Abstract
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This issue also highlights the variety of subjects that are addressed in Breastfeeding Medicine. On the one hand, we are pleased to publish a study by Kaingade et al. 1 from India that demonstrated the capacity of fresh human breastmilk mesenchymal stem cells to secrete human growth factors, both vascular endothelial growth factor and hepatocyte growth factor. Although this was only an in vitro study, these data emphasize that the theoretical value of feeding human milk is not limited or solely a matter of nutrition. Growth factors such as these play a critical role in the maturation of both the immature lung and the immature gastrointestinal tract. This suggests that there is an additional value in feeding such functional stem cells to the premature infant. Clearly in vivo human studies are needed to explore this issue and to delineate, in addition, what of the breastmilk stem cell's capacity is or is not lost in the pasteurization process.
The vernacular is called the “real world” of breastfeeding advocacy and support. Garner et al. 3 performed a series of in-depth qualitative interviews of healthcare workers and confirmed what many of us have perceived (i.e., that there is a discontinuity of care of breastfeeding mothers reflected not only in the lack of specific knowledge but also the more problematic reality of the absence of a guiding responsible hand, or, as phrased by the authors, “there's no captain of the ship”). The problem that they document highlights the need to provide more attention to organizational, structural, system analyses and the need for incorporating expertise in these matters if we are going to move forward in supporting the mother and infant. The article by Furman et al. 4 no less addresses these issues in their study of the role that inner-city fathers can and should play in breastfeeding support.
Both these study confirm the all too true axiom: “If breastmilk value is beyond nutrition then breastfeeding support is beyond knowledge of biology!”