7,695 results on '"Milk, Human"'
Search Results
2. Reducing Disparity in Receipt of Mother's Own Milk in Very Low Birth Weight Infants (ReDiMOM)
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National Institute on Minority Health and Health Disparities (NIMHD) and Ohio State University
- Published
- 2023
3. Curds in the way: A milk curd obstruction review and normal sonographic bowel appearances using a novel scoring system in neonates on fortified breast milk feeds.
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Kimble, Lara L, Perry, David, and Bach, Katinka P
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BREAST milk , *NEWBORN infants , *LOW birth weight , *BIRTH weight , *NEONATAL intensive care , *BIOFORTIFICATION - Abstract
Introduction: Fortified expressed breast milk (FEBM) is a standard of care for premature and low birth weight neonates, but comes with an elevated risk of a rare but re‐emergent pathology called milk curd obstruction (MCO). Little is known about normal sonographic appearances of bowel contents in this feeding setting, making the recognition of abnormalities difficult. Thus, we aimed to describe appearances that may be considered typical pre‐ and post‐fortifier inclusion. Methods: Ten neonates of <32 weeks' gestation or a birth weight of <1,800 g recruited from Auckland City Hospital Neonatal Intensive Care between 1/5/2019 and 10/9/2019 received bowel ultrasounds within 24 h before and 10–14 days after starting FEBM. Bowel contents in six abdominal regions were assigned scores of 1–6 based on increasing solidification. Results: Lower gestational age was correlated with more solid contents on the pre‐fortifier ultrasound (P = 0.02). Fortifier was significantly associated with increasing solidity, particularly in the left abdomen (P < 0.001). The left lower quadrant and rectum accounted for much of this change (P = 0.012 and P = 0.002). One subject who subsequently developed a clinical picture consistent with early MCO had uniquely demonstrated non‐rectal solid contents (score 6). The interobserver kappa score for two assessors was 0.91 (95% CI 0.94–0.99) on still images. Conclusion: This small cohort demonstrated increasing bowel content solidification after breast milk fortification using a novel ultrasound scoring system with good interobserver agreement. Non‐rectal solid contents (score 6) appeared atypical. Ultrasound shows promise for its non‐irradiating diagnostic utility in the setting of early milk curd disease evaluation of the premature neonate. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Polyphenol analysis in human milk by a rapid, costeffective, and accurate micromethod: translational development.
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Valentina Cortez, Mariela, Veronica Scotta, Ana, Ramiro Miranda, Agustín, and Andrés Soria, Elio
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BREAST milk , *GALLIC acid , *HYDROXYCINNAMIC acids , *GOAT milk , *FOOD consumption , *POLYPHENOLS - Abstract
Objective: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. Methods: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the KruskalWallis H test (p<0.05). The best technique was applied to 284 HM samples to determine their polyphenolic content and its association with maternal diet by multifactorial linear regression. Results: Acidic extraction successfully recovered the gallic acid reference standard, whereas alkaline extraction overestimated it. Calibration curves for all methods were linear (R²>0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. Conclusions: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Polyphenol analysis in human milk by a rapid, cost-effective, and accurate micromethod: translational development
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Mariela Valentina Cortez, Ana Veronica Scotta, Agustín Ramiro Miranda, and Elio Andrés Soria
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Analytic sample preparation methods ,Clinical laboratory techniques ,Milk, human ,Polyphenols ,Technology assessment, biomedical ,Pediatrics ,RJ1-570 - Abstract
ABSTRACT Objective: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. Methods: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the Kruskal-Wallis H test (p0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. Conclusions: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks.
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- 2024
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6. Breast Milk Composition: Interindividual Variations and Dietary Factors in Galicia
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PATRICIA REGAL, Professor and PhD researcher
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- 2020
7. Genetic Variants Modulate Association Between Dietary n-3 LCPUFAs and DHA Proportion in Breast Milk
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- 2019
8. The Feasibility of Drug Delivery to Infants During Breastfeeding (FEDD)
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University of Cambridge and Kathryn Beardsall, University Lecturer, University of Cambridge
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- 2019
9. Donor human milk for preventing necrotising enterocolitis in very preterm or very low-birthweight infants.
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Quigley M, Embleton ND, Meader N, and McGuire W
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- Humans, Infant, Newborn, Bias, Enteral Nutrition methods, Infant Formula, Infant, Extremely Premature, Infant, Premature, Infant, Premature, Diseases prevention & control, Infant, Premature, Diseases mortality, Randomized Controlled Trials as Topic, Enterocolitis, Necrotizing epidemiology, Enterocolitis, Necrotizing prevention & control, Infant, Very Low Birth Weight, Milk, Human
- Abstract
Background: When sufficient maternal milk is not available, donor human milk or formula are the alternative forms of enteral nutrition for very preterm or very low-birthweight (VLBW) infants. Donor human milk may retain the non-nutritive benefits of maternal milk and has been proposed as a strategy to reduce the risk of necrotising enterocolitis (NEC) and associated mortality and morbidity in very preterm or VLBW infants., Objectives: To assess the effectiveness of donor human milk compared with formula for preventing NEC and associated morbidity and mortality in very preterm or VLBW infants when sufficient maternal milk is not available., Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Maternity and Infant Care (MIC) database, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), from the earliest records to February 2024. We searched clinical trials registries and examined the reference lists of included studies., Selection Criteria: Randomised or quasi-randomised controlled trials comparing feeding with donor human milk versus formula in very preterm (< 32 weeks' gestation) or VLBW (< 1500 g) infants., Data Collection and Analysis: Two review authors evaluated the risk of bias in the trials, extracted data, and synthesised effect estimates using risk ratio, risk difference, and mean difference, with associated 95% confidence intervals. The primary outcomes were NEC, late-onset invasive infection, and all-cause mortality before hospital discharge. The secondary outcomes were growth parameters and neurodevelopment. We used the GRADE approach to assess the certainty of the evidence for our primary outcomes., Main Results: Twelve trials with a total of 2296 infants fulfilled the inclusion criteria. Most trials were small (average sample size was 191 infants). All trials were performed in neonatal units in Europe or North America. Five trials were conducted more than 40 years ago; the remaining seven trials were conducted in the year 2000 or later. Some trials had methodological weaknesses, including concerns regarding masking of investigators and selective reporting. Meta-analysis showed that donor human milk reduces the risk of NEC (risk ratio (RR) 0.53, 95% confidence interval (CI) 0.37 to 0.76; I² = 4%; risk difference (RD) -0.03, 95% CI -0.05 to -0.01; 11 trials, 2261 infants; high certainty evidence). Donor human milk probably has little or no effect on late-onset invasive infection (RR 1.12, 0.95 to 1.31; I² = 27%; RD 0.03, 95% CI -0.01 to -0.07; 7 trials, 1611 infants; moderate certainty evidence) or all-cause mortality (RR 1.00, 95% CI 0.76 to 1.31; I² = 0%; RD -0.00, 95% CI -0.02 to 0.02; 9 trials, 2116 infants; moderate certainty evidence)., Authors' Conclusions: The evidence shows that donor human milk reduces the risk of NEC by about half in very preterm or VLBW infants. There is probably little or no effect on late-onset invasive infection or all-cause mortality before hospital discharge., (Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
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- 2024
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10. Formal and informal human milk donation in New Zealand: a mixed-method national survey.
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Harris S, Bloomfield FH, and Muelbert M
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- Humans, New Zealand, Female, Adult, Male, Surveys and Questionnaires, Infant, Newborn, Parents psychology, Middle Aged, Young Adult, Infant, Milk, Human, Milk Banks
- Abstract
Background: Mother's milk provides optimal nutrition for infants. Donor human milk (DHM) is recommended for low birthweight infants when mother's milk is unavailable. Little is known about human milk (HM) donation practices in New Zealand (NZ), where few HM banks are available. This study aimed to investigate parents' and health professionals' (HP) experiences with formal and informal HM donation in NZ., Methods: Two electronic surveys were disseminated in 2022 to parents and HPs involved with HM donation in NZ. The surveys covered respondents' views and experiences with HM donation. HPs were also asked about HM donation practices in their workplace. Chi-squared and Fisher-Freeman-Halton exact tests were used for quantitative analysis and qualitative data were thematically analysed using inductive approach., Results: A total of 232 HP and 496 parents completed the surveys. Most parents either donated (52%) or sought DHM (26%) for their infant and most donations were informal, arranged between individuals (52%) or through hospital staff (22%). HP reported DHM was used in 86% of facilities, with only 20% of donations facilitated by HM banks. Almost half (48%) of HP stated they would like to use DHM in their workplace but access was limited. The most common screening processes undertaken by parents and HP before informal HM donation were lifestyle including smoking status, medication, drug and alcohol intake (44% and 36%, respectively) and serological screening such as CMV, HIV, Hepatitis C or B (30% and 39%, respectively). Pasteurisation of DHM obtained informally was not common. Most donors were satisfied with their HM donation experiences (informal and/or formal, 91%) and most respondents supported use of DHM in hospitals and community. Participants reported HM donation could be improved (e.g., better access) and identified potential benefits (e.g., species-specific nutrition) and risks (e.g., pathogens) for the infant. Potential benefits for the donor were also identified (e.g., altruism), but respondents acknowledged potential negative impacts (e.g., cost)., Conclusion: Informal HM donation in NZ is common. Most parents and HP support the use of DHM; however, improvements to current practices are needed to ensure safer and more equitable access to DHM., (© 2024. The Author(s).)
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- 2024
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11. Invited Commentary: Analysis of Breast Milk Samples in Lactating Women After Undergoing Botulinum Toxin Injections for Facial Rejuvenation: A Pilot Study.
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Paragh L and Labadie JG
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- Humans, Female, Pilot Projects, Neuromuscular Agents administration & dosage, Neuromuscular Agents therapeutic use, Cosmetic Techniques, Face, Skin Aging drug effects, Lactation drug effects, Rejuvenation, Botulinum Toxins, Type A administration & dosage, Milk, Human
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- 2024
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12. Direct breastfeeding frequency of late preterm and term infants in the neonatal intensive care unit and availability of mother's own milk at six months of age. a retrospective cohort study.
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Smith AE, Sweigart E, Falatic K, Stuart D, Szugye H, Lam SK, Aly H, and Das A
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- Humans, Retrospective Studies, Female, Infant, Newborn, Male, Infant, Adult, Cohort Studies, Logistic Models, Breast Feeding statistics & numerical data, Intensive Care Units, Neonatal, Milk, Human, Infant, Premature
- Abstract
Background: Mother's Own Milk (MOM) reduces the risk of complications in premature infants. Breastfeeding rates for late preterm and term infants in the neonatal intensive care unit (NICU) are significantly lower than that of breastfed healthy term newborns at 6 months of age., Design: This was a retrospective cohort study of neonates born at 34 weeks 0 days or later. Infants who were directly breastfed in the NICU and were discharged on breast milk were included. Logistic regression modeling was used to determine the significance of association., Results: 171 mother-infant dyads were included. After adjusting for confounders, the number of breastfeeding attempts during the NICU stay was significantly associated with the availability of MOM at six months of age (p = 0.003, 95% CI 1.02 to 1.14)., Conclusion: This study is the first to show an association between the number of direct breastfeeding attempts in the NICU and availability of MOM at six months of age., (© 2024. The Author(s).)
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- 2024
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13. Biomarker-based text messages to promote lactation success in mothers of critically Ill infants: a randomized controlled pilot study.
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Parker LA, Varma D, Bendixen MM, Sullivan S, Cacho N, and Martina M
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- Humans, Female, Pilot Projects, Infant, Newborn, Adult, Breast Feeding, Milk, Human, Mothers, Text Messaging, Lactation physiology, Critical Illness therapy, Breast Milk Expression methods, Intensive Care Units, Neonatal, Biomarkers
- Abstract
Objective: Infrequent breast pumping limits mother's own milk production in mothers of infants admitted to the neonatal intensive care unit. We aimed to determine the feasibility and benefit of biomarker-based personalized text messages on pumping frequency and milk sodium levels. A secondary aim examined lactation outcomes., Study Design: In this randomized controlled pilot study, 51 mothers were randomized to receive personalized text messages regarding pumping frequency or standard care., Results: There were no differences in pumped milk volume or sodium level, however, there was a trend towards the intervention group pumping more frequently, which was significant on day 5 (p = 0.035), and they lactated nearly 9 days longer. Post-hoc analysis found the intervention group tended to be more likely to pump ≥ 500 mL by day14 (p = 0.08), a marker of long-term lactation success., Conclusion: Personalized biomarker-based text messages are feasible and may support lactation in mothers of critically ill infants., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
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- 2024
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14. Mother's Milk Donation to a Human Milk Bank During Bereavement: Circumstances Associated with Completing the Donation Process.
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Pidaparti M, Knowles G, Henner N, Fry JT, Kelly SG, Hoggarth J, and Robinson DT
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- Humans, Female, Retrospective Studies, Infant, Adult, Male, Infant, Newborn, Tissue Donors psychology, Milk Banks, Bereavement, Mothers psychology, Milk, Human
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Background: Bereaved mothers describe positive experiences donating breast milk and negative experiences when not informed of opportunities to donate. Predictors of whether mothers donate milk are unknown, impairing efforts to optimize support in completing donation. Objective: To define circumstances associated with completing mother's milk (MM) donation during bereavement. Methods: A retrospective cohort study included dyads of bereaved mothers and their deceased children if a child's death occurred on-site at a quaternary care children's hospital during 2016-2020, the child had documentation of MM availability, and age at death <24 months. The primary outcome was the completion of MM donation to the milk bank. Multivariate logistic regression measured associations between clinical variables and odds of completion. Results: Of 124 deceased children with documented MM exposure, 34 mothers (28%) of 35 of those children completed MM donation, donating a mean of 13.7 liters (SD 16.8). The child's race/ethnicity documented in the medical record was White for 25 (71%), Black/African American (AA) for 1 (3%), Asian for 1 (3%), and Hispanic/Latino for 8 (23%). Referenced to mothers of White children, being a mother of an AA [OR 0.05 (95% CI: 0.01-0.43)] or Asian [0.08 (0.01-0.75)] child was associated with lower odds of donation. Referenced to mothers delivering full term (≥37 weeks'), mothers delivering <34 weeks showed higher odds [5.0 (1.5-17.5)] of donation. Conclusion: Relatively few bereaved mothers of children with indicators of MM exposure completed donation. The results suggest an opportunity to ensure bereaved mothers are uniformly informed and supported in donating.
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- 2024
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15. Achieving sufficient milk supply supports mothers to cope with premature birth.
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Schwab I, Wullenkord R, Ohnhäuser T, Dresbach T, and Scholten N
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- Humans, Female, Cross-Sectional Studies, Infant, Newborn, Adult, Retrospective Studies, Milk, Human, Breast Milk Expression psychology, Premature Birth, Qualitative Research, Surveys and Questionnaires, Adaptation, Psychological, Infant, Very Low Birth Weight, Mothers psychology
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Aim: To explore whether and how expressing breast milk is perceived as helpful in coping with negative emotions due to premature birth by mothers of very low birth weight (VLBW) infants., Methods: Qualitative interviews and a retrospective cross-sectional questionnaire with mothers of VLBW infants were conducted and analysed using an exploratory sequential mixed-method design. Hypotheses were built using qualitative content analysis and quantitatively tested using multivariate regression analysis., Results: Interviews with 12 mothers and questionnaires of 518 mothers were analysed. Coping with prematurity by expressing milk was seen as a way to maintain the caregiving role for the mothers, where three relevant factors arouse: making up for what happened, providing the best for their infant and fear of low milk supply. Quantitative analysis showed that mothers with a high milk supply (Coef. = 1.1, p < 0.000) and more feelings of guilt due to premature birth (Coef. = -0.1; p = 0.015) perceived expressing breast milk significantly more as a resource for coping., Conclusion: This study adds knowledge on how expressing breast milk for their VLBW infant may support mothers in coping with premature birth, by revealing the association with milk supply and feelings of guilt due to premature birth., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
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- 2024
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16. Evaluating milk flow patterns using the high flow rate period during breast pumping.
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Idei Y, Ochiai Y, Yoshibe K, Kuroishi S, Takase M, and Mizuno K
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- Humans, Female, Cross-Sectional Studies, Adult, Japan, Milk Ejection physiology, Infant, Newborn, Lactation physiology, Breast Milk Expression methods, Breast Milk Expression instrumentation, Breast Milk Expression statistics & numerical data, Milk, Human
- Abstract
Problem: Breast pumping practices have scope for improvement., Background: Breast milk weight measurement can be used to evaluate milk flow pattern dynamics during breast pumping., Aim: To determine inter-individual differences in milk flow patterns and their practical implications based on high milk flow rate period (HFP) data among Japanese women expressing breast milk using an electric pump., Methods: This cross-sectional, observational study analysed data from 19 women (33.0 ± 3.9 years) nursing 1-6-month-old infants and with previous breast milk expression experience. Breast milk was weighed continuously during a 15-min single-breast electric pumping session. The HFP features and flow rate time (≥0.1 g/s) were analysed to determine each individual's milk flow pattern., Findings: The total expressed breast milk was 69.8 ± 42.5 g with a maximum individual flow rate of 0.5 ± 0.2 g/s. The breast milk yielded during the HFPs was 43.1 (34.4-81.3) g, accounting for 82.5 % (69.9-89.5 %) of the total expressed breast milk. HFP occurred 0-3 times during the 15-min session. Multiple discrete and continuous milk flow patterns were observed. Among those with discrete HFP, the HFP interval was 221 (68-371) s. Breast milk fat content changes and subjective residual milk measurements implied sufficient milk removal. A strong positive correlation was noted between HFP length and total breast milk expression volume., Discussion: Individual differences in milk flow patterns were observed among the women using HFP. Milk flow patterns were consistent with previous reports., Conclusion: Milk flow pattern data can be used to guide individualised lactation support., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: K.M. and M.T. received payment from Pigeon for advice and consultation, respectively., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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17. Comparison of Two Pumping Strategies to Improve Exclusive Breastfeeding at Discharge in Mothers of VLBW Infants with Low Milk Output - A Pilot Randomized Controlled Trial.
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Kalathingal T, Manerkar S, Mondkar J, Kalamdani P, Patra S, Kaur S, and Khandekar H
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- Humans, Infant, Newborn, Pilot Projects, Female, Adult, Milk, Human, Mothers, Lactation physiology, Male, Breast Feeding, Breast Milk Expression methods, Infant, Very Low Birth Weight, Patient Discharge
- Abstract
Objectives: To compare the effect of two strategies of breast pumping -power pumping (PP) vs. routine pumping (RP) over one week in mothers of very low birth weight (VLBW) infants with low milk output to improve breastfeeding rates at discharge., Methods: Mothers with low milk output, defined as inability to express sufficient breastmilk to meet the feeding requirements of their infant on or after post-natal day 14, were randomized to receive power pumping vs. routine pumping - once daily for 7 d coupled with routine lactation support and hand expression 3 hourly in both groups. The primary outcome was exclusive breastfeeding at discharge., Results: There was no difference in the two pumping strategies with respect to exclusive breastfeeding rates [61.1% in PP vs. 50% in RP group; (p = 0.477, RR 1.2; 95% CI 0.76 to 2.17)]. Median milk volume pumped in the individual power pumping session on 7th day of intervention was significantly higher than that in the individual routine pumping session on the 7th day (50 mL vs. 27 mL, p = 0.014). The cumulative median milk volume expressed per individual pumping session over the 7 sessions of power pumping was also higher than that with routine pumping (305 mL vs. 213 mL, p = 0.054)., Conclusions: In this pilot trial, expressed milk volume was significantly higher after each individual power pumping session compared to routine pumping. However, the exclusive breastfeeding rates at discharge were similar in the two groups., (© 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.)
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- 2024
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18. Unveiling the voices: Exploring perspectives and experiences of women, donors, recipient mothers and healthcare professionals in human milk donation: A systematic review of qualitative studies.
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Li J, Ip HL, Fan Y, Kwok JY, Fong DY, and Lok KYW
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- Humans, Female, Tissue Donors psychology, Adult, Motivation, Breast Feeding psychology, Milk, Human, Mothers psychology, Qualitative Research, Milk Banks, Health Personnel psychology
- Abstract
Objectives: This study aims to examine and synthesise the views and experiences of women, donors, recipient mothers and healthcare professionals regarding human milk donation or sharing., Methods: The Joanna Briggs Institute (JBI) meta-aggregative approach to systematic reviews of qualitative studies was adopted. Six databases, MEDLINE, CINAHL, Embase, PsycINFO, Web of Science and Scopus were searched. English written qualitative studies from database inception to February 2024 were included. The JBI Critical Appraisal Checklist for Qualitative Research was used to appraise the collected research evidence., Results: A total of 629 papers were screened, and 41 studies were included in the review. Six key findings were synthesised. (i) Donors, recipients and their families all benefit from milk donation. (ii) Motivation to receive or donate breast milk. (iii) Awareness and participation are affected by formal vs. informal sharing, mothers' personal experiences and external factors. (iv) Concerns about disease transmission, jealousy, bonding and traits. (v) Challenges encountered by donors, recipient mothers, staff and milk banks (vi) Suggestions for promoting human milk donation., Discussion: Stakeholders of human milk donation, including donors, recipient mothers, healthcare professionals, and human milk bank representatives, face various physical, mental and practical challenges. Informal sharing complements formal donations and contributes to improved breastfeeding rates. Advocacy and education efforts are still needed to increase participation and safety levels. The major limitation of the study is the inadequate search on views of immediate family members., Competing Interests: Declaration of Competing Interest No conflicts of interest have been declared by the authors., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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19. Experiences of breast milk donors in Sweden: balancing the motivation to do something good with overcoming the challenges it entails.
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Blomqvist YT and Olsson E
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- Humans, Sweden, Female, Adult, Breast Feeding psychology, Infant, Newborn, COVID-19 psychology, Mothers psychology, Tissue Donors psychology, Young Adult, SARS-CoV-2, Motivation, Milk, Human, Milk Banks, Qualitative Research
- Abstract
Background: Infants requiring neonatal care often face initial breastfeeding challenges, leading them to receive expressed breast milk from their mother or donor milk. While emphasizing the mother's own milk as the gold standard for infant nutrition, the utilization of donor milk stands as the preferred alternative over infant formula due to its numerous benefits. To facilitate the provision of donor milk to preterm and ill infants in neonatal units, the active participation of women willing to contribute their breast milk is crucial. This study aims to enhance the understanding of women's experiences in the donation process, thereby contributing to efforts aiming at alleviating the shortage of donated breast milk by improve the care and support for breast milk donors., Methods: This descriptive qualitative study took an inductive approach based on individual semi-structured interviews conducted during 2021 with 15 breast milk donors in Sweden. The data were analysed with thematic analysis., Results: Two themes were identified in the analysis: motivation to donate and challenges to overcome. Many of the women struggled to overcome the apparent challenges of not only starting the process of donating breast milk but also maintaining it. Despite the strain, they were motivated to donate their breast milk and seeking information by themselves to do something important for someone else. Only a few of the women talked about the financial benefits of donating breast milk; donating seemed to be mostly based on altruistic reasons., Conclusions: Despite the challenges posed by COVID-19 restrictions, time consumption, and the hard work of sterilizing pump utensils, women continued to donate their milk driven by altruism. To enhance donor support and increase milk donation, several improvements are suggested: providing comprehensive information and resources, simplifying the donation process, offering flexible scheduling, and recognizing donors' contributions., (© 2024. The Author(s).)
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- 2024
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20. Adjusted versus Targeted Fortification in Extremely Low Birth Weight Preterm Infants: Fortin Study-A Randomized Clinical Trial.
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Sanchez-Holgado M, Saenz de Pipaon M, Jimenez MC, Crespo Sanchez G, Molero-Luis M, Montes MT, Segovia C, Losantos-García I, Jimenez-Gonzalez M, Escribano E, and Cabrera-Lafuente M
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- Humans, Infant, Newborn, Female, Male, Infant Nutritional Physiological Phenomena, Dietary Proteins administration & dosage, Blood Urea Nitrogen, Spain, Birth Weight, Infant, Extremely Low Birth Weight growth & development, Food, Fortified, Weight Gain, Milk, Human, Infant, Premature growth & development
- Abstract
Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight of <1000 g exclusively fed with human milk. A total of 38 patients were enrolled, 15 of them randomized to AF group and 23 to TF group. AF was based on blood urea nitrogen (BUN) concentration and TF on human milk analysis. The primary outcome was weight gain velocity (g/kg/day). No significant differences were found in weight gain velocity at 28 days, at 36 weeks of postmenstrual age, at discharge, nor during the intervention. Protein intake was significantly higher in the AF group (5.02 g/kg/day vs. 4.48 g/kg/day, p = 0.001). No differences were found in the lipid, carbohydrate, and energy intake; in the weight z score change between the different time points; nor in the length and head circumference growth. Both AF and TF are comparable methods of fortification and provide the appropriate growth rate in ELBW infants.
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- 2024
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21. Maternal Breast Growth and Body Mass Index Are Associated with Low Milk Production in Women.
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Jin X, Lai CT, Perrella SL, McEachran JL, Gridneva Z, and Geddes DT
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- Humans, Female, Adult, Pregnancy, Western Australia epidemiology, Breast Feeding, Maternal Age, Obesity, Risk Factors, Young Adult, Body Mass Index, Lactation physiology, Breast growth & development, Milk, Human
- Abstract
Background: Maternal breast volume is determined by the quantity of glandular and adipose tissue, and it undergoes significant changes during pregnancy. These changes are intricately linked to the development of glandular tissue, which most likely reflects lactation capacity. Evidence indicates that women with overweight or obesity exhibit larger breast volume compared to those with a normal body mass index (BMI), emphasizing the close relationship between breast volume and maternal adiposity. Hence, we aim to investigate breast volume growth and maternal BMI as potential risk factors for low milk production., Methods: Lactating women (n = 609) from the Perth metropolitan area in Western Australia between 2011 and 2023 were included in the analysis. Twenty-four-hour milk production measurements were conducted using the test weighing method, and milk removal frequencies were recorded. Mothers completed questionnaires regarding demographic, obstetric and infant details. Linear and logistic regression models were used to determine maternal and infant factors associated with milk production., Results: Here we show that increasing maternal age and BMI are associated with low milk production. Moreover, larger pre-pregnancy breast volume and breast growth are associated with both higher BMI and milk production., Conclusions: Women who are older, have an obese BMI and who have minimal pre-pregnancy breast volume and breast growth should be provided with antenatal screening and breastfeeding support as they are more likely to experience low milk production.
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- 2024
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22. Donor and newborn profiles and their influence on donation volume and duration: a cross-sectional study in a Spanish human milk bank.
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Flores-Rojas K, Gil-Campos M, Lacort-Peralta I, Párraga-Quiles MJ, and Pastor-Villaescusa B
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- Humans, Cross-Sectional Studies, Spain, Female, Infant, Newborn, Adult, Tissue Donors psychology, Young Adult, Pregnancy, Milk Banks, Milk, Human
- Abstract
Background: Human milk banks are essential facilities to provide donated human milk (DHM) to preterm and term infants with health complications. Little is known regarding milk bank donors and how their characteristics may influence the particularities of the donation process. The present study aims to assess characteristics of donors and their newborns to identify associations with the amount of DHM and initiation and donation time, during the first and second year of the milk bank operation in Córdoba, Spain., Methods: This cross-sectional study was conducted in three periods: pre-opening of the milk bank (PRE) including all women who gave birth to a newborn between January - May 2017 and were hospital users; donors in the first year after the opening (Period 1 (P1): April 2019 - March 2020); and in the second year (P2: April 2020 - March 2021). For P1 and P2, DHM data were recorded. The relationships between donor and newborn characteristics and the donation process were examined using univariable and regression models., Results: From 391 women interviewed in the PRE period, 55 (14%) showed intention to donate. In P1 and P2, there were 51 and 25 human milk (HM) donors, respectively. Age, gestational age (GA) and parity were similar between periods. In P2, a higher proportion of donors had higher education (P1: 46%; P2: 70.8%, p = 0.045). Around 40% of donors in both periods were on maternity leave. In P1, donors who had low birth weight infants (< 2500 g) donated more HM than those with infants weighing ≥ 2500 g (p = 0.020). In P2, women whose GA was < 37 weeks donated a higher volume vs. those with ≥ 37 weeks (p = 0.002). Maternity leave was linked to a shorter initiation time for donations in both periods (P1: p = 0.002; P2: p < 0.001)., Conclusions: Data obtained from a Spanish human milk bank indicate that prematurity and low birth weight appear to influence the amounts of DHM. Employment status might be a decisive factor in initiating HM donation. Additional efforts are required to identify shared donor characteristics that influence the initiation and volume of donation., (© 2024. The Author(s).)
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- 2024
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23. Breastfeeding in PKU and Other Amino Acid Metabolism Disorders-A Single Centre Experience.
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Kowalik A, Gudej-Rosa S, Nogalska M, Myszkowska-Ryciak J, and Sykut-Cegielska J
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- Humans, Infant, Newborn, Retrospective Studies, Female, Male, Infant, Amino Acid Metabolism, Inborn Errors, Infant Nutritional Physiological Phenomena, Breast Feeding, Milk, Human, Phenylketonurias diet therapy, Neonatal Screening methods
- Abstract
In addition to the numerous immunological and nutritional benefits that breast milk offers to infants, its proportion in the diet must be limited or even excluded in the case of inborn errors of amino acid metabolism (IEM). The objective of the study was to expand knowledge about breastfeeding and the degree of contribution of breast milk to the feeding of infants with IEM before and after the introduction of expanded newborn screening. A retrospective single-centre study was conducted on 127 infants born between 1997 and 2020: 66 with phenylketonuria (PKU), 45 with other IEM (non-PKU), all diagnosed through newborn screening (NBS), and 16 non-PKU diagnosed through selective screening (SS). The time of initiation of dietary treatment and the proportion of breast milk in the diet, both expressed and breastfed, with or without intake control, were analysed at 1, 3, and 6 months after birth. For 47% of the newborns in Groups 1 and 2, the dietary treatment was started before the 10th day of life; in Group 3, the dietary treatment was started after the 10th day of life for all children. During the first month of life, the proportion of infants receiving breast milk was higher in the NBS-PKU (74%) and the NBS non-PKU (80%) groups, compared with 38% in the SS non-PKU infants. In the subsequent months of life, the proportion of infants receiving human milk (either from the breast or a bottle) declined in all groups. This decline occurred more in bottle-fed rather than directly breast-fed infants. Our observations indicate that the model of feeding from a bottle with expressed milk may have had an adverse effect on maintaining lactation and may have contributed to a faster transition to formula milk. Maintaining lactation and extending the period of feeding the infant with human milk in the first 6 months of life is possible by breastfeeding on demand, under regular biochemical monitoring: preferably weekly in PKU infants, and at least every 2-4 weeks in infants with other IEM.
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- 2024
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24. Prenatal intention to human milk feed in the native Hawaiian population: predictors of any human milk feeding from birth to six months postpartum.
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Murray M, Kai J, Dentinger A, Kaplan L, Roman M, O'Brien E, Kearney J, Kaneshiro B, Zhu F, and Fialkowski MK
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- Adult, Female, Humans, Infant, Infant, Newborn, Pregnancy, Young Adult, Hawaii, Intention, Mothers psychology, Native Hawaiian or Other Pacific Islander psychology, Postpartum Period psychology, Prospective Studies, Surveys and Questionnaires, Breast Feeding psychology, Breast Feeding statistics & numerical data, Milk, Human
- Abstract
Background: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawai'i. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants., Methods: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted., Results: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23)., Conclusion: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH., (© 2024. The Author(s).)
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- 2024
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25. Nutrition and the gut-brain axis in neonatal brain injury and development.
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Perez KM, Strobel KM, Hendrixson DT, Brandon O, Hair AB, Workneh R, Abayneh M, Nangia S, Hoban R, Kolnik S, Rent S, Salas A, Ojha S, and Valentine GC
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- Humans, Infant, Newborn, Brain Injuries physiopathology, Child Development physiology, Brain physiopathology, Neurodevelopmental Disorders etiology, Neurodevelopmental Disorders physiopathology, Female, Infant, Premature, Milk, Human, Gastrointestinal Microbiome physiology, Infant Nutritional Physiological Phenomena physiology, Brain-Gut Axis physiology
- Abstract
Early nutritional exposures, including during embryogenesis and the immediate postnatal period, affect offspring outcomes in both the short- and long-term. Alterations of these modifiable exposures shape the developing gut microbiome, intestinal development, and even neurodevelopmental outcomes. A gut-brain axis exists, and it is intricately connected to early life feeding and nutritional exposures. Here, we seek to discuss the (1) origins of the gut-brain access and relationship with neurodevelopment, (2) components of human milk (HM) beyond nutrition and their role in the developing newborn, and (3) clinical application of nutritional practices, including fluid management and feeding on the development of the gut-brain axis, and long-term neurodevelopmental outcomes. We conclude with a discussion on future directions and unanswered questions that are critical to provide further understanding and insight into how clinicians and healthcare providers can optimize early nutritional practices to ensure children not only survive, but thrive, free of neurodevelopmental impairment., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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26. Nonpharmacological Interventions to Mitigate Procedural Pain in the NICU: An Integrative Review.
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Sutton R and Lemermeyer G
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- Humans, Infant, Newborn, Infant, Premature, Kangaroo-Mother Care Method methods, Facilitated Tucking methods, Pacifiers, Milk, Human, Sucrose therapeutic use, Sucrose administration & dosage, Intensive Care Units, Neonatal, Pain, Procedural prevention & control, Pain Management methods
- Abstract
Background: Small infants experience a myriad of stimuli while in the Neonatal Intensive Care Unit (NICU), with many being painful or stressful experiences, although medically necessary., Purpose: To determine what is known about nonpharmacological developmental care interventions used in the NICU to mitigate procedural pain of infants born under 32 weeks gestation., Search/strategy: Five electronic databases were searched: Medline, CINAHL, Scopus, Embase and the Cochrane Library. The inclusion criteria were as follows: experimental and nonexperimental studies from all publication years with infants born at less than 32 weeks gestational age; peer-reviewed research articles studying nonpharmacological interventions such as skin-to-skin care, facilitated tucking, nonnutritive sucking, hand hugs, and swaddling; and English language articles. Our search yielded 1435 articles. After the elimination of 736 duplicates, a further 570 were deemed irrelevant based on their abstract/titles. Then, 124 full-text articles were analyzed with our inclusion and exclusion criteria., Findings: Twenty-seven studies were reviewed. Sucrose, facilitated tucking, pacifier, skin-to-skin care, and human milk appeared to lessen pain experienced during heel sticks, suctioning, nasogastric tube insertions, and echocardiograms. All nonpharmacological interventions failed to prove efficacious to adequately manage pain during retinopathy of prematurity (ROP) examinations., Implications for Practice: Evidence review demonstrates that healthcare practitioners should use nonpharmacological measures to help prevent pain from day-to-day procedures in the NICU including heel sticks, nasogastric tube insertions, suctioning, echocardiograms, and subcutaneous injections., Implications for Research: Future research is necessary to better understand and measure how pain is manifested by very small premature infants. Specific research on mitigating the pain of examinations for retinopathy of prematurity is also needed., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 by The National Association of Neonatal Nurses.)
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- 2024
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27. Supporting Direct Breastfeeding for a Tracheostomy-Dependent Extremely Premature Infant: A Case Study.
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Lakoff A, Beckford J, Charbonneau C, Lepine S, and Lawrence SL
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- Humans, Infant, Newborn, Female, Bronchopulmonary Dysplasia therapy, Male, Milk, Human, Breast Feeding methods, Tracheostomy methods, Infant, Extremely Premature
- Abstract
Introduction: The benefits of human milk for preterm infants are well documented. Complex medical conditions can limit the extremely premature infant's ability to breastfeed and to receive human milk directly, yet these vulnerable infants may benefit most from receiving it., Main Issue: Extremely preterm infants are at risk for infections, digestive challenges, and chronic lung disease, and occasionally require a tracheostomy to facilitate weaning from mechanical ventilation. There is a risk of aspiration when orally feeding a child with a tracheostomy. This case study describes a tertiary neonatal team supporting a family's direct breastfeeding goal in an extremely premature infant with a diagnosis of bronchopulmonary dysplasia requiring a tracheostomy., Management: Initially, the infant participant (born at 24 weeks and 3 days of gestation, with a birthweight of 540 g) was gavage fed with human milk. The interdisciplinary team collaborated with the family to guide the infant's feeding goals, providing positive oral stimulation with soothers, oral immune therapy, and frequent skin-to-skin contact to prepare for future oral feeding. Within a month of the tracheotomy procedure, oral feeding was initiated, and direct breastfeeding with the tracheostomy tubing in place was achieved at 50 weeks and 1 day of age as a primary source of nutrition., Conclusion: The open dialogue between the family and healthcare team was the foundation for trialing direct breastfeeding for an extremely premature infant with a tracheostomy. While direct breastfeeding of full-term infants with tracheostomies has been previously described in the literature, this is the first case study of an extremely premature infant with a tracheostomy transitioning to direct breastfeeding., Competing Interests: Disclosures and Conflicts of InterestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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28. Having Enough Milk to Sustain a Lactation Journey: A Call to Action.
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Spatz DL, Rodríguez SÁ, Benjilany S, Finderle B, von Gartzen A, Yates A, and Brumley J
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- Humans, Female, Milk, Human, Infant, Newborn, Pregnancy, Breast Feeding methods, Lactation physiology
- Abstract
The rates of human milk feeding are suboptimal worldwide. Recommendations for healthy, term mother-infant dyads include early breastfeeding initiation, frequent skin-to-skin contact, and frequent breastfeeding. The normal physiology of lactation can be affected by prenatal factors such as diabetes, obesity, and excessive gestational weight gain. Furthermore, birth-related factors such as early-term gestation, stressful labor, unscheduled cesarean birth, and postpartum hemorrhage can additionally disrupt recommended practices such as early initiation of breastfeeding and skin-to-skin contact. Given that the first 2 to 3 days postpartum are critical to achieving timely secretory activation and establishing an adequate volume of milk, a proactive approach to care can include building awareness of risk factors and development of protocols for the effective early initiation of lactation., (Copyright © 2024 AWHONN. Published by Elsevier Inc. All rights reserved.)
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- 2024
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29. Donor human milk treated by high-pressure processing improves the body growth of growth-restricted mice pups.
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Dubernat L, Lefevre A, Marousez L, Tran LC, Van Hul M, de Lamballerie M, Cani PD, Gottrand F, Ley D, and Lesage J
- Subjects
- Animals, Mice, Humans, Female, Lactation, Gastrointestinal Microbiome, Growth Disorders etiology, Weight Gain, Male, Milk Banks, Milk, Human, Pasteurization methods, Hydrostatic Pressure, Animals, Newborn
- Abstract
Introduction: Pasteurized human donor milk (DM) is frequently used for feeding preterm newborns and extrauterine growth-restricted (EUGR) infants. Most human milk banks performed a pasteurization of DM using the standard method of Holder pasteurization (HoP) which consists of heating milk at 62.5°C for 30 min. High hydrostatic pressure (HHP) processing was proposed to be an innovative nonthermal method to pasteurize DM. However, the effect of different modes of DM pasteurization on body growth, intestinal maturation, and microbiota has never been investigated in vivo during the lactation., Objectives: We aimed to study these effects in postnatally growth-restricted (PNGR) mice pups daily supplemented with HoP-DM or HHP-DM., Methods: PNGR was induced by increasing the number of pups per litter (15 pups/mother) at postnatal Day 4 (PND4). From PND8 to PND20, mice pups were supplemented with HoP-DM or HHP-DM. At PND21, the intestinal permeability was measured in vivo, the intestinal mucosal histology, gut microbiota, and short-chain fatty acids (SCFAs) level were analyzed., Results: HHP-DM pups displayed a significantly higher body weight gain than HoP-DM pups during lactation. At PND21, these two types of human milk supplementations did not differentially alter intestinal morphology and permeability, the gene-expression level of several mucosal intestinal markers, gut microbiota, and the caecal SCFAs level., Conclusion: Our data suggest that HHP could be an attractive alternative to HoP and that HHP-DM may ensure a better body growth of preterm and/or EUGR infants., (© 2024 The Author(s). Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
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- 2024
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30. Conceptualizing the Commercialization of Human Milk: A Concept Analysis.
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Rusi HC, Grummer-Strawn L, Perrin MT, Risling T, and Brockway ML
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- Humans, Infant, Newborn, Breast Feeding methods, Commerce methods, Commerce standards, Female, Milk, Human, Milk Banks standards
- Abstract
Background: Donor human milk is recommended when infants are unable to be fed their mother's own milk or require supplementation. For-profit companies use technologies to create human milk products for infants in the neonatal intensive care setting without consistent guidelines and regulatory frameworks in place. This commercialization of human milk is inadequately conceptualized and ill-defined., Research Aims: The aim of this study is to conceptualize and define the commercialization of human milk and discuss the need for policy guidelines and regulations., Method: Using a concept analysis framework, we reviewed the literature on the commercialization of human milk, analyzed the antecedents and potential consequences of the industry, and developed a conceptual definition. The literature review resulted in 13 relevant articles., Results: There has been a surge in the development and availability of human milk products for vulnerable infants developed by for-profit companies. Commercialized human milk can be defined as the packaging and sale of human milk and human milk components for financial gain. Factors contributing to the commercialization of human milk include an increased demand for human milk, and consequences include potential undermining of breastfeeding. The lack of guidelines and regulations raises concerns of equity, ethics, and safety., Conclusion: The industry is rapidly growing, resulting in an urgent need for consistent guidelines and regulatory frameworks. If left unaddressed, there could be potential risks for donor milk banking, the future of breastfeeding, and infant and maternal health., Competing Interests: Disclosures and Conflicts of InterestThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors declare no conflicting interests with respect to the research, authorship, and/or publication of this article. Heather Rusi is a Doctor of Nursing Student at the University of Calgary and is supervised by Meredith Brockway and Tracie Risling. Laurence Grummer-Strawn and Maryanne Perrin are on Ms. Rusi’s supervisory committee. Meredith Brockway holds funding from the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council, and the University of Calgary. Laurence Grummer-Strawn is employed by the World Health Organization. Maryanne Perrin holds funding from the National Institute of Child Health and Human Development. Tracie Risling has no funding to disclose.
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- 2024
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31. Human Milk Feeding and Ultraprocessed Food Intake in Toddlerhood.
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Yisahak SF, Racke CA, Edlund KM, and Keim SA
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- Humans, Infant, Female, Male, Infant, Newborn, Infant, Premature, Breast Feeding, Ohio, Fast Foods adverse effects, Food Handling, Milk, Human, Infant Nutritional Physiological Phenomena
- Abstract
Objective: The objective of the study was to estimate associations between early-life human milk feeding and ultraprocessed food (UPF) intake at two timepoints during toddlerhood among children born at <35 weeks' gestation. Study Design: Children were enrolled in the Omega Tots trial (2012-2017, Ohio) at 10-17 months' corrected age after having discontinued human milk and formula feeding. Caregivers reported children's human milk feeding history at baseline and past month diet through a food frequency questionnaire at baseline and follow-up (180 days later). We used the NOVA classification system to estimate UPF intake. We estimated covariate-adjusted associations between human milk feeding (ever and duration) and UPF intake at baseline and follow-up using linear and logistic regression. Results: Nearly 89% ( n = 295) of 333 toddlers had received human milk but only 4.2% ( n = 14) were fed exclusively human milk to 6 months of age. UPFs represented 37.7 (standard deviation [SD] = 13.2)% and 43.4 (SD = 11.3)% of total calories at the two timepoints. Human milk feeding (exclusive or otherwise) was unassociated with UPF intake in toddlerhood (e.g., months of exclusive human milk feeding with the number of daily servings of UPFs at follow-up: β = -0.09, 95% confidence interval [CI]: -0.26, 0.08). Conclusion: In this sample of toddlers born preterm, any exposure to as well as the duration of human milk feeding was unassociated with UPF intake during the second year of life. These results require replication in larger samples given the small number of children in some human milk feeding categories.
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- 2024
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32. The Added Effect of Music-Assisted Kangaroo Care Applied to Mothers with Premature Babies in the Intensive Care Unit on the Amount of Breast Milk, the Initiation Time of Breastfeeding, and Anxiety Level.
- Author
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Bakır E and Eroglu K
- Subjects
- Humans, Female, Infant, Newborn, Adult, Music Therapy, Milk, Human, Time Factors, Mother-Child Relations, Breast Feeding statistics & numerical data, Breast Feeding psychology, Anxiety, Kangaroo-Mother Care Method, Infant, Premature, Intensive Care Units, Neonatal, Mothers psychology
- Abstract
Background: The aim of this study is to determine the effect of music-assisted kangaroo care, applied to mothers with premature babies in the intensive care unit on the amount of breast milk, the initiation time of breastfeeding, and the level of anxiety. Methods: The study was carried out with mothers whose premature babies were hospitalized in the neonatal intensive care unit. The sample size of the study was 99 mothers. Results: 85.5% of the mothers were aged >35 years, 30.1% were high school graduates, 38.6% had equal income and expenses and 77.1% had a cesarean section. The state and trait anxiety levels of the mothers in the music assisted kangaroo care (MAKC), kangaroo care (KC), and control (C) groups decreased after the first day according to the follow-up times. The trait anxiety levels of the mothers in the MAKC group experienced on the first and sixth days were lower than those of the mothers in the KC and C groups, with the statistically significant differences ( p < 0.05). It was found that the mothers in the MAKC group started breastfeeding earlier than those in the KC and C groups, and the difference was statistically significant ( p < 0.05). Conclusion: A significant difference was found between the MAKC and KC groups and the control group in terms of an increase in the amount of milk, a decrease in trait anxiety levels, and early initiation of breastfeeding ( p < 0.05).
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- 2024
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33. Physiology of Human Lactation and Strategies to Support Milk Supply for Breastfeeding.
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Pados BF and Camp L
- Subjects
- Humans, Female, Infant, Newborn, Milk, Human, Breast Feeding methods, Lactation physiology
- Abstract
Despite advances across the globe in breastfeeding initiation rates, many families continue to report they are not meeting their breastfeeding goals. Concerns about milk supply, infant nutritional intake, and infant weight gain are among the most commonly cited reasons for early breastfeeding cessation. Nurses working with individuals during the perinatal period are uniquely positioned to educate families and offer evidence-based interventions to promote optimal milk supply, infant growth, and maternal mental and physical health. Such interventions include early and frequent skin-to-skin care, emptying of the breast, and professional lactation support. By implementing such evidence-based practices in the first hours after birth and connecting families to lactation support in the first 14 days, nurses can begin to help families achieve their breastfeeding goals., (Copyright © 2024 AWHONN. Published by Elsevier Inc. All rights reserved.)
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- 2024
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34. Factors Affecting Mother's Own Milk (MOM) Usage in the NICU - A Cross-sectional Study.
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Reddy VN, Murugesan A, and Adhisivam B
- Subjects
- Humans, Cross-Sectional Studies, Infant, Newborn, Female, Breast Feeding, Adult, Intensive Care Units, Neonatal, Milk, Human, Mothers psychology
- Published
- 2024
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35. Evaluation puramatrix as a 3D microenvironment for neural differentiation of human breastmilk stem cells.
- Author
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Goudarzi N, Shabani R, Moradi F, Ebrahimi M, Katebi M, Jafari A, Mehdinejadiani S, Vahabzade G, and Soleimani M
- Subjects
- Humans, Cells, Cultured, Tissue Scaffolds, Neural Stem Cells physiology, Neurons cytology, Neurons physiology, Neurons metabolism, Hydrogels, Cell Survival physiology, Glial Fibrillary Acidic Protein metabolism, Female, Microtubule-Associated Proteins metabolism, Stem Cells physiology, Stem Cells cytology, Tissue Engineering methods, Tubulin metabolism, Cell Culture Techniques methods, Extracellular Matrix metabolism, Nerve Tissue Proteins metabolism, Neurogenesis physiology, Peptides, Antigens, Nuclear, Cell Differentiation physiology, Milk, Human
- Abstract
The extracellular matrix is recognized as an efficient and determining component in the growth, proliferation, and differentiation of cells due to its ability to perceive and respond to environmental signals. Applying three-dimensional scaffolds can create conditions similar to the extracellular matrix and provide an opportunity to investigate cell fate. In this study, we employed the PuraMatrix hydrogel scaffold as an advanced cell culture platform for the neural differentiation of stem cells derived from human breastmilk to design an opportune model for tissue engineering. Isolated stem cells from breastmilk were cultured and differentiated into neural-like cells on PuraMatrix peptide hydrogel and in the two-dimensional system. The compatibility of breastmilk-derived stem cells with PuraMatrix and cell viability was evaluated by scanning electron microscopy and MTT assay, respectively. Induction of differentiation was achieved by exposing cells to the neurogenic medium. After 21 days of the initial differentiation process, the expression levels of glial fibrillary acidic protein (GFAP), microtubule-associated protein (MAP2), β-tubulin III, and neuronal nuclear antigen (NeuN) were analyzed using the immunostaining technique. The results illustrated a notable expression of MAP2, β-tubulin-III, and NeuN in the three-dimensional cell culture in comparison to the two-dimensional system, indicating the beneficial effect of PuraMatrix scaffolds in the process of differentiating breastmilk-derived stem cells into neural-like cells. In view of the obtained results, the combination of breastmilk-derived stem cells and PuraMatrix hydrogel scaffold could be an advisable preference for neural tissue regeneration and cell therapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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36. A simple step to improve fat and energy delivery of human milk delivered via bottle-feeding pump: An experimental study.
- Author
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Irwin C, Beard K, Martin L, Kua KL, and Huff K
- Subjects
- Humans, Infant, Newborn, Infant Nutritional Physiological Phenomena, Dietary Proteins administration & dosage, Dietary Proteins analysis, Nutrients analysis, Female, Milk, Human, Dietary Fats administration & dosage, Dietary Fats analysis, Enteral Nutrition methods, Enteral Nutrition instrumentation, Energy Intake, Bottle Feeding
- Abstract
Background: Enteral feeding pump systems deliver decreased amounts of macronutrients in human milk to neonates. This study determined the macronutrient loss associated with a bottle-feeding pump system and the effect of manually mixing the human milk during extended feeds., Methods: Macronutrient content from samples of donor human milk was analyzed after simulated extended feeds with a bottle-feeding pump system, using a human milk analyzer. Simulations were repeated using manual mixing of the bottle every 30 min during feeding. The percentage of the baseline was calculated, and one-sample t tests and analysis of variance compared the effect of manual mixing and the duration of feeding on macronutrient delivery., Results: The delivery of fat and energy was lower over time, but manual mixing considerably improved retention. The length of feeding impacted fat delivery, with less fat delivered over time (P < 0.001). Manually mixing significantly increased fat delivery (P < 0.001). Similar results were found for energy, with a significant reduction in energy delivery over time (P < 0.001) and significantly more energy delivered with mixing (P < 0.001). Mixing and the duration of feeding had minimal effect on protein or carbohydrate delivery., Conclusions: Bottle-feeding pump systems are associated with a significant reduction in the delivery of fat and energy of donor human milk. The manual mixing of donor human milk during prolonged feeds is a simple way to improve fat and energy delivery to the neonate., (© 2024 The Author(s). Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.)
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- 2024
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37. Kangaroo mother care enhances exclusive breastmilk feeding and shortens time to achieve full enteral feeding in extremely preterm infants requiring non-invasive assisted ventilation.
- Author
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Li J, Wang H, Yang J, Chen X, Cao A, Yang C, and Xiong X
- Subjects
- Humans, Retrospective Studies, Infant, Newborn, Female, Male, Noninvasive Ventilation, Milk, Human, Time Factors, Enteral Nutrition, Infant, Extremely Premature, Kangaroo-Mother Care Method, Breast Feeding
- Abstract
Background: Extremely preterm infants (EPIs) frequently encounter challenges in feeding due to their underdeveloped digestive systems. Attaining full enteral feeding at the earliest possible stage can facilitate the removal of vascular catheters and decrease catheter-related complications., Methods: We performed a retrospective cohort study comprising 145 extremely preterm infants with a gestational age < 28 weeks who underwent non-invasive mechanical ventilation at Shenzhen Maternity & Child Healthcare Hospital between January 2019 and June 2020. The KMC group received standard nursing care along with KMC, while the control group received standard nursing care without KMC. KMC initiation took place three weeks after admission and continued for a period of two weeks or more while maintaining stable vital signs. We evaluated the rate of exclusive breastmilk feeding within 24 h prior to discharge and the time to full enteral feeding throughout hospitalization. Additionally, we conducted a multiple linear regression analysis to identify the independent factors associated with exclusive breastmilk feeding rates and the time to full enteral feeding., Results: The KMC group exhibited a significantly higher rate of exclusive breastmilk feeding in the 24 h before discharge in comparison to the Non-KMC group (52.8% vs. 31.5%, OR 2.43; 95% CI 1.24, 4.78). Moreover, the KMC group achieved full enteral feeding in a shorter duration than the Non-KMC group (43.1 ± 9.6 days vs. 48.7 ± 6.9 days, p < 0.001). Multiple linear regression analysis revealed that KMC was an independent protective factor associated with improved exclusive breastmilk feeding rates (OR 2.43; 95% CI 1.24, 4.78) and a reduction in the time to full enteral feeding (β -5.35, p < 0.001) in extremely preterm infants., Conclusion: Kangaroo Mother Care (KMC) can expedite the achievement of full enteral feeding and enhance exclusive breastmilk feeding rates in extremely preterm infants receiving non-invasive assisted ventilation. These findings highlight the beneficial effects of KMC on the feeding outcomes of this vulnerable population, underscoring the importance of implementing KMC as a part of comprehensive care for extremely preterm infants., (© 2024. The Author(s).)
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- 2024
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38. Simulated in vitro infant digestion and lipidomic analysis to explore how the milk fat globule membrane modulates fat digestion.
- Author
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Pan Y, Liu Y, Zhao J, Cui L, Li X, Liu L, Kouame KJE, Wang Z, Tan X, Jiang Y, and Gao C
- Subjects
- Infant, Humans, Glycolipids, Milk, Human, Infant Formula, Lipidomics, Digestion, Glycoproteins, Lipid Droplets
- Abstract
We hypothesized that the addition of milk fat globule membranes (MFGMs) to infant formula would improve its lipolysis, making it more similar to human milk (HM) and superior to commercial infant formula (CIF) in fat digestion. Therefore, we prepared two model infant formulas (MIFs) by adding MFGMs to dairy ingredients in different ways and compared their fat digestion behavior with those of HM and CIF. MFGMs were added alone (MIF1) and with other milk-based materials (MIF2) before homogenization. The addition of MFGMs reduced the flocculation of lipids and proteins in the gastric phase and promoted lipolysis in the intestine phase. The amount of free fatty acids released followed the order of HM > MIF1 > CIF ≥ MIF2. After digestion, the number of different glyceride species between each sample and HM reached 64 (MIF1), 73 (MIF2), 67 (CIF1), and 72 (CIF2). In conclusion, the fat digestion of MIF1 had the highest similarity with HM., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. No conflict of interest exits in the submission of this manuscript, and manuscript is approved by all authors for publication., (Copyright © 2023. Published by Elsevier Ltd.)
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- 2024
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39. Human milk sphingomyelin: Function, metabolism, composition and mimicking.
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Yuan Y, Zhao J, Liu Q, Liu Y, Liu Y, Tian X, Qiao W, Zhao Y, Liu Y, and Chen L
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- Infant, Child, Humans, Diet, Nutritional Status, Infant Nutritional Physiological Phenomena, Sphingomyelins, Milk, Human
- Abstract
Human milk, which contains various nutrients, is the "gold standard" for infant nutrition. Healthy human milk meets all the nutritional needs of early infant development. Polar lipids mainly exist in the milk fat globule membrane, accounting for approximately 1-2% of human milk lipids; sphingomyelin (SM) accounts for approximately 21-24% of polar lipids. SM plays an important role in promoting the development of the brain and nervous system, regulating intestinal flora, and improving skin barriers. Though SM could be synthesized de novo, SM nutrition from dietary is also important for infants. The content and composition of SM in human milk has been reported, however, the molecular mechanisms of nutritional functions of SM for infants required further research. This review summarizes the functional mechanisms, metabolic pathways, and compositional, influencing factors, and mimicking of SM in human milk, and highlights the challenges of improving maternal and infant early/long-term nutrition., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)
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- 2024
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40. Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study.
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Winderlich J, Little B, Oberender F, Bollard T, Farrell T, Jenkins S, Landorf E, McCall A, Menzies J, O'Brien K, Rowe C, Sim K, van der Wilk M, Woodgate J, Paul E, Udy AA, and Ridley EJ
- Abstract
Background: Children who are critically ill are often reliant on enteral and oral nutrition support. However, there is limited evidence to guide "what" to prescribe, and current practice is unknown. The primary objective of this study was to describe enteral nutrition prescription in children ≤2 years of age in the pediatric intensive care unit (PICU). The secondary objectives were to describe oral nutrition support practices and factors associated with the use of increased energy and protein density nutrition support., Methods: Children ≤2 years of age admitted to participating PICUs over a 2-week period in June 2021 were enrolled. Data were collected on PICU admission days 1 to 7, 14, 21, and 28 on the mode of nutrition, enteral and oral nutrition support prescription, and dietitian intervention., Results: Eighty-four children were included (49 [58%] male; 79 [94%] ≤1 year of age). Enteral nutrition was administered to 79 (94%) children (with expressed breast milk in 45 [57%]). Forty-three children received formula as enteral nutrition. Increased energy and protein density formulas were provided to 14 (33%) children enterally, with concentrated standard infant formula powder being the most common (5 [12%]). Among children offered oral intake (22; 26%), three (14%) received oral nutrition support. Children who received increased energy and protein density enteral nutrition were more likely to receive dietitian intervention (P = 0.002)., Conclusion: In children ≤2 years of age admitted to PICU, expressed breast milk was provided to half of those requiring enteral nutrition and oral nutrition support prescription was infrequent. One third of children receiving formula via enteral nutrition received an increased energy and protein density feed, and this was strongly associated with dietitian intervention., (© 2024 The Author(s). Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.)
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- 2024
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41. Cost analysis of establishing and operating the first human milk bank at Da Nang Hospital for Women and Children in Vietnam: an activity-based costing ingredients study.
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Hoang MV, Nguyen TT, Tran AT, Luu TQ, Vu MQ, Tran HT, Nguyen OTX, and Mathisen R
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- Humans, Vietnam, Female, Infant, Newborn, Infant, Breast Feeding economics, Milk Banks economics, Costs and Cost Analysis, Milk, Human
- Abstract
Background: Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam., Methods: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation., Results: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021., Conclusion: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs., (© 2024. The Author(s).)
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- 2024
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42. Role of breastfeeding in disease prevention.
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Masi AC and Stewart CJ
- Subjects
- Humans, Infant, Milk, Human, Female, Infant, Newborn, Breast Feeding
- Abstract
Human milk provides the infant with many bioactive factors, including immunomodulating components, antimicrobials and prebiotics, which modulate the infant microbiome and immune system maturation. As a result, breastfeeding can impact infant health from infancy, through adolescence, and into adulthood. From protecting the infant from infections, to reducing the risk of obesity, type 1 diabetes and childhood leukaemia, many positive health outcomes are observed in infants receiving breastmilk. For the mother, breastfeeding protects against postpartum bleeding and depression, increases weight loss, and long-term lowers the risk of type 2 diabetes, breast and ovarian cancer, and cardiovascular diseases. Beyond infants and mothers, the wider society is also impacted because of avoidable costs relating to morbidity and mortality derived from a lack of human milk exposure. In this review, Medline was used to search for relevant articles to discuss the health benefits of breastfeeding and its societal impact before exploring future recommendations to enhance our understanding of the mechanisms behind breastfeeding's positive effects and promote breastfeeding on a global scale., (© 2024 The Author(s). Microbial Biotechnology published by John Wiley & Sons Ltd.)
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- 2024
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43. Use of Donor Human Milk in Populations Other than Preterm Very Low Birthweight Infants: Where Are We Now?
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Parker LA
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- Humans, Infant, Newborn, Infant, Very Low Birth Weight, Infant, Premature physiology, Female, Milk, Human, Milk Banks
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- 2024
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44. Breastfeeding Barriers for Preterm Infants in Neonatal Intensive Care Unit Environments: A Systematic Assessment and Meta-Analysis.
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Liu C, Pan M, Lu X, Gao Y, Xu J, and Chen X
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- Humans, Infant, Newborn, Female, Milk, Human, Breast Feeding statistics & numerical data, Intensive Care Units, Neonatal, Infant, Premature, Mothers statistics & numerical data
- Abstract
Background: Breast milk is vital for the growth and development of preterm infants. However, in Neonatal Intensive Care Units (NICUs), mothers often encounter significant challenges in breastfeeding. Objective: This study aims to systematically evaluate the barriers to breastfeeding in NICUs, thereby providing evidence-based support for clinical practices. Methods: A comprehensive search was conducted in the Cochrane Library, PubMed, Web of Science, Embase, and Scopus databases, up to September 2023. Meta-analysis was performed using Stata 15.0, applying fixed or random effects models to calculate odds ratios (OR) and their 95% confidence intervals (CI). Study quality was assessed using the Newcastle-Ottawa Scale for cases and cohorts and the Agency for Healthcare Research and Quality standards for cross-sectional studies. Heterogeneity was evaluated using Cochran's chi-squared test (Cochran's Q) and I
2 statistics, and publication bias was assessed through funnel plots and symmetry tests. Results: A total of 32 studies were included, encompassing 96,053 preterm infants. The main barriers to breastfeeding in preterm infants included: low gestational age (OR = 1.36, 95% CI: 1.06-1.75), lower maternal education (OR = 1.64, 95% CI: 1.39-1.93), insufficient breast milk (OR = 2.09, 95% CI: 1.39-1.93), multiple births (OR = 1.615, 95% CI: 1.18-2.210), smoking (OR = 2.906, 95% CI: 2.239-3.771), and single motherhood (OR = 1.439, 95% CI: 1.251-1.654). Conclusion: This study underscores the need for individualized breastfeeding support strategies in NICUs, taking into account the diverse backgrounds of mothers. Future research should focus on unraveling the underlying mechanisms affecting breastfeeding in preterm infants, with the goal of enhancing breastfeeding rates and improving developmental outcomes.- Published
- 2024
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45. Donation barriers, enablers, patterns and predictors of milk bank donors in the United States and United Kingdom.
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Dos Santos BG, Shenker N, Weaver G, and Perrin MT
- Subjects
- Humans, United Kingdom, United States, Cross-Sectional Studies, Female, Adult, Surveys and Questionnaires, Young Adult, Male, Mothers statistics & numerical data, Milk Banks statistics & numerical data, Milk, Human, Tissue Donors statistics & numerical data
- Abstract
Pasteurised donor human milk is recommended for very low birthweight infants who do not have access to their mother's milk. Although the use of donor milk continues to increase, little is known about the donation experiences of milk bank donors. We aimed to describe and compare enablers, barriers and patterns of human milk donation and identify factors predicting donation volume in a convenience sample of approved milk bank donors in the United Kingdom and the United States. A cross-sectional online survey was conducted from August 2022 to December 2022. Approved milk bank donors (n = 556) from three milk banks in the United States (n = 369, Mothers' Milk Bank of Florida, Mother's Milk Bank of North Texas and Northwest Mothers Milk Bank) and one milk bank in the United Kingdom (n = 187, Hearts Milk Bank) completed the survey. A substantial portion of donors in both settings reported participating in other forms of milk exchange (51% of U.S. donors vs. 39% of UK donors, p = 0.009). Top donation barriers reported in both settings were completing the serological screening and having enough space to store collected milk. Most donors started donating when their infant was 3 months old or older and reported donating mature milk. The most common source of information related to milk banking in each setting was the internet (United Kingdom-70% vs. United States - 63%, p = 0.112). Variables that predicted lifetime donation volume differed between the United States and the United Kingdom, highlighting the importance of setting-specific milk banking research., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)
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- 2024
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46. Maternal milk in the NICU: An everyday intervention to improve brain development.
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Merhar SL and Miller SP
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- Humans, Infant, Newborn, Child Development, Female, Infant, Premature, Breast Feeding, Milk, Human, Intensive Care Units, Neonatal, Brain growth & development
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- 2024
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47. Effects of Maternal Diet on Infant Health: A Review Based on Entero-Mammary Pathway of Intestinal Microbiota.
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Sun Q, Zhou Q, Ge S, Liu L, Li P, and Gu Q
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- Humans, Female, Infant, Breast Feeding, Maternal Nutritional Physiological Phenomena, Infant, Newborn, Intestines microbiology, Gastrointestinal Microbiome physiology, Milk, Human, Infant Health, Diet
- Abstract
Scope: The microbes in breast milk are critical for the early establishment of infant gut microbiota and have important implications for infant health. Breast milk microbes primarily derive from the migration of maternal intestinal microbiota. This review suggests that the regulation of maternal diet on gut microbiota may be an effective strategy to improve infant health., Methods and Results: This article reviews the impact of breast milk microbiota on infant development and intestinal health. The close relationship between the microbiota in the maternal gut and breast through the entero-mammary pathway is discussed. Based on the effect of diet on gut microbiota, it is proposed that changing the maternal dietary structure is a new strategy for regulating breast milk microbiota and infant intestinal microbiota, which would have a positive impact on infant health., Conclusion: Breast milk microbes have beneficial effects on infant development and regulation of the immune system. The mother's gut and breast can undergo certain bacterial migration through the entero-mammary pathway. Research has shown that intervening in a mother's diet during breastfeeding can affect the composition of the mother's gut microbiota, thereby regulating the microbiota of breast milk and infant intestines, and is closely related to infant health., (© 2024 Wiley‐VCH GmbH.)
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- 2024
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48. Equations to estimate human milk intake in infants aged 7 to 10 months: prediction models from a cross-sectional study.
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Haszard JJ, Heath AM, Taylor RW, Bruckner B, Katiforis I, McLean NH, Cox AM, Brown KJ, Casale M, Jupiterwala R, Diana A, Beck KL, Conlon CA, von Hurst PR, and Daniels L
- Subjects
- Humans, Cross-Sectional Studies, Infant, Female, Male, Breast Feeding, Infant Formula, Diet, Energy Intake, Body Mass Index, Milk, Human, Infant Nutritional Physiological Phenomena
- Abstract
Background: Obtaining valid estimates of nutrient intake in infants is currently limited by the difficulties of accurately measuring human milk intake. Current methods are either unsuitable for large-scale studies (i.e., the gold standard dose-to-mother stable isotope technique) or use set amounts, regardless of known variability in individual intake., Objectives: This cross-sectional study aimed to develop equations to predict human milk intake using simple measures and to carry out external validation of existing methods against the gold standard technique., Methods: Data on human milk intake were obtained using the dose-to-mother stable isotope technique in 157 infants aged 7-10 mo and their mothers. Predictive equations were developed using questionnaire and anthropometric data (Model 1) and additional dietary data (Model 2) using lasso regression. Bland-Altman plots and intraclass correlation coefficients (ICC) also assessed the validity of existing methods (FITS and ALSPAC studies)., Results: The strongest univariate predictors of human milk intake in infants of 8.3 mo on average (46% female) were infant age, infant body mass index (BMI), number of breastfeeds a day, infant formula consumption, and energy from complementary food intake. Mean [95% confidence interval (CI)] differences in predicted versus measured human milk intake [mean (SD): 762 (257) mL/day] were 0.0 mL/day (-26, 26) for Model 1 (ICC 0.74) and 0.5 mL/day (-21, 22) for Model 2 (ICC 0.83). Corresponding differences were -197 mL/day (-233, -161; ICC 0.32) and -175 mL/day (-216, -134; ICC 0.41) for the methods used by FITS and ALSPAC, respectively., Conclusions: The Human Milk Intake Level Calculation provides substantial improvements on existing methods to estimate human milk intake in infants aged 7-10 mo, while utilizing data commonly collected in nutrition surveys. Although further validation in an external sample is recommended, these equations can be used to estimate human milk intake at this age with some confidence. This clinical trial was registered at http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436) as ACTRN12620000459921., Competing Interests: Conflict of interest The authors declare no competing interests., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)
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- 2024
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49. A breast milk production model for achieving exclusive breastfeeding in low-risk primiparas who had vaginal births at 4 months postpartum: A prospective cohort study.
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Takahata K, Horiuchi S, Miyauchi A, Tadokoro Y, and Shuo T
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- Humans, Female, Prospective Studies, Adult, Postpartum Period, Pregnancy, Parity, Milk, Human, Cohort Studies, Breast Feeding
- Abstract
Background: This study aimed to investigate the thresholds of milk production for predicting the achievement of exclusive breastfeeding (EBF) at 4 months postpartum., Methods: The inclusion criteria were singleton, low-risk primiparas, non-cesarean section, and healthy mothers and infants. Temporary feeding of artificial milk in the past was included. Women who could be judged to have intentionally used artificial milk were excluded from the analysis. Measurements of the 24-h milk production by test weights were obtained at early postpartum (days 3-4) and at 1 month postpartum. To predict the achievement of EBF at 4 months postpartum, the area under the receiver operating characteristic (ROC) curve was calculated for early postpartum and 1 month milk production., Results: There were 80 eligible participants analyzed. ROC analysis of milk production for achieving EBF at 4 months revealed an area under the curve (AUC) of 0.736 (95% CI: [0.625, 0.848]) for early postpartum and an AUC of 0.854 (95% CI: [0.772, 0.936]) for 1 month postpartum. The proposed thresholds are 102 g/day (higher sensitivity) and 161 g/day (higher specificity) at early postpartum, and 527 g/day (higher sensitivity) at 1 month postpartum., Conclusions: In low-risk primiparas, the milk production models at early postpartum and 1 month postpartum showed a high accuracy for predicting the achievement of EBF at 4 months postpartum. The present study indicates that even when formula milk is temporarily used, it is still possible to reach the goal of achieving EBF., (© 2024 Japan Academy of Nursing Science.)
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- 2024
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50. The acceptability of a donor human milk bank and donated human milk among mothers in Limpopo Province, South Africa.
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Mampane T and Wolvaardt JE
- Subjects
- Humans, South Africa, Female, Adult, Young Adult, Infant, Newborn, Breast Feeding psychology, Qualitative Research, Tissue Donors psychology, Health Knowledge, Attitudes, Practice, Milk Banks, Milk, Human, Mothers psychology
- Abstract
Breastfeeding is a crucial public health approach that reduces infant morbidity and mortality by providing essential nutrients and antibodies, and breast milk is easily digested. Breastfeeding and donated milk serve as a preventative measure against necrotising enterocolitis. Additionally, they protect against viruses and nosocomial sepsis. When a birthing parent's own milk is unavailable, alternative enteral nutrition for preterm or low-birth-weight infants is either donor human milk (DHM) or artificial formula. This study aimed to understand mothers' acceptance of the donor human milk bank (DHMB) and DHM. A qualitative phenomenological study was conducted in Limpopo Province, South Africa. The study used purposive sampling to select 23 mothers in postnatal and neonatal wards. Data collection was via in-depth interviews using a semistructured interview guide. Manual data analysis using an interpretative phenomenological analysis (IPA) framework was used to coding. Concepts were grouped to generate themes. Three themes and nine subthemes were generated: (1) DHMBs (2) cultural perspective of DHMB, and (3) health considerations of DHM. Participants were unaware of the DHMB. Hesitancy in accepting DHM due to fear of contracting HIV was observed. Cultural beliefs are an influencing factor for use, while donation was driven by altruistic reasons, preventing waste, helping others and having previously benefited from DHM. The study found that mothers are willing to donate human milk. Willingness to donate can be increased by raising awareness about DHMB and addressing culture and safety concerns at antenatal clinics., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)
- Published
- 2024
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- View/download PDF
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