Revolutionizing lactation support and outcomes

University of Pennsylvania School of Nursing

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PHILADELPHIA (August 1, 2025) – Faculty and doctoral students at Penn Nursing are at the forefront of advancing human milk feeding through a series of research studies, featured in the current issue of MCN The American Journal of Maternal/Child Nursing. The issue, edited by Penn Nursing's Diane L. Spatz, PhD, RN-BC, FAAN, FAWHONN, the Helen M. Shearer Professor of Nutrition and Professor of Perinatal Nursing in the Department of Family and Community Health, highlights articles showcasing critical strategies to enhance lactation care and improve outcomes for families.

These investigations highlight critical strategies, from empowering frontline healthcare providers and fostering supportive work environments to standardizing language, all aimed at enhancing lactation care and improving outcomes for families. Recent studies underscore the vital role of nurses and the broader healthcare team in supporting breastfeeding journeys:

• Guidelines for Primary Pediatric Care Providers to Help Patients Establish and Protect Milk Supply A study led by Courtney N. Slater and Spatz details the critical role of primary pediatric care nurses in the early establishment of a robust milk supply. The research emphasizes that the period shortly after birth is a crucial window for lactation, often missed by traditional postpartum assessments. The authors provide a resource for nurses to prioritize strategies such as frequent and effective milk removal (8-12 times in 24 hours), responsive feeding based on infant cues, promoting safe skin-to-skin contact, and facilitating connections to lactation support specialists.
• Nurses Partnering with Medical Assistants to Enhance Breastfeeding Care in the Pediatric Primary Care Setting Nicole Conover and Spatz explored how medical assistants (MAs) can be empowered to provide crucial breastfeeding support. Their findings indicate that most MAs surveyed were already offering informal support and expressed a strong interest in additional training to expand their roles. This research highlights the potential for MAs to be valuable partners with nurses in enhancing care within pediatric primary care settings, addressing the decline in breastfeeding exclusivity observed in the first six months postpartum.
• Nurse Work Environments and Exclusive Breast Milk Feeding during the Birth Hospitalization Research by Aleigha Mason and colleagues investigated the link between nurse work environments during labor and birth and the rates of exclusive breast milk feeding during birth hospitalization. The study found a significant association between good or mixed nurse work environments and higher hospital-level exclusive breast milk feeding rates. Interestingly, the hospital's "Baby-Friendly" status alone was not a significant predictor in their models. This suggests that supportive nursing environments are paramount in enabling nurses, who are instrumental in breastfeeding initiation, to optimize outcomes.
• Promoting Accurate Language on Lactation from Prenatal to Postpartum Nina A. S. Juntereal, and Spatz address the challenge of inconsistent and ambiguous terminology in lactation. Given that many healthcare professionals receive limited formal education in lactation, the study emphasizes the necessity of precise and consistent language to improve communication and care. The authors introduce "LactaPedia," a free online glossary designed to standardize lactation terminology for healthcare providers and the public, ultimately enhancing evidence-based education, support, and intervention.

“Collectively, these studies from Penn Nursing underscore a multi-faceted approach to improving human milk feeding,” said Spatz. “From early intervention in primary care and optimizing team collaboration to ensuring supportive work environments and promoting clear communication, Penn Nursing researchers are driving evidence-based changes that empower healthcare providers and support families in achieving their breastfeeding goals.”

About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing (Penn Nursing) is one of the world’s leading nursing schools. It has been ranked the #1 nursing school in the U.S. by QS University for a decade. Our Bachelor of Science in Nursing (BSN) is among the top-ranked programs in the nation, according to the 2025 U.S. News & World Report’s Best Colleges rankings. Penn Nursing also consistently earns high rankings in U.S. News & World Report’s annual list of best graduate schools and is a top recipient of National Institutes of Health (NIH) funding for nursing research. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, X, LinkedIn, YouTube, & Instagram.

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Journal

MCN The American Journal of Maternal/Child Nursing

 

New Antarctic research project leverages citizen science to spot environmental changes over time

Northern Arizona University

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High-resolution aerial imagery captured in January 1983 by the U.S. Geological Survey compared to modern high-resolution satellite imagery collected 36 years later.  Since then, the landscape has slowly but noticeably evolved, as can be seen by the rise in lake shoreline.

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Credit: U.S. Geological Survey

Mark Salvatore, an associate professor in NAU’s Department of Astronomy and Planetary Sciences, won a grant from the National Science Foundation to kick off an Antarctic citizen science project.

Working with Lumberjack Ph.D. student Gavin Moriarty, Salvatore will work with ecological researchers in the McMurdo Dry Valleys (MDV) of Antarctica and the crowdsourcing platform Zooniverse to create a citizen science project aimed at measuring environmental change on the continent over the last 70 years. Salvatore said the MDV is one of the most stable landscapes on Earth, and as a result, it’s particularly challenging to study change there.

“Since the 1950s, the U.S. military and the NSF have collected terabytes of aerial photographs over Antarctica for reconnaissance, logistics and scientific purposes,” Salvatore said. “This extensive archive of historical imagery provides a unique opportunity to reconstruct and analyze how cold desert landscapes evolve over decadal to centennial timescales.”

After a short training session, volunteers will be tasked with matching modern satellite images with historical air photos, giving Antarctic researchers a better understanding of how lake level rise, stream evolution and snowfall has changed across the decades. Salvatore said their work could aid researchers for decades to come.

“These contributions will support the creation of a long-term, high-quality dataset and searchable archive that can serve as a foundation for future scientific investigations of Antarctic landscape change,” he said. “In addition to enabling robust data generation, the project emphasizes public engagement through citizen science, open data accessibility and the development of scalable tools that can be applied to similar remote sensing challenges in other polar and remote regions."

Salvatore said citizen scientists should stay tuned for more information about how to get involved.

New study illuminates how diatoms thrive in — and light up — the Southern Ocean

Bigelow Laboratory for Ocean Sciences

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An iceberg spotted near the most southern point of the research cruise’s transect highlights some of the challenges and dangers of gathering data from this part of the ocean.

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Credit: Bigelow Laboratory for Ocean Sciences

An area of the remote Southern Ocean that’s long confused ocean color satellites by reflecting large amounts of turquoise-colored light appears to be full of silica-rich diatoms, according to a new study. Surprisingly, there is also evidence in these polar waters of coccolithophores, a type of marine microalgae with elaborate calcium carbonate shells that plays a critical role in the global carbon cycle.

The study helps answer a longstanding mystery for satellite oceanographers as to what microbes dominate in this part of the ocean that’s proven largely inaccessible, illuminating how the plankton community shifts in response to changing seawater temperature and chemistry. That, in turn, has important implications for the cycling of carbon in the Southern Ocean and the remote sensing tools scientists use to study it.

“This work takes a broad brush to understand the biological and geochemical dynamics of this far-flung body of water in ways that haven’t been previously possible,” said the study’s lead author Barney Balch, a senior research scientist emeritus at Bigelow Laboratory for Ocean Sciences.

The study was published this week in the journal Global Biogeochemical Cycles.

In the early 2000s, Balch and colleagues identified a swath of seawater encircling Antarctica, that became known as the Great Calcite Belt. This area is marked by unusually high levels of particulate inorganic carbon, like calcium carbonate and limestone, that reflects light back to satellites. Scientists eventually confirmed that this was due to the shiny calcium carbonate shells of vast blooms of coccolithophores.

At the same time, though, they identified an area well south of the calcite belt that also appeared unusually bright in satellite images, even though the water was considered too cold for coccolithophores. This mystery has been harder to explain with heavy cloud cover, icebergs, and rough seas making it challenging to monitor this far south with either ships or satellites. Until now.

Researchers sailed aboard the R/V Roger Revelle from Hawaii, down to 60 degrees latitude, taking a brief easterly detour to monitor where water from further south appears to be pinched up into several eddies. Along the transect, the team measured ocean color; calcification and photosynthesis rates; and concentrations of inorganic carbon and silica, two minerals that reflect light and are critical for helping sequester organic carbon in the deep ocean.

“Satellites only see the top several meters of the ocean, but we were able to drill down with multiple measurements at multiple depths,” Balch said. “We’ve never had such a complete suite of integrated measurements through the water column in this part of the ocean.”

The multi-tiered approach — combining biogeochemical measurements, optical data, and even visual counts of microbes with microscopy — enabled the scientists to observe how the plankton community shifts moving south: from dinoflagellates in the warmer, stratified waters of the subtropics, to coccolithophores in the calcite belt, and finally to diatoms in the silica-rich, colder waters south of the Polar Front.

This combination of complementary methods provides a “smoking gun,” Balch said, that the high levels of reflectance scientists have observed in satellite images south of the calcite belt can be explained by frustules. These silica-based structures that diatoms build, resembling microscopic pillboxes, reflect light in much the same way as coccolithophore shells (it takes far more frustules to produce the same optical effect as coccolithophores, though — a testament to how dense their concentration is).

Surprisingly, though, the team also observed small concentrations of inorganic carbon, some amount of calcification happening — a first — and visual evidence of coccolithophores in the far southern waters. This, Balch said, suggests that coccolithophores can survive in colder waters than expected. Perhaps, he said, the eddies coming up from the south even serve as “seed populations,” providing a small but consistent stream of coccolithophores into the Great Calcite Belt.  

The presence of coccolithophores across a wider geographic range than expected could influence how carbon moves through the Southern Ocean, which is considered one of the planet’s most critical sinks for atmospheric carbon. Meanwhile, the dominance of diatoms south of the Polar Front highlights the need to improve the algorithms scientists use to translate satellite data into meaningful predictions of ocean biology. That means potentially combining measurements of other satellite-derived variables to help distinguish between diatoms and coccolithophores in satellite images.

“We’re expanding our view of where coccolithophores live and finally beginning to understand the patterns we see in satellite images of this part of the ocean we rarely get to go to,” Balch said. “There’s nothing like measuring something multiple ways to tell a more complete story.”

In addition to Balch, the interdisciplinary team includes Bigelow Laboratory researchers Dave Drapeau, Bruce Bowler, and Sunny Pinkham, as well as scientists from Woods Hole Oceanographic Institute, Arizona State University, Texas A&M University, and the Bermuda Institute of Ocean Sciences.

Study co-authors Dave Drapeau (left) and Bruce Bowler (right) prepare to launch an probe on a rare sunny day to collect optical data down to the top of the euphotic zone.

Researchers, including study lead author Barney Balch, prepare to launch an probe on a rare sunny day to collect optical data down to the top of the euphotic zone.

Researchers, including study co-authors Bruce Bowler (left) and Sunny Pinkham (with the clipboard), take samples from a CTD rosette that collects water at each station for several variables at multiple depths.

Credit

Bigelow Laboratory for Ocean Sciences

Journal

Global Biogeochemical Cycles

DOI

10.1029/2024GB008457 

Method of Research

Observational study

Subject of Research

Cells

Article Title

Biological, Biogeochemical, Bio-Optical, and Physical Variability of the Southern Ocean Along 150°W and Its Relevance to the Great Calcite Belt

Article Publication Date

4-Aug-2025

 

For city dwellers, even 15 minutes in nature can improve mental health

Stanford University

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As the proportion of the global population living in cities rises to 70% by 2050, mental health challenges more common in urbanites – such as anxiety and mood disorders – become even more broadly relevant. A new study from the Stanford University-based Natural Capital Project (NatCap) shows that spending even a little time in nature provides significant benefits for a broad range of mental health conditions. The results, published today in Nature Cities, offer guidance to urban planners, policymakers, and others for how to use greenspace as a mental health solution, one that comes with additional benefits like lowering temperatures and sequestering carbon. The research team is now incorporating its findings into a modeling tool for urban planners. 

“We are working to translate the effect size we found through this analysis to more intuitive indicators that would be useful for decision-makers by way of a new mental health-focused InVEST model,” said Yingjie Li, postdoctoral scholar at NatCap and lead author of the study. “For example, we could run scenarios like: if a city currently has 20% green space or tree cover, how many preventable cases of mental health disorders could be avoided if that were increased to 30%? We will also be working to include estimates of the potential avoided healthcare costs associated with such improvements in urban nature.”

NatCap’s flagship mapping and modeling tools, known as InVEST, are used around the world to quantify ecosystem services, or nature’s benefits to people. For years the team has been building a collection of tools focused specifically on nature in cities. Yet while research in multiple countries has shown this includes both mental and physical health, that evidence had not yet been pulled into InVEST.

“Previous studies have documented strong links between contact with nature and mental health,” said Anne Guerry, chief strategy officer and lead scientist at NatCap and senior author on the paper. “But with most studies, you either can’t infer a causal link, they can’t be easily generalized, or they aren’t designed to distinguish the effects of different types of nature. This analysis helps fill that gap.”

The team’s analysis collates data from close to 5,900 participants across 78 field-based experimental studies, all either randomized controlled trials or pre-post intervention studies. While all types of urban nature provided benefits, the researchers found urban forests were even better for certain measures like reducing depression and anxiety. Young adults experience even greater benefits than the general population – an important data point because most mental health disorders emerge before the age of 25. Perhaps surprisingly, spending non-active, stationary time in greenspaces was more effective at reducing negative mental health outcomes like depression than active time in nature, though both are equally beneficial for positive outcomes like vitality (measured by asking how alive, alert, and energized people feel). They also found effects to be greater in Asian countries, where physiological effects may be enhanced by cultural associations with nature that “prime” people to their benefits. 

Based on the findings of this analysis, while larger city parks and forests are critical, the researchers suggest it is also important to create smaller “pocket parks” and additional street trees to increase access throughout cities. Even additional windows with views facing green spaces could be beneficial, as well as quiet, nature-filled spaces and community programming that provides passive nature exposure such as guided park meditation – relatively low-cost methods for improving public health in cities.  

At the personal level, Li has found that doing this work has improved his own lifestyle. He walks to the office more frequently and finds he is more curious about birds and plants he encounters along the way. “I also talk to my friends about thinking this way and encourage them to notice how even small moments with nature can make a difference. This work has helped me see that urban nature isn’t just good for cities – it’s good for us.” said Li.  

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Li is also a postdoctoral scholar in the Department of Biology in Stanford’s School of Humanities and Sciences (H&S). Additional Stanford NatCap co-authors on the paper are Lisa Mandle (NatCap/Woods Institute), Anders Rydström (NatCap/Biology, H&S), Tong Wu (NatCap/Woods Institute), Yougeng Lu (NatCap/Biology, H&S), and Gretchen Daily (NatCap/Biology, H&S and Woods Institute). The other co-authors are Yuanyuan Mao and Roy P. Remme from the Institute of Environmental Sciences at Leiden University; Xin Lan from the Department of Geography, Environment, and Spatial Sciences at Michigan State University; Chao Song from the College of Ecology at Lanzhou University; Kari C. Nadeau from the Department of Environmental Health at the Harvard T.H. Chan School of Public Health; and Andreas Meyer-Lindenberg from the Department of Psychiatry and Psychotherapy, Central Institute of Mental Health and Medical Faculty Mannheim/University of Heidelberg.

This research is supported by grants from the Stanford Woods Institute for the Environment’s Realizing Environmental Innovation Program, the Cyrus Tang Foundation, the Marcus and Marianne Wallenberg Foundation, the Heinz Foundation, the Winslow Foundation, and individual contributors John Miller and Kristy Hsiao.

The Natural Capital Project is based out of the Woods Institute for the Environment in the Stanford Doerr School of Sustainability and the Department of Biology in the Stanford School of Humanities and Sciences.

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Journal

Nature Cities

DOI

10.1038/s44284-025-00297-9 

Article Title

Urban nature and mental health

Article Publication Date

30-Jul-2025

 

Study shows major health insurance gap for some adopted children

Adopted children often have more health needs, some are less likely to have health insurance in the U.S.

University of Maryland

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Dr Dahai Yue, assistant professor of health policy and management at University of Maryland's School of Public Health. 

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Credit: UMD

COLLEGE PARK, M.d. – People in America adopt hundreds of thousands of children every year, but not all of them receive health insurance once adopted into their second home. A study by University of Maryland (UMD) School of Public Health, out today in Health Affairs, reveals major differences in coverage depending on adoption type (domestic or international) and citizenship status of the adoptive parent. 

“Adopted children generally have more and different health needs – such as cognitive or physical difficulties – than non-adopted children. Previous studies, many of which did not differentiate between different types of adoptees, found adopted children were consistently insured,” said study co-author Jamie Fleishman. 

“Our study, which considered four types of adoptee, found a very high uninsured rate for some adopted children – particularly those adopted internationally by non-citizens living in the United States.” The study found that almost one-third (30.7%) of the children in this group has no health insurance at all.

Fleishman is a Chinese transnational adoptee who was adopted from China to an American parent. She graduated from UMD in 2024 with a masters in public health (MPH), focusing on health equity, and her master’s thesis was the foundation of this study.  

The UMD researchers analyzed insurance coverage over five years (2018 – 2022,) comparing adopted and non-adopted children up to 17 years old who live with their head of household, using data from the American Community Survey (ACS), which includes over three million adopted and non-adopted children. The study distinguishes between international and domestic adoptions and further distinguishes international adoptees by householder citizenship, because international adoptees of U.S. citizens are, similar to a U.S.-born child, eligible for public insurance coverage such as Children’s Health Insurance Program (CHIP) or Medicaid. 

“The findings clearly show that we must not treat adopted children as a single group. International adoptees and domestic adoptees are very different. The citizenship status and other factors such as income of adoptive parents are also different. So policies need to be tailored to these differences,” said Dahai Yue, co-author and assistant professor in SPH’s Department of Health Policy and Management. Yue was Fleishman’s MPH advisor. 

The study compared four different groups of adopted children in the U.S. against a control group of non-adopted children: domestic adoptions, international adoptions by U.S. citizens, international adoptions by non-U.S. citizens and children who live with a biological relative, such as a grandparent, but who is not their biological parent.  

Children adopted internationally by non-U.S. citizens living in the U.S. have the highest uninsured rate at 30.7%. They also had lower rates of private and public health insurance than other adoptee groups, by 12.1 percentage points and 9.1 percentage points respectively. The non-U.S. citizens adopting these children were also more likely to be the same race as the child, more likely to have an income below the federal poverty line and less likely to own a home than other groups. 

The study also highlights a significantly high uninsured rate (7.3%) for children who are living with relatives other than their biological parents, and who are also more likely to live in lower-income families. 

“There are likely multiple factors behind these disparities which were not examined in this study. But the data is clear: These groups are not homogenous, despite previous research often treating them as a single population. These children are worthy of policy attention to ensure all children have access to health care in the United States,” said Yue. 

Key Findings

Children adopted internationally by non-U.S. citizens living in the U.S. 

• Almost one-third (30.7%) of this group has no health insurance at all. 
• This group has lower rates of private health insurance (by 12.1 percentage points) and of public health insurance (by 9.1 percentage points) than other adoptee groups. 
• The non-U.S. citizens adopting these children were also more likely to be the same race as the child, more likely to have an income below the federal poverty line and less likely to own a home than other groups. 

Other adopted and non-adopted children

• Children who are living with relatives other than their biological parents also have a significantly high uninsured rate (7.3%). 
• Children who are the most likely to have private insurance coverage are children adopted domestically (56.2%), children adopted internationally to U.S. citizens (89.1%) and nonadopted children (63.8%). 
• Children who are most likely to have public insurance coverage, such as Medicaid, are those adopted domestically, and those who live with relatives other than their biological father or mother. 
• International adoptees of U.S. citizens were the most insured compared to non-adopted children – in fact, they were more insured than nonadoptees. 

To request an interview with one of the study authors, please contact sph-comm@umd.edu. 

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Journal

Health Affairs

DOI

10.1377/hlthaff.2024.01224 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Health Insurance Coverage Varied By Children’s Adoption Status In The US, 2018–22

Article Publication Date

4-Aug-2025