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Despite the well-known nutritive, psychological, immunological and economical benefits of breast-feeding, some contraindications exist, such as some mother infectious diseases transmitted through the breastfeeding itself. The risk of transmitting an infectious agent through breast milk seems to be relatively low, except for some virus diseases (CMV HIV), for some invasive bacteria forms (Salmonella typhimurium and Brucella) and for the presence of abscesses and mastitis. In some mother infectious disease, a correct hygiene allows the continuation of breastfeeding without risks for the infant, whereas in other cases it is recommended to breastfeed for the role of defence carried out from specific antibodies contained in the breast milk. Therefore, the decision of interrupting the breastfeeding may be done only after comparing risks and benefits, considering current knowledge on transmission of infectious pathologies.

Aim: An investigation on human milk donors among the milk banks of Tuscany's network was carried out. Milk banks select, collect, check, process, store and deliver human milk, whose donors should have certain physical and psychological well-being features. The aim of the study was to describe a personal and social profile of milk donors., Methods: The study included a sample of 100 milk donors and a sample of 100 non-milk donor mothers; a questionnaire that collected data about mothers' general information, clinical history, pregnancy and delivery, weight variations, state of health, lifestyle, breastfeeding and knowledge about milk banks was administered to all of them. Then information about food history of mothers has also been collected., Results: First the samples of donors were analysed for all variables considered. Subsequently the samples of donors were compared with the samples of non-donors: statistical analysis was carried out with χ2 test and documented significant differences between donors and non-donors for the majority of variables considered in the questionnaire and for food history., Conclusion: Milk donors have a good state of health, and the integration in milk donation initiative headed towards a healthier lifestyle. It is necessary to promote an advertising campaign to integrate social and sanitary politics, fitting to local socio-economical contest. Furthermore, the improvement of milk banks of public hospitals is necessary, as hospitals are places of major stream both of potential donors and newborns.

Scientific knowledge has demonstrated that breastfeeding is the ideal method of feeding and nurturing infants and has recognised breastfeeding as primary in achieving optimal infant health, growth and development. Human milk is species-specific and offers a superior method of feeding. All other options differ markedly from it. Milk formulas are designed to mimic human milk as much as possible, but important compositional differences between human milk and formulas remain, and it is unlikely that this situation will change very soon, if ever. Thus, the breastfed infant remains the reference model against which all alternative feeding methods are measured, with regard to health, growth and development. Human milk has a dynamic nature and varies with time postpartum, but the variations of its composition with time of lactation match the changing needs of the growing infant. The role of the pediatrician is essential in promoting, protecting and supporting breastfeeding in the hospital, medical schools, individual practices and in the community. The purpose of this review is to describe and provide insight into the nutritional benefits, the contributions to host defence and the social and psychological benefits of maternal-infant bonding obtained by breastfeeding. This paper also summarises other substantial advantages obtained when infants are fed at the breast and describes the rare situations and medical reasons when human milk is not recommended, when alternative options should be considered, or when breastfeeding must be closely monitored. Early identification of those infants fed at the breast who have inadequate intakes is important, also to preserve breastfeeding.

Many factors are involved in infants' health; one of the most important of them may be the kind of early feeding. Recent evidences suggest that breastfeeding, in addition to its well-established beneficial effects during lactation period, provides also beneficial long-term effects, like the protection against infectious and immune-related diseases, a better cognitive development, a decreased risk of metabolic syndrome and of obesity. It has been reported that the early feeding mode affects growth and body composition and it could be considered a critical factor for metabolic development. Human milk is a source of different nutrients and bioactive factors, especially hormones and growth factors like leptin, ghrelin, insulin, insulin-like growth factor (IGF-I) playing a role in food intake regulation, metabolism and body composition. In particular breast milk leptin may provide a physiological explanation for a number of advantages seen in reaching proper growth and energy balance in breast-fed infants compared with formula fed ones. Etiopathogenesis and therapeutic approach in common minor gastrointestinal diseases in infants are important subject of study for pediatricians. Colic, constipation and regurgitation can be considered feeding problems and they might benefit from dietary treatment. Regarding infantile colic, dietary modifications seem to be more suitable than pharmacological treatment in resolving symptoms; also prebiotics and probiotics are useful for this aim. The occurence of constipation is related to the kind of feeding and it is lower in breastfed infants. Moreover formulas with probiotics and beta-palmitic acid could promote a regression of symptoms. A dietary approach may be useful also in regurgitation. Anyway we have to remember that breastfeeding require a supplementation of vitamin D and K for some months and a correct weaning program is needed from the 5th-6th months of life to prevent iron deficiency.

In recent years the efforts of companies manufacturing cow milk (CM) formulas have led to the development and availability of special formulas, which have dramatically reduced the morbidity of infants with food allergy (FA). However, the safety of several infants and children with food allergy is put to a severe test by transgenic foods, pesticides, and dioxin entering the scenario, also provoking breast milk contamination. Regarding transgenic foods, it is significant the attitude taken against people attempting to call them Frankenstein food, whereas pesticides and dioxin present in dietary foods for infants and young children, after a first arising of alarmed and inflamed controversies, have almost fallen into oblivion. Several of these substances are able to trigger immune alterations. Recent reports have shown that pears can contain pesticides in 54% of cases, a finding which obliges us to review elimination diets devised for allergic babies. However, these foods are far from being ideal both from the nutritional adequacy and hypoallergenicity; moreover, passive smoke is now a genetic factor. We would like to stress, according to the Latin wisdom that stands on the portal of our Clinic in puero homo, which means. In infant is the seed of the future man, that our goal is not only to reduce morbidity and mortality, but mainly to insure the best quality of life both to infants and adults.

Authors have studied, in high risk for atopy newborns, with a follow-up of two years, the effect of feeding whey hydrolysate, evaluating the incidence of atopic manifestations, the growth pattern and different biochemical nutritional parameters, comparing the results to those observed in breast fed newborns. No significative differences have been shown suggesting that whey protein hydrolysate could be a good alternative to breast milk, when this is not available.