{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:04:09Z","timestamp":1791529449746,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T00:00:00Z","timestamp":1547337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["RGPIN\u20102016\u201004961"],"award-info":[{"award-number":["RGPIN\u20102016\u201004961"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Infant growth faltering occurs in breastfed infants &lt;6\u00a0months of age. The possibility that maternal health status contributes to this growth faltering is underexplored. We investigated whether (a) subclinical mastitis (SCM), an asymptomatic inflammation of the breast, (b) maternal intestinal nematode and protozoan infections, indicators of faecal\u2013oral contamination, or (c) poor breastfeeding practices increased the odds of stunting (length\u2010for\u2010age z\u2010score\u00a0&lt;\u00a0\u22122\n                    <jats:italic>SD<\/jats:italic>\n                    ), underweight (weight\u2010for\u2010age z\u2010score\u00a0&lt;\u00a0\u22122\n                    <jats:italic>SD<\/jats:italic>\n                    ), or low head circumference (head circumference\u2010for\u2010age z\u2010score\u00a0&lt;\u00a0\u22122\n                    <jats:italic>SD<\/jats:italic>\n                    ) in breastfed infants in rural indigenous communities in Guatemala. Mother\u2013infant dyads (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0105) were subdivided into those with and without SCM (milk Na:K ratio\u00a0&gt;\u00a00.6). Maternal and infant anthropometry were measured at the time of breast milk collection. Maternal stool samples were examined for the presence of intestinal nematodes and protozoa. Questionnaires were used to characterize breastfeeding practices (exclusivity and frequency) and support, hygiene (latrine use and household faucet), and infant diarrhoea. SCM occurred in 14% of women and was associated with increased odds of infant stunting (odds ratio [OR]\u00a0=\u00a04.3; confidence interval [CI] [1.1, 15.8]), underweight (OR\u00a0=\u00a09.2; CI [1.8, 48.0]), and low head circumference (OR\u00a0=\u00a015.9; CI [2.6, 96.9]). Maternal pathogenic protozoa and nematodes were uncommon (&lt;4%), but nonpathogenic protozoa were common (e.g.,\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Entamoeba coli<\/jats:italic>\n                    <\/jats:styled-content>\n                    [39%]).\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Entamoeba coli<\/jats:italic>\n                    <\/jats:styled-content>\n                    increased the likelihood (OR\u00a0=\u00a03.3; CI [1.02, 10.6]) of low head circumference, whereas higher breastfeeding frequency lowered its odds (OR\u00a0=\u00a00.74, CI [0.56, 0.97]). Prevention of SCM may improve early infant growth, but public health measures that increase breastfeeding frequency and reduce faecal\u2013oral contamination may be required to minimize low head circumference.\n                  <\/jats:p>","DOI":"10.1111\/mcn.12756","type":"journal-article","created":{"date-parts":[[2018,11,25]],"date-time":"2018-11-25T19:24:47Z","timestamp":1543173887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Infant growth faltering linked to subclinical mastitis, maternal faecal\u2013oral contamination, and breastfeeding"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1075-6779","authenticated-orcid":false,"given":"Hilary M.","family":"Wren\u2010Atilola","sequence":"first","affiliation":[{"name":"School of Human Nutrition McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6314-7526","authenticated-orcid":false,"given":"Noel W.","family":"Solomons","sequence":"additional","affiliation":[{"name":"Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM)  Guatemala City Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3553-4550","authenticated-orcid":false,"given":"Marilyn E.","family":"Scott","sequence":"additional","affiliation":[{"name":"Institute of Parasitology McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2088-2931","authenticated-orcid":false,"given":"Kristine G.","family":"Koski","sequence":"additional","affiliation":[{"name":"School of Human Nutrition McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2012.11.003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2008.0131"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0379572115610944"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10911-011-9234-0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12258"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/137.1.144"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0000000000000466"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.116.241737"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2006.1.136"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/69.5.953"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05038-11"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(03)90124-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114508083554"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2017.07.005"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006205"},{"key":"e_1_2_10_17_1","first-page":"364","article-title":"Prevalence and risk factors of human intestinal parasites in Roudehen, Tehran Province, Iran","volume":"12","author":"Hemmati N.","year":"2017","journal-title":"Iranian Journal of Parasitology"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/s1678-9946201759056"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12070"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00746.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.191882"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/156482651303400308"},{"key":"e_1_2_10_23_1","first-page":"CD003517","article-title":"Optimal duration of exclusive breastfeeding","volume":"15","author":"Kramer M. 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