We determined the concentration of lead in human milk samples from lactating parents with normal blood lead levels whose children showed signs of lead exposure via a blood screen at a pediatric medical office between 12 months and 24 months of age. This project was completed in collaboration with Dr. Euhna Hoh at San Diego State University (Hoh Lab)

Related Publication:
Tran CD, Dodder NG, Quintana PJE, et al. Organic contaminants in human breast milk identified by non-targeted analysis. Chemosphere. 2020;238:124677. doi:10.1016/j.chemosphere.2019.124677 

Related Publication:
Crouch D, Chambers C, Bertrand K, Bandoli G. The Association Between Adverse and Positive Childhood Experiences and Marijuana Use During Lactation. Breastfeed Med. 2023;18(3):212-218. doi:10.1089/bfm.2022.0243

We evaluated associations between maternal symptoms of depression, anxiety, and stress and the concentrations of 19 prevalent human milk oligosaccharides in breast milk samples. We determined that heightened symptoms of depression and stress are negatively associated with the concentrations of several HMOs, which may have important health consequences to the breastfed infant.

In collaboration with Dr. Mohit Jain at UC San Diego, (Mohit Jain, MD, Ph.D. – Jain Laboratory) we are measuring bioactive lipids in human milk, which may enhance or prevent the development of early childhood disease, including asthma and allergies.

In collaboration with the lab of Dr. Brookie Best at the University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (https://pharmacy.ucsd.edu/faculty/best), we are measuring the quantity of cannabinoids (∆9-THC, 11-OH-THC, CBD, and CBN) in human milk samples provided by lactating parents who report recent marijuana use. In addition, we are evaluating child growth through medical record review, and child neurodevelopment through maternal report questionnaires and face-to-face testing.

Related Publication:
Bertrand KA, Hanan NJ, Honerkamp-Smith G, Best BM, Chambers CD. Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk. Pediatrics. 2018;142(3):e20181076. doi:https://doi.org/10.1542/peds.2018-1076 

Related Publication:
Yeung CHT, Bertrand KA, Best BM, et al. Cannabidiol Exposure Through Maternal Marijuana Use: Predictions in Breastfed Infants. Clin Pharmacokinet. 2023;62(11):1611-1619. doi:10.1007/s40262-023-01307-6

In collaboration with Dr. Lars Bode of the Mother-Milk-Infant Center of Research Excellence (MoMi Core) at UC San Diego (http://www.bodelab.com/; https://medschool.ucsd.edu/research/coe/momicore/about/Pages/default.aspx) and The Antigen Discovery Institute (ADI; https://antigendiscovery.com/), human milk samples were analyzed to establish the presence of SARS-CoV-2-specific IgA and IgG and to characterize the specific antigenic regions of SARS-CoV-2 proteins that were reactive with antibodies in human milk from lactating parents with confirmed SARS-CoV-2 infection.

Related Publication:
Bode L, Bertrand K, Najera JA, et al. Characterization of SARS-CoV-2 antibodies in human milk from 21 women with confirmed COVID-19 infection. Pediatr Res. 2023;93(6):1626-1633. doi:10.1038/s41390-022-02360-w 

In collaboration with Dr. Robert Naviaux of the UC San Diego Mitochondrial and Metabolic Disease Center (https://naviauxlab.ucsd.edu/), we evaluated if the chemistry and xenobiotic profile of human milk differs according to the developmental risk status of the chest/breastfed child by utilizing the results from the Ages and Stages Questionnaire 2, which is a maternal report questionnaire that screens the development of children in five different domains.  

Related Publication:
Li K, Bertrand K, Naviaux JC, et al. Metabolomic and exposomic biomarkers of risk of future neurodevelopmental delay in human milk. Pediatr Res. 2023;93(6):1710-1720. doi:10.1038/s41390-022-02283-6 

In collaboration with Dr. Brookie Best at the UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (https://pharmacy.ucsd.edu/faculty/best), we determined the concentration of etanercept in human milk samples from parents prescribed this medication during lactation. In addition, we are evaluating child growth through medical record review and child neurodevelopment through maternal report questionnaires.

Related Publication:
Bertrand K, Rossi S, Wells A, Best B, Chambers CD. The Concentration of Etanercept in Human Milk and Infant Outcomes. J Rheumatol. 2023;50(5):712-714. doi:10.3899/jrheum.220724

We determined the concentration of methotrexate in human milk samples from lactating parents who were prescribed this medication while lactating. This project was completed in collaboration with Dr. Shinya Ito at The Hospital for Sick Children, Toronto, Ontario, Canada

Related Publication:
Ito S, Lee A. Drug excretion into breast milk–overview. Adv Drug Deliv Rev. 2003;55(5):617-627. doi:10.1016/s0169-409x(03)00034-6 

Related Publication:
Bandoli G, Bertrand K, Saoor M, Chambers CD. The Design and Mechanics of an Accessible Human Milk Research Biorepository. Breastfeed Med. 2020;15(3):155-162. doi:10.1089/bfm.2019.0277

Dr. Lam Nguyen, of VaxArt, will use breast milk to develop and optimize an MSD assay to detect norovirus-specific IgA from breast milk. This will aid in the development of a vaccine that induced Norovirus antibodies in breast milk which would be of great value to public health.

Together with dr Essi Whaites Heinonen from Karolinska Institutet, Stockholm, Sweden, we are studying whether chronically taken maternal medications such as antidepressants and anti-inflammatory medications could affect the composition of human milk. Specifically, we are comparing the levels of macronutrients (carbohydrates, fat, and protein) measured in samples of human milk from mothers with and without these chronic medications.

We have also, in collaboration with Dr Lars Bode of the Mother-Milk-Infant Center of Research Excellence (MoMi Core) at UC San Diego (http://www.bodelab.com/; https://medschool.ucsd.edu/research/coe/momicore/about/Pages/default.aspx), measured the quantity of human milk oligosaccharides (HMOs) in human milk. HMOs are complex sugars found in human milk, associated with health outcomes for both mother and infant. In this project, we are evaluating whether maternal antidepressant and anti-inflammatory medications could affect the total levels and the composition of the HMOs that were measured in our sample.

In collaboration with Dr. John Miklavcic with Chapman University, we will evaluate the effects of skimming milk on human milk composition which will be beneficial to practitioners working with newly diagnosed VLCAD or chylothorax patients so that these patients may still receive the benefits of human milk nutrition.

In collaboration with Dr. Amy Non in UC San Diego’s Anthropology Department, we studied associations between maternal perceived stress, depression, and anxiety on milk cortisol, miRNA expression levels, and infant growth across the postnatal period.

Non AL, Binder AM, Kubzansky LD, Michels KB. Genome-wide DNA methylation in neonates exposed to maternal depression, anxiety, or SSRI medication during pregnancy. Epigenetics. 2014;9(7):964-972. doi:10.4161/epi.28853 

In collaboration with Dr. Lars Bode of the Mother-Milk-Infant Center of Research Excellence (MoMi Core) at UC San Diego (http://www.bodelab.com/; https://medschool.ucsd.edu/research/coe/momicore/about/Pages/default.aspx) and Dr. Grace Aldrovandi, Dr. Nicole Tobin, and Dr. Paul Krogstad at the UC Los Angeles (UCLA), human milk samples were examined for the presence of SARS-CoV-2, the virus that causes COVID-19, using RT-PCR and/ or viral culture. Milk samples that contained viral RNA were examined for the presence of subgenomic coronavirus RNA, which is a marker of infectivity.

Related Publication:
Chambers C, Krogstad P, Bertrand K, et al. Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women. JAMA. 2020;324(13):1347-1348. doi:10.1001/jama.2020.15580 

In collaboration with the lab of Dr. Jeremiah Momper at the University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, we are measuring the quantity of heavy metal levels in human milk samples previously collected by the Human Milk Bank Repository.  We are analyzing the distribution of detectable levels by donor’s race/ethnicity, socioeconomic status, geographic location, and potential sources of exposure to help identify the risk of heavy metal exposure in fetuses and children through the testing of those breast milk samples.

In collaboration with Dr. Theresa M. Casey at Purdue University, we are measuring lipid composition of infant cheek cells and maternal milk and collecting information on infant feeding practices to determine the relationship between milk fat composition, lipid composition of infant cells and nutrition the first weeks postnatal. We are exploring neonate DNA methylation patterns of buccal cells to determine if they are related to infant feeding practices. This information may provide insight into the connection between early life nutrition and  long-term health. 

We are analyzing milk macronutrients, including carbohydrates, fat, protein, and total caloric content, in milk samples from breastfeeding mothers with autoimmune rheumatic diseases (ARDs) compared to those without. Additionally, we will explore how therapies used to treat ARDs may affect milk macronutrient composition. In a subset of patients with systemic lupus erythematosus (SLE), we will further investigate milk micronutrients and human milk oligosaccharides (HMOs). This study will lay the groundwork for future research on breast milk in the ARD population.

In collaboration with Dr. Robert Turesky at the University of Minnesota (Turesky Lab), we examined human milk from lactating parents who were either omnivores or vegetarians to identify if any chemicals found in cooked meats, which are potential mammary carcinogens, are present in the milk samples.

Related Publication:
Turesky RJ, Le Marchand L. Metabolism and biomarkers of heterocyclic aromatic amines in molecular epidemiology studies: lessons learned from aromatic amines. Chem Res Toxicol. 2011;24(8):1169-1214. doi:10.1021/tx200135s 

We evaluated the heterogeneity of human milk from lactating parents with multiple pregnancies by characterizing potential shifts in the maternal milk IgA repertoire over the course of multiple pregnancies. This project is being conducted in collaboration with Dr. Chelsea Johnson and Dr. Timothy Hand of the University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh (Timothy W. Hand, PhD | Department of Pediatrics | University of Pittsburgh; Chelseá B. Johnson, MD | Department of Pediatrics | University of Pittsburgh).

Related Publication:
Johnson-Hence CB, Gopalakrishna KP, Bodkin D, et al. Stability and heterogeneity in the antimicrobiota reactivity of human milk-derived immunoglobulin. A. J Exp Med. 2023;220(8):e20220839. doi:10.1084/jem.20220839

We are measuring the quantity of human milk oligosaccharides (HMOs) in human milk samples in collaboration with Dr. Lars Bode of the Mother-Milk-Infant Center of Research Excellence (MoMi Core) at UC San Diego (http://www.bodelab.com/; https://medschool.ucsd.edu/research/coe/momicore/about/Pages/default.aspx). HMOs are complex sugars that are found in the milk of most mammals and are associated with both maternal and infant health outcomes. We are evaluating which maternal and infant characteristics are associated with the various HMOs that we measure in our sample.

Related Publication:
Bode L. Human Milk Oligosaccharides: Structure and Functions. Nestle Nutr Inst Workshop Ser. 2020;94:115-123. doi:10.1159/000505339 

In collaboration with Vanderbilt University, we will extract DNA and sequence human milk samples exposed to sertraline (Zoloft) for relevant polymorphisms associated with drug metabolism.

We are measuring the quantity of macronutrients in human milk samples in collaboration with the lab of Dr. Jae Kim (https://www.cincinnatichildrens.org/bio/k/jae-kim) at Cincinnati Children’s Hospital. Some of the macronutrients that we are measuring include carbohydrates, fat, and protein (ng/mL). We are also measuring the total caloric count of the human milk samples being analyzed. Using this data, we are able to evaluate what maternal and infant characteristics may influence the macronutrients of human milk.

We sought to evaluate a cohort of vaccinated lactating women for vaccine-related symptoms and their chest/breastfed children for any nonserious and serious adverse events.

Related Publication:
Bertrand K, Honerkamp-Smith G, Chambers CD. Maternal and Child Outcomes Reported by Breastfeeding Women Following Messenger RNA COVID-19 Vaccination. Breastfeed Med. 2021;16(9):697-701. doi:10.1089/bfm.2021.0169 

We are classifying the microbiome of human milk in collaboration with the lab of Dr. Robin Knight of the UC San Diego Center for Microbiome Innovation. (https://knightlab.ucsd.edu/). We are profiling the human milk samples to see which bacteria are present and the most abundant in the human milk microbiome. In addition, we are evaluating what intrinsic and extrinsic factors of lactating individuals may influence and potentially change the human milk microbiome.

Related Publication:
Krogstad P, Contreras D, Ng H, et al. No Evidence of Infectious SARS-CoV-2 in Human Milk: Analysis of a Cohort of 110 Lactating Women. Preprint. medRxiv. 2021;2021.04.05.21254897. Published 2021 Apr 7. doi:10.1101/2021.04.05.21254897 

In collaboration with Dr. Cindy H.T. Yeung at the University of Waterloo (Cindy Yeung | Pharmacokinetics Research Group | University of Waterloo (uwaterloo.ca), data previously collected from parents who used cannabis while lactating will be used to build a physiologically-based pharmacokinetic (PBPK) model? (need to see protocol) of cannabidiol (CBD) for pediatric scaling in predicting CBD exposure to infants through human milk.

In collaboration with Dr. Lindsey Miles at Scripps Research (The Miles Laboratory) and Dr. Robert Parmer at the UC San Diego School of Medicine (Robert Parmer Research-UC San Diego Division of Nephrology), we developed an assay to evaluate whether Plg-RKT protein was detectable in membrane fractions from frozen milk samples. Plg-RKT protein may be involved in milk production, which could help us answer questions about lactating parents with milk supply challenges. Information from this study could potentially help lactating parents improve low milk supply.

In collaboration with Dr. Katherine Luskin of Scripps Clinic, we explored the presence of non-human proteins in milk by mass spectrometry. We evaluated 44 non-human proteins encompassing 26 plant and animal species in human milk samples from lactating parents of both pre-term and term infants. The aim of this research was to better inform how specific components in human milk can impact the development of or protection from allergies.

Related Publications:
Luskin K, Leibel S, Majid Ghassemian, et al. Analysis of Non-Human Proteins/Peptides in Human Breast Milk by Mass Spectrometry. The Journal of Allergy and Clinical Immunology. Published online February 1, 2020. doi:https://doi.org/10.1016/j.jaci.2019.12.432 

Luskin K, Mortazavi D, Bai-Tong S, et al. Allergen Content and Protease Activity in Milk Feeds from Mothers of Preterm Infants. Breastfeed Med. 2022;17(11):947-957. doi:10.1089/bfm.2022.0115 

Related Publication:
Bertrand K, Kelly A, Chambers CD. The Prevalence of Nonserious Events in a Cohort of Breastfed Infants. Breastfeed Med. 2023;18(1):43-47. doi:10.1089/bfm.2022.0245

We are examining if the drug vedolizumab (Entyvio^®), a prescription medication for the treatment of moderate to severe ulcerative colitis and Crohn’s disease, interferes with the migration of antibody secreting cells (ASCs) to the mammary gland, thereby decreasing the amount of Immunoglobulin A (IgA) antibody levels in human milk. We are conducting this research in collaboration with Dr. Jesus Rivera-Nieves at the UC San Diego Department of Medicine, Division of Gastroenterology (https://medschool.ucsd.edu/som/medicine/divisions/gastro/research/labs/Pages/Rivera-Lab-.aspx).

Related Publication:
Holmer AK, Battat R, Dulai PS, et al. Biomarkers are associated with clinical and endoscopic outcomes with vedolizumab treatment in Crohn’s disease. Therap Adv Gastroenterol. 2020;13:1756284820971214. Published 2020 Nov 12. doi:10.1177/1756284820971214 

We are identifying the metabolites present in human milk using an untargeted Mass Spectrometry approach in collaboration with Dr. Pieter Dorrestein and the UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (https://dorresteinlab.ucsd.edu/). We are profiling human milk samples to see which metabolites are present and the most abundant in human milk. In addition, we are evaluating what maternal and infant characteristics are associated with the metabolites identified and how maternal report of medication and substance exposures compares to the laboratory results.

Related Publication:
Thomas S, Gauglitz JM, Tripathi A, et al. An untargeted metabolomics analysis of exogenous chemicals in human milk and transfer to the infant. Clin Transl Sci. 2022;15(11):2576-2582. doi:10.1111/cts.13393