Out-Going President's Update
By Daniel Sellen
As the first quarter of 2024 closes ISRHML is gearing up for our 22nd international conference later this year and elected leadership transitions ensure great coordination on all continuing and new activities.
The conference theme is “Advancing Science, Fostering Inclusivity, Shaping the Future” and a stellar program will take place in a wonderful venue in the delightful city of Charleston, South Carolina, December 9-13, 2024. As well as the lovely climate, you won’t want to miss the exciting program developed by our large and active scientific committee chaired by Carol Wagner. The Executive Committee carefully selected the venue and conference organizing, and unanimously approved it will be supported by Medical University of Southern Carolina’s conference and CME team led by Elizabeth Gossen. MUSC’s team has previously worked with ISRHML to put on the Kiawah meetings and the CME aspects of both Kiawah and Panama and are once again proving excellent partners. ISRHML 2024 will be the ideal conference to disseminate your team’s science, and you will find early bird and later rates at excellent value at the registration and abstract submission site. So, make your plans and secure your attendance right away!
We heartily thank Elizabeth Johnson, Ellen Demerath and Alex Anderson for their excellent stewardship and wisdom these past 3 years as members of the Executive Committee, Berthold Koletzko who completes his term as past President and Jimi Francis who has been an active and influential TIG advisor. Joining our Executive Committee starting 2024 are Adwoa Gyamfi, Jonathan Seigel, and Meghan Azad (a past Secretary and former Executive Committee member). Donna Geddes continues as TEP President, Maria-Carmen Collado as Chair of the TEP scientific review committee and Anita Esquerra-Zwiers as one of two TIG advisors; while Paula Meier joins Anita and succeeds Jimi as our second TIG advisor beginning 2024. On the Officers team, Carol Wagner begins her term as President, and we must thank her for already contributing hugely during two energetic years as President-Elect. Diane Spatz and Janet Williams continue as Treasurer and Secretary, building on their excellent established leadership in these roles. Maureen Groer joins as President-Elect, and we are excited by the collegiality, skills and experience Maureen brings.
Another milestone in our annual cycle of activities is this year’s fresh call for nominations for the 2024 Macy-Gyorgy lifetime achievement and Ehrlich-Koldovosky early investigator awards; you can find the information at our site (https://isrhml.org/about-isrhml/awards/). Other items are described below thanks to the wonderful efforts of our newsletter editors Carrie-Ellen Briere and Adrianna Greco and all our contributors.
As I look forward to continuing active involvement as Past-President I am so grateful to each of the officers, executive committee members and voluntary leaders who continue to serve the Society in so many ways and are such a joy to work with. Collectively, they ensure ISRHML remains a valuable and distinctive community of scholars with a specific and unique niche in the happily expanding international landscape of human milk and lactation research. Their dedication and hard work mean ISRHML is globally recognized for integrating and recognizing multiple conceptual perspectives, nurturing inclusion, and providing significant recognition and networking support across the career span in our field.
TIG President’s Update January 2024
By Noura El Habbal PhD, RD, Trainee Interest Group Governing Committee President
Postdoctoral Research Fellow, Gregory Lab, Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
Dear ISRHML Members and Milk Minutes Readers,
I am thrilled to share some exciting updates from the Trainee Interest Group (TIG) and welcome our incoming TIG Governing Committee (GC) members for 2024.
First and foremost, a heartfelt thank you to all our dedicated trainees for their active participation in the TIG, recent TIG networking events, and webinars. Your engagement is what makes the TIG a vibrant and thriving community. Secondly, I am in awe of all the work that the TIG GC has been up to, and I would like to take a minute to acknowledge the team’s stellar commitment to trainee success. Thank you to Dr. Kristin Elgersma (outgoing Secretary), Miranda Loutet (outgoing Professional Development Coordinator), Dr. Sarah Nyquist (Membership Chair), Dr. Kelsey Johnson (Global Representation Chair), Eow Shiang Yen (Social Media and Communications Chair), and Adrianna Greco (Newsletter and Blog Editor) for all their dedication to the TIG. Additionally, we are grateful for the support and guidance received by our TIG advisors Drs. Jimi Francis and Anita Esquerra-Zwiers and Dr. Janet Williams (ISRHML Executive Committee Secretary). As we appreciate all the work of our TIG members, I am especially grateful for our outgoing members, Dr. Kristin Elgersma and Miranda Loutet, and I would like to welcome our incoming TIG GC members, Laasya Devi Annepureddy (President-Elect), Oluwaseyifunmi Valentina Oladipo (Secretary), and Aria Grabowski (Professional Development Coordinator). Welcome aboard! We are excited to have you on the TIG GC and look forward to continuing the great work of the TIG!
Some of the work we have been up to includes our TIG webinars which have been a tremendous success. Special thanks to Miranda Loutet and Sara Shama for organizing the webinar session on “Global and Holistic Perspectives on Lactation Management Research” (virtual, October 2023) and led by Drs. Jimi Francis, Chantell Witten, and Andrea Esquivel, and the webinar session on “Closing the Gap Between Research and Sustainability” (virtual, January 2024) and led by Dr. Katharina Lichtner. We are grateful to our presenters for sharing their time and experience with us! Recordings of these webinars are available for ISRHML members on our website using this link here (member login required).
Providing trainees with networking opportunities has been a pillar of the TIG GC, and I am proud to announce that our virtual trainee networking events held in August and December of 2023 have been a success. These events provided a unique opportunity for trainees interested in human milk or lactation research to network and connect informally. We plan to continue this tradition in 2024. The networking events are open to all trainees who are ISRHML or non-ISRHML members.
For any news you would like ISRHML to share on our social media platforms or in future Milk Minutes newsletters, please let us know by emailing [email protected]. We also follow our trainees’ Google Scholar profiles to help showcase their work on our Social Media Platforms. We encourage you to make a Google Scholar profile and share it with us at [email protected] so we can highlight your newest publications!
Interested in getting involved with the TIG? Fill out this form, and one of our TIG Governing Committee members will contact you. Don’t hesitate to reach out to us at [email protected] for any questions, concerns, or ideas for future events.
If your membership has expired, we hope you will consider renewing and continue being a part of the ISRHML community, as well as connect with other trainees on our Slack channel and receive emails regarding our upcoming events.
Lastly, with the 22nd ISRHML conference being announced for December 9-13 of 2024 in Charleston, South Carolina, USA, we hope to see many of you at the conference.
Thank you, trainees, for being the most integral part of this journey and at the heart of all the work we do!
Research Highlight
Building strong hearts: Advancing the science of human milk and lactation for infants with critical congenital heart disease
By Kristin Elgersma, Assistant Professor, School of Nursing, University of Minnesota
In 2015 I gave birth to my first child, who was postnatally diagnosed with critical congenital heart disease (CCHD). At that time, I had been working in an academic music career for many years, and was completely unprepared for the challenges of breastfeeding a newborn who needed cardiac surgery and intensive care. Although I pumped exclusively for a year, I never reached my goal of direct breastfeeding. Along the way, I met many other parents of infants with CCHD with similar struggles and realized that, with a little more support and encouragement, our lactation experiences could have (should have!) been very different.
As I moved into a new career in the health sciences I learned that, while feeding is consistently ranked as the number one concern for parents of infants with CCHD – even above the actual cardiac defect, evidence about feeding in this population is sparse. In a systematic review, we found that the existing evidence on human milk and outcomes for infants with CCHD was limited by single-site analyses, small sample sizes, lack of clear delineation of feeding groups, and risk for statistical bias (Breastfeed Med., https://doi.org/10.1089/bfm.2021.0334). Furthermore, despite the well-documented benefits of human milk for preterm infants, parents at 26 US cardiac centers reported that healthcare teams typically did not prioritize human milk/breastfeeding; rather, they often actively discouraged these feeding practices for infants with CCHD (Cardiol Young. https://doi.org/10.1017/S1047951122003808).
My 2023 dissertation addressed some of the limitations in the literature through a series of three analyses of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry, including 2491 infants from 68 US sites who were diagnosed with with single ventricle CCHD (considered the most severe form of the disease). In our first analysis, we established that the prevalence of human milk and direct breastfeeding for these infants was far lower than national and global recommendations (e.g., 14.4% any direct breastfeeding at neonatal discharge; 9.3% exclusive/37.1% any human milk at ~5 months old). Prevalence varied widely across sites, suggesting that lactation practices are clinically modifiable even in this highly vulnerable population (Breastfeed Med., https://doi.org/10.1089/bfm.2023.0036).
In our second NPC-QIC analysis, we used machine learning techniques to identify supportive and limiting predictors of lactation practices for infants with single ventricle CCHD during the first six months of life. We found that the strongest predictor domain areas included preoperative feeding practices during the first week of life, demographics and social determinants of health, and the clinical site. The infant’s feeding route (e.g., feeding tube, bottle) and clinical course also played a role, but were not the primary determinants of human milk and breastfeeding status. Importantly, we found that direct breastfeeding during the neonatal hospitalization significantly predicted human milk exposure at the subsequent 5-month cardiac surgery (J Pediatr. https://doi.org/10.1016/j.jpeds.2023.113562).
Finally, using propensity score matching to reduce bias and support causal inference, we found that infants in human milk and direct breastfeeding groups had multiple significantly improved outcomes (e.g., 63% lower preoperative and 72% lower postoperative necrotizing enterocolitis; 93% lower postoperative sepsis, 20-25% lower length of stay for both the neonatal and 5-month cardiac surgeries). This was the first large, multisite analysis of the impact of human milk and breastfeeding on outcomes for infants with CCHD, and our findings of substantial statistical and clinical significance provide robust support for the importance of human milk and breastfeeding for these critically-ill infants (JAHA, https://doi.org/10.1161/JAHA.123.030756). Encouragingly, the oral abstract of these findings was highlighted as the best in its category at the recent World Congress of Pediatric Cardiology and Cardiac Surgery, indicating a new openness to human milk and breastfeeding within the field.
It is an exciting time to be a human milk researcher in the context of CCHD, as there are many, many questions that have yet to be explored in this population! I have learned so much from ISRHML members during my time as a trainee member. As I move into my new role as an early stage investigator, I look forward to future collaborations with ISRHML members to advance the science of human milk and lactation for these vulnerable neonates.
Trainee Expansion Program Experience Down Under
By Marion M. Bendixen, Assistant Professor, College of Nursing, University of Florida
For the summer of 2023, I traveled from Orlando, Florida, USA on a very long plane flight to Perth, Western Australia to work with Dr. Donna Geddes and the Geddes Hartmann Human Lactation Research Group at the University of Western Australia (UWA). Our research purpose is to determine whether maternal health (diabetes, hypertension, obesity) is associated with differences in human milk biomarkers of secretory activation and milk volume in pump dependent mothers of critically ill infants. Gratefully, I was awarded a 2022 Trainee Travel Fund (TTF) award sponsored by the International Society of Research in Human Milk and Lactation (ISRHML) and Family Larsson-Rosenquist Foundation (FLRF).
As a nurse, lactation consultant, and now a researcher, I have extensive clinical experience, however, I lacked lab skills. This immersive lab experience expanded upon my pre- and post-doctoral training by building research skills on milk composition analysis using previously collected milk samples and subject data (de-identified) in collaboration with my post doc mentor Dr. Leslie Parker’s research project ‘The effect of Maternal Breast Milk Production, Gestational Age, and Infant Sex on Mother’s Own Milk Composition: An Exploratory Study’. Guided by Dr. Ching Lai, I used a pipette for the first time and was able to analyze human milk biomarkers of secretory activation, total protein, citrate, and lactose, as well as sodium, potassium, macro-and trace elements (markers of SA) using inductively coupled plasma optical emission spectrometry (ICP-OES) technique optimized for human milk.
I became part of Dr. Geddes’ lactation research group and TEP cohort with 2022 TTF recipient Nina Juntereal, PhD candidate and 2023 TTF recipient Omobolaji Adewuyi, PhD candidate. The experience that I did not expect was how the three of us and other students training at UWA became lab mates that supported each other to live, work, and play in another culture. We navigated the Purple Cat bus to have pizza at Elizabeth Quay on the Swan River. We incorporated each other’s samples needing repeat analysis onto our next plate run. We shared ideas for future research and collaborations.
Uniquely, I was able to shadow Dr. Sharron Perrella with the Geddes Hartmann Human Lactation Research Group providing lactation services and incorporating research into the clinical setting. This experience plus site visits to local hospitals highlighted the similarity of mother’s struggle and joy with breastfeeding, as well as likeness and differences in maternal/infant care across countries.
At the time of the TEP application, I was a postdoctoral associate with Dr. Parker at the University of Florida, where I am now an assistant professor. I have applied my new skills, including the protocols optimized for limited quantities of human milk that we enhanced into my recently funded NIH/NINR K23 grant under the mentorship of Drs. Geoffrey Dahl, Paula Meier, Leslie Parker, and Martina Mueller exploring the effect of gestational age at delivery on lactation outcomes in pump-dependent mothers of critically ill infants.
My advice for TEP trainees is to think of what skills and knowledge that you will need to expand the scope and impact of your research. If you could work with a top researcher anywhere in the world, who and where would that be. Reach out – the networking opportunities and resources through ISRHML are expansive. My first application was not selected for funding. However, I gained valuable experience writing, reflecting, revising, and working with my mentors that led to a second funded TEP-TTF application. Additionally, start early on the application and the regulations needed to travel and ship samples.
Thank you to Drs. Geddes, Lai, and the Geddes/Hartman lactation team; Dr. Parker and the University of Florida, College of Nursing; ISRHML; and the FRLF for supporting mine and others research skills to use and share in lactation research.
Member News and Achievements
Congratulations to the six newest Trainee Expansion Program (TEP) Grant Awardees! Read more about their research and project goals here.
Trainee Bridge Fund (TBF), award USD 100,000
Miranda Loutet, MSc, PhD Candidate
Trainee Travel Fund (TTF), awards up to USD 10,000 each
Laasya Devi Annepureddy, PhD Student
Dr. Michelle Asbury, MSc, PhD, Postdoctoral Associate
Maheshwar Bhasin, PhD Candidate
Dr. Michael A. Pitino, PhD, MSc, Postdoctoral Scholar
Dr. Brock Williams, PhD, MSc, RD
Event Recaps
American Society for Nutrition Conference- Human Milk Highlights
By Adrianna Greco
The American Society for Nutrition Annual Conference was held from July 21st to 25th, 2023, in Boston, Massachusetts, United States. The 3.5-day conference featured a variety of speakers and presentations focused on diverse areas within nutrition research, which was attended by ISRHML members and trainees alike.
Of interest, the Robert Suskind and Leslie Lewinter Pediatric Nutrition Lifetime Achievement Award was presented to Dr. Steven Abrams (University of Texas at Austin) for his work on human milk fortification for preterm infants. It was great to see an honor bestowed to a leader in human milk research. Paving the way for future pediatric nutrition leaders, there were also trainee presentations featured in this session, including a highlight on human milk oligosaccharides (Shiqi Zhang).
Many of the sessions and talks were centered around early life and human milk feeding. One symposium entitled ‘Milk to Meals- Feeding from Birth to Childhood’ highlighted some of the novel research being conducted on human milk composition, feeding practices, and impacts of child development. The audience learned about early human milk fortification in preterm infants (Dr. Ariel Salas), the impact of maternal thiamine supplementation during exclusive breastfeeding on infant neurodevelopmental outcomes (Dr. Dare Baldwin), and the effect of opaque bottles on maternal sensitivity, infant intake and weight status (Dr. Alison Ventura). Nutrition during the first 1000 days of life was highlighted in a poster flash session, which featured research on the association between human milk macronutrient content with early childhood growth and neurodevelopment in rural Bangladesh (Dr. Krysten North).
The conference was also a great chance for ISRHML members to meet and connect, and there was a great turn out by executive members. The diverse and multidisciplinary nature of the conference featured a wide array of early life nutrition research, with a unique focus on the diverse human milk research being conducted by ISRHML members. Congratulations to all those ISRHML members that participated in the conference, and we look forward to connecting again later this year at the ISRHML annual meeting!
International Milk Genomics Consortium (IMGC)- 2023 Hybrid Symposium
By Michael Pitino
On September 6-8th, 2023, international milk researchers convened in Cork, Ireland to attend the International Milk Genomics Consortium (IMGC) annual hybrid symposium, co-hosted by the University College Cork and University of California, Davis! This 2.5-day symposium highlighted the most recent scientific research related to milk, especially human milk, and human health, and was well-attended by several ISRHML members and trainees.
Cutting edge human milk-related talks were abundant, especially related to human milk proteins and proteases. Dr. David Dallas (Oregon State University) talked about survival of bioactive milk proteins across digestion in preterm infants fed human milk, while Dr. Anthony O’Donoghue (UC San Diego) discussed novel mass spectrometry-based peptide digestion assays used to identify the functional role of proteases in human milk for digestion and whether supplementing Holder-pasteurized donor human milk with recombinant enzymes could help regain physiologically-relevant levels of proteolysis. This work was complimented by the presentation of Dr. Lotte Larsen (Aarhus University) who aimed to decipher proteolytic cleavage sites from the primary proteases in human milk and Dr. Rebecca Powell (Icahn School of Medicine) who spoke about seasonal flu vaccination and human milk antibodies. Dr. Fanyu Meng (Beijing Technology and Business University) also presented their work evaluating factors affecting human milk fatty acids and the creaming of human milk during handling and storage.
Discussions were also centered around human milk and genetics and were guided by Dr. Kelsey Johnson (University of Minnesota) who spoke on understanding the genetic basis of lactational variation to elucidate the mechanisms linking milk composition and production to infant and maternal health, by Dr. Sharon Donovan (University of Illinois, Urbana-Champaign), who introduced novel approaches to quantify exosomal miRNAs in human milk and in plasma and by Dr. Lina Tingö, who characterized the immune-related miRNAs in human milk and their relation to regulatory T-cells in breastfed children. Dr. Cristina Campoy (University of Granada) engaged attendees with a comprehensive presentation on the short- and long-term implications of human milk microbiota on maternal and child health, followed by Dr. Lewis Rubin (Georgetown University Medical Center) who spoke on the use of probiotic supplementation in preterm infants to enhance immunity and reduce inflammation as well as a talk from Dr. Nicholas Embleton (Newcastle University) who discussed opportunities and challenges related to human milk and immunity in preterm infants.
Overall, the symposium provided an excellent opportunity to learn and recent advances in the field of human milk while actively engaging with leading researchers in the field, many of whom are ISRHML members. This year’s conference will be held at UC Davis October 22nd – 24th 2024, in Davis, California. Registration opens May 1st.
Announcements
Join Our Newsletter Team! We’re seeking Ad hoc Contributing Writers for the ISRHML Milk Minutes Newsletter. Enjoy flexibility to write engaging articles on topics that interest you. Let your voice make an impact—join us in creating compelling content that informs and inspires. Interested? Reach out to our editors Carrie-Ellen Briere or Adrianna Greco
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Video Editing: Are you skilled at video editing and looking for a chance to be part of a fun and exciting project at ISRHML? If your answer is yes, we are looking for you! The ISRHML Social Media Committee (SoMe) is looking for a volunteer to help with video editing for the new “interview with the member” initiative that will be going live soon on ISRHML’s YouTube and other social media pages! Get in touch by emailing us at [email protected] – We look forward to hearing from you!
Upcoming Events
The Professional Society for Health Economics and Outcomes Research (ISPOR), May 5-8 2024. Learn More.
American Society for Nutrition, June 29 – July 2, 2024. Learn More.
International Milk Genomics Consortium (IMGC) Hybrid Symposium, October 22-24, 2024. Learn More.
Save the Date: ISRHML, December 9-13, 2024. Learn More.
ISRHML Newsletter | Editorial Board
Carrie-Ellen Briere
University of Massachusetts Amherst
Omobolaji Adewuyi
University of Ibadan, Nigeria
Adrianna Greco
University of British Columbia
Laura Galante
Swansea University
Jimi Francis
University of Texas San Antonio