Mammary epithelium permeability, lactation outcomes, and infant health

Active Project Grant Awarded Last action

Award ID
R01HD111200
Recipient
Awarding agency
Obligated
$3,968,413

Award facts

Completion date 66% complete
Place of performance
Hadley, MA 01035, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Human milk provides significant health benefits for infants. Beyond nutrients, breastmilk contains antibodies for immunity, growth factors associated with GUT epithelial maturation, bacteria for establishment of the GUT microbiome, and metabolites that modulate inflammation. These important elements of human milk support strong immune system development within the infant GUT and better infant health. Unfortunately, many parents aiming to breastfeed will supplement or wean earlier than planned and frequently report perceived low milk supply as the reason. Increased mammary epithelium permeability (imep), as indicated by elevated milk sodium, is a physiologic condition that could have significant implications for milk secretion, composition and infant health. Lactation physiology studies have established that closed paracellular pathways, i.e., low permeability, are essential for the establishment and maintenance of adequate milk secretion. Human studies on permeability have focused on the period of secretory activation and persistent mammary epithelium permeability at day 7 postpartum has been associated with perceived low milk supply. However, little is known about imep during established lactation. We recently reported that imep among US women is more common across lactation than previously recognized. Longitudinal US studies are needed to quantify mammary epithelium permeability during established lactation and to investigate the extent to which increased permeability influences lactation insufficiency. Our overall goal is to establish a clinically relevant robust imep threshold, based on our analysis of sodium as a continuous variable, and determine the extent to which imep is associated with suboptimal lactation outcomes and reduced infant health. We propose that imep is associated with low milk supply and earlier than desired weaning. We also posit that imep results in altered milk nutrient content, shifted inflammatory profiles and milk microbiome composition impacting the infant GUT immune profile and microbiome. We will enroll a diverse cohort of 400 mother-infant dyads from new mexico and massachusetts. Participants will provide bilateral milk and infant fecal samples at four timepoints spanning transitional, early and mature milk. Understanding the extent of imep linkage to suboptimal lactation outcomes and infant intestinal health is of major importance because imep can be measured, treated and prevented. Interventions to limit imep could include behavioral and dietary changes, as well as medications or supplements. This will be the first study to determine the prevalence of imep and associated changes in milk throughout the first five months postpartum, and the only large US cohort study of imep. Results from this study could lead to a major change in clinical practice. Assessment of imep in milk could become routine, especially among women seeking lactation counseling, and this may lead to improved outcomes. We expect that our geographically and ethnically diverse cohorts will provide novel data on differences in risk factors for imep with implications for lactation outcomes.

Transactions

Action Obligated Date
Amendment $661,417
Amendment $627,120
Amendment $639,253
Amendment $639,253
Amendment $700,685
Original award $700,685

Subawards

Subrecipient Amount Awarded
University Of Illinois Massachusetts AI and Technology Center for Connected Care in Aging and Alzheimer's Disease $102,779
Cognitive Health Solutions Inc. $136,283
Baystate Medical Center, Inc. Mammary Epithelium Permeability, Lactation Outcomes, and Infant Health $392,109
The Leland Stanford Junior University Massachusetts AI and Technology Center for Connected Care in Aging and Alzheimer's Disease $238,338
Musical Health Technologies, LLC $150,142
The General Hospital Corporation $245,787
Mindmics, Inc. Mammary Epithelium Permeability, Lactation Outcomes, and Infant Health $112,173
Boston Medical Center Corporation $47,704
University Of Massachusetts Medical School $199,178
Brigham & Womens Hospital Inc. $613,524
University Of New Mexico $748,764
Baystate Medical Center, Inc. $555,263
Show all 12

Quick answers

Who received award R01HD111200?

R01HD111200 was awarded to University Of Massachusetts by National Institute of Child Health and Human Development (National Institutes of Health) on August 11, 2023.

How much is award R01HD111200 worth?

$3,968,413 has been obligated on R01HD111200.

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