited evidence) human Milk feeding are associated with higher type 1 diabetes risk. Insufficient evidence examined type 2 diabetes. Limited evidence suggests that the durations of any and exclusive human Milk feeding are not associated with intermediate outcomes (e.g., fasting glucose, insulin resistance) during childhood. Conclusions Limited to moderate evidence suggests that feeding less or no human Milk is associated with higher risk of type 1 diabetes in offspring. Limited evidence suggests no associations between the durations of any and exclusive human Milk feeding and intermediate diabetes outcomes in children. Additional research is needed on Infant Milk-feeding practices and type 2 diabetes and intermediate outcomes in US populations, which may have distinct metabolic risk.

  • Infant Milk feeding practices and cardiovascular disease outcomes in offspring a systematic review
    The American Journal of Clinical Nutrition, 2019
    Co-Authors: Darcy Gungor, Perrine Nadaud, Concetta C Lapergola, Carol Dreibelbis, Yat Ping Wong, Nancy Terry, Steve A Abrams, Leila Beker, Tova Jacobovits, Kirsi M Jarvinen
    Abstract:

    Background During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations. Objectives The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human Milk, 2) shorter versus longer durations of any human Milk feeding, 3) shorter versus longer durations of exclusive human Milk feeding, and 4) lower versus higher intensities of human Milk fed to mixed-fed Infants with intermediate and endpoint cardiovascular disease (CVD) outcomes in offspring. Methods The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. Results The 4 systematic reviews included 13, 24, 6, and 0 articles, respectively. The evidence was insufficient to draw conclusions about endpoint CVD outcomes across all 4 systematic reviews. Limited evidence suggests that never versus ever being fed human Milk is associated with higher blood pressure within a normal range at 6-7 y of age. Moderate evidence suggests there is no association between the duration of any human Milk feeding and childhood blood pressure. Limited evidence suggests there is no association between the duration of exclusive human Milk feeding and blood pressure or metabolic syndrome in childhood. Additional evidence about intermediate outcomes for the 4 systematic reviews was scant or inconclusive. Conclusions There is insufficient evidence to draw conclusions about the relationships between Infant Milk-feeding practices and endpoint CVD outcomes; however, some evidence suggests that feeding less or no human Milk is not associated with childhood hypertension.

  • Infant Milk feeding practices and childhood leukemia a systematic review
    The American Journal of Clinical Nutrition, 2019
    Co-Authors: Darcy Gungor, Perrine Nadaud, Concetta C Lapergola, Carol Dreibelbis, Yat Ping Wong, Nancy Terry, Steve A Abrams, Leila Beker, Tova Jacobovits, Kirsi M Jarvinen
    Abstract:

    BACKGROUND During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations. OBJECTIVES The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human Milk, 2) shorter versus longer durations of any human Milk feeding, 3) shorter versus longer durations of exclusive human Milk feeding, and 4) feeding a lower versus higher intensity of human Milk to mixed-fed Infants with acute childhood leukemia, generally, and acute lymphoblastic leukemia, specifically. METHODS The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980 to March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. RESULTS We included 24 articles from case-control or retrospective studies. Limited evidence suggests that never feeding human Milk versus 1) ever feeding human Milk and 2) feeding human Milk for durations ≥6 mo are associated with a slightly higher risk of acute childhood leukemia, whereas evidence comparing never feeding human Milk with feeding human Milk for durations <6 mo is mixed. Limited evidence suggests that, among Infants fed human Milk, a shorter versus longer duration of human Milk feeding is associated with a slightly higher risk of acute childhood leukemia. None of the included articles examined exclusive human Milk feeding or the intensity of human Milk fed to mixed-fed Infants. CONCLUSIONS Feeding human Milk for short durations or not at all may be associated with slightly higher acute childhood leukemia risk. The evidence could be strengthened with access to broadly generalizable prospective samples; therefore, we recommend linking surveillance systems that collect Infant feeding and childhood cancer data.

  • Infant Milk feeding practices and diagnosed celiac disease and inflammatory bowel disease in offspring a systematic review
    The American Journal of Clinical Nutrition, 2019
    Co-Authors: Darcy Gungor, Perrine Nadaud, Concetta C Lapergola, Carol Dreibelbis, Yat Ping Wong, Nancy Terry, Steve A Abrams, Leila Beker, Tova Jacobovits, Kirsi M Jarvinen
    Abstract:

    Background During the Pregnancy and Birth to 24 Months Project, the USDA and US Department of Health and Human Services initiated an evidence review on diet and health in these populations. Objective The aim of these systematic reviews was to examine the relationships of never versus ever feeding human Milk, shorter versus longer durations of any and exclusive human Milk feeding, and feeding a lower versus a higher intensity of human Milk to mixed-fed Infants with diagnosed celiac disease and inflammatory bowel disease (IBD). Methods The Nutrition Evidence Systematic Review team (formerly called the Nutrition Evidence Library) conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January, 1980 to March, 2016, dual-screened the results using predetermined criteria, extracted data from and assessed risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. Results We included 9 celiac disease and 17 IBD articles. Limited case-control evidence suggests never versus ever being fed human Milk is associated with higher risk of celiac disease, but concerns about reverse causality precluded a conclusion about the relationship of shorter versus longer durations of any human Milk feeding with celiac disease. Evidence examining never versus ever feeding human Milk and IBD was inconclusive, and limited, but consistent, case-control evidence suggests that, among Infants fed human Milk, shorter versus longer durations of any human Milk feeding are associated with higher risk of IBD. For both outcomes, evidence examining the duration of exclusive human Milk feeding was scant and no articles examined the intensity of human Milk fed to mixed-fed Infants. Conclusion Limited case-control evidence suggests that feeding human Milk for short durations or not at all associates with higher risk of diagnosed IBD and celiac disease, respectively. The small number of studies and concern about reverse causality and recall bias prevent stronger conclusions.

  • Infant Milk feeding practices and food allergies allergic rhinitis atopic dermatitis and asthma throughout the life span a systematic review
    The American Journal of Clinical Nutrition, 2019
    Co-Authors: Darcy Gungor, Perrine Nadaud, Concetta C Lapergola, Carol Dreibelbis, Yat Ping Wong, Nancy Terry, Steve A Abrams, Leila Beker, Tova Jacobovits, Kirsi M Jarvinen
    Abstract:

    Background During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these populations. Objectives The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human Milk, 2) shorter versus longer durations of any human Milk feeding, 3) shorter versus longer durations of exclusive human Milk feeding prior to Infant formula introduction, 4) feeding a lower versus higher intensity of human Milk to mixed-fed Infants, and 5) feeding a higher intensity of human Milk by bottle versus breast with food allergies, allergic rhinitis, atopic dermatitis, and asthma. Methods The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published between January 1980 and March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. Results The systematic reviews numbered 1-5 above included 44, 35, 1, 0, and 0 articles, respectively. Moderate, mostly observational, evidence suggests that 1) never versus ever being fed human Milk is associated with higher risk of childhood asthma, and 2) among children and adolescents who were fed human Milk as Infants, shorter versus longer durations of any human Milk feeding are associated with higher risk of asthma. Limited evidence does not suggest associations between 1) never versus ever being fed human Milk and atopic dermatitis in childhood or 2) the duration of any human Milk feeding and allergic rhinitis and atopic dermatitis in childhood. Conclusions Moderate evidence suggests that feeding human Milk for short durations or not at all is associated with higher childhood asthma risk. Evidence on food allergies, allergic rhinitis, and atopic dermatitis is limited.