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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.

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. [ABSTRACT FROM AUTHOR]

Human milk reduces risk for necrotizing enterocolitis in preterm infants. Necrotizing enterocolitis occurs in the ileocecal region where thousands of milk protein-derived peptides have been released from digestion. Digestion-released peptides may exert bioactivity, such as antimicrobial and immunomodulatory activities, in the gut. In this study, we applied mass spectrometrybased peptidomics to characterize peptides present in colostrum before and after in vitro digestion. Sequence-based computational modeling was applied to predict peptides with antimicrobial activity. We identified more peptides in undigested samples, yet the abundances were much higher in the digested samples. Heatmapping demonstrated highly different peptide profiles between undigested and digested samples. Four peptides (αS1-casein [157–163], αS1-casein [157–165], β-casein [153–159] and plasminogen [591–597]) were selected, synthesized and tested against common pathogenic bacteria associated with necrotizing enterocolitis. All four exhibited bacteriostatic, though not bactericidal, activities against Klebsiella aerogenes, Citrobacter freundii and Serratia marcescens, but not Escherichia coli. [ABSTRACT FROM AUTHOR]

Summary: Mother’s milk contains diverse bacterial communities, although their impact on microbial colonization in very-low-birth-weight (VLBW,

Introduction: Breast fissure is a disorder during breastfeeding that causes the lack of successful breastfeeding. Considering its high prevalence and due to the anti-inflammatory properties of ostrich oil, this study was conducted with aim to compare the effect of ostrich oil and breast milk on the improvement of breast fissures in lactating primiparous women. Methods: This clinical trial study was conducted on 106 lactating primiparous women in 2022-2023. Mothers were divided into two groups of ostrich oil and breast milk (n=53 in each group). After teaching the correct method of breastfeeding, they continued the treatment 3 times a day for one week. In the intervention group, lactating women covered the nipple and the surrounding area with ostrich oil, and in the control group with their breast milk, for one consecutive week. The intensity of pain and nipple fissure score were recorded by the researcher based on the quality of visual analogue and the result of Store. Data analysis was done using SPSS statistical software (version 25) and independent t-test, paired t-test, chi-square, analysis of variance with repeated data and Fisher's exact tests. P

Lack of breast milk intake in newborns is a serious health problem in Indonesia. Moringa (Moringa oleifera) is a plant rich in nutrients such as protein, vitamins, and minerals, and has been traditionally used to enhance breast milk production. This study aimed to evaluate the effect of moringa pudding on increasing breast milk production in postpartum women. A qualitative research method was employed, conducted in Loa Bakung, Sungai Kunjang District, Samarinda City. Data collection techniques included in-depth interviews, participant observation, and document analysis. The collected data were analyzed using the Miles and Huberman model, which involves data reduction, data presentation, and conclusion drawing. The results indicated that breast milk production increased by 150 cc in the group given Moringa Leaf Pudding. Initially, the milk production was minimal, and after the intervention, there was a notable increase. The minimum milk production observed was 0.00 cc, while the maximum reached 150 cc. This study concludes that Moringa Leaf Pudding can effectively increase breast milk production in postpartum women, suggesting its potential as a beneficial intervention. [ABSTRACT FROM AUTHOR]

Introduction: Breast fissure is a disorder during breastfeeding that causes the lack of successful breastfeeding. Considering its high prevalence and due to the anti-inflammatory properties of ostrich oil, this study was conducted with aim to compare the effect of ostrich oil and breast milk on the improvement of breast fissures in lactating primiparous women. Methods: This clinical trial study was conducted on 106 lactating primiparous women in 2022-2023. Mothers were divided into two groups of ostrich oil and breast milk (n=53 in each group). After teaching the correct method of breastfeeding, they continued the treatment 3 times a day for one week. In the intervention group, lactating women covered the nipple and the surrounding area with ostrich oil, and in the control group with their breast milk, for one consecutive week. The intensity of pain and nipple fissure score were recorded by the researcher based on the quality of visual analogue and the result of Store. Data analysis was done using SPSS statistical software (version 25) and independent t-test, paired t-test, chi-square, analysis of variance with repeated data and Fisher's exact tests. P<0.05 was considered statistically significant. Results: The mean nipple pain before the intervention was not significant in the two groups (p=0.659), but there was a statistically significant difference between the two groups on the 7th and 10th days after delivery (p<0.001). There was a significant difference in the severity of nipple damage before and after the intervention in the two groups (p<0.001); So that the severity of damage in the ostrich oil group was higher before the intervention and less during the 7 days of treatment. Conclusion: Ostrich oil improves breast fissures and reduces nipple pain. [ABSTRACT FROM AUTHOR]

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Human milk, especially mother's milk, is the optimal food for infants. Breastfed children grow and gain weight more appropriately, are less often ill and have better neurological development. The unique composition of human milk, which contains anti-infective and anti-inflammatory factors, along with skin-to-skin contact from direct breastfeeding, promotes optimal growth, protects from environmental risk factors, and promotes the development of the child's innate immune system. Human milk, compared to infant formula, also provides continued protection against acute illnesses in the first years of life. Breastfeeding has been associated with long-term benefits by reducing the risk of several chronic diseases. Extensive research confirms that many acute and chronic paediatric disorders, such as otitis media, acute diarrhoeal diseases, lower respiratory illnesses, sudden infant death syndrome, inflammatory bowel disease, childhood leukaemia, diabetes mellitus, obesity, hypertension, asthma, and atopic dermatitis, occur less frequently among children who were breastfed at an early age. In this review article, some of the benefits of breastfeeding and feeding with breast milk or human milk for the child are discussed.

Abstract Background Ethanol intoxications in newborns are generally due to false preparation of formula with alcoholics or alcohol consumption by the breastfeeding mothers. Rarely, intoxications occur in hospitalized newborns, e.g., from excessive use of alcoholic hand sanitizers. We herein report a strange case of acute ethanol intoxications in our NICU. Case presentation An extremely premature infant (23 0/7 weeks gestational age, birthweight 580 g) suffered from repeated life-threatening events with hemodynamic compromise, apnea, and lactic acidosis while being treated in our neonatal intensive care unit (NICU). Symptomatic treatment with intravenous fluids and, if necessary, intubation and catecholamine therapy led to recovery after several hours each time. The episodes eventually turned out to be severe ethanol intoxications brought about by breast milk contaminated with ethanol. The breast milk was supplied by the infant’s mother, who consumed non-trivial amounts of alcohol to build up her strength and make herself produce more milk, which was recommended to her by a family member. Additionally, she supplemented her own mother’s milk with cow’s milk because she was worried her baby was underserved with her milk. The mother admitted to this in intensive conversations with our team and a professional translator. Conclusions This unique case underlines how different cultural dynamics can attribute to life-threatening events in the care of premature infants. It is important for us to emphasize that intensive communication and building a confident relationship with the parents of patients is essential to the work on NICUs. Child safeguarding issues and possibilities of intoxications have to stay in mind even in a supposedly safe space like the NICU.

Background Mechanisms responsible for associations between intake of mother's milk in very-low-birth-weight (VLBW, <1500 g) infants and later neurodevelopment are poorly understood. It is proposed that early nutrition may affect neurodevelopmental pathways by altering gene expression through epigenetic modification. Variation in DNA methylation (DNAm) at cytosine-guanine dinucleotides (CpGs) is a commonly studied epigenetic modification. Objectives We aimed to assess whether early mother's milk intake by VLBW infants is associated with variations in DNAm at 5.5 y, and whether these variations correlate with neurodevelopmental phenotypes. Methods This cohort study was a 5.5-y follow-up (2016–2018) of VLBW infants born in Ontario, Canada who participated in the Donor Milk for Improved Neurodevelopmental Outcomes trial. We performed an epigenome-wide association study (EWAS) to test whether percentage mother's milk (not including supplemental donor milk) during hospitalization was associated with DNAm in buccal cells during early childhood (n  = 143; mean ± SD age: 5.7 ± 0.2 y; birth weight: 1008 ± 517 g). DNAm was assessed with the Illumina Infinium MethylationEPIC array at 814,583 CpGs. In secondary analyses, we tested associations between top-ranked CpGs and measures of early childhood neurodevelopment, e.g. total surface area of the cerebral cortex (n  = 41, MRI) and Full-Scale IQ (n  = 133, Wechsler Preschool and Primary Scale of Intelligence-IV). Results EWAS analysis demonstrated percentage mother's milk intake by VLBW infants during hospitalization was associated with DNAm at 2 CpGs, cg03744440 [myosin XVB (MYO15B)] and cg00851389 [metallothionein 1A (MT1A)], at 5.5 y (P  < 9E−08). Gene set enrichment analysis indicated that top-ranked CpGs (P  < 0.001) were annotated to genes enriched in neurodevelopmental biological processes. Corroborating these findings, DNAm at several top identified CpGs from the EWAS was associated with cortical surface area and IQ at 5.5 y (P  < 0.05). Conclusions In-hospital percentage mother's milk intake by VLBW infants was associated with variations in DNAm of neurodevelopmental genes at 5.5 y; some of these DNAm variations are associated with brain structure and IQ. This trial was registered at isrctn.com as ISRCTN35317141 and at clinicaltrials.gov as NCT02759809. [ABSTRACT FROM AUTHOR]

Background: Ethanol intoxications in newborns are generally due to false preparation of formula with alcoholics or alcohol consumption by the breastfeeding mothers. Rarely, intoxications occur in hospitalized newborns, e.g., from excessive use of alcoholic hand sanitizers. We herein report a strange case of acute ethanol intoxications in our NICU.Case Presentation: An extremely premature infant (23 0/7 weeks gestational age, birthweight 580 g) suffered from repeated life-threatening events with hemodynamic compromise, apnea, and lactic acidosis while being treated in our neonatal intensive care unit (NICU). Symptomatic treatment with intravenous fluids and, if necessary, intubation and catecholamine therapy led to recovery after several hours each time. The episodes eventually turned out to be severe ethanol intoxications brought about by breast milk contaminated with ethanol. The breast milk was supplied by the infant's mother, who consumed non-trivial amounts of alcohol to build up her strength and make herself produce more milk, which was recommended to her by a family member. Additionally, she supplemented her own mother's milk with cow's milk because she was worried her baby was underserved with her milk. The mother admitted to this in intensive conversations with our team and a professional translator.Conclusions: This unique case underlines how different cultural dynamics can attribute to life-threatening events in the care of premature infants. It is important for us to emphasize that intensive communication and building a confident relationship with the parents of patients is essential to the work on NICUs. Child safeguarding issues and possibilities of intoxications have to stay in mind even in a supposedly safe space like the NICU. [ABSTRACT FROM AUTHOR]

Mother's milk contains diverse bacterial communities, although their impact on microbial colonization in very-low-birth-weight (VLBW, <1,500 g) infants remains unknown. Here, we examine relationships between the microbiota in preterm mother's milk and the VLBW infant gut across initial hospitalization (n = 94 mother-infant dyads, 422 milk-stool pairs). Shared zero-radius operational taxonomic units (zOTUs) between milk-stool pairs account for ∼30%-40% of zOTUs in the VLBW infant's gut. We show dose-response relationships between intakes of several genera from milk and their concentrations in the infant's gut. These relationships and those related to microbial sharing change temporally and are modified by in-hospital feeding practices (especially direct breastfeeding) and maternal-infant antibiotic use. Correlations also exist between milk and stool microbial consortia, suggesting that multiple milk microbes may influence overall gut communities together. These results highlight that the mother's milk microbiota may shape the gut colonization of VLBW infants by delivering specific bacteria and through intricate microbial interactions., Competing Interests: Declaration of interests E.M.C. acknowledges research support from Lallemand Health Solutions and Ocean Spray and consultant fees, speaker, and/or travel support from Danone, Nestlé, and Lallemand Health Solutions. P.M.S. is a stockholder and an advisory board member for Antibe Therapeutics Inc. A.S. is a co-founder of MedBiome, a clinical microbiomics company., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aim: To summarise existing evidence about barriers and enablers to breastfeeding babies with Down syndrome (DS) in peer‐reviewed literature. Methods: Ovid Medline, CINAHL, Scopus and Ovid Emcare were searched. Inclusion and exclusion criteria were used to screen yielded articles and those meeting the criteria were included for data extraction. Two authors extracted data including outcomes, design, definition of DS, barriers and enablers to breastfeeding babies with DS. Results: Sixteen studies met the inclusion and exclusion criteria. Barriers and enablers were categorised into maternal, child and health professional factors. Conclusions: This review identified a significant literature gap related to breastfeeding babies with DS and more definitive research under current standards is needed. Mothers reported the need for high‐quality health professional breastfeeding support and evidence‐based effective breastfeeding techniques. A collaborated and concerted approach from both mothers and health professionals is important to optimise breastfeeding for babies with DS. [ABSTRACT FROM AUTHOR]

As part of the Pre-B Project, a systematic review was conducted to evaluate associations between exclusive maternal milk (≥75%) intake and exclusive formula intake and growth and health outcomes in very-low-birthweight (VLBW) preterm infants. The protocols from the Academy of Nutrition and Dietetics' Evidence Analysis Center and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist were followed. Thirteen observational studies were included; 11 studies reported data that could be synthesized in a pooled analysis. The evidence is very uncertain (very low quality) about the effect of exclusive maternal milk on all outcomes due to observational study designs and risk of selection, performance, detection, and reporting bias in most of the included studies. Very-low-quality evidence suggested that providing VLBW preterm infants with exclusive maternal milk was not associated with mortality, risk of necrotizing enterocolitis, sepsis, or developing bronchopulmonary dysplasia, as compared with exclusive preterm formula, but exclusive maternal milk was associated with a lower risk of retinopathy of prematurity (very low certainty). Results may change when additional studies are conducted. There was no difference in weight, length, and head circumference gain between infants fed fortified exclusive maternal milk and infants receiving exclusive preterm formula; however, weight and length gain were lower in infants fed non-fortified exclusive maternal milk. Given the observational nature of human milk research, cause-and-effect evidence was lacking for VLBW preterm infants.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=86829, PROSPERO ID: CRD42018086829.

Human milk reduces risk for necrotizing enterocolitis in preterm infants. Necrotizing enterocolitis occurs in the ileocecal region where thousands of milk protein-derived peptides have been released from digestion. Digestion-released peptides may exert bioactivity, such as antimicrobial and immunomodulatory activities, in the gut. In this study, we applied mass spectrometry-based peptidomics to characterize peptides present in colostrum before and after in vitro digestion. Sequence-based computational modeling was applied to predict peptides with antimicrobial activity. We identified more peptides in undigested samples, yet the abundances were much higher in the digested samples. Heatmapping demonstrated highly different peptide profiles between undigested and digested samples. Four peptides (α S1 -casein [157-163], α S1 -casein [157-165], β-casein [153-159] and plasminogen [591-597]) were selected, synthesized and tested against common pathogenic bacteria associated with necrotizing enterocolitis. All four exhibited bacteriostatic, though not bactericidal, activities against Klebsiella aerogenes , Citrobacter freundii and Serratia marcescens , but not Escherichia coli .

• Environmental factors in early life have a long-lasting influence on health. • Gut microbiota is seeded by the microbes encountered in the environment. • Colonization of gut microbiota is influenced by maternal commensal bacteria. • Colonization of microbiota early in life can be perturbed by environmental factors. • The gut microbiota can be critical points of action of environmental factors. Environmental factors in early life interact with genetics to exert a long-lasting and broad influence on health and disease. There has been a marked growth in the number of environmental factors studied in association with neurodevelopmental disorders. Colonization of the gut microbiota in the offspring uses the maternal resident flora as a primary source of bacteria during perinatal periods. Several lines of evidence have shown that various environmental factors including the mode of delivery, exposure to antibiotics, infection, stress, diet, quality of breast milk, and type of infant-feeding during the perinatal periods can perturb the gut microbiota colonization in the offspring, finally leading to disturbances in brain development. This study proposes that the gut microbiota seeded primarily by maternal microbiota, and the postnatal colonization of the microbiota in the offspring can be critical action points of environmental factors when deciphering the mechanisms of actions of environmental factors in brain development. This research reviews the inheritance and colonization of the microbiota during early life and the potential actions of the environmental factors influencing brain development in the offspring by modulating the vertical transmission of gut microbiota. [ABSTRACT FROM AUTHOR]

The antibacterial potential of citrus extract, EOs (mediterranean formulation, oregano, lemongrass, cinnamon and clove), organic acids and salts (citric acid, lactic acid and sodium carbonate) was evaluated against E. sakazakii , E. coli O157:H7, S. aureus , L. monocytogenes , S. Typhimurium , B. cereus by determining the minimal inhibitory concentration (MIC). Based on the results, MIC value ranges from 312.5 to 5000 ppm against tested bacterial strains, with citrus extract showing the highest antibacterial activity (312.5 ppm). Four antimicrobial formulations based on quaternary combination of compounds were developed based on the fractional inhibitory concentration (FIC) index. Formulation 1 (Oregano/Mediterranean formulation/Citrus extract/Lactic acid), Formulation 2 (Cinnamon/Lemongrass/Citrus extract/Citric acid), Formulation 3 (Oregano/Mediterranean formulation/Citrus extract/Citric acid), Formulation 4 (Cinnamon/Lemongrass/Citrus extract/Lactic acid) showed a synergistic effect against all tested pathogens. Results demonstrated that bacterial radiosensitivity (1.34–3.99) was increased by the combined treatment of γ-irradiation with developed formulations in frozen mother's milk. Formulation 3 and 4 induced greater radiosensitivity in bacterial strains including sporulated B. cereus (1.90 and 1.89 respectively) compared to formulation 1 and 2. Therefore, the combined treatment can be an effective method to reduce the γ-irradiation dose (kGy) required to eliminate the pathogens and assures the safety of frozen mother's milk. • EOs, citrus extract and organic acids were used against selected foodborne pathogens. • MIC and FIC were determined to develop quaternary combinations of antimicrobials. • All formulations exhibited a synergistic effect against the bacterial strains. • Antimicrobial formulations diminished irradiation required for pathogens. • Higher radiosensitivity was observed for all antimicrobial formulations. [ABSTRACT FROM AUTHOR]

Holder pasteurization (HoP) enhances donor human milk microbiological safety but damages many bioactive milk proteins. Though ultraviolet-C irradiation (UV-C) can enhance safety while better preserving some milk proteins, it has not been optimized for dose or effect on a larger array of bioactive proteins. We determined the minimal UV-C parameters that provide >5-log reductions of relevant bacteria in human milk and how these treatments affect an array of bioactive proteins, vitamin E, and lipid oxidation. Treatment at 6000 and 12 000 J/L of UV-C resulted in >5-log reductions of all vegetative bacteria and bacterial spores, respectively. Both dosages improved retention of immunoglobulin A (IgA), IgG, IgM, lactoferrin, cathepsin D, and elastase and activities of bile-salt-stimulated lipase and lysozyme compared with HoP. These UV-C doses caused minor reductions in α-tocopherol but not γ-tocopherol and no increases in lipid oxidation products. UV-C treatment is a promising approach for donor human milk processing.

The child microbiome, including gut and skin communities, is shaped by a multitude of factors, and breastfeeding is one of the most essential. Food allergy (FA) and atopic dermatitis (AD) are among the most common diseases in pediatrics, with the prevalence of each up to 6% and 20%, respectively. Therefore, we aimed at finding differences between the fecal and skin microbiomes of FA and AD patients in the context of breastfeeding, by means of the Illumina sequencing of 16S rRNA gene fragment libraries amplified from the total DNA isolated from samples collected from allergic and healthy infants. We also analyzed milk samples from the mothers of the examined children and searched for patterns of incidence suggesting milk influence on an infant’s allergy status. Here we show that a mother’s milk influences her child’s fecal and skin microbiomes and identify Acinetobacter as the taxon whose abundance is correlated with milk and child-derived samples. We demonstrate that breastfeeding makes allergic children's fecal and skin communities more similar to those of healthy infants than in the case of formula-feeding. We also identify signature taxa that might be important in maintaining health or allergy development.

Human milk banks (HMBs), established in the early 20th century, aimed to provide safe breast milk for infants with challenges obtaining it. The spread of infections since the 1980s resulted in strict regulations and screening in HMBs, to ensure the safety of donated milk. Several social and personal factors discourage mothers from practicing breastfeeding, making donated milk a viable alternative because of its protective and immunity-enhancing properties. However, psychological barriers can affect the decision to donate or receive donated milk. To identify psychological factors related to donating and receiving human milk from HMBs, we searched PubMed to identify studies reporting psychological factors in donating and receiving milk and excluding studies not reporting psychological factors. The search identified 28 articles meeting the inclusion criteria. Eligible studies from various countries spanned from 1995 to 2023 and focused on psychological factors influencing milk donation and receiving. Most studies were descriptive-qualitative. Factors facilitating or hindering milk donation and reception included perceptions, psychological aspects, and previous experiences. Positive factors for donors included the desire to help other mothers, support from health care professionals, and personal well-being. Negative factors included breast milk exclusivity and discomfort caused by health checks. For recipients, awareness of donated milk benefits was a positive factor, whereas fear regarding safety was negative. The altruistic motivation to help other mothers drove many women to donate. Proper awareness and support from health care professionals and families can help women understand the value of milk donation and support their personal and identity reintegration, especially in cases of the loss of a child., Competing Interests: Declaration of Competing Interest All authors declare no competing interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

This investigation was conducted to evaluate persistent pesticides residues in human breast milk in five govemorates in the middle of Jordan. One hundred and twenty samples of mother's milk were collected from the six regions in 2018 and 2019 to monitor the organochlorine pesticides residues. The samples collected from Amman area contained only p,p -DDE, those from Zarqa and Madaba contained only dieldrin, those from Salt contained p,p'-DDE and p,p'-DDD, those from Deir Alla contained dieldrin and p,p'-DDE and those from south Shounah contained dieldrin, endrin, α-HCH, p,p DDE and p,p -DDD. All analyzed samples did not contain residues of HCB, y-HCH, heptachlor, a-endosulfan, β-endosulfan, o,p'-DDD, o,p'-DDT, o,p -DDE and p,p -DDT. The results of this study compared with the results of previous studies of 2013 and 2014 show slight increase in DDTs, cy-clodiens and HCH residue concentrations. It is recommended to continue studying pesticide residues in human breast milk and other environmental components in Jordan. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the effect of feeding with own mother's milk on the incidence of bronchopulmonary dysplasia (BPD) and other preterm morbidities in very low birth weight (VLBW) infants. Materials and Methods: VLBW infants followed in our unit were divided into three groups according to their predominantly feeding type such as own mother's milk group (MM), preterm formula group (PF) and mix fed group (MxF) in the first postnatal month. Groups were compared regarding demographic and clinical features including BDP. Results: The mean birth week of 117 VLBW infants was 29.3 ± 2.1 weeks and the mean birth weight was 1115 ± 265 g. Seventy seven infants were in the MM group, 17 infants were in the PF group and 23 infants were in the MxF group. There was a significant decrease in BPD incidence in the MM group compared to infants in the PM group (p=0.03). The frequency of necrotizing enterocolitis, late-onset sepsis and severe intraventricular hemorrhage (IVH) were found to decrease in the MM group when compared with other infants. Conclusion: The incidence of BPD decreases in VLBW infants fed with their own mother's milk compared to VLBW infants fed with formula. Also besides feeding with mother's milk may contribute to a decrease in the frequency of severe IVH. [ABSTRACT FROM AUTHOR]

Background: Upon birth, the extremely low birth weight (ELBW) infant experiences an abrupt cessation of amniotic fluid exposure. The ELBW infant's oropharynx is no longer exposed to immunoprotective biofactors, which modulate the immune system and promote maturation of the gastrointestinal tract. Many immune and trophic biofactors are also contained in the mother's own milk, and are especially concentrated in the milk expressed by mothers of ELBW infants; particularly in colostrum. Unfortunately, clinical instability precludes enteral feeding for ELBW infants in the first days of life. Once started, enteral feeds are administered via a nasogastric tube; therefore oropharyngeal exposure to protective milk biofactors cannot occur until the infant begins per oral feeds, with mother's milk; typically at 32 weeks corrected gestational age. The delay, or lack of, oropharyngeal exposure to protective milk biofactors, during the critical first weeks of life for the ELBW infant, may be contributing substantially to prematurity-associated infectious morbidities. Oro-Pharyngeal Therapy with Mother's Own Milk (OPT-MOM)-placing drops of mother's milk onto the infant's oral mucosa to provide early postnatal modulation of the immune system-can serve as a potential substitute for amnioticfluid (biofactor) exposure. Purpose: To describe how OPT-MOM may protect the ELBW infant against prematurity-associated infectious morbidities including Late-Onset Sepsis, necrotizing enterocolitis (NEC), and also Ventilator-Associated Pneumonia. This manuscript will provide neonatal clinicians with the latest evidence to guide clinical practice. Important implications, in terms of patient safety, will also be addressed. [ABSTRACT FROM AUTHOR]

• Synthesis of hexagonal BN and SmNiO@BN nanocomposite by co-precipitation method. • SmNiO nanoparticles supported over BN nanosheets are clearly observed by SEM and TEM. • Broad calibration range from 0.5 to 13,000 µM was observed. • Better sensitivity, high selectivity, low detection limit. • Significant potential for application in real samples like bio-fluids. An effective electrochemical sensor utilizing the superior electrocatalytic activity of SmNiO@BN nanocomposite is presented for the sensitive determination of Acetaminophen. In this study, SmNiO@BN-based nanocomposite was synthesized and characterized by FT-IR, XRD, RAMAN, XPS, SEM, TEM, and AFM analysis to inspect the structural and morphological constitution. TEM image revealed excellent morphology of hexagonal BN and synthesized nanocomposite. The electrochemical behavior of Acetaminophen on the surface of a modified GCE was studied using CV, DPV, and EIS. SmNiO@BN modified GCE has a synergistically catalytic effect for the oxidation of Acetaminophen attributed to its large surface area, more active sites, rapid charge transfer, and abundance of defects. The proposed electrochemical sensing platform for Acetaminophen detection has high selectivity, low LOD (0.43 µM), a wide linear range (0.5–13,000 µM), and a short reaction time. Modified GCE is useful for Acetaminophen detection in the real sample. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Donor human milk banks use Holder pasteurization (HoP; 62.5°C, 30 min) to reduce pathogens in donor human milk, but this process damages some bioactive milk proteins., Objectives: We aimed to determine minimal parameters for high-pressure processing (HPP) to achieve >5-log reductions of relevant bacteria in human milk and how these parameters affect an array of bioactive proteins., Methods: Pooled raw human milk inoculated with relevant pathogens (Enterococcus faecium, Staphylococcus aureus, Listeria monocytogenes, Cronobacter sakazakii) or microbial quality indicators (Bacillus subtilis and Paenibacillus spp. spores) at 7 log CFU/mL was processed at 300-500 MPa at 16-19°C (due to adiabatic heating) for 1-9 min. Surviving microbes were enumerated using standard plate counting methods. For raw milk, and HPP-treated and HoP-treated milk, the immunoreactivity of an array of bioactive proteins was assessed via ELISA and the activity of bile salt-stimulated lipase (BSSL) was determined via a colorimetric substrate assay., Results: Treatment at 500 MPa for 9 min resulted in >5-log reductions of all vegetative bacteria, but <1-log reduction in B. subtilis and Paenibacillus spores. HoP decreased immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G, lactoferrin, elastase and polymeric immunoglobulin receptor (PIGR) concentrations, and BSSL activity. The treatment at 500 MPa for 9 min preserved more IgA, IgM, elastase, lactoferrin, PIGR, and BSSL than HoP. HoP and HPP treatments up to 500 MPa for 9 min caused no losses in osteopontin, lysozyme, α-lactalbumin and vascular endothelial growth factor., Conclusion: Compared with HoP, HPP at 500 MPa for 9 min provides >5-log reduction of tested vegetative neonatal pathogens with improved retention of IgA, IgM, lactoferrin, elastase, PIGR, and BSSL in human milk., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

To determine the breastfeeding problems encountered in the postpartum period and effect of interventions done in relation to the problems based on breastfeeding studies in Turkey. This study is a systematic review and was conducted by performing a scan of the Turkish and English literature over the period October 2016-February 2017. The study included 27 articles and seven theses, which were published in 2000-2015 in Turkey and published in 2008-2017. Data are presented tabulating and the aggregate percentages were calculated for some data showing common characteristics. A total of 6736 parents and 592 babies were included in these studies. As a result of the combined percentage calculation based on the data of cross-sectional and case-control studies, the most frequently reported problems were having breastfeeding problem (24.5%), mother's milk deficiency/worry about milk deficiency/thinking her baby is not satisfied/baby's inadequate weight gain (15.7%), lack of knowledge and experience about breastfeeding/need for education and support (17.8%). Again, these studies showed that women stated the problems about have flat/depressed/small nipple (7.7%), pain/sensitivity (3.9%), swelling/fullness/ engorgement (10.8%), redness (28.8%), crack/wound/ bleeding (26.1%) and mastitis (5.6%). Methods of prenatal education/ counselling/motivation/follow-up, strong motivation, proactive lactation management and social support, moist warm application, using of breast milk and olive oil and using of breast shield and feeding with container and pacifier using have been reported to be effective in the experimental/quasi-experimental and case report studies included in this systematic review. This study showed that women experienced a lot problem with breastfeeding and that more prenatal education/counselling/monitoring was used in reducing problems. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to isolate Lactobacillus bacteria from mother's milk and to assess their probiotic potential. Sixty breast milk samples were collected from the volunteered mothers aged from 19 to 35 and from rural areas of Lorestan and Markazi Provinces, Iran. At first, 970 bacill-shaped bacterial colonies were isolated from these samples and stored in proper condition. Two hundred isolates were randomly selected and investigated for their ability to tolerate acidic condition and to tolerate bile salt as well. Only 33 isolates could withstand the exposure to low pH and bile salt. The isolates were identified using PCR primer specific to Lactobacillus and it was demonstrated that eighteen of thirty-three isolates were belonged to the Lactobacillus . Among the isolates, 16 and 2 of them were Lactobacillus reuteri and L. gasseri , respectively. In addition, the antibiotic resistance of the isolates was determined using disc diffusion method and all of the isolates were shown to be sensitive to eight out of the twelve investigated antibiotics. Moreover, the antagonistic effect of the isolates was inspected on ten indicator pathogens. Interestingly, all of the pathogenic bacteria were inhibited by Lactobacillus isolates. In addition, to partially understand the nature of inhibition mechanism, well diffusion deployed for two randomly-selected indicator bacteria and the resulting halos of three isolates were statistically significant compared to other lactobacillus (p < 0.05). Subsequently, bacteriocin genes ( pln S, La f, gas A) were identified by PCR among the isolates. The results showed that only 2 isolates possessed the gas A gene which were in accordance with well diffusion test. Consequently, eighteen Lactobacillus isolated from breast milk samples which all of them were able to tolerate low pH and bile salt. Similarly, all of the Lactobacillus isolates were proved to inhibit the growth of pathogen strains and two of them possess a bacteriocin-related gene. [ABSTRACT FROM AUTHOR]

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Human milk contains active proteases that initiate hydrolysis of milk proteins within the mammary gland. Milk expressed at the beginning of feeding is known as foremilk and that at the end of feeding is known as hindmilk. As hindmilk contains higher fat, vitamins A and E, and higher calories than foremilk, feeding only hindmilk initially and reserving foremilk for later are practiced in some neonatal intensive care units. This study investigated the difference in peptide profiles, predicted milk protease activities, and bioactive peptides between foremilk and hindmilk. Bioactive peptides are short fragments of proteins that influence biological processes. Four mothers pumped 10 mL of their foremilk and 10 mL of their hindmilk into iced containers prepared with antiproteases and the samples were immediately frozen. The peptide profile of each sample was analyzed by liquid chromatography nano-electrospray ionization Orbitrap Fusion tandem mass spectrometry. Peptide abundance (sum of ion intensities) and count (number of unique peptide sequences) in each milk sample were determined from this analysis. The specific enzymes that participated in peptide release were predicted based on the amino acids positioned at each cleavage site. Peptide bioactivity was predicted based on homology to a known functional peptide database and two bioactivity prediction algorithms. Hindmilk contained a higher count of peptides than foremilk. The higher number of unique peptide sequences in hindmilk was related to hydrolysis of β-casein, osteopontin, αs1-casein and mucin-1 via plasmin and elastase cleavage, and possible aminopeptidase and carboxypeptidase activities. Though hindmilk contained a greater number of peptides than foremilk, the overall peptide abundance did not differ and most of the total peptide abundance derived from peptide sequences that were present in both milk types. The presence of higher numbers of predicted bioactive peptides in the hindmilk could indicate that the practice of providing hindmilk rather than foremilk to premature infants could positively impact health outcomes; however, as there are few differences in overall peptide abundance, the overall effect is likely limited.

Background: Own mother’s milk (OMM) is the optimal nutrition for preterm infants. However, pasteurized donor human milk (DHM) is a valid alternative. We explored the differences of the transcriptome in exfoliated epithelial intestinal cells (EEIC) of preterm infants receiving full feed with OMM or DHM. Methods: The prospective observational study included preterm infants ≤ 32 weeks’ gestation and/or ≤1500 g birthweight. Total RNA from EEIC were processed for genome-wide expression analysis. Results: Principal component analysis and unsupervised hierarchical clustering analysis revealed two clustered groups corresponding to the OMM and DHM groups that showed differences in the gene expression profile in 1629 transcripts. The OMM group overexpressed lactalbumin alpha gene (LALBA), Cytochrome C oxidase subunit I gene (COX1) and caseins kappa gene (CSN3), beta gene (CSN2) and alpha gene (CSN1S1) and underexpressed Neutrophil Cytosolic Factor 1 gene (NCF1) compared to the DHM group. Conclusions: The transcriptomic analysis of EEIC showed that OMM induced a differential expression of specific genes that may contribute to a more efficient response to a pro-oxidant challenge early in the postnatal period when preterm infants are at a higher risk of oxidative stress. The use of OMM should be strongly promoted in preterm infants.

The first 6 months of life is a crucial time in meeting iron needs. The purpose of this review is to examine iron in mother’s milk and whether or not it meets the physiological needs of the growing infant. Key issues include iron content and iron transport from the mammary gland as well as when and what foods should be added to the solely breastfed infant. We examine these topics in light of new molecular biology findings in the mammary gland.

Background: Very preterm infants often receive donor milk from mothers who deliver at term, but its composition differs from that of their own mother's milk. Because breast-milk glucocorticoids can support developing neonates, we explored concentration variability within and between mothers.Objective: We hypothesized that breast-milk glucocorticoid concentrations would be higher after very preterm delivery [gestational age (GA) <32 wk; study 1] and would follow the diurnal rhythm of maternal adrenocortical activity (study 2).Methods: Study 1 assessed differences in milk cortisol, cortisone, and the cortisone-to-(cortisol+cortisone) ratio of mothers who delivered at (median) GA: 28.6 wk or at term weekly during the first month postpartum. Study 2 assessed variations in milk cortisol, cortisone, and the cortisone-to-(cortisol+cortisone) ratio over 24 h, and tested Pearson correlations between milk and salivary concentrations in mothers who delivered at term (median GA: 38.9 wk) during week 4 postpartum. In these studies, foremilk glucocorticoids were measured by liquid chromatography-tandem mass spectrometry. Associations of milk cortisol, milk cortisone, and the milk cortisone-to-(cortisol+cortisone) ratio with prematurity (study 1) or collection time (study 2) were studied with longitudinal data analyses.Results: In study 1, giving birth to a very preterm infant was associated with reductions in milk cortisol and cortisone concentrations of 50% (β: 0.50; 95% CI: 0.26, 0.99; P = 0.05) and 53% (β: 0.53; 95% CI: 0.30, 0.93; P = 0.03), respectively, when adjusted for collection time. In study 2, concentrations of milk cortisol and cortisone were associated with collection time (both P < 0.01), peaking at ∼0700. Milk and salivary concentrations of cortisol (r = 0.92, P < 0.01) and cortisone (r = 0.93, P < 0.01) as well as the cortisone-to-(cortisol+cortisone) ratio (r = 0.64, P < 0.01) were correlated with one another.Conclusions: Breast-milk glucocorticoid concentrations follow the diurnal rhythm of maternal hypothalamus-pituitary-adrenal axis activity and are lower in mothers who deliver very preterm. [ABSTRACT FROM AUTHOR]