Researcher Developing New Child, Family Lab
By Susie Phillips Gonzalez
One of the nation’s leading researchers studying the benefits of human milk for preterm infants recently joined the School of Nursing at UT Health San Antonio.
Elizabeth Brownell, Ph.D., M.A., associate professor of nursing, is a perinatal epidemiologist whose research is performed in collaboration with nurse researchers. In fact, her dissertation chair was a nurse so joining the School of Nursing is a natural fit.
Dr. Brownell is developing the Child and Family Laboratory within the school’s existing Biobehavioral Research Laboratory to house biospecimens such as saliva, human milk, other bodily fluids, and associated data to allow faculty and students to study maternal and infant health long-term outcomes. The lab will mirror the Connecticut Human Milk Research Center that Dr. Brownell founded in the Neonatal Intensive Care Unit (NICU) at Connecticut Children’s Hospital in Hartford, Connecticut. It was the first such center in the country with a multi-disciplinary team researching the relationship of human milk’s benefits on preterm infants.
While she was at Connecticut Children’s Hospital, Dr. Brownell had access to data from the National Children’s Study (NCS) that examined environmental influences on the health and development of children. It was during her work there to explore the relationship of human milk intake in premature newborns and their growth, development and health that she discovered the biomarker linking a pregnant woman’s saliva with the likelihood of a preterm birth.
Dr. Brownell said this discovery has proven that the saliva of a pregnant woman can predict a 400 percent increased risk of having a premature baby. This knowledge can better prepare the mom for an early birth, she said.
She explained that one element of a preterm infant’s success is human milk, which she defines as expressed human milk, donor milk or milk derivatives with a human milk-based fortifier. “Experts view human milk as medicine because it has the nutritive and immunologic factors that are vital for infant and child growth and development,” she said.
Dr. Brownell said benefits of human milk for babies include reduced infection, obesity and chronic disease coupled with improved cognition. Both the World Health Organization and the American Academy of Pediatrics recommend a diet of exclusive human milk for the first several months of life.
Since arriving on campus in 2019, Dr. Brownell has joined the research team led by Jacqueline M. McGrath, Ph.D., RN, FNAP, FAAN, vice dean for faculty excellence, and Lisa M. Cleveland, Ph.D., RN, CPNP, IBCLC, FAAN, associate professor of nursing.
Dr. Cleveland is exploring the heartbreaking effects of opioid use by mothers on their newborn infants. Studies show that one infant is born every 15 minutes with an opioid addiction in the United States. These infants exhibit symptoms such as tremors, crying, and difficulty feeding and digesting food. Although not necessarily premature, these infants face multiple health challenges due to withdrawal and extended hospital stays.
Dr. Brownell said she, Dr. Cleveland and the entire research team will continue to build evidence for the role of an exclusive human milk diet for newborns with the clinical diagnosis of Neonatal Abstinence Syndrome (NAS), which is based on maternal history and the appearance of withdrawal symptoms.
“This novel study may lead to human milk as the standard of care for this vulnerable patient population,” Dr. Brownell said. “Before I got here, I didn’t know a lot about opioid-exposed babies, but I do know that human milk can help them.” She adds that the primary objective of a funded clinical trial is to decrease the length of hospital stays for infants at risk for NAS who are fed an exclusive human milk diet for the first 28 days of life or until they go home.
Recognizing that not all mothers can or will breastfeed their infants, Dr. Brownell said her research shows that even a 10 percent increase in mother’s milk or donor milk improves both short- and long-term health outcomes for babies.
“When increasing human milk by 10 percent and thus decreasing exposure to formula, those infants did better in terms of multiple measures of growth,” she said. When researchers looked at how those same children were doing two years later, Dr. Brownell says the protective effects of human milk dissipated over time, but the children nevertheless showed improved neurodevelopmental outcomes. “It’s nice to see that linear pathway,” she added.
Because funding for the NCS has ended, Dr. Brownell moved some biospecimens (milk, maternal/infant saliva and serum) with her when she came to UT Health, where the samples are stored in three freezers purchased by the School of Nursing. Since moving to UT Health, she obtained additional samples (cord blood, whole blood, vaginal swabs, and meconium) and says the combination of detailed biospecimens and publicly available data will be an innovative research resource.
“This research demonstrates the importance of secondary data analyses regarding human milk,” Dr. Brownell said. “It shows that you can do one thing at one institution and one thing at another, and it’s all interconnected.” Dr. Brownell is thrilled to be a new faculty member at the School of Nursing and embraces multi-disciplinary collaboration.