{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:23Z","timestamp":1753879223702,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/J000434\/1"],"award-info":[{"award-number":["MR\/J000434\/1"]}],"id":[{"id":"10.13039\/501100000265","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":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The WHO recommends exclusive breastfeeding for 6\u00a0months, but despite interventions, breastfeeding rates remain stubbornly low. Financial voucher incentives have shown promise but require a biomarker for validation of intake. This study aimed to develop a simple biochemical assay of infant urine that would tell if an infant was receiving <jats:italic>any<\/jats:italic> breast milk to validate maternal report. Urine samples were collected and snap frozen from 34 infants attending with minor illness or feeding problems, of whom 12 infants were exclusively breastfed, nine exclusively formula fed, and 11 mixed breast\/formula fed. High\u2010performance anion exchange chromatography was used to identify discriminating patterns of monosaccharide composition of unconjugated glycans in a sequence of three experiments. The absolute concentration of all human milk oligosaccharides measured blind could detect \u201cany breastfeeding\u201d only with a sensitivity of 48% and specificity of 78%. Unblinded examination of <jats:italic>N<\/jats:italic>\u2010acetylglucosamine (GlcNAc) measured as GlcNH<jats:sub>2<\/jats:sub> after hydrolysis of GlcNAc improved sensitivity to 75% at the expense of a specificity of 28%. Estimation of the relative abundance of GlcNH2 (GlcNH2[%]) or the ratio of GlcNH2 to endogenous mannose (Man) improved accuracy. In a further blind experiment, the GlcNH2\/Man ratio with a cut\u2010off of 1.5 correctly identified all those receiving \u201cany breast milk,\u201d while excluding exclusively formula fed infants. The GlcNH2\/Man ratio in infant urine is a promising test to provide biochemical confirmation of <jats:italic>any<\/jats:italic> breastfeeding for trials of breastfeeding promotion.<\/jats:p>","DOI":"10.1111\/mcn.12859","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T12:44:07Z","timestamp":1560948247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development of a biochemical marker to detect current breast milk intake"],"prefix":"10.1111","volume":"16","author":[{"given":"Ruth","family":"Addison","sequence":"first","affiliation":[{"name":"NHS Ayrshire &amp; Arran Primary Care Trust, Rainbow House Paediatric Unit Ayrshire Central Hospital  Irvine UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9444-4435","authenticated-orcid":false,"given":"Lauren","family":"Hill","sequence":"additional","affiliation":[{"name":"General Paediatrics Pinderfields General Hospital  Wakefield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-9571","authenticated-orcid":false,"given":"Lars","family":"Bode","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Larsson\u2010Rosenquist Foundation Mother\u2010Milk\u2010Infant Center of Research Excellence (LRF MOMI CORE) University of California  San Diego California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Larsson\u2010Rosenquist Foundation Mother\u2010Milk\u2010Infant Center of Research Excellence (LRF MOMI CORE) University of California  San Diego California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biswa","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Glycoanalytical Core, Glycobiology Research and Training Center University of California  San Diego California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics University of Strathclyde  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6256-6315","authenticated-orcid":false,"given":"Charlotte","family":"Wright","sequence":"additional","affiliation":[{"name":"Section of Child Health, School of Medicine Glasgow University  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8530-5011","authenticated-orcid":false,"given":"Clare","family":"Relton","sequence":"additional","affiliation":[{"name":"ScHARR University of Sheffield  Sheffield UK"},{"name":"Centre for Primary Care and Public Health Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3526-2380","authenticated-orcid":false,"given":"Ada L.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Human Nutrition, School of Medicine, Dentistry and Nursing Glasgow University  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8914-055X","authenticated-orcid":false,"given":"David M.","family":"Tappin","sequence":"additional","affiliation":[{"name":"Section of Child Health, School of Medicine Glasgow University  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91242-M"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312819"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)90350-E"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yrtph.2013.11.005"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-013-6817-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/fsn3.477"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101692"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/33.6.847"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-2697(88)90089-9"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-3-18"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.jproteome.6b00234"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00320.2018"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665116000999"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0379572116654644"},{"key":"e_1_2_11_16_1","unstructured":"McAndrew F. Thompson J. Fellows L. Large A. Speed M. &Renfrew M. J.(2010)Infant feeding survey. Retrieved fromhttp:\/\/content.digital.nhs.uk\/article\/3895\/Infant\u2010Feeding\u2010Survey\u20102010."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2011.00293.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.4.1075"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002765"},{"key":"e_1_2_11_20_1","unstructured":"Relton C.(2017)Financial incentives may increase breastfeeding rates. Retrieved fromhttps:\/\/www.sheffield.ac.uk\/news\/nr\/financial\u2010incentives\u2010increase\u2010breastfeeding\u2010rates\u20101.751381"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010158"},{"key":"e_1_2_11_22_1","first-page":"1","article-title":"Do conditional cash transfers improve 6\u20108 week breastfeeding prevalence? The NOurishing Start for Health (NOSH) cluster randomised trial","volume":"172","author":"Relton C.","year":"2017","journal-title":"JAMA"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000058924.30819.17"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1079\/BJNBJN\/2002551"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114515000823"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12429"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00995.x"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00270"},{"key":"e_1_2_11_30_1","unstructured":"World Health Organization. (2001).The optimal duration of exclusive breastfeeding. Report of an expert consultation. Geneva: World Health Organization. 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