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I
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4
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Dec
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b
er
20
24
:
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88
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8
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1882
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x
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eo
li
ce
lls
r
esp
o
n
s
ib
le
f
o
r
m
ilk
p
r
o
d
u
ctio
n
.
Sev
e
r
al
f
ac
to
r
s
in
f
lu
en
ce
th
e
s
m
o
o
th
p
r
o
d
u
ctio
n
o
f
m
ilk
,
in
clu
d
in
g
d
iet,
m
en
tal
an
d
em
o
tio
n
al
well
-
b
ein
g
,
co
n
t
r
ac
ep
tiv
e
u
s
ag
e,
b
r
ea
s
t
ca
r
e
,
b
r
ea
s
t
an
ato
m
y
,
p
h
y
s
io
lo
g
ical
f
ac
to
r
s
,
r
est
p
att
er
n
s
,
th
e
f
r
e
q
u
en
c
y
o
f
in
f
an
t
s
u
ck
in
g
o
r
f
ee
d
in
g
,
b
ir
t
h
weig
h
t,
g
estatio
n
al
a
g
e
at
d
eliv
er
y
,
an
d
th
e
co
n
s
u
m
p
tio
n
o
f
to
b
ac
co
an
d
alco
h
o
l.
I
n
ad
eq
u
ate
m
ilk
p
r
o
d
u
ctio
n
ca
n
r
esu
lt
i
n
v
a
r
io
u
s
co
n
s
eq
u
en
ce
s
s
u
ch
as
p
ain
,
b
r
ea
s
t
s
wellin
g
,
m
asti
tis
,
an
d
,
in
s
ev
er
e
ca
s
es,
ab
s
ce
s
s
f
o
r
m
atio
n
lead
in
g
to
in
f
ec
tio
n
s
.
I
n
f
ec
ted
b
r
ea
s
ts
ca
n
n
o
t
b
e
b
r
ea
s
tf
ed
,
r
esu
ltin
g
i
n
p
o
ten
tial
is
s
u
es
lik
e
d
eh
y
d
r
atio
n
,
m
aln
u
t
r
itio
n
,
jau
n
d
ice,
d
iar
r
h
ea
,
a
n
d
a
c
o
m
p
r
o
m
is
ed
im
m
u
n
e
s
y
s
tem
in
in
f
an
ts
[
1
0
]
.
Ad
v
an
ce
m
en
ts
in
s
cien
tific
k
n
o
wled
g
e
h
av
e
led
to
th
e
d
e
v
elo
p
m
en
t
o
f
d
iv
er
s
e
m
eth
o
d
s
aim
ed
at
tack
lin
g
ch
allen
g
es
ass
o
ciate
d
with
b
r
ea
s
tf
ee
d
in
g
.
On
e
s
u
c
h
ap
p
r
o
ac
h
is
th
e
o
x
y
t
o
cin
m
ass
ag
e,
p
ar
ticu
lar
ly
ef
f
ec
tiv
e
in
th
e
p
o
s
tp
ar
tu
m
p
er
io
d
,
as
it
tr
ig
g
er
s
th
e
p
r
o
d
u
ctio
n
o
f
th
e
o
x
y
to
cin
h
o
r
m
o
n
e.
R
ec
o
g
n
ized
as
a
v
iab
le
s
o
lu
tio
n
,
th
e
o
x
y
to
cin
m
ass
ag
e
o
f
f
er
s
ad
d
itio
n
al
b
en
ef
its
,
in
clu
d
in
g
r
e
d
u
cin
g
b
r
ea
s
t
en
g
o
r
g
em
e
n
t,
r
eso
lv
in
g
b
lo
ck
ed
m
ilk
d
u
cts,
an
d
aid
in
g
in
s
u
s
tain
in
g
m
ilk
p
r
o
d
u
ctio
n
d
u
r
in
g
p
e
r
io
d
s
o
f
m
ater
n
al
an
d
in
f
a
n
t
illn
ess
es [
1
1
]
–
[
1
3
]
.
An
o
th
er
wid
ely
u
tili
ze
d
m
eth
o
d
is
th
e
Ok
etan
i
m
ass
ag
e,
wh
ich
is
a
g
en
tle
b
r
ea
s
t
ca
r
e
tech
n
iq
u
e
d
esig
n
ed
to
s
tim
u
late
th
e
p
ec
t
o
r
alis
m
u
s
cle,
th
er
eb
y
e
n
h
an
c
in
g
m
ilk
p
r
o
d
u
ctio
n
,
a
n
d
p
r
o
m
o
tin
g
s
o
f
ter
,
m
o
r
e
elastic
b
r
ea
s
ts
.
Or
ig
in
atin
g
f
r
o
m
J
ap
an
a
n
d
p
io
n
ee
r
e
d
b
y
Mid
wif
e
So
to
m
i
Ok
etan
i,
t
h
is
d
is
tin
ctiv
e
tr
ea
tm
en
t
h
as
g
ain
ed
p
o
p
u
lar
ity
an
d
is
p
r
ac
ticed
in
v
ar
io
u
s
co
u
n
tr
i
es,
s
u
ch
as
Ko
r
ea
,
J
ap
an
,
an
d
B
an
g
lad
esh
[
1
4
]
.
Ok
etan
i
m
ass
ag
e
ass
is
ts
b
r
ea
s
tf
ee
d
in
g
m
o
th
er
s
b
y
ad
d
r
ess
in
g
ch
allen
g
es,
o
f
f
er
i
n
g
co
m
f
o
r
t,
r
eliev
in
g
p
o
s
tp
ar
tu
m
p
ain
,
a
n
d
in
d
u
cin
g
r
elax
atio
n
.
I
n
co
n
tr
ast
to
t
r
ad
itio
n
al
m
ass
ag
es,
Ok
etan
i
m
ass
ag
e
r
esu
lts
in
s
o
f
ter
b
r
ea
s
ts
,
m
o
r
e
elastic
ar
eo
las,
an
d
n
ip
p
les,
th
u
s
f
ac
ilit
atin
g
th
e
b
r
ea
s
tf
ee
d
in
g
p
r
o
ce
s
s
.
T
h
e
p
r
ess
u
r
e
ap
p
lied
d
u
r
in
g
t
h
e
m
ass
ag
e
co
n
tr
ib
u
tes to
a
s
m
o
o
t
h
er
m
ilk
f
lo
w
b
y
s
tim
u
latin
g
th
e
alv
eo
li [
1
5
]
,
[
1
6
]
.
A
m
o
th
er
'
s
co
n
f
id
en
ce
in
h
e
r
ab
ilit
y
to
b
r
ea
s
tf
ee
d
is
a
cr
u
ci
al
f
ac
to
r
in
s
u
cc
ess
f
u
l
b
r
ea
s
tf
e
ed
in
g
.
T
h
e
s
u
b
co
n
s
cio
u
s
m
in
d
p
lay
s
a
s
ig
n
if
ican
t
r
o
le
in
s
h
ap
in
g
o
n
e'
s
ex
p
er
ien
ce
s
,
a
n
d
p
o
s
itiv
e
s
u
g
g
esti
o
n
s
o
r
af
f
ir
m
atio
n
s
ca
n
b
e
ef
f
ec
tiv
e
ly
ap
p
lied
th
r
o
u
g
h
m
en
tal
r
e
lax
atio
n
.
A
r
elax
ed
an
d
co
n
t
en
t
s
tate
o
f
m
i
n
d
co
n
tr
ib
u
tes
to
t
h
e
s
m
o
o
th
f
l
o
w
o
f
b
r
ea
s
t
m
ilk
[
1
7
]
,
[
1
8
]
.
T
o
s
u
p
p
o
r
t
p
o
s
tp
ar
tu
m
m
o
th
er
s
in
ac
h
ie
v
in
g
E
x
clu
s
iv
e
B
r
ea
s
tf
ee
d
in
g
,
co
n
s
id
er
in
g
th
e
p
iv
o
tal
r
o
le
o
f
th
e
in
itial
d
ay
s
o
f
m
ilk
p
r
o
d
u
cti
o
n
an
d
p
r
o
d
u
ctio
n
,
an
d
to
en
d
o
r
s
e
th
e
E
x
clu
s
iv
e
B
r
ea
s
tf
ee
d
in
g
p
r
o
g
r
am
,
th
e
r
e
s
ea
r
ch
er
is
in
ter
ested
in
d
ev
elo
p
in
g
an
d
v
alid
atin
g
a
s
tu
d
y
.
T
h
e
r
ef
o
r
e
,
th
is
s
tu
d
y
aim
ed
to
in
teg
r
ates o
k
etan
i a
n
d
o
x
y
t
o
cin
m
ass
ag
e
with
a
s
u
g
g
esti
v
e
ap
p
r
o
ac
h
in
o
r
d
er
to
ass
ess
th
eir
im
p
ac
t
o
n
b
r
ea
s
tm
ilk
p
r
o
d
u
ctio
n
a
m
o
n
g
m
o
th
er
s
’
.
T
h
is
s
tu
d
y
was
co
n
d
u
cte
d
at
PKU
Mu
h
am
m
ad
iy
a
h
Go
m
b
o
n
g
H
o
s
p
ital.
T
h
e
o
u
tco
m
es
o
f
th
is
r
esear
ch
co
u
ld
h
av
e
im
m
e
d
iate
an
d
lo
n
g
-
ter
m
im
p
licatio
n
s
f
o
r
b
o
th
m
ater
n
al
an
d
c
h
ild
h
ea
lth
,
em
p
h
asizin
g
th
e
u
r
g
en
c
y
o
f
ex
p
lo
r
in
g
in
t
er
v
en
tio
n
s
th
at
ca
n
p
o
s
itiv
ely
im
p
ac
t b
r
ea
s
tf
ee
d
i
n
g
o
u
tco
m
es.
2.
M
E
T
H
O
D
2
.
1
.
D
e
s
i
g
n
a
n
d
s
a
mp
l
in
g
s
e
t
t
i
n
g
T
h
i
s
r
e
s
e
a
r
c
h
a
d
o
p
t
s
a
q
u
a
n
t
it
at
i
v
e
a
p
p
r
o
a
c
h
u
t
i
l
i
zi
n
g
a
q
u
a
s
i
-
e
x
p
e
r
i
m
e
n
t
a
l
d
e
s
i
g
n
w
i
t
h
a
c
o
n
t
r
o
l
g
r
o
u
p
o
r
c
o
m
p
a
r
a
t
i
v
e
g
r
o
u
p
.
T
h
e
s
t
u
d
y
w
a
s
c
o
n
d
u
c
t
e
d
a
t
P
KU
M
u
h
a
m
m
a
d
i
y
a
h
G
o
m
b
o
n
g
H
o
s
p
i
ta
l
d
u
r
i
n
g
t
h
e
p
e
r
i
o
d
f
r
o
m
S
e
p
t
e
m
b
e
r
2
0
2
3
t
o
N
o
v
em
b
e
r
2
0
2
3
.
T
h
e
p
o
p
u
l
a
t
i
o
n
t
h
a
t
is
b
ei
n
g
e
x
a
m
i
n
e
d
i
s
m
a
d
e
u
p
o
f
m
o
t
h
e
r
s
w
h
o
h
a
v
e
r
e
c
e
n
t
l
y
g
i
v
e
n
b
i
r
t
h
a
t
PK
U
M
u
h
a
m
m
a
d
i
y
a
h
G
o
m
b
o
n
g
H
o
s
p
it
a
l
.
T
h
e
d
e
t
e
r
m
i
n
a
t
i
o
n
o
f
t
h
e
s
a
m
p
le
s
i
z
e
w
a
s
a
c
h
i
e
v
e
d
b
y
e
m
p
l
o
y
i
n
g
t
h
e
f
o
r
m
u
l
a
f
o
r
a
s
s
es
s
i
n
g
t
h
e
d
is
p
a
r
i
t
y
b
e
t
w
ee
n
t
w
o
p
r
o
p
o
r
t
i
o
n
s
[
1
9
]
.
C
o
n
s
e
q
u
e
n
t
l
y
,
t
h
i
s
l
e
d
t
o
t
h
e
es
t
a
b
li
s
h
m
e
n
t
o
f
a
m
i
n
i
m
u
m
s
a
m
p
l
e
s
i
z
e
o
f
6
0
i
n
d
i
v
i
d
u
a
l
s
,
w
it
h
3
0
p
a
r
t
ic
i
p
an
t
s
al
l
o
c
a
t
e
d
t
o
b
o
t
h
t
h
e
t
r
e
a
t
m
e
n
t
a
n
d
c
o
n
t
r
o
l
g
r
o
u
p
s
.
T
h
i
s
a
l
l
o
c
at
i
o
n
w
a
s
a
cc
o
m
p
l
i
s
h
e
d
t
h
r
o
u
g
h
t
h
e
u
t
i
l
i
za
t
i
o
n
o
f
p
u
r
p
o
s
i
v
e
s
a
m
p
l
i
n
g
t
e
c
h
n
i
q
u
es
.
H
o
w
e
v
e
r
,
w
e
a
c
k
n
o
w
l
e
d
g
e
t
h
a
t
t
h
e
s
am
p
l
e
s
i
z
e
i
n
t
h
is
s
t
u
d
y
w
as
r
e
la
t
i
v
e
l
y
s
m
al
l
,
w
h
i
c
h
w
e
r
e
c
o
g
n
i
z
e
a
s
a
l
i
m
i
t
at
i
o
n
o
f
t
h
i
s
s
t
u
d
y
.
T
h
e
c
r
i
t
e
r
i
a
f
o
r
i
n
clu
s
i
o
n
i
n
t
h
e
s
t
u
d
y
a
r
e
as
f
o
l
l
o
ws
:
m
o
t
h
e
r
s
w
h
o
a
r
e
i
n
t
h
e
f
i
r
s
t 1
-
3
d
a
y
s
a
f
t
e
r
g
i
v
i
n
g
b
i
r
t
h
,
m
o
t
h
e
r
s
w
h
o
a
r
e
wi
l
l
i
n
g
t
o
p
a
r
t
i
ci
p
a
t
e
,
m
o
t
h
e
r
s
w
h
o
h
a
v
e
h
e
a
l
t
h
y
i
n
f
a
n
t
s
,
a
n
d
m
o
t
h
e
r
s
w
h
o
r
e
s
i
d
e
i
n
K
eb
u
m
e
n
R
e
g
e
n
c
y
.
T
h
e
c
r
i
t
e
r
i
a
f
o
r
e
x
c
l
u
s
i
o
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3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
I
n
th
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s
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tio
n
,
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e
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les
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d
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etailed
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m
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p
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is
cu
s
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h
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d
d
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s
s
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r
g
an
ized
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s
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s
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p
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n
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d
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aly
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th
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3
.
1
.
P
a
rt
icipa
nts c
ha
ra
ct
er
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t
ics
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h
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p
ar
ticip
a
n
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s
d
em
o
g
r
ap
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ar
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ter
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tics
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T
a
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1
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t
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d
is
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v
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ed
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at
th
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m
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ity
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wer
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d
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ts
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ts
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t
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Similar
ly
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h
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test
r
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in
d
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at
th
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in
r
esp
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th
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s
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at
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p
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le.
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h
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r
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p
r
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in
T
a
b
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2
r
e
v
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l
a
n
o
tewo
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th
y
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if
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ce
b
etwe
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ter
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p
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b
y
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p
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0
0
5
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h
is
s
u
g
g
ests
a
s
ig
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if
ican
t
ch
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g
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th
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ea
tm
e
n
t g
r
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p
f
o
llo
win
g
th
e
im
p
lem
e
n
tatio
n
o
f
o
k
etan
i a
n
d
o
x
y
to
cin
m
as
s
ag
es,
in
co
n
tr
ast to
th
e
co
n
tr
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l
g
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p
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C
o
n
v
er
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ely
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th
e
c
o
n
tr
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l
g
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p
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s
b
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t
m
ilk
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ex
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ited
a
p
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v
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a
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a
b
s
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ce
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u
b
s
tan
tial
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o
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win
g
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ter
v
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o
f
Ok
eta
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i
an
d
o
x
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to
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m
ass
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B
ased
o
n
th
e
T
ab
le
3
,
th
e
tr
e
atm
en
t
g
r
o
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p
'
s
b
r
ea
s
t
m
ilk
p
r
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d
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ctio
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is
1
.
9
6
tim
es
s
m
o
o
t
h
er
th
an
th
e
c
o
n
tr
o
l
g
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d
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th
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m
en
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g
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s
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ilk
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1
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1
7
tim
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s
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f
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t
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m
p
ar
ed
to
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co
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l g
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C
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[
2
2
]
.
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lly
[
1
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[
2
3
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[
2
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[
2
7
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,
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s
t
m
ilk
ad
eq
u
ac
y
f
o
r
p
o
s
tp
ar
tu
m
m
o
th
er
s
is
n
o
tewo
r
th
y
.
T
h
is
n
o
n
-
p
h
a
r
m
a
co
lo
g
ical
ap
p
r
o
ac
h
ef
f
ec
tiv
ely
s
tim
u
lates
th
e
r
elea
s
e
o
f
o
x
y
to
cin
an
d
e
n
h
an
ce
s
m
ilk
p
r
o
d
u
ctio
n
[
3
1
]
.
T
h
e
m
a
s
s
ag
e,
ap
p
lied
d
u
r
in
g
lacta
tio
n
,
h
as
b
ee
n
s
h
o
wn
to
in
cr
ea
s
e
m
ilk
r
elea
s
e
b
y
1
1
.
5
tim
es th
r
o
u
g
h
s
tim
u
latio
n
o
f
t
h
e
s
p
in
al
m
u
s
cles a
n
d
a
2
8
% r
ed
u
ctio
n
in
c
o
r
tis
o
l le
v
els [
3
2
]
.
Neu
r
o
tr
an
s
m
itter
s
s
tim
u
late
th
e
m
ed
u
lla
o
b
lo
n
g
a
ta,
s
en
d
in
g
s
ig
n
als
to
th
e
h
y
p
o
th
alam
u
s
to
s
ec
r
ete
o
x
y
t
o
cin
f
r
o
m
th
e
p
o
s
ter
io
r
p
itu
itar
y
.
B
y
r
ed
u
ci
n
g
m
u
s
cle
ten
s
io
n
,
r
eliev
in
g
s
tr
ess
,
an
d
tr
ig
g
er
in
g
th
e
m
ilk
let
-
d
o
wn
r
ef
lex
,
th
e
m
ass
ag
e
h
elp
s
en
h
an
ce
m
ilk
p
r
o
d
u
ctio
n
[
3
2
]
,
[
3
3
]
.
I
n
co
m
p
a
r
is
o
n
to
s
tan
d
ar
d
ca
r
e,
th
e
Ok
etan
i
Ma
s
s
ag
e
is
ef
f
ec
tiv
e
in
r
ed
u
cin
g
th
e
s
ev
er
it
y
o
f
p
o
s
t
-
d
eliv
er
y
b
r
ea
s
t
en
g
o
r
g
e
m
en
t
[
1
5
]
,
[
1
6
]
.
Ad
d
itio
n
ally
,
Ok
eta
n
i
b
r
ea
s
t
m
ass
ag
e
s
ig
n
if
ican
tly
en
h
an
ce
s
th
e
to
tal
s
o
lid
s
,
lip
id
s
,
ca
s
ein
co
n
ten
t,
an
d
g
r
o
s
s
en
er
g
y
o
f
b
r
ea
s
t
m
ilk
,
r
esu
ltin
g
i
n
an
o
v
e
r
all
im
p
r
o
v
em
en
t
in
q
u
ality
[
1
4
]
,
[
2
7
]
.
T
h
e
c
o
m
b
in
atio
n
o
f
Ok
etan
i
m
ass
ag
e
tr
ig
g
e
r
s
p
r
o
lactin
an
d
o
x
y
to
cin
r
ef
le
x
es,
wh
ich
aim
to
s
tim
u
late
n
er
v
es
in
th
e
p
o
s
te
r
io
r
p
itu
itar
y
g
lan
d
,
lead
in
g
t
o
th
e
r
elea
s
e
o
f
o
x
y
to
cin
.
T
h
is
r
elea
s
e
in
d
u
ce
s
co
n
tr
ac
tio
n
s
in
th
e
m
y
o
e
p
ith
el
ial
ce
lls
s
u
r
r
o
u
n
d
i
n
g
th
e
alv
eo
li [
2
4
]
,
f
ac
ilit
atin
g
th
e
m
o
v
e
m
en
t o
f
m
ilk
in
to
th
e
am
p
u
lla
[
3
4
]
.
W
h
ile
th
e
r
elea
s
e
o
f
o
x
y
to
cin
is
in
f
l
u
en
ce
d
b
y
th
e
b
a
b
y
'
s
s
u
ck
in
g
,
r
ec
e
p
to
r
s
in
th
e
d
u
cts
also
co
n
tr
ib
u
te
to
th
e
r
elea
s
e
o
f
o
x
y
to
cin
[
3
1
]
,
[
3
2
]
.
W
h
ile
th
e
p
r
esen
t
s
tu
d
y
s
h
e
d
s
lig
h
t
o
n
t
h
e
p
o
te
n
tial
b
en
ef
its
o
f
Ok
etan
i
m
ass
ag
e
an
d
o
x
y
to
cin
in
ter
v
en
tio
n
in
im
p
r
o
v
in
g
b
r
ea
s
tf
ee
d
in
g
o
u
tco
m
es,
it
is
cr
u
cial
to
ac
k
n
o
wled
g
e
ce
r
tain
lim
i
tatio
n
s
.
Firstl
y
,
th
e
s
tu
d
y
'
s
d
u
r
atio
n
was
r
elativ
ely
s
h
o
r
t,
co
n
d
u
cted
o
v
er
th
r
ee
d
ay
s
,
wh
ich
m
ig
h
t
n
o
t
ca
p
t
u
r
e
lo
n
g
-
ter
m
im
p
ac
ts
o
r
v
a
r
iatio
n
s
in
b
r
ea
s
tf
ee
d
in
g
s
u
cc
ess
.
Ad
d
itio
n
ally
,
th
e
s
am
p
le
s
ize
was
m
o
d
est,
lim
itin
g
t
h
e
g
en
e
r
aliza
b
ilit
y
o
f
f
i
n
d
in
g
s
to
a
b
r
o
ad
e
r
p
o
p
u
latio
n
.
T
h
e
s
tu
d
y
f
o
cu
s
ed
o
n
p
o
s
tp
ar
tu
m
m
o
th
er
s
i
n
a
s
p
ec
if
ic
h
o
s
p
ital
s
ettin
g
,
an
d
cu
ltu
r
al
o
r
c
o
n
tex
tu
al
v
ar
i
atio
n
s
m
ay
in
f
lu
e
n
ce
th
e
a
p
p
li
ca
b
ilit
y
o
f
th
e
r
esu
lts
in
d
if
f
er
en
t r
eg
io
n
s
.
Nev
er
th
eless
,
th
e
im
p
licatio
n
s
o
f
th
is
s
tu
d
y
ar
e
n
o
tewo
r
th
y
.
T
h
e
p
o
s
itiv
e
ef
f
ec
ts
o
b
s
er
v
ed
in
b
r
ea
s
tf
ee
d
in
g
s
u
cc
ess
am
o
n
g
m
o
th
er
s
r
ec
eiv
in
g
Ok
etan
i
m
ass
ag
e
an
d
o
x
y
t
o
cin
in
te
r
v
en
tio
n
s
u
g
g
est
th
e
p
o
ten
tial
f
o
r
in
te
g
r
atin
g
t
h
ese
tech
n
iq
u
es
in
to
p
o
s
tp
ar
tu
m
ca
r
e
p
r
o
to
c
o
ls
.
Hea
lth
p
r
ac
t
itio
n
er
s
,
esp
ec
ially
th
o
s
e
in
m
ater
n
ity
war
d
s
,
m
ay
co
n
s
id
er
in
co
r
p
o
r
atin
g
Ok
eta
n
i m
ass
ag
e
an
d
o
x
y
to
cin
in
ter
v
en
tio
n
s
to
en
h
an
ce
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
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I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
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1
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1
8
87
1886
b
r
ea
s
tf
ee
d
in
g
ex
p
e
r
ien
ce
s
f
o
r
p
o
s
tp
ar
tu
m
m
o
th
e
r
s
.
Fu
r
th
er
r
esear
ch
with
lar
g
er
an
d
d
iv
er
s
e
s
am
p
les,
co
n
s
id
er
in
g
c
u
ltu
r
al
n
u
an
ce
s
,
i
s
r
ec
o
m
m
en
d
e
d
to
v
alid
ate
an
d
ex
ten
d
th
e
f
i
n
d
in
g
s
.
I
f
r
e
p
lic
ated
an
d
v
alid
ated
,
th
e
s
tu
d
y
'
s
o
u
tco
m
es
c
o
u
ld
co
n
tr
ib
u
te
t
o
ev
i
d
en
ce
-
b
ased
p
r
a
ctice
s
,
f
o
s
ter
in
g
im
p
r
o
v
ed
b
r
e
astfe
ed
in
g
s
u
p
p
o
r
t
an
d
m
ater
n
al
well
-
b
ein
g
in
p
o
s
tp
ar
tu
m
ca
r
e
s
ettin
g
s
.
Mo
r
e
o
v
er
,
an
im
p
o
r
tan
t
co
n
s
tr
ain
t
is
o
u
r
lac
k
o
f
ab
ilit
y
to
ad
eq
u
ately
m
an
ag
e
ex
t
r
an
eo
u
s
v
ar
iab
les,
m
ak
in
g
it
d
if
f
icu
lt
to
co
m
p
r
eh
e
n
s
iv
ely
co
n
tr
o
l
f
ac
to
r
s
th
at
in
f
lu
en
ce
o
b
s
er
v
ed
ass
o
ciatio
n
s
;
th
is
co
n
s
tr
ain
t
h
as
th
e
p
o
t
en
tial
to
af
f
ec
t
th
e
in
ter
n
al
v
a
lid
ity
o
f
th
e
s
tu
d
y
,
h
ig
h
lig
h
tin
g
th
e
n
ec
ess
ity
f
o
r
ca
r
ef
u
l
in
ter
p
r
etatio
n
o
f
th
e
r
esu
lts
,
th
u
s
,
f
u
tu
r
e
r
esear
ch
s
h
o
u
ld
u
tili
ze
m
o
r
e
s
o
p
h
is
ticated
tech
n
iq
u
es to
en
h
an
ce
co
n
tr
o
l o
v
er
co
n
f
o
u
n
d
in
g
v
ar
iab
les.
4.
CO
NCLU
SI
O
N
I
n
co
n
clu
s
io
n
,
th
is
s
tu
d
y
in
v
esti
g
ated
th
e
co
m
b
in
e
d
im
p
ac
t
o
f
o
k
eta
n
i
m
ass
ag
e
an
d
o
x
y
to
ci
n
in
ter
v
en
tio
n
o
n
b
r
ea
s
tf
ee
d
in
g
o
u
tco
m
es
am
o
n
g
p
o
s
tp
ar
tu
m
m
o
th
er
s
.
T
h
e
f
in
d
in
g
s
s
u
g
g
e
s
t
p
o
s
itiv
e
ef
f
ec
ts
,
h
ig
h
lig
h
tin
g
im
p
r
o
v
e
m
en
ts
in
b
r
ea
s
tf
ee
d
in
g
s
u
cc
ess
,
in
cl
u
d
in
g
r
ea
d
in
ess
f
o
r
f
ee
d
in
g
,
r
o
o
t,
f
ix
atio
n
(
latch
i
n
g
o
n
)
,
an
d
s
u
ck
in
g
.
Ok
eta
n
i
m
ass
ag
e
an
d
o
x
y
to
cin
in
ter
v
en
tio
n
d
em
o
n
s
tr
ated
p
o
ten
tial
in
en
h
an
cin
g
b
r
ea
s
t
s
o
f
tn
ess
,
n
ip
p
le
an
d
ar
eo
la
elasticity
,
an
d
o
v
er
all
m
ilk
p
r
o
d
u
ctio
n
,
p
r
o
v
id
in
g
v
alu
a
b
le
in
s
ig
h
ts
in
to
n
o
n
-
p
h
ar
m
ac
o
l
o
g
ical
ap
p
r
o
ac
h
es t
o
s
u
p
p
o
r
t b
r
ea
s
tf
ee
d
in
g
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
e
au
th
o
r
ex
p
r
ess
es
g
r
atitu
d
e
to
PKU
Mu
h
am
m
ad
iy
a
h
G
o
m
b
o
n
g
Ho
s
p
ital
an
d
t
h
e
p
ar
t
icip
an
ts
in
th
is
s
tu
d
y
.
T
h
e
au
th
o
r
also
ac
k
n
o
wled
g
es
th
e
R
esear
ch
an
d
C
o
m
m
u
n
ity
Ser
v
ice
I
n
s
titu
te
o
f
Mu
h
am
m
a
d
iy
ah
Un
iv
er
s
ity
Go
m
b
o
n
g
f
o
r
th
eir
f
in
an
cial
s
u
p
p
o
r
t in
co
n
d
u
ctin
g
th
is
r
esear
ch
.
RE
F
E
R
E
NC
E
S
[
1
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
,
“
N
u
t
r
i
t
i
o
n
l
a
n
d
sc
a
p
e
i
n
f
o
r
m
a
t
i
o
n
s
y
st
e
m
(
N
LI
S
)
c
o
u
n
t
r
y
p
r
o
f
i
l
e
i
n
d
i
c
a
t
o
r
s:
I
n
t
e
r
p
r
e
t
a
t
i
o
n
g
u
i
d
e
,
”
Wo
r
l
d
H
e
a
l
t
h
O
rg
a
n
i
z
a
t
i
o
n
,
p
p
.
1
–
5
1
,
2
0
1
0
.
[
2
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
,
“
N
u
r
t
u
r
i
n
g
c
a
r
e
f
o
r
e
a
r
l
y
c
h
i
l
d
h
o
o
d
d
e
v
e
l
o
p
men
t
:
a
f
r
a
m
e
w
o
r
k
f
o
r
h
e
l
p
i
n
g
c
h
i
l
d
r
e
n
su
r
v
i
v
e
a
n
d
t
h
r
i
v
e
t
o
t
r
a
n
sf
o
r
m
h
e
a
l
t
h
a
n
d
h
u
m
a
n
p
o
t
e
n
t
i
a
l
.
,
”
Wh
o
,
p
p
.
1
–
4
,
2
0
1
8
,
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
:
/
/
w
w
w
.
w
h
o
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