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If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID‐19 pandemic has presented a range of challenges to HMBs worldwide. This study aimed to understand the impacts of the pandemic on HMB services and develop initial guidance regarding risk limitation. A Virtual Collaborative Network (VCN) comprising over 80 HMB leaders from 36 countries was formed in March 2020 and included academics and nongovernmental organisations. Individual milk banks, national networks and regional associations submitted data regarding the number of HMBs, volume of DHM produced and number of recipients in each global region. Estimates were calculated in the context of missing or incomplete data. Through open‐ended questioning, the experiences of milk banks from each country in the first 2 months of the pandemic were collected and major themes identified. According to data collected from 446 individual HMBs, more than 800,000 infants receive DHM worldwide each year. Seven pandemic‐related specific vulnerabilities to service provision were identified, including sufficient donors, prescreening disruption, DHM availability, logistics, communication, safe handling and contingency planning, which were highly context‐dependent. The VCN now plans a formal consensus approach to the optimal response of HMBs to new pathogens using crowdsourced data, enabling the benchmarking of future strategies to support DHM access and neonatal health in future emergencies. [ABSTRACT FROM AUTHOR]

Background: The WHO and UNICEF have suggested pasteurized donor milk (PDM) as the best alternative for infants who do not receive enough milk from their mothers. Objective: This study aimed to assess the short-term outcomes of launching the first mother's milk bank in North-West of Iran. Methods: The present retrospective study included 366 premature infants (181 pre-launch and 185 post-launch) who were hospitalized in Al-Zahra Hospital of Tabriz, Iran. The study included infants with birth weight <2000 g and/or gestation age <32 weeks who were born before and after the launch of mother's milk bank. Frequency of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), late onset sepsis (LOS) and mortality rate were compared. Data were analyzed using SPSS 23 with the chi- square test, Fisher exact test, independent t test, and logistic regression test. Results: In total, NEC grade ≥ 2 was reported in 9 cases; 8 cases (4.41%) in pre-launch and one case (0.54%) in post-launch (adjusted OR = 0.091; 95% CI = 0.010 to 0.849, P = 0.035). ROP was reported in 21 cases in two groups. Nineteen cases (10.5%) belonged to the pre-launch group and 2 cases (3.7%) to the post-launch group (adjusted OR = 0.105; 95% CI = 0.022 to 0.488, P = 0.004). LOS was also found in 17 cases (9.39%) in the pre-launch group and 4 cases (2.16%) in the post-launch period, suggesting a significant difference between the two groups (adjusted OR = 0.297; 95%CI = 0.089 to 0.995, P = 0.049). There was no significant difference in mortality of infants during hospitalization between the two groups (P = 0.789); however, it was decreased from 15 to 8. Conclusion: Launching the human milk bank significantly improved the outcomes of premature infants. [ABSTRACT FROM AUTHOR]

Necrotizing Enterocolitis (NEC) is a common devastating gastrointestinal disease, which usually develops in premature infants. Erythropoietin (EPO) as a hematopoietic hormone produced by the kidney can also be naturally found in amniotic fluid and breast milk. There is some evidence that supports the contribution of EPO in the prevention of inflammation and intestinal tissue repair. This study was aimed to determine if oral administration of artificial amniotic fluid with or without EPO would protect preterm infants against NEC and improve the certain neonatal outcomes. In this study, 150 preterm infants with gestational age 28 weeks or less and birth weight 1250 grams or less were enrolled. The infants were divided randomly into 3 groups: 1) Control group (n=50) with routine feeding protocol without any administration; 2) Amniotic fluid group (n=50) with 5mL/kg synthetic amniotic fluid; 3) EPO group (n=50) with RhuEPO dissolved in the synthetic amniotic fluid. The administrations of the study solution were started 3 days after the birth and were continued for 3 weeks (21 days). The infants in the study groups were followed up until discharge and the frequency of NEC, mortality, and other complications of the disease among the groups were compared. The mortality rate in preterm infants of the amniotic fluid and EPO groups were significantly lower than in the control group (p=0.027). We couldn't find any significant differences in the frequency of NEC and other complications among the three study groups. The administration of synthetic amniotic fluid (with or without EPO) in preterm infants may decrease the mortality rate. Use of EPO in synthetic amniotic fluid did not affect the frequency of NEC. [ABSTRACT FROM AUTHOR]

Objective: Growth and development of preterm infants may be negatively affected by constant bright light in neonatal intensive care units ( NICUs ). It may also contribute to sleep pattern disorders commonly seen in in this group of infants. Reducing exposure to light by covering the incubators is recommended by guidelines of the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP). Materials and Methods: This randomized clinical trial study was performed on 60 preterm infants with gestational age of 28-32 weeks admitted at NICU of Al-Zahra Teaching Hospital of Tabriz University of Medical Sciences in 2014. Preterm infants were divided randomly in 2 groups: In the first group (intervention), incubators were covered with a thick cover and the face was covered with a cloth (face cover). In the second group (observation), incubators were covered with a thick cover but the face was not covered. We darkened the environment of NICU by closing the curtain and turning off additional florescent lights from 19:30 pm till 7:30 am in both groups, then we compared sleep pattern in 2 groups of infants by using sleep diagram. Results: In the intervention group (face cover), the mean frequency of sleep during the 6 days increased by 2.96 times/ observations and the mean amount of sleep increased by 59 minutes. Conclusion: This study showed that light reduction with incubator covers and eye shield, increases the frequency and sleep duration in premature infants. [ABSTRACT FROM AUTHOR]

In this study, a fluorometric probe based on luminol-terbium coordination polymer nanoparticles (luminol-Tb CP NPs) is validated for the quantification of phenobarbital in the exhaled breath condensate collected from expiratory circuit of the mechanical ventilator (MVEBC). It relies on the coordination of phenobarbital to luminol-Tb CP NPs which casing an aggregation-induced fluorescence enhancement of probe owing to the increasing the system rigidity and the decreasing the nonradiative decay rate. As the increase in response intensity is proportional to phenobarbital amount, a method is offered for its determination in MVEBC. This method presents a linear relationship with phenobarbital concentration in the range of 0.1–10.0 mg.L−1 with a limit of detection of 0.024 mg.L−1 and the relative standard deviation of 3.6%. The proposed method is used in MVEBC of the pre-term newborn babies receiving phenobarbital under mechanical ventilator. • Validation a nanosensor based on luminol-Tb CP NPs for phenobarbital determination. • Using an auxiliary linking ligand effect of phenobarbital for its determination. • Determination of phenobarbital in EBC of newborns receiving phenobarbital. [ABSTRACT FROM AUTHOR]

Objective: The macronutrients of human milk are considered essential nutritional sources in the first few months of a newborn's life. The present study aimed to investigate the effect of delivery mode on the macronutrients of human milk., Methods: This retrospective cohort study was conducted on 102 women who gave birth by cesarean section or vaginal delivery between September 2019 and November 2019. The participants were requested to provide their milk samples on day 15 ± 1 after childbirth., Results: There were no significant differences between the two groups (cesarean and vaginal delivery) regarding the sociodemographic characteristics and intake of fat, carbohydrate, protein, and energy. The lactose level was significantly higher in women who gave birth by vaginal delivery (adjusted mean difference, 1.2 (95 % CI 0.02- 1.82)). For other macronutrients, there were no statistically significant differences between the two groups., Conclusion: The vaginal delivery might influence the mature milk lactose level., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Exosomes are nano-sized vesicles secreted by nearly all cells and have received massive attention recently. In addition to their roles in pathophysiological processes and diagnostic evaluations, recently, several studies have applied exosomes to design novel therapeutic applications. Exosomes can be derived from a variety of cells and tissues and based on the source, they can carry different native contents such as DNAs, non-coding small RNAs, mRNAs, and proteins. They can also be engineered by adding desirable agents including specific biomolecules or drugs. Both forms can be therapeutically used for delivering their cargoes to the target cells and desirably alter their functions. The present study aimed to provide a comprehensive review of the various studies which applied exosomes as a therapeutic tool in the treatment of different types of diseases including cancer, cardiovascular, neurologic, psychiatric, liver, and kidney diseases., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The aim of this study was to evaluate the freeze-thawing method in reducing viral load of cytomegalovirus (CMV) in breast milk of mothers of preterm infants., Materials and Methods: In this study, 169 nursing mothers of preterm infants were evaluated serologically for CMV infection. We found 29 (17.15%) nursing mothers who had serologic evidence of CMV infections consistent with recent infection (N = 2, IgG + IgM +) or prior infection (N = 27 IgG + IgM-). Two to 6 weeks after delivery, breast milk of seropositive mothers (N = 29) was evaluated for CMV load by real-time polymerase chain reaction (PCR) before and after freezing at -20°C for 72 hours. All preterm infants with milk results positive for DNA particles of CMV (N = 25) were followed up for signs and symptoms of CMV infection until 3 months of age, together with urine testing for CMV by real-time PCR., Results: Examination of breast milk by real-time PCR of the seropositive mothers showed 25 of them with CMV DNA particles in their breast milk. After freezing and thawing, we found virus DNA in 4 of 25 (16%) of the breast milk samples and there was no CMV DNA particles in 21 (84%) of them. In these samples, mean viral load before freezing was 76.04 ± 34.08 copies/μL (20-135.00 copies/μL) and after freezing it was 6.75 ± 4.34 copies/μL (0.00-13.00 copies/μL). Freezing showed a significant decrease in viral load of the samples (p = 0.001)., Conclusion: The study showed that the freeze-thawing method is an effective method in reducing the CMV load in breast milk samples.