Displaying publications 1 - 20 of 72 in total

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  1. Chow AY, Simpson IA
    J Trop Pediatr (Lond), 1956 Sep;2(2):69-76.
    PMID: 24544134
    (1) The effect has been studied of the oral administration of supplementary thiamine on the thiamine content of milk from sixteen women, whose initial thiamine content was low ; and of the parenteral administration of thiamine to ten women, some of whom initially showed mild, clinical symptoms of beriberi.
    (2) The response in the milk content of thiamine to supplementary thiamine, administered either orally or by injection, showed marked variation in different women. While comparatively small doses taken by mouth evoked a marked response in some women, fairly large doses administered by injection failed to produce much response in others.
    (3) In some women, a marked increase in the thiamine content of their milk occurred soon after the administration of thiamine, either orally or parenterally. In others, the response was slow and meagre.
    (4) The highest thiamine level obtained in a sample of milk was 38.9 ug./100 ml., after the injection, twice daily, of 20 mg. thiamine for six days — a total intake of 240 mg. of thiamine parenterally. The initial milk thiamine level in this case was 2.3 ug./100 ml., but had increased to 16.2ug./100 ml., by the supply of a good diet alone, before the course of injections was commenced.
    (5) It would appear, that, in cases where the thiamine content of the milk is low, initial parenteral administration of thiamine must be supplemented by a continued intake of additional thiamine, if a satisfactory level of thiamine in the milk is to be maintained.
    Matched MeSH terms: Milk, Human*
  2. Abbas MA, Al-Saigh NN, Saqallah FG
    Rev Endocr Metab Disord, 2023 Apr;24(2):297-316.
    PMID: 36692804 DOI: 10.1007/s11154-023-09788-3
    Milk is a rich source of miRNA packaged in exosomes. Evidence for the systemic uptake and tissue distribution of milk exosomes was reported in newborn and adult humans and animals. Breastfeeding in infants was associated with a reduced risk of obesity. Numerous adipogenesis-related miRNAs have been detected in human milk exosomes. It has been demonstrated that ingested exosomal milk miRNAs may alter gene expression in offspring to regulate their metabolism and growth. In humans, consumption of other species' milk, such as cows and goats, is continued through adulthood. Since miRNAs are conserved, the concern of cross-species transfer of adipogenic miRNA has been raised in recent years, and the increase in obesity worldwide was attributed partially to dairy milk consumption by humans. However, evidence is still weak. Research emphasizes the need for an adequate number of exosomal milk's miRNAs to reach the target cell for biological action to be achieved. It was reported that obese women's milk had less miRNA-148a and miRNA-30b, which may affect the fat acquisition of their babies. Some exosomal milk miRNAs, such as miRNA-29, miRNA-148, miRNA-30b and miRNA-125b, may have epigenetic effects on milk recipients. Moreover, the ability of milk exosomes to cross the gastrointestinal barrier makes them a promising oral drug delivery tool. Yet, exosomes may also be tagged with specific ligands which target certain tissues. Thus, milk exosomes can be engineered and loaded with certain miRNAs responsible for adipocyte differentiation, conversion, or browning. Modifications in the miRNA cargo of exosomes can benefit human health and be an alternative to traditional drugs.
    Matched MeSH terms: Milk, Human/metabolism
  3. Abdul Razak SF, Rosli NL, Kamis NH, Rahim NCA, Abdullah MFA
    PLoS One, 2023;18(9):e0290311.
    PMID: 37708192 DOI: 10.1371/journal.pone.0290311
    Informal human milk exchange is the practice of donating and receiving expressed human milk based on mutual consent between the donor and receiver in the need of human milk for infants below 2 years old. Main concerns related to informal human milk exchange is related to milk siblings and safety handling of the expressed breastmilk. Even though there are countries which have policies and procedures related to human milk bank, informal milk exchange has not been given much attention. Compared to human milk bank, informal human milk exchange is not regulated. This study aims to identify the system focused on personalized breastfeeding tracking and monitoring, online discussion forum, web-based consultation, and breastfeeding station locator. Review of current applications in supporting breastfeeding practices was conducted based on the PRISMA-ScR framework. A literature search was conducted in Scopus and Google Scholar databases to identify articles published in English or Malay and containing systems/applications related to breastfeeding, milk sharing, milk exchange, milk siblings/kinship within the societal context. According to the scoping review, current scientific publications mostly focused on breast milk, breastfeeding, and milk banking concerns, with recurring themes including social reasons, lactation insufficiency, and unsolved nursing problems. These themes highlight the complexities and complexities of informal human milk exchange practices. Two reviewers screened the articles, and the data were extracted and narratively synthesized. During the primary database search, 360 articles were found based on the related titles, abstracts, and keywords. Seventy eight met the inclusion criteria and were finalized in this review. We found that most scholarly works focused on breast milk, breastfeeding and milk banking challenges and issues with recurrent themes i.e., societies, lactation inadequacy and unresolved nursing problems. Based on our literature search and to the best of our knowledge, there is no recent scoping reviews which focuses on technology-based approaches on informal human milk exchange. Findings from this scoping review is important for advancing research and practice in this field, as well as improving outcomes for individuals and families affected by informal human milk exchange.
    Matched MeSH terms: Milk, Human*
  4. de Weerth C, Aatsinki AK, Azad MB, Bartol FF, Bode L, Collado MC, et al.
    Crit Rev Food Sci Nutr, 2023;63(26):7945-7982.
    PMID: 35352583 DOI: 10.1080/10408398.2022.2053058
    Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions.
    Matched MeSH terms: Milk, Human*
  5. Ramachandran K, Dahlui M, Nik Farid ND
    PLoS One, 2024;19(3):e0299308.
    PMID: 38437241 DOI: 10.1371/journal.pone.0299308
    The World Health Organisation (WHO) recommends that all babies be exclusively breastfed, stating that donor milk is the next best alternative in the absence of the mother's own milk. Milk sharing takes many forms, namely wet nursing, co-feeding, cross-feeding, and a human milk bank (HMB). However, the establishment of a human milk bank is still not widely accepted and is a debatable topic because of religious concerns in Malaysia. The aim of this study is to determine the facilitators and barriers among Malaysians towards the acceptance of an HMB. A cross-sectional study with 367 participants was conducted; the participants answered an online-validated, self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB-specific issues were analysed in terms of frequency before proceeded with multiple logistic regression. The majority of the respondents were Muslim (73.3%), had completed their tertiary education (82.8%), and were employed (70.8%). Only 55.9% of respondents had heard of HMB, stating the internet as their main source of information, but many respondents were agreeable to its establishment (67.8%). Most respondents had a good score on knowledge of breastfeeding benefits and on HMB-specific issues (70% and 54.2%, respectively), while 63.8% had a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715; 95% CI 1.047-2.808) were more likely to accept the establishment of HMB, while being a Muslim was negatively associated with its establishment (AOR = 0.113, 95% CI 0.050-0.253). The study found a high prevalence of mothers who were willing to accept the establishment of HMB. By educating mothers on the benefits of breastfeeding, as well as addressing their religious concerns, the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their beliefs or the health benefit of donor milk.
    Matched MeSH terms: Milk, Human*
  6. Kwan SH, Abdul-Rahman PS
    Plant Foods Hum Nutr, 2021 Sep;76(3):257-269.
    PMID: 34292494 DOI: 10.1007/s11130-021-00901-y
    Human milk is recommended by the World Health Organization (WHO) for the general well-being of infants. However, many mothers face an insufficient milk supply to breastfeed their children. Galactagogue, in particular, plant galactagogue, serves as a method to promote lactation. This in-depth review examines the evidence supporting different plants' galactagogic activity through clinical studies around the globe. A scoping review approach was adopted to establish the research questions, and define the findings, selection and analysis of the study. This scoping review highlights and compiles the clinical research performed globally involving plant galactagogue to better inform the medical practitioners, lactation consultants, nursing mothers, communities and relevant personnel on practicing, guidelines, policymaking and research. In general, a total of 1041 research publications were retrieved from different global bibliographic databases, of which only 13 articles were retained for analysis after applying the exclusion criteria. A total of 14 types of plants have undergone clinical studies in the past decade to verify their galactagogic activity. All but two showed a positive effect on promoting milk production. There were 42 articles categorised as excluded studies. The category includes review articles, surveys, case reports, introductory articles of regional plant galactagogue and preclinical studies, which involves animal testing and the studies exploring other issues related to plant galactagogue. The findings demonstrate that there is a significant research gap on the plant galactagogue using clinical studies. More clinical research is necessary to identify and verify the efficacy of various types of plant galactagogue for the benefit of humankind.
    Matched MeSH terms: Milk, Human
  7. Prameela KK
    Med J Malaysia, 2011 Jun;66(2):166-9; quiz 170.
    PMID: 22106709
    Essential nutritive and immunological ingredients abundantly present in breastmilk make it the choice infant nutrition. The uniqueness of mother's milk, in contrast to most therapeutics and immunizations, lies in its potential to adapt itself to the requirements of the infant so that timely immune defenses are tapped from its constituents by immune regulation, modulation and immune acceleration to stimulate novel substances; these render it pertinent as defense when faced with challenging organisms. While it is appreciated that immunity can be transferred from mother to infant through breastmilk following maternal influenza vaccination, the immense benefits conferred by breastfeeding per se during influenza pandemics may not be fully valued. This is substantiated by debates and ambiguities for continued breastfeeding in the face of maternal influenza infections. This article emphasises the utmost importance of breastfeeding in viral pandemics in the light of the changing immunological strategies used by viruses at different times and the urgent need for such opportune defenses. The prolific interaction of its constituents is frequently understated as enormous advantages to the suckling infant.
    Matched MeSH terms: Milk, Human/immunology*
  8. Yadav M, Nagappan N, Iyngkaran N
    J Pediatr, 1980 Mar;96(3 Pt 1):515-6.
    PMID: 7359251
    Matched MeSH terms: Milk, Human/immunology*
  9. Nayak R, Nagaraj KN, Gururaj G
    Indian J Pediatr, 2020 05;87(5):353-358.
    PMID: 31989459 DOI: 10.1007/s12098-020-03182-6
    OBJECTIVES: To compare the efficacy of orally administered 10% dextrose, breast milk and sterile water on pain prevention during screening examination for Retinopathy of prematurity (ROP) in preterm neonates as measured by Premature infant pain profile (PIPP).

    METHODS: A three-limbed double-blinded randomized control trial was conducted in a Level 3 neonatal intensive care unit. Forty five preterm neonates undergoing ROP screening were included. Eligible babies were randomly assigned to one of the three groups that orally received either expressed breast milk (n = 14), 10% dextrose solution (n = 14) or sterile water (n = 17), one minute before eye examination. The outcome measure was PIPP score.

    RESULTS: All 3 groups were similar in baseline characteristics. The mean PIPP scores were comparable (p = 0.18) in the three groups (11.8 ± 2.8 vs. 9.8 ± 3.3 vs. 10.2 ± 2.9). The behavioral and physiological variables were also similar across all three groups.

    CONCLUSIONS: Expressed breast milk, 10% dextrose or sterile water administered orally before ROP screening in preterm neonates have similar analgesic effects and do not significantly alleviate pain during the procedure.

    Matched MeSH terms: Milk, Human*
  10. Abdul Hamid H, Szatkowski L, Budge H, Cheah FC, Ojha S
    BMJ Paediatr Open, 2021;5(1):e001153.
    PMID: 34514178 DOI: 10.1136/bmjpo-2021-001153
    Objective: To explore differences in nutritional practices and growth outcomes among preterm infants in neonatal units in Malaysia and the UK.

    Design: Prospective exploratory study of infants born at <34 weeks gestational age (GA).

    Setting: Two neonatal units, one in Malaysia and one in the UK (May 2019 to March 2020).

    Methods: Data collected from birth until discharge and compared between units.

    Results: From 100 infants included, median GA (IQR) was 31 (30-33) and mean±SD birth weight was 1549±444 g. There were more small-for-gestational age infants in Malaysian unit: 12/50 (24%) vs UK: 3/50 (6%), p=0.012 and more morbidities. More Malaysian infants received breast milk (Malaysia: 49 (98%) vs UK: 38 (76%), p=0.001), fortified breast milk (Malaysia: 43 (86%) vs UK: 13 (26%), p<0.001) and exclusive breast milk at discharge (Malaysia: 26 (52%) vs UK: 16 (32%), p=0.043). There was higher parenteral nutrition use among Malaysian infants (40/50 (80%)) vs UK (19/50 (38%)) (p<0.001) with higher protein intake (mean±SD Malaysia: 3.0±0.5 vs UK: 2.7±0.6 g/kg/d, p=0.004) in weeks 1-4 and smaller cumulative protein deficits (mean±SD Malaysia: 11.4±6.1 vs UK: 15.4±8.0 g/kg, p=0.006). There were no significant differences in short-term growth between units and more than half of the infants in both units had ≥1.28 changes in weight-for-age Z-score at discharge (p=0.841).

    Conclusions: An exploratory comparison of practices showed differences in patient characteristics and nutritional practices which impacted growth. Future studies with larger sample sizes and detailed analysis of maternal characteristics and infants' outcomes are needed for improving care of preterm infants in all settings.

    Matched MeSH terms: Milk, Human*
  11. Boo NY
    Malays J Pathol, 2016 Dec;38(3):223-227.
    PMID: 28028291 MyJurnal
    Necrotising enterocolitis (NEC) is the most commonly acquired gastrointestinal disease of neonates, particularly the very preterm (gestation <32 weeks) and/or very low birth weight (<1500g). It is associated with high morbidity and mortality. Despite improvement in neonatal care and increased use of expressed breast milk (EBM), the incidence remains high in many neonatal intensive care units (NICU), and even shows increasing trend in some countries. Numerous studies have pointed to the infective nature of NEC. Some investigators have reported an increase in the incidence of NEC in their NICU when the percentage of infants with pathogens isolated from their gut increased, and decreased when gut colonisation rate was low. Both bacteria and viruses have been reported to be associated with outbreaks of NEC. The majority (>90%) of the NEC cases occurred in neonates on enteral feeding. Studies have shown that milk (whether EBM or formula) fed to neonates was not sterile and were further contaminated during collection, transport, storage and/or feeding. Other investigators have reported a reduction in the incidence of NEC when they improved infection control measures and hygienic procedures in handling milk. It is, therefore, hypothesised that the most common cause of NEC is due to the feeding of neonates, particularly the vulnerable very preterm small neonates, with milk heavily contaminated during collection at source, transport, storage and/or feeding. Because of the immaturity of the immune system of the neonates, excessive inflammatory response to the pathogen load in the gut leads to the pathogenesis of NEC.
    Matched MeSH terms: Milk, Human/microbiology*
  12. Cheang HK, Yeung CY, Cheah I, Tjipta GD, Lubis BM, Garza-Bulnes R, et al.
    Acta Paediatr, 2022 Jul;111(7):1362-1371.
    PMID: 35340076 DOI: 10.1111/apa.16344
    AIM: To gain insight into nutritional practices and expected growth outcomes of infants born between 34 and 36 gestational weeks defined as late preterm infants (LPT).

    METHODS: An anonymous online survey among paediatricians and neonatologists from Bangladesh, Indonesia, Mexico, Nigeria, Malaysia, Singapore and Taiwan was conducted from March until October 2020. The questionnaire consisted of 40 questions on the nutritional management and expected growth outcomes of LPT in and after-hospital care.

    RESULTS: Healthcare professionals from low to high Human Development (HDI) countries (n = 322) and very high HDI countries (n = 169) participated in the survey. Human milk was the preferred feeding, resulting in an adequate growth of LPT (weight, length and occipitofrontal circumference), according to a majority of respondents (low to high HDI, 179/265, 68% vs. very high HDI, 73/143, 51%; p = 0.002). The expected growth outcome was higher after-hospital discharge. Less than half of healthcare professionals started enteral feeding during the 1st hour of life. Lactation difficulties, limited access to human milk fortifiers and donor human milk, especially among low to high HDI countries, were reported as major hurdles.

    CONCLUSION: Human milk is the first feeding choice for LPT. The diverse opinions on nutritional practices and expected growth outcomes among healthcare professionals indicate the necessity to develop general nutritional guidelines for LPT.

    Matched MeSH terms: Milk, Human*
  13. Khor GL
    Asia Pac J Clin Nutr, 2022;31(4):576-583.
    PMID: 36576276 DOI: 10.6133/apjcn.202212_31(4).0001
    BACKGROUND AND OBJECTIVES: This narrative review aims to provide recent understanding of the implications of maternal diet on fatty acid composition of breast milk, with focus on the docosahexaenoic acid (22:6n-3 (DHA) and arachidonic acid 20:4n-6 (AA) contents, for fetal growth and development. Breast milk n6/n3 polyunsaturated fatty acids (PUFA) ratio will also be highlighted in relations to maternal lipid intake.

    METHODS AND STUDY DESIGN: PubMed and Google Scholar were searched for relevant publications in English focusing on but not limited to the use of the key words stated below.

    RESULTS: Studies since the 1950s of different population groups worldwide affirmed the recognition that breastmilk fatty acid compositions are highly sensitive to maternal diet. Colostrum is richer in long-chain PUFA (LC-PUFA) metabolites of both linoleic and linolenic acids than mature milk. Among these LC-PUFA, both DHA and AA are incorporated preferentially and rapidly within the cerebral cortex and the retina during the last trimester of pregnancy and postnatal 18 months. Maternal supply of DHA and AA include maternal fatty acid stores, endogenous synthesis or directly from diet. Decreasing fish intake concomitant with increased intake of meat and vegetable oil leading to decreased intake of DHA and EPA, and an increase in AA intake, have resulted in an imbalanced n-6/n-3 PUFA ratio in breastmilk.

    CONCLUSIONS: A balanced intake of PUFAs during pregnancy and lactation is recommended for fetal and childhood growth and development.

    Matched MeSH terms: Milk, Human*
  14. Prameela KK, Vijaya LR
    Malays J Nutr, 2012 Apr;18(1):103-11.
    PMID: 23713234 MyJurnal
    Globally, rotaviral vaccines in use today have contributed to the reduction of the incidence of rotaviral diarrhoeas. Despite the substantial protection conferred by the current vaccines against the rotaviral strains, it is only prudent to recognise that other protective factors, like breastfeeding, also provide some degree of protection against this disease. This article has attempted to review some important mechanisms of protection in breast milk against the rotaviruses and highlight the oft forgotten non-immunoglobulin fraction in breast milk as an additional tool of protection against rotavirus disease. The adaptive capacity of breast milk to environment is another compelling reason to continue breastfeeding as it can usefully complement and be significant in the use of many vaccines. Vital immunoprotective constituents in breast milk beneficially protect the infant by initiating and strengthening many immune responses and should be borne in mind as essential tools of defence even in an era where vaccines play a pivotal role in the combat against certain diseases. It is impressive that besides nutritive advantages, the suckling infant enjoys appreciable immunoprotection via exclusive breastfeeding.
    Matched MeSH terms: Milk, Human/immunology; Milk, Human/chemistry
  15. Prameela KK
    Med J Malaysia, 2012 Dec;67(6):644-51.
    PMID: 23770969 MyJurnal
    Breastmilk protects the infant from many diseases and many short- term and long- term benefits accrue. At the same time it is also known that breastfeeding acts as a vehicle for some infective agents. It is now accepted that breastmilk transmission of Human Immunodeficiency Virus- 1 (HIV-1) is an important mode of paediatric infection . Despite this fact, many researchers have observed that corresponding to the volume of milk consumed by the infant, maternal transmission via breastmilk is still comparatively low. Some have noted the long latency period of breastmilk HIV transmission with evidence of numerous anti-HIV factors in breastmilk. Although there are accepted standard guidelines on infant feeding in mothers who are HIV positive in many countries, it maybe equally important to realize gaps in our knowledge of mother- to -child HIV transmission. From an evolutionary perspective, the role of the mammary epithelial cell (MEC) and of breastmilk , in contributing to and possibly in influencing HIV-1 transmission is intriguing. The presence of HIV-1 or of other viruses in maternal milk seem to be a requisite to spur immunological defenses to optimize necessary protection to the infant. This article reviews some aspects of the science of HIV transmission through breastmilk and reflects the concept -based understanding of current policies on HIV and breastfeeding. At the same time, it highlights uncertainties in this field and the urgency for future research in this direction. Accepting current notions of breastmilk HIV transmission, greater deliberation by research may throw more light on why breastfeeding with its abundant advantages is fraught with the hazards of transmission of a deadly disease.
    Matched MeSH terms: Milk, Human
  16. Koe, Swee-Lee
    MyJurnal
    It is ironical to realize that a perfect and free nutritional product, individually produced and naturally distributed to all families, is not universally used. This product is of course breast milk that nurtures the optimal health, growth and development of the human young. Breast milk also protects infants and young children from and prevents diseases in the short and long term. (Copied from article)
    Matched MeSH terms: Milk, Human
  17. Radzi, Z., Yahya, N.A.
    Ann Dent, 2005;12(1):-.
    MyJurnal
    Breast-feeding offers many benefits to the baby and the mother. For instance, breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Even though breastfeeding is a natural process, it is not always easy. In certain situations, some mothers are unable to breastfeed their babies or the babies are unable to adapt to breastfeeding. This will lead to the use of bottle-feeding. The effect of breast-feeding and bottle-feeding on physical growth has been well established but less has been concentrated on the craniofacial growth and dental development. This review reveals the effects of breast-feeding and bottle-feeding on craniofacial growth and dentoalveolar development based on the available literature.
    Matched MeSH terms: Milk, Human
  18. Asmah Rahmat, Rozita Rosli, Tan, Mui Hoon, Nasir Umar-Tsafe, Abdul Manaf Ali, Mohd Fadzelly Abu Bakar
    MyJurnal
    Objective: Previous studies have shown milk to contain cancer inhibitors. In this context, this study was conducted to screen the potential cytotoxic properties of four different types of milk, namely cow's milk, goat's milk, mare's milk and human milk.
    Methods: In evaluating the cytotoxic properties of milk, two different human leukemia cell lines namely, Raji and CEM-SS were used. The treated and untreated cells of milk were cultured at 37°C in 5% CO2 for 5 days according to standard guidelines. The CellTiter 96® Aqueous (MTS) assay was carried out on the first, third and fifth days to measure cell viability. The percentage of cell viability was determined by comparing the optical density of the treated cells against the untreated controls. One-way ANOYA at p
    Matched MeSH terms: Milk, Human
  19. Norita Kamaruddin, Nora'inan Bahari, Zanariah Dimon, Nurhayati Abd Ghani
    MyJurnal
    The awareness of the Muslim community on the importance of understanding breastfeeding according
    to Islamic perspective needs to be emphasized in promoting the implementation of breastfeeding in the
    best way. This proved that breast milk is the major food after birth and a mother should know the right
    and the regulation of breastfeeding in order to be in line with Islamic law. This article aims to discuss
    the level of awareness among the Muslim community in Selangor regarding breast milk donation. Data
    were collected through a questionnaire distributed to 400 respondents involving three locations in
    Selangor, namely in the northern zone (Hulu Selangor district), central zone (Klang district) and
    southern zone (Sepang district). The findings showed that the respondents had a moderate level of
    awareness regarding milk donation laws with average mean value of 3.26. This finding shows that the
    Muslim community in Selangor are concerned about the rights and the regulation of breastfeeding.
    Matched MeSH terms: Milk, Human
  20. Che Abdul Rahim N, Sulaiman Z, Ismail TAT
    PLoS One, 2024;19(1):e0291758.
    PMID: 38277383 DOI: 10.1371/journal.pone.0291758
    BACKGROUND: Induction of lactation occurs when breast milk is produced in a human (woman), without going through the process of pregnancy and delivery. Efforts to produce milk by women who had never been pregnant and give birth are not easy. According to the many who have attempted it, it is far more arduous a task than initiating postpartum lactation, but it is possible and worth the effort.

    RESEARCH AIM: This study aimed to explore and understand the challenges for women during induced lactation in Malaysia.

    METHODS: This qualitative study was done in 2017 and utilized in-depth interview among women who induced lactation in five states based on five regions in Malaysia [Central Region (Selangor), Northern Region (Penang), Southern Region (Johor), East Coast Region (Kelantan), Malaysia Borneo (Sabah)]. All interviews were consented, audio-recorded then transcribed verbatim, followed by identification of main themes.

    RESULTS: Data saturation was achieved after interviewing a total of 23 induced lactation women. Data synthesized using thematic analysis revealed six themes describing the main challenges during the induction process were (1) health condition, (2) work commitment, (3) overexertion, (4) not eligible to take leave, (5) inability to follow the treatment plan, and (6) difficulty attaching the adopted baby to initiate breastfeeding during induced lactation process.

    CONCLUSIONS: The challenges faced by women during the process of induced lactation were complex and the induced lactation process requires considerable dedication and determination. The findings of this research will help other women and their spouses/partners comprehend the challenges, obstacles, and support that are needed along the induced lactation process. The Government and other stakeholders have roles in more efforts and programs to help these mothers breastfeed their adoptive child and make them feel more accomplished as women and mothers.

    Matched MeSH terms: Milk, Human
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