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    Effectiveness of Combining LATCH and Bristol Breastfeeding Assessment Scales in Predicting Exclusive Breastfeeding
    (Mary Ann Liebert, Inc, 2025) Say, Birgul Livaoglu; Kaya, Fatma Erva; Hatipoglu, Halil Ugur
    Background: Early identification of breastfeeding difficulties is crucial for targeted interventions. However, the comparative effectiveness of these assessment tools remains unclear. Objective: To compare the predictive validity of the LATCH and Bristol Breastfeeding Assessment Tool (BBAT) scores measured at 24 hours and day 7 postpartum for exclusive breastfeeding at 42 days and to evaluate their combined predictive performance. Methods: This prospective cohort study included 157 mother-infant dyads (September 2024-March 2025) at a university hospital in Turkey. LATCH and BBAT scores were assessed at 24 hours and on day 7 postpartum. The primary outcome was exclusive breastfeeding at 42 days. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off values and predictive performance. Results: The rate of exclusive breastfeeding (EBF) was 83.4% (n = 132) in the first 24 hours and 68.8% (n = 108) on day 42 of life. The LATCH score in the first week showed the highest specificity for predicting EBF on day 42. (cut-off value >= 10: area under the curve [AUC] 0.671 (95% CI: 0.582-0.760; p < 0.001), sensitivity 55.6%, specificity 72.3%, false positive rate 27.7%). A multiple ROC analysis was conducted to determine which of the four scores was better at predicting EBF on the 42nd day. The cutoff values were 8 for the first-week Bristol score alone, 10 for the first-week LATCH score, 5 for the first 24-hour Bristol score, and 7 for the first 24-hour LATCH score. Conclusions: Combined early assessment using LATCH and BBAT scores provides a superior prediction of EBF at 42 days compared with single indicators. The implementation of systematic screening using these tools may facilitate targeted lactation support for at-risk dyads.
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    Impact of Short-Term Freezing at-20°C on Macronutrient Content in Human Milk from Preterm Infants
    (Mary Ann Liebert, Inc, 2025) Livaoglu Say, Birgul; Hatipoglu, Halil Ugur; Uras, Hatice Buse; Uras, Nurdan
    Objectives: Breast milk is an ideal food for newborns born term and preterm. The short-term storage of human milk (HM) involves freezing at low temperatures; however, its effects on macronutrients remain unclear. The macronutrients in HM are generally thought to be unaffected by short-term freezing. This study aimed to analyze the impact of freezing HM from preterm infants at -20 degrees C for 5 days on macronutrient content. Methods: HM samples were collected from 54 mothers of preterm infants. Each sample was divided into three aliquots and stored at -20 degrees C for 1 and 5 days. After thawing and homogenization, energy and macronutrient contents were measured using a HM infrared spectroscopy analyzer. Results: We analyzed 162 samples (from 54 mothers of preterm infants). Mean baseline concentrations in fresh milk were protein 1.55 +/- 0.61 g/100 mL, carbohydrates 6.87 +/- 0.81 g/100 mL, fat 4.29 +/- 2.16 g/100 mL, and energy 75.9 +/- 27.3 kcal/100 mL. Freezing at -20 degrees C reduced protein to 1.33 +/- 0.35 g/100 mL after 24 hours and 1.21 +/- 0.38 g/100 mL after 5 days (14.2% and 21.9% decrease, p < 0.001), fat to 3.23 +/- 1.15 g/100 mL and 3.04 +/- 1.40 g/100 mL (24.7% and 29.1% decrease, p < 0.001), and energy to 64.3 +/- 12.8 kcal/100 mL and 61.7 +/- 16.1 kcal/100 mL, respectively (p < 0.001); carbohydrate content remained unchanged (p = 0.41). Conclusions: Freezing HM at -20 degrees C for 5 days can significantly reduce critical nutrients, including fat and protein, suggesting the need for individualized fortification strategies to ensure optimal growth in preterm infants.