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Sinkiewicz-Darol E, Martysiak-Żurowska D, Puta M, Adamczyk I, Barbarska O, Wesołowska A, Bernatowicz-Łojko U. Nutrients and Bioactive Components of Human Milk After One Year of Lactation: Implication for Human Milk Banks. J Pediatr Gastroenterol Nutr 2022; 74:284-291. [PMID: 34520401 DOI: 10.1097/mpg.0000000000003298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Specifying the nutrient content and bioactive compounds in milk from long-term lactation for the purpose of finding additional sources of donors' milk for human milk banks. METHOD Human milk samples were collected from 43 mothers of term infants (term infant human milk, TIHM) (3-6 weeks of lactation) and 50 mothers who have breastfed for over a year (long-nursing human milk, LNHM). The milk collection time was 24 hours. The analyses of fat, protein, carbohydrate and energy content were performed with human milk analyzer MIRIS (Miris HMA™ ); lactoferrin and vitamin C content using high performance liquid chromatography in reversed phase (RP-HPLC); total antioxidant activity (TAC) and lysozyme by enzyme-linked immunosorbent assay (ELISA); and the activity of glutathione peroxidase (GPx) and catalase (CAT) via spectrophotometric methods. Sociodemographic characteristics of both groups of mothers have been compiled. RESULTS Higher fat content and energy value was found in LNHM than in TIHM. Protein content in LNHM and TIHM did not differ. Carbohydrate content was lower in LNHM than in TIHM. TAC, CAT and GPx activity were higher in LNHM compared to TIHM. No significant differences in the content of lysozyme, lactoferrin and vitamin C between the studied groups were found. CONCLUSIONS The findings suggest that after 12 months of lactation, human milk still has significant nutritional value, does not lose bioactive components and can be considered for use in human milk banks.
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Affiliation(s)
- Elena Sinkiewicz-Darol
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Bydgoszcz
| | - Dorota Martysiak-Żurowska
- Department of Chemistry, Technology and Biotechnology of Food, Chemical Faculty, Gdansk University of Technology, Gdansk
| | - Małgorzata Puta
- Department of Chemistry, Technology and Biotechnology of Food, Chemical Faculty, Gdansk University of Technology, Gdansk
| | - Iwona Adamczyk
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Bydgoszcz
| | - Olga Barbarska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital; Medical University of Warsaw, The Faculty of Health Sciences, Department of Medical Biology, Warsaw
| | - Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital; Medical University of Warsaw, The Faculty of Health Sciences, Department of Medical Biology, Warsaw
| | - Urszula Bernatowicz-Łojko
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinic Hospital in Torun, Torun
- Department of Midwifery, Centre of Postgraduate Medical Education, St. Sophia's Hospital, Warsaw, Poland
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Sheen W, Ahmed M, Patel H, Codipilly CN, Schanler RJ. Is the Antioxidant Capacity of Stored Human Milk Preserved? Breastfeed Med 2021; 16:564-567. [PMID: 33728983 DOI: 10.1089/bfm.2020.0407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: In the neonatal intensive care unit (NICU) expressed mothers' milk usually is stored frozen until used. We found that when human milk was stored at -20°C for up to 9 months there were reduced bacterial counts and pH, increased free fatty acids, but unchanged immune proteins. Antioxidant protection is an important benefit of human milk. Few studies have evaluated long-term effects of cold storage on the antioxidant capacity of human milk. We hypothesized that the antioxidant capacity of human milk is affected adversely by long-term storage at -20°C. Objective: To study the impact of long-term cold storage on the oxidative capacity of human milk and the biological impact of these changes on macromolecular constituents of human milk. Methods: Freshly expressed milk was obtained from mothers in the NICU, stored at -20°C for 6 months, and compared with the baseline. Paired samples were analyzed for glutathione, hydrogen peroxide (H2O2), 8-isoprostane, catalase, and superoxide dismutase. Results: There was no change in H2O2 concentration between baseline and 6 months. Significant reductions from baseline in both catalase and superoxide dismutase concentrations and activities, total glutathione, oxidized glutathione, reduced glutathione, and the ratio of reduced to oxidized glutathione were observed (p < 0.05). There was a significant increase in 8-isoprostane concentrations (p < 0.001). Conclusion: These data indicate significant changes in antioxidant capacity of human milk, including oxidation of macromolecules, after storage at -20°C for 6 months. The clinical implication of these findings may explain the nonuniform protection against oxidant disease in preterm infants fed human milk.
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Affiliation(s)
- Winston Sheen
- Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.,Lilling Family Neonatal Research Lab, Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Mohamed Ahmed
- Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.,Lilling Family Neonatal Research Lab, Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Hardik Patel
- Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.,Lilling Family Neonatal Research Lab, Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Champa N Codipilly
- Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.,Lilling Family Neonatal Research Lab, Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Richard J Schanler
- Neonatal-Perinatal Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.,Lilling Family Neonatal Research Lab, Feinstein Institutes for Medical Research, Manhasset, New York, USA.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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3
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Quitadamo PA, Comegna L, Cristalli P. Anti-Infective, Anti-Inflammatory, and Immunomodulatory Properties of Breast Milk Factors for the Protection of Infants in the Pandemic From COVID-19. Front Public Health 2021; 8:589736. [PMID: 33738273 PMCID: PMC7960784 DOI: 10.3389/fpubh.2020.589736] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
COVID-19 pandemic since the end of 2019 spreads worldwide, counting millions of victims. The viral invasion, systemic inflammation, and consequent organ failure are the gravest features of coronavirus disease 2019 (COVID-19), and they are associated with a high mortality rate. The aim of this study is to evaluate the role of breast milk in the COVID-19 pandemic, analyzing its antiviral, anti-inflammatory, and immunoregulatory effects due to its bioactive components, so numerous and important for the protection of infants. The study tried to demonstrate that all the components of human milk are capable of performing functions on all the pathogenic events recognized and described in COVID-19 disease. Those human milk factors are well-tolerated and practically free of side effects, so breast milk should become a research topic to discover therapies even in this epidemic. In the first part, the mechanisms of protection and defense of the breast milk elements will be delineated; in the second section, it will describe the human milk effects in viral infections and it will be hypothesized how the known mechanisms could act in COVID infection.
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Affiliation(s)
- Pasqua Anna Quitadamo
- NICU “Casa Sollievo della Sofferenza” Foundation, Scientific Research and Care Institute, San Giovanni Rotondo, Italy
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4
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Sánchez-Hernández S, Esteban-Muñoz A, Samaniego-Sánchez C, Giménez-Martínez R, Miralles B, Olalla-Herrera M. Study of the phenolic compound profile and antioxidant activity of human milk from Spanish women at different stages of lactation: A comparison with infant formulas. Food Res Int 2021; 141:110149. [PMID: 33642015 DOI: 10.1016/j.foodres.2021.110149] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
Human milk (HM) has been proven to have important and essential antioxidant properties to counteract infant susceptibility to oxidative stress. Phenolic compounds are secondary metabolites which come from plants and are potent natural antioxidants. The ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method used in the present study allowed the quantification of 26 phenolic compounds (ten hydroxybenzoic acids, seven hydroxycinnamic acids, four flavonoids, three hydroxybenzaldehydes and two other polyphenols) in HM samples at different stages of lactation (colostrum, transitional milk and mature milk) and infant formulas (IF). Many of the phenolic compounds identified have been reported to be present in HM for the first time. The total phenolic compound content (TPC) was quantified using the Folin assay and the antioxidant activity (AC) was evaluated with the DPPH, ABTS and FRAP assays. Significant differences were evidenced between HM and IF. HM from mothers with an adherence to a Mediterranean diet contained twice as many individual phenolic compounds as infant formulas, with a higher proportion of hydroxybenzoic acids. Conversely, IF showed a higher proportion of hydroxycinnamic acids. Overall, the antioxidant activity of HM showed small variations during lactation.
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Affiliation(s)
- Silvia Sánchez-Hernández
- Departament of Nutrition and Bromatology, University of Granada, Campus de Cartuja, s.n., 18071 Granada, Spain; Ph.D. Programme in Nutrition and Food Science, University of Granada, Spain
| | - Adelaida Esteban-Muñoz
- Departament of Nutrition and Bromatology, University of Granada, Campus de Cartuja, s.n., 18071 Granada, Spain; Ph.D. Programme in Nutrition and Food Science, University of Granada, Spain.
| | - Cristina Samaniego-Sánchez
- Departament of Nutrition and Bromatology, University of Granada, Campus de Cartuja, s.n., 18071 Granada, Spain
| | - Rafael Giménez-Martínez
- Departament of Nutrition and Bromatology, University of Granada, Campus de Cartuja, s.n., 18071 Granada, Spain; Institute of Biosanitary Research ibs. University of Granada, Av. del Conocimiento, s/n., 18016 Granada, Spain
| | - Beatriz Miralles
- Institute of Food Science Research (CIAL), CSIC.UAM, Calle Nicolás Cabrera, 9, 28049 Madrid, Spain
| | - Manuel Olalla-Herrera
- Departament of Nutrition and Bromatology, University of Granada, Campus de Cartuja, s.n., 18071 Granada, Spain; Institute of Biosanitary Research ibs. University of Granada, Av. del Conocimiento, s/n., 18016 Granada, Spain
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5
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Quinn EA. Centering human milk composition as normal human biological variation. Am J Hum Biol 2021; 33:e23564. [DOI: 10.1002/ajhb.23564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/25/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Elizabeth A. Quinn
- Department of Anthropology Washington University in St. Louis Saint Louis Missouri USA
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6
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González-González JN, Vallejo-Cordoba B, González-Córdova AF, Beltrán-Barrientos LM, García HS, Hernández-Mendoza A. Effect of the intracellular content from Lactobacillus casei CRL-431 on the antioxidant properties of breast milk: Randomized double-blind controlled trial. Lebensm Wiss Technol 2020. [DOI: 10.1016/j.lwt.2020.109672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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A Review of Bioactive Factors in Human Breastmilk: A Focus on Prematurity. Nutrients 2019; 11:nu11061307. [PMID: 31185620 PMCID: PMC6628333 DOI: 10.3390/nu11061307] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 12/20/2022] Open
Abstract
Preterm birth is an increasing worldwide problem. Prematurity is the second most common cause of death in children under 5 years of age. It is associated with a higher risk of several pathologies in the perinatal period and adulthood. Maternal milk, a complex fluid with several bioactive factors, is the best option for the newborn. Its dynamic composition is influenced by diverse factors such as maternal age, lactation period, and health status. The aim of the present review is to summarize the current knowledge regarding some bioactive factors present in breastmilk, namely antioxidants, growth factors, adipokines, and cytokines, paying specific attention to prematurity. The revised literature reveals that the highest levels of these bioactive factors are found in the colostrum and they decrease along the lactation period; bioactive factors are found in higher levels in preterm as compared to full-term milk, they are lacking in formula milk, and decreased in donated milk. However, there are still some gaps and inconclusive data, and further research in this field is needed. Given the fact that many preterm mothers are unable to complete breastfeeding, new information could be important to develop infant supplements that best match preterm human milk.
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Sun H, Han S, Cheng R, Hei M, Kakulas F, Lee SK. Testing the feasibility and safety of feeding preterm infants fresh mother's own milk in the NICU: A pilot study. Sci Rep 2019; 9:941. [PMID: 30700726 PMCID: PMC6353969 DOI: 10.1038/s41598-018-37111-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022] Open
Abstract
Necrotizing enterocolitis (NEC) is the leading cause of death among infants born at <30 weeks’ gestation, but donor human milk can reduce the incidence of NEC. Unfortunately, freezing or pasteurizing human milk deactivates beneficial bioactive components. We evaluated the feasibility, safety, and impact of feeding very preterm infants fresh (unprocessed) mother’s own milk within 4 hours of expression. In our multicentre prospective cohort analytic study, we fed 109 control and 98 intervention infants previously frozen donor or mother’s own milk; only the intervention group was fed fresh mother’s own milk once daily from enrollment until 32 weeks’ corrected age. Control group mothers could not commit to provide fresh milk daily and were less likely receive antenatal corticosteroids than mothers in the intervention group. In the intervention group, 87.5% (98/112) of mothers were able to provide at least one feed of fresh milk a day. No critical incidents or non-compliance with the protocol were reported. The duration of mechanical ventilation and total parenteral nutrition use were shorter in the intervention group than controls (P < 0.01) but the length of hospital stay was similar (P = 0.57). Although the study might be underpowered, the intervention group had lower unadjusted rates of the composite outcome NEC ≥ stage 2 or mortality (8% vs 20%, P = 0.04), sepsis (22% vs 38%, P = 0.02), retinopathy of prematurity (17% vs 39%, P < 0.01) and bronchopulmonary dysplasia (32% vs 47%, P < 0.01) than the control. These results indicated that feeding fresh mother’s own milk once daily was safe, feasible, and may reduce morbidity.
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Affiliation(s)
- Huiqing Sun
- Department of Neonatology, Children's Hospital of Zhengzhou University, Zhengzhou, China.,Department of Neonatology, Henan Children's Hospital, Zhengzhou, China.,Department of Neonatology, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Shuping Han
- Department of Pediatrics, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Rui Cheng
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mingyan Hei
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China.,Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Foteini Kakulas
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shoo K Lee
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. .,Department of Paediatrics, Department of Obstetrics & Gynecology, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. .,Department of Paediatrics, Sinai Health System, Toronto, Ontario, Canada.
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9
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Păduraru L, Dimitriu DC, Avasiloaiei AL, Moscalu M, Zonda GI, Stamatin M. Total antioxidant status in fresh and stored human milk from mothers of term and preterm neonates. Pediatr Neonatol 2018. [PMID: 29519632 DOI: 10.1016/j.pedneo.2018.02.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Antioxidant defense of the body is assured by both endogenous and exogenous factors comprising several enzymes, vitamins, protein components and derivates and oligoelements. Breast milk has been proven to have important and essential antioxidant composition to prevent and protect against diseases in infancy. The objective of this study was to determine the total antioxidant status (TAS) of human milk and to evaluate the differences between premature milk and term milk at different moments of lactation (colostrum, transitional milk and mature milk). A second objective was to evaluate how TAS varies whether the human milk is refrigerated or frozen. METHODS Pumped human milk samples of the third, seven and 30th day were collected from women who had term deliveries (30 cases) and preterm deliveries (60 cases). Samples were refrigerated (+4 °C) or frozen in domestic conditions (-20 °C) for various durations and TAS was determined using the ABTS® technique with Randox® reagents and compared for the two groups. RESULTS Higher values were found in term versus preterm fresh milk at 30 days of lactation. A slight reduction in TAS was found after 72 h of refrigeration, while 1 week freezing produced significant decrease of total antioxidants. Freezing for 12 weeks reduced more than 50% of TAS in fresh milk. CONCLUSION Breastfeeding provides the optimal antioxidant for neonates, regardless of gestational age. Fresh milk has the higher antioxidant power. When it is not available, refrigerated milk for 24 h is better than for 72 h and preferable than frozen milk. Freezing human milk for 3 months in household conditions markedly diminishes TAS.
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Affiliation(s)
- Luminiţa Păduraru
- Division of Neonatology, Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania
| | - Daniela Cristina Dimitriu
- Division of Biochemistry, Department of Morphological and Functional Sciences, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania
| | - Andreea Luciana Avasiloaiei
- Division of Neonatology, Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania.
| | - Mihaela Moscalu
- Division of Medical Statistics and Informatics, Department of Preventive Medicine and Interdisciplinarity, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania
| | - Gabriela Ildiko Zonda
- Division of Neonatology, Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania
| | - Maria Stamatin
- Division of Neonatology, Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania
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10
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Cacho NT, Lawrence RM. Innate Immunity and Breast Milk. Front Immunol 2017; 8:584. [PMID: 28611768 PMCID: PMC5447027 DOI: 10.3389/fimmu.2017.00584] [Citation(s) in RCA: 230] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/01/2017] [Indexed: 12/16/2022] Open
Abstract
Human milk is a dynamic source of nutrients and bioactive factors; unique in providing for the human infant's optimal growth and development. The growing infant's immune system has a number of developmental immune deficiencies placing the infant at increased risk of infection. This review focuses on how human milk directly contributes to the infant's innate immunity. Remarkable new findings clarify the multifunctional nature of human milk bioactive components. New research techniques have expanded our understanding of the potential for human milk's effect on the infant that will never be possible with milk formulas. Human milk microbiome directly shapes the infant's intestinal microbiome, while the human milk oligosaccharides drive the growth of these microbes within the gut. New techniques such as genomics, metabolomics, proteomics, and glycomics are being used to describe this symbiotic relationship. An expanded role for antimicrobial proteins/peptides within human milk in innate immune protection is described. The unique milieu of enhanced immune protection with diminished inflammation results from a complex interaction of anti-inflammatory and antioxidative factors provided by human milk to the intestine. New data support the concept of mucosal-associated lymphoid tissue and its contribution to the cellular content of human milk. Human milk stem cells (hMSCs) have recently been discovered. Their direct role in the infant for repair and regeneration is being investigated. The existence of these hMSCs could prove to be an easily harvested source of multilineage stem cells for the study of cancer and tissue regeneration. As the infant's gastrointestinal tract and immune system develop, there is a comparable transition in human milk over time to provide fewer immune factors and more calories and nutrients for growth. Each of these new findings opens the door to future studies of human milk and its effect on the innate immune system and the developing infant.
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Affiliation(s)
- Nicole Theresa Cacho
- Division of Neonatology, Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Robert M Lawrence
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Florida, Gainesville, FL, United States
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11
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Dicky O, Ehlinger V, Montjaux N, Gremmo-Féger G, Sizun J, Rozé JC, Arnaud C, Casper C. Policy of feeding very preterm infants with their mother's own fresh expressed milk was associated with a reduced risk of bronchopulmonary dysplasia. Acta Paediatr 2017; 106:755-762. [PMID: 28128874 DOI: 10.1111/apa.13757] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/17/2016] [Accepted: 01/23/2017] [Indexed: 01/30/2023]
Abstract
AIM Since 2005, the French Food Safety Agency has recommended that very preterm or low-birthweight babies should be fed with pasteurised, expressed breastmilk, and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants. METHODS This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation. We analysed necrotising enterocolitis, bronchopulmonary dysplasia, in-hospital mortality, late-onset sepsis, weight gain, length of hospital stay, the duration of parenteral nutrition and the duration of enteral feeding with a nasogastric tube. Multivariate analyses were conducted to assess the impact of maternal milk policies. RESULTS After adjustment, there was a reduced risk of bronchopulmonary dysplasia in the fresh milk group with an odds ratio of 0.40 and 95% confidence interval of 0.27-0.67 (p < 0.001). No other statistically significant differences were observed. CONCLUSION Feeding very preterm infants with their mother's expressed fresh milk was associated with a reduced risk of bronchopulmonary dysplasia, and further investigations are needed to evaluate the clinical impact of this practice.
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Affiliation(s)
- Odile Dicky
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
| | - Virginie Ehlinger
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
| | - Nathalie Montjaux
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
| | | | - Jacques Sizun
- Department of Woman, Mother and Child; University Hospital; Brest France
| | | | - Catherine Arnaud
- U.1027; INSERM; Toulouse France
- Paul Sabatier University; Toulouse France
- Clinical Epidemiology Unit; CHU Purpan; Toulouse France
| | - Charlotte Casper
- Department of Neonatology; Children Hospital; University Hospital; Toulouse France
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12
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Jochum F, Alteheld B, Meinardus P, Dahlinger N, Nomayo A, Stehle P. Mothers' Consumption of Soy Drink But Not Black Tea Increases the Flavonoid Content of Term Breast Milk: A Pilot Randomized, Controlled Intervention Study. ANNALS OF NUTRITION AND METABOLISM 2017; 70:147-153. [PMID: 28391283 DOI: 10.1159/000471857] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 03/21/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE We performed a pilot RCT to prove the hypothesis that a controlled ingestion of polyphenol-rich beverages (soy drink, decaffeinated black tea) in nutritive dosages by nursing women has an effect on the composition (flavonoid concentration, total antioxidant capacity) of breast milk. METHODS Healthy nursing women were supplemented with either 250 mL of a soy drink (12 mg isoflavones; n = 18), 300 mL decaffeinated black tea (67 mg catechins; n = 18), or 300 mL water (n = 8, control) for 6 days. Milk samples were collected before, during, and after intervention. Flavonoid content (isoflavones/catechins, HPLC) and total antioxidant capacity of milk and test drinks in milk specimens were assessed. RESULTS Isoflavone content (genistein and daidzein) in breast milk increased up to 12 nmol/L after soy drink consumption; the major flavonoids constituents of black tea (catechin, epicatechin, and respective conjugates) could not be detected in milk samples. With both interventions, the total antioxidant capacity of breast milk was not affected. CONCLUSIONS Mothers' daily consumption of a soy drink considerably increases isoflavone content of breast milk resulting in an estimated daily exposure of 9.6 nmol isoflavones in a 4-month-old suckling infant. Luminal flavanol uptake from black tea consumed by the nursing mother may be too low to affect flavanol concentrations in breast milk.
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Affiliation(s)
- Frank Jochum
- Department of Neonatology and Paediatric Intensive Care, Ernst-Moritz-Arndt University, Greifswald, Germany
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13
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Abstract
The aim of human milk banks is to deliver safe and high quality donor human milk. Treatment of human milk has to destroy most microorganisms while preserving immunological and nutrient components, which is obtained when using low time low temperature pasteurization. However it destroys bile-simulated lipase, reduces lactoferrin, lysozyme, immunoglobulins, and bactericidal capacity of human milk. New methods are under investigation such as high temperature short time pasteurization, high pressure processing, or ultraviolet irradiation. They have been tested in experimental conditions and there are promising results, but they have to be tested in real conditions in human milk bank.
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Affiliation(s)
- Jean-Charles Picaud
- Neonatal Unit, Hôpital de la Croix-Rousse, Lyon F-69004, France; Rhone-Alpes Auvergneregional Human Milk Bank, Hôpital de la Croix-Rousse, Lyon F-69004, France; Lyon Sud Charles Merieux School of Medicine, Université Claude Bernard Lyon 1, Pierre-Bénite F-69310, France; Rhone-Alpes Human Nutrition Research Center, Hôpital Lyon Sud, Pierre-Bénite F-69310, France; European Milk Bank Association (EMBA), Milano, Italy.
| | - Rachel Buffin
- Neonatal Unit, Hôpital de la Croix-Rousse, Lyon F-69004, France; Rhone-Alpes Auvergneregional Human Milk Bank, Hôpital de la Croix-Rousse, Lyon F-69004, France
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Lemas DJ, Young BE, Baker PR, Tomczik AC, Soderborg TK, Hernandez TL, de la Houssaye BA, Robertson CE, Rudolph MC, Ir D, Patinkin ZW, Krebs NF, Santorico SA, Weir T, Barbour LA, Frank DN, Friedman JE. Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome. Am J Clin Nutr 2016; 103:1291-300. [PMID: 27140533 PMCID: PMC4841936 DOI: 10.3945/ajcn.115.126375] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/08/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Increased maternal body mass index (BMI) is a robust risk factor for later pediatric obesity. Accumulating evidence suggests that human milk (HM) may attenuate the transfer of obesity from mother to offspring, potentially through its effects on early development of the infant microbiome. OBJECTIVES Our objective was to identify early differences in intestinal microbiota in a cohort of breastfeeding infants born to obese compared with normal-weight (NW) mothers. We also investigated relations between HM hormones (leptin and insulin) and both the taxonomic and functional potentials of the infant microbiome. DESIGN Clinical data and infant stool and fasting HM samples were collected from 18 NW [prepregnancy BMI (in kg/m(2)) <24.0] and 12 obese (prepregnancy BMI >30.0) mothers and their exclusively breastfed infants at 2 wk postpartum. Infant body composition at 2 wk was determined by air-displacement plethysmography. Infant gastrointestinal microbes were estimated by using 16S amplicon and whole-genome sequencing. HM insulin and leptin were determined by ELISA; short-chain fatty acids (SCFAs) were measured in stool samples by using gas chromatography. Power was set at 80%. RESULTS Infants born to obese mothers were exposed to 2-fold higher HM insulin and leptin concentrations (P < 0.01) and showed a significant reduction in the early pioneering bacteria Gammaproteobacteria (P = 0.03) and exhibited a trend for elevated total SCFA content (P < 0.06). Independent of maternal prepregnancy BMI, HM insulin was positively associated with both microbial taxonomic diversity (P = 0.03) and Gammaproteobacteria (e.g., Enterobacteriaceae; P = 0.04) and was negatively associated with Lactobacillales (e.g., Streptococcaceae; P = 0.05). Metagenomic analysis showed that HM leptin and insulin were associated with decreased bacterial proteases, which are implicated in intestinal permeability, and reduced concentrations of pyruvate kinase, a biomarker of pediatric gastrointestinal inflammation. CONCLUSION Our results indicate that, although maternal obesity may adversely affect the early infant intestinal microbiome, HM insulin and leptin are independently associated with beneficial microbial metabolic pathways predicted to increase intestinal barrier function and reduce intestinal inflammation. This trial was registered at clinicaltrials.gov as NCT01693406.
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Affiliation(s)
| | | | - Peter R Baker
- Clinical Genetics and Metabolism, Department of Pediatrics
| | | | | | - Teri L Hernandez
- Divisions of Endocrinology, Metabolism, and Diabetes and College of Nursing
| | | | | | | | - Diana Ir
- Infectious Diseases, Department of Medicine
| | | | | | - Stephanie A Santorico
- Human Medical Genetics and Genomics Program; and Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO; and
| | - Tiffany Weir
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Linda A Barbour
- Divisions of Endocrinology, Metabolism, and Diabetes and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Jacob E Friedman
- Sections of Neonatology, Divisions of Endocrinology, Metabolism, and Diabetes and
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Perrin MT, Fogleman AD, Newburg DS, Allen JC. A longitudinal study of human milk composition in the second year postpartum: implications for human milk banking. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 26776058 DOI: 10.1111/mcn.12239] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/01/2015] [Accepted: 10/15/2015] [Indexed: 01/06/2023]
Abstract
While the composition of human milk has been studied extensively in the first year of lactation, there is a paucity of data regarding human milk composition beyond one year postpartum. Policies vary at milk banks around the world regarding how long lactating women are eligible to donate their milk. The primary purpose of this study is to describe longitudinal changes in human milk composition in the second year postpartum to support the development of evidence based guidelines regarding how long lactating women can donate human milk to a milk bank. Nineteen lactating women in North Carolina provided monthly milk samples from 11 months to 17 months postpartum (N = 131), and two non-profit milk banks provided (N = 33) pooled, unpasteurized milk samples from 51 approved donors less than one year postpartum. There was a significant increase (P < 0.05) in the concentration of total protein, lactoferrin, lysozyme, Immunoglobulin A, oligosaccharides and sodium in longitudinal samples of mother's milk between 11 and 17 months postpartum, while zinc and calcium concentrations declined, and no changes were observed in lactose, fat, iron and potassium. Human milk in the second year postpartum contained significantly higher concentrations of total protein, lactoferrin, lysozyme and Immunoglobulin A, than milk bank samples, and significantly lower concentrations of zinc, calcium, iron and oligosaccharides. Accepting milk bank donations beyond one year postpartum is a potential strategy for increasing the supply of donor milk, but may require mineral fortification.
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Affiliation(s)
- Maryanne T Perrin
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - April D Fogleman
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - David S Newburg
- Department of Biology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jonathan C Allen
- Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina, USA
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