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Abstract
PURPOSE OF REVIEW Breast milk (BM) is a peculiar fluid owing unique properties and resulting the ideal food during early neonatal period. As widely known, it can improve the outcome of both neonate and lactating mother, influencing their whole life. BM is characterized by several beneficial components; among these, a great role is played by BM own and specific microbiome, deeply investigated in many studies. Moreover, the use of metabolomics in BM analysis allowed a better characterization of its metabolic pathways that vary according to lactation stage and neonatal gestational age. The aim of this review is to describe growth factors, cytokines, immunity mediators, and stem cells (SCs) contained in BM and investigate their functions and effects on neonatal outcome, especially focusing on immuno- and neurodevelopment. RECENT FINDINGS We evaluated recent and updated literature on this field. The article that we analyzed to write this review have been found in MEDLINE using breast milk-derived stem cells, biofactors, growth factors, breastfeeding-related outcomes, neurodevelopment, and neonatal immunological system as keywords. Discovering and characterizing BM components could result very useful to clarify the pathophysiology of their influence on neonatal growth and even to improve artificial formulations' composition. Moreover, since SCs abilities and their involvement in the development of several diseases, they could help to discover specific targets for new therapies. It could be useful to characterize BM-derived SC markers, properties, and variations during lactation stages, to understand their potential role in therapeutic applications, since they could be noninvasively isolated from BM. More studies will help to describe more in detail the characteristics of mother-to-child communication through breastfeeding and its potential role in the next future.
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Medina Poeliniz C, Engstrom JL, Hoban R, Patel AL, Meier P. Measures of Secretory Activation for Research and Practice: An Integrative Review. Breastfeed Med 2020; 15:191-212. [PMID: 32155345 DOI: 10.1089/bfm.2019.0247] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Maternal concern about inadequate milk volume commonly emerges in the first 2 weeks postpartum, a critical lactation period that includes secretory activation. This review summarizes the biology of secretory activation and evaluates the accuracy and feasibility of published measures of secretory activation. Materials and Methods: A systematic search of measures of secretory activation for mothers of healthy term and preterm infants yielded 62 abstracts. Following additional screening, 15 publications qualified for quantitative synthesis review and were evaluated with respect to accuracy (validated with another measure of secretory activation in the same mother) and feasibility (accessibility, cost, and ease of use). Results:Maternal perception of milk coming in (MP) is the most feasible measure, but its accuracy has not been established. Patterns of increase in maternal milk volume have been validated with maternal milk-borne biomarkers in breastfeeding, and breast pump-dependent mothers and normal values have been published. Accuracy of serial maternal urinary lactose concentrations has not been established for secretory activation and lacks feasibility. Maternal milk biomarkers are the accurate standard to which other measures are compared but currently lack feasibility for routine use. Conclusions: Use of secretory activation measures can personalize lactation care by matching maternal risk with appropriate diagnostics. Priorities for research and practice include validation of MP as a population-based screening tool, implementation of techniques that measure patterns of increase in milk volume for moderate risk populations, and the development of milk biomarker science for point-of-care use in the most complicated lactation scenarios.
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Affiliation(s)
| | - Janet L Engstrom
- Department of Women and Children's Nursing, College of Nursing, Rush University, Chicago, Illinois
| | - Rebecca Hoban
- Department of Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, Illinois.,Department of Pediatrics, Division of Neonatology, The Hospital for Sick Children, Toronto, Canada
| | - Aloka L Patel
- Department of Women and Children's Nursing, College of Nursing, Rush University, Chicago, Illinois.,Department of Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, Illinois
| | - Paula Meier
- Department of Women and Children's Nursing, College of Nursing, Rush University, Chicago, Illinois.,Department of Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, Illinois
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Bardanzellu F, Fanos V, Strigini FAL, Artini PG, Peroni DG. Human Breast Milk: Exploring the Linking Ring Among Emerging Components. Front Pediatr 2018; 6:215. [PMID: 30131948 PMCID: PMC6091001 DOI: 10.3389/fped.2018.00215] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/13/2018] [Indexed: 12/19/2022] Open
Abstract
Maternal breast milk (BM) is a complex and unique fluid that evolution adapted to satisfy neonatal needs; in addition to classical nutrients, it contains several bioactive components. BM characteristically shows inter-individual variability, modifying its composition during different phases of lactation. BM composition, determining important consequences on neonatal gut colonization, influences both short and long-term development. Maternal milk can also shape neonatal microbiota, through its glycobiome rich in Lactobacilli spp. and Bifidobacteria spp. Therefore, neonatal nourishment during the first months of life seems the most important determinant of individual's outcomes. Our manuscript aims to provide new evidence in the characterization of BM metabolome and microbiome, and its comparison to formula milk, allowing the evaluation of each nutrient's influence on neonatal metabolism. This result very interesting since potentially offers an innovative approach to investigate the complex relationship between BM components and infant's health, also providing the chance to intervene in a sartorial way on diet composition, according to the nutritional requests. Future research, integrating metabolomics, microbiomics and stem cells knowledge, could make significant steps forward in understanding BM extraordinary properties and functions.
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Affiliation(s)
- Flaminia Bardanzellu
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, Azienda Ospedaliera Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | | | - Paolo G Artini
- Gynecology and Obstetrics, Università degli Studi di Pisa, Pisa, Italy
| | - Diego G Peroni
- Section of Pediatric, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Kaingade P, Somasundaram I, Sharma A, Patel D, Marappagounder D. Cellular Components, Including Stem-Like Cells, of Preterm Mother's Mature Milk as Compared with Those in Her Colostrum: A Pilot Study. Breastfeed Med 2017. [PMID: 28640669 DOI: 10.1089/bfm.2017.0063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PARTICIPATING AND STUDY OBJECTIVE Whether the preterm mothers' mature milk retains the same cellular components as those in colostrum including stem-like cell, cell adhesion molecules, and immune cells. PARTICIPANTS A total of five preterm mothers were recruited for the study having an average age of 30.2 years and gestational age of 29.8 weeks from the Pristine Women's Hospital, Kolhapur. Colostrum milk was collected within 2-5 days and matured milk was collected 20-30 days after delivery from the same mothers. METHODOLOGY Integral cellular components of 22 markers including stem cells, immune cells, and cell adhesion molecules were measured using flowcytometry. OUTCOME Preterm mature milk was found to possess higher expressions of hematopoietic stem cells, mesenchymal stem-like cells, immune cells, few cell adhesion molecules, and side population cells than colostrum. CONCLUSION The increased level of these different cell components in mature milk may be important in the long-term preterm baby's health growth. Further similar research in a larger population of various gestational ages and lactation stages of preterm mothers is warranted to support these pilot findings.
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Affiliation(s)
- Pankaj Kaingade
- 1 Department of Biochemistry, P.D. Patel Institute of Applied Sciences, Charotar University of Science and Technology , Changa, Gujarat, India
| | - Indumathi Somasundaram
- 2 Department of Stem Cell and Regenerative Medicine, Centre for Interdisciplinary Research, D.Y. Patil University , Kolhapur, Maharashtra, India
| | - Akshita Sharma
- 2 Department of Stem Cell and Regenerative Medicine, Centre for Interdisciplinary Research, D.Y. Patil University , Kolhapur, Maharashtra, India
| | - Darshan Patel
- 1 Department of Biochemistry, P.D. Patel Institute of Applied Sciences, Charotar University of Science and Technology , Changa, Gujarat, India
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Lawn JE, Davidge R, Paul VK, Xylander SV, de Graft Johnson J, Costello A, Kinney MV, Segre J, Molyneux L. Born too soon: care for the preterm baby. Reprod Health 2013; 10 Suppl 1:S5. [PMID: 24625233 PMCID: PMC3828583 DOI: 10.1186/1742-4755-10-s1-s5] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
As part of a supplement entitled “Born Too Soon”, this paper focuses on care of the preterm newborn. An estimated 15 million babies are born preterm, and the survival gap between those born in high and low income countries is widening, with one million deaths a year due to direct complications of preterm birth, and around one million more where preterm birth is a risk factor, especially amongst those who are also growth restricted. Most premature babies (>80%) are between 32 and 37 weeks of gestation, and many die needlessly for lack of simple care. We outline a series of packages of care that build on essential care for every newborn comprising support for immediate and exclusive breastfeeding, thermal care, and hygienic cord and skin care. For babies who do not breathe at birth, rapid neonatal resuscitation is crucial. Extra care for small babies, including Kangaroo Mother Care, and feeding support, can halve mortality in babies weighing <2000 g. Case management of newborns with signs of infection, safe oxygen management and supportive care for those with respiratory complications, and care for those with significant jaundice are all critical, and are especially dependent on competent nursing care. Neonatal intensive care units in high income settings are de-intensifying care, for example increasing use of continuous positive airway pressure (CPAP) and this makes comprehensive preterm care more transferable. For health systems in low and middle income settings with increasing facility births, district hospitals are the key frontier for improving obstetric and neonatal care, and some large scale programmes now include specific newborn care strategies. However there are still around 50 million births outside facilities, hence home visits for mothers and newborns, as well as women’s groups are crucial for reaching these families, often the poorest. A fundamental challenge is improving programmatic tracking data for coverage and quality, and measuring disability-free survival. The power of parent’s voices has been important in high-income countries in bringing attention to preterm newborns, but is still missing from the most affected countries.
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Affiliation(s)
- Joy E Lawn
- MARCH, London School Hygiene & Tropical Medicine, UK
- Saving Newborn Lives, Save the Children, Cape Town, South Africa
| | - Ruth Davidge
- Kwa-Zulu Natal Dept. of Health, Pietermartizburg, South Africa
- NNASA-Neonatal Nurses Association of Southern Africa, Durban, South Africa
- Congress of International Neonatal Nurses (COINN
| | - Vinod K Paul
- All India Institute for Medical Sciences, New Delhi, India
| | | | | | | | - Mary V Kinney
- Saving Newborn Lives, Save the Children, Cape Town, South Africa
| | - Joel Segre
- Consultant to Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Liz Molyneux
- Queen Elizabeth Hospital, College of Medicine, Blantyre, Malawi
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Bibliography. Current world literature. Genetics and epidemiology. Curr Opin Allergy Clin Immunol 2008; 8:489-93. [PMID: 18769207 DOI: 10.1097/aci.0b013e32830f1c83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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