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Item Saccharomyces cerevisiae Yeast-Based Supplement and Breast Milk Supply: A Randomised Placebo-Controlled Trial(John Wiley and Sons Ltd, 2025-09-11) Jia L; Brough L; Weber JLSaccharomyces cerevisiae yeast-based supplements (SCYS) are frequently used as galactagogues with limited evidence of their efficacy. This study investigates the effect of SCYS on human milk oligosaccharide (HMO) concentration and indicators of milk supply. Sixty-eight breastfeeding women with a healthy singleton infant aged 1–7 months were randomly assigned to consume a SCYS product (5 g/day) or placebo for 4 weeks. The primary outcome was the change in the total HMO concentration. The secondary outcomes included participants' perceptions of milk supply, intervention effectiveness, postnatal distress, infant feeding patterns, infant anthropometry, and adverse effects. Intention-to-treat analysis was performed. Multivariable linear regression analysis showed no significant effect of SCYS on individual or total HMO concentrations. However, 65% of women in the SCYS group, compared to 35% in the placebo group, perceived an increase in milk production (p < 0.05). No significant differences were found for other secondary outcomes. However, mothers in the SCYS group had a small but significant improvement in perception of their milk quantity and quality (p < 0.05). SCYS use was also associated with significantly lower formula use at 6 months postpartum (4% vs. 27%, p < 0.05). While SCYS does not impact HMO concentration, it may improve women's perceptions of milk supply. A larger randomised controlled trial is needed to assess its potential effects on actual milk production and composition and address issues of perceived insufficient milk. Trial Registration: This trial was registered at the Australian New Zealand Clinical Trials Registry (trial registration number: ACTRN12619000704190).Item Concentration of 12 Oligosaccharides in the Milk of New Zealand Breastfeeding Women(MDPI (Basel, Switzerland), 2023-03-23) Jia LL; Brough L; Weber JL; Smith C; Mackay S; Jalili-Moghaddam S; Gibbs MHuman milk oligosaccharides (HMOs) are the third most abundant component in breast milk. HMOs benefit infant gut health, modulate immune responses, and promote brain development. The profile and concentration of HMOs vary considerably among breastfeeding women, and are reported to be associated with genetic, maternal, and environmental factors as well as feeding practices. One reason for the diversity in HMO concentration is the secretor gene, which determines the presence of an enzyme responsible for the synthesis of 2′-FL and LNFP-I. To date, there is no report about HMO concentration or profile in the New Zealand population. Our objective was to investigate 12 HMO concentrations in a small sample of New Zealand women. Sixty-eight breastfeeding mothers (mean age 32 years, 77% Caucasian) of singleton infants (median age [Q1, Q3] 108 [70, 166] days) were included, with 65% exclusively breastfeeding and 54% who had two or more children. Concentrations of 12 HMOs were measured by UHPLC with fluorescence detection. Overall, 68% of mothers were secretors, which was defined by the presence of 2′-FL in the milk. HMO profiles varied widely; total HMO concentration varied 4.2-fold between women; and individual HMOs varied from 4.8-fold to >100-fold. The median of total HMO concentration (Q1, Q3) of the secretors and non-secretors were 6774.9 (6395.4, 8245.6) mg/L and 7128.0 (6093.1, 7880.1) mg/L respectively. Significant differences in concentration of 2′-FL, 3-FL, A-Tet, LNFP-I, LNFP-II, LNFPV, and LNnT between secretors and non-secretors were found by Mann–Whitney tests. However, there was no significant difference in concentrations of LNFP-III, LNnFP, 3′-SL, 6′-SL, LNT, or total HMOs between the secretors and the non-secretors. HMO concentrations vary broadly between breastfeeding women. A longitudinal cohort of a larger sample size is required to fully investigate HMO profiles at different lactation stages of New Zealand women and to further explore the influence of maternal and environmental factors on HMO concentration.Item An exploration into the use of galactagogues among breastfeeding women in Aotearoa and the factors associated with use : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science majoring in Nutrition and Dietetics, Massey University, Auckland(Massey University, 2024) Gash, Madeline CaitBackground: Galactagogues are herbal, food, or pharmaceutical substances increasingly used to enhance breast milk production in breastfeeding women. Despite limited evidence on galactagogue efficacy and use generally, literature has reported use of G associated use with perceived insufficient milk; a mother’s belief that their quality or quantity is insufficient to meet infant needs. This thesis aims to describe the type, duration, and purpose of galactagogue use by breastfeeding women in Aotearoa. Additionally, this study will identify factors associated with galactagogue use and explore associations with perceived insufficient milk supply. Methods: A quantitative cross-sectional online survey was distributed via study advertisements on Facebook, the Le Leche League, Lactation Consultants, or by word of mouth. Women currently breastfeeding, or who breastfed in the past year, aged 16+ in Aotearoa, were eligible. The 58 question survey included demographics, birth characteristics, breastfeeding practices and galactagogue behaviours. The data were analysed using descriptive statistics and bivariate and logistic analyses. Results: In total, 763 women were included in this study. More than half the participants (63.8%) reported using a galactagogue. The most commonly reported galactagogues were oats (71.1%), followed by lactation cookies (59.3%) and nuts and seeds (42.1%). Bivariate analyses found galactagogue use was higher among primiparous women (68.8% vs 57.6%, p=0.001), those with caesarean births (70.4% vs 60.4%, p=0.010), having previously used galactagogues (yes=69% vs no=30.3%, p=<0.001), those concerned with perceived insufficient milk quantity (44% vs 78%, p=<0.001). Multivariate analysis found perceived insufficient milk quantity was the only predictor of galactagogue use. Many women who never reported perceived insufficient milk quantity (54%) or quality (44%) still reported galactagogue use. The most common reason for using galactagogues was to increase milk supply (47.9%). Nearly two-thirds of women (60.5%) commenced galactagogue use within the first four weeks postpartum. Using a galactagogue for less than one week was uncommon (<13%). Conclusion: This study revealed that galactagogue use was high among breastfeeding women in Aotearoa. Mothers concerned about perceived insufficient milk quantity or quality were more likely to use galactagogues, yet a significant proportion of mothers who never questioned these aspects were also users. Qualitative research is needed to clarify decision making processes and influences.Item Food Group Consumption and Nutrient Intake by Breastfeeding Women: Comparison to Current Dietary Guidelines and Nutrient Recommendations.(MDPI (Basel, Switzerland), 2025-01-21) Jin Y; Coad J; Brough L; Billeaud C; Asher OBACKGROUND/OBJECTIVES: Optimal nutrition is essential for the health of breastfeeding women and their infants. This study aimed to assess food and nutrient intake and alignment with nutrition guidelines for breastfeeding women living in New Zealand. METHODS: Seventy-six breastfeeding women were enrolled in the longitudinal Mother and Infant Nutrition Investigation study and completed a weighed four-day diet diary including supplement use at three months postpartum. The number of servings consumed for each food group were calculated based on the 2020 Eating and Activity Guidelines for New Zealand Adults. Nutrient intakes were compared to the nutrient reference values for Australia and New Zealand. RESULTS: Overall, the percentages of women who met the recommended number of servings for fruits, vegetables, grain foods, meats and milk/milk products were 25%, 0%, 5%, 34%, and 13%, respectively. None of women met the current recommendations for all food groups. Many participants had intakes below the estimated average requirement or adequate intake and were at risk of nutrient inadequacy for vitamin E (55%), vitamin D (53%), manganese (61%), and selenium (55%). CONCLUSIONS: Breastfeeding women had a low alignment with the current dietary guidelines and were at risk of an inadequate intake of vitamin E, D, manganese, and selenium. Research to investigate the barriers and enablers of healthy food choices is needed.Item Adherence to Infant Feeding Guidelines in the First Foods New Zealand Study.(MDPI (Basel, Switzerland), 2023-11-02) Brown KJ; Beck KL; Von Hurst P; Heath A-L; Taylor R; Haszard J; Daniels L; Te Morenga L; McArthur J; Paul R; Jones E; Katiforis I; Rowan M; Casale M; McLean N; Cox A; Fleming E; Bruckner B; Jupiterwala R; Wei A; Conlon C; Rodríguez Martínez GInfant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.Item Validation and reproducibility of an iodine and selenium specific food frequency questionnaire in breastfeeding women : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand(Massey University, 2023) Bertasius, CharlotteBackgrounds: New Zealand has poor levels of iodine and selenium in its food sources. During lactation, women have increased selenium and iodine requirements, as their breastfeeding infant relies on their intake, putting them at increased risk of deficiency. Thyroid function is impacted by iodine and selenium status, and if these nutrients are low can cause consequences for the mother and breastfed infant. Dietary assessment methods, such as a Food Frequency Questionnaire (FFQ), can be utilised to assess nutrient intake, and validating an FFQ shows that the questionnaire can be used on the intended population to predict nutrient intake. To the best of our knowledge, New Zealand currently does not have a valid iodine and selenium specific FFQ for breastfeeding women. Due to this population risk with iodine and selenium, it is justified to test the validity and reproducibility of this FFQ on breastfeeding women in New Zealand. Aim: The aim of this study is to assess the validity and reproducibility of an iodine and selenium specific Food Frequency Questionnaire for breastfeeding women living in New Zealand. Methods: As part of the Mother and Infant Nutrition Investigation study (MINI), data was collected from breastfeeding mothers from three months to 12 months postpartum (PP). Participants (n = 87) were administered an iodine and selenium specific FFQ at three months and a four-day diet diary (4DDD). To assess reproducibility the FFQ was readministered at 12 months PP (FFQ2). FFQ1 was validated via 4DDD and selected biomarkers (urinary and breastmilk iodine concentrations and plasma selenium); statistical analysis was used, including Wilcoxon signed ranked test, Spearman’s correlation, cross-classifications, weighted kappa statistics, Bland Altman plots, the same statistical analysis carried out to assess reproducibility between FFQ1 and FFQ2. Results: For the validation, the correlation observed ranged from 0.317 (selenium) to 0.532 (total iodine) between the FFQ and 4DDD and for FFQ to EIB, 0.146 (selenium) and 0.155 (total iodine). Cross-classifications majority of the nutrient groups were >50% correctly classified (32.9% (selenium) to 71.6% (iodine food only)) when comparing the FFQ to 4DDD. Most of the groups were <10% misclassified (1.37% (iodine and salt) to 11.0% (selenium)). For the FFQ to EIB, the correctly classified participants were 50% (iodine) and 73.1% (selenium), and the grossly misclassified participants were 16.35% (iodine) and 3.4% (selenium). For FFQ to 4DDD, the weighted kappa values showed poor agreement (k<0.21) for two groups and fair agreement (k 0.21-0.41) for three groups. For EIB, the weighted kappa showed poor agreement (k<0.21) for four groups and fair agreement (k 0.21-0.41) for one. The Bland-Altman plots showed fair agreement for the difference between FFQ1 to 4DDD or EIB. For reproducibility, the correlation between FFQ1 and FFQ2 was 0.625 (iodine) and 0.429 (selenium). Cross-classification for correctly classified participants was >50% for iodine; for selenium and iodine, <10% were grossly misclassified. The weight kappa value showed poor agreement (k0.21) for both iodine and selenium. Conclusion: The FFQ showed reasonable validity when assessing iodine and selenium intake using the FFQ for breastfeeding women in New Zealand and showed good reproducibility for iodine and selenium. This FFQ could be used in future research on this population and could be used in primary care as a convenient way to assess iodine and selenium intake for breastfeeding women in New Zealand.Item Saccharomyces cerevisiae Yeast-Based Supplementation as a Galactagogue in Breastfeeding Women? A Review of Evidence from Animal and Human Studies(MDPI (Basel, Switzerland), 2021-03) Jia LL; Brough L; Weber JL; Demmelmair HPerceived insufficient milk production (PIM) adversely affects breastfeeding duration. Women sometimes use galactagogues with the intent to increase breast milk production and support lactation. Saccharomyces cerevisiae yeast-based supplement (SCYS) is an inactive form of Saccharomyces cerevisiae yeast (SCY) either obtained from the fermentation process or grown on molasses. Anecdotal evidence suggests SCYS is a galactagogue. SCYS is promoted on the internet as a galactagogue in various forms and doses. Dietary supplementation with SCYS during gestation and lactation significantly increases milk yield in ruminants. No human study has evaluated efficacy of SCYS as a galactagogue. SCYS is rich in B vitamins, beta-glucan, mannan oligosaccharides and bioavailable chromium; these may impact breast milk production or composition, thus may alleviate PIM. The safety of taking SCYS during lactation is not well studied. Studies have reported contamination of SCYS with ochratoxin A (OTA) as well as minor side effects from SCYS. Studies are needed to evaluate the efficacy of SCYS on breast milk production and composition and to assess the safety of taking SCYS during lactation in humans.