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Abstract
Human breast milk is the optimal nutrition for all infants and is comprised of many bioactive and immunomodulatory components. The components in human milk, such as probiotics, human milk oligosaccharides (HMOs), extracellular vesicles, peptides, immunoglobulins, growth factors, cytokines, and vitamins, play a critical role in guiding neonatal development beyond somatic growth. In this review, we will describe the bioactive factors in human milk and discuss how these factors shape neonatal immunity, the intestinal microbiome, intestinal development, and more from the inside out.
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Affiliation(s)
- Sarah F Andres
- Department of Pediatrics, Pediatric GI Division, School of Medicine, Oregon Health and Science University, Portland, OR 97229, United States
| | - Brian Scottoline
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, United States
| | - Misty Good
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, 101 Manning Drive, Campus Box 7596, Chapel Hill, NC 27599, United States.
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Arias-Borrego A, Soto Cruz FJ, Selma-Royo M, Bäuerl C, García Verdevio E, Pérez-Cano FJ, Lerin C, Velasco López I, Martínez-Costa C, Collado MC, García-Barrera T. Metallomic and Untargeted Metabolomic Signatures of Human Milk from SARS-CoV-2 Positive Mothers. Mol Nutr Food Res 2022; 66:e2200071. [PMID: 35687731 PMCID: PMC9350005 DOI: 10.1002/mnfr.202200071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/30/2022] [Indexed: 11/29/2022]
Abstract
Scope Lack of information about the impact of maternal severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection on the elemental and metabolomic profile of human milk (HM). Methods and results An observational study on HM from mothers with COVID‐19 is conducted including a prepandemic control group. Maternal–infant clinical records and symptomatology are recorded. The absolute quantification of elements and untargeted relative metabolomic profiles are determined by inductively coupled plasma mass spectrometry and gas chromatography coupled to mass spectrometry, respectively. Associations of HM SARS‐CoV‐2 antibodies with elemental and metabolomic profiles are studied. COVID‐19 has a significant impact on HM composition. COVID‐19 reduces the concentrations of Fe, Cu, Se, Ni, V, and Aluminium (Al) and increases Zn compared to prepandemic control samples. A total of 18 individual metabolites including amino acids, peptides, fatty acids and conjugates, purines and derivatives, alcohols, and polyols are significantly different in HM from SARS‐CoV‐2 positive mothers. Aminoacyl‐tRNA biosynthesis, phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine, and linoleic acid pathways are significantly altered. Differences are obtained depending on COVID‐19 symptomatic and asymptomatic status. Conclusions This study provides unique insights about the impact of maternal SARS‐CoV‐2 infection on the elemental and metabolomic profiles of HM that warrants further research due the potential implications for infant health.
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Affiliation(s)
- Ana Arias-Borrego
- Research Center for Natural Resources, Health and the Environment (RENSMA), Department of Chemistry, Faculty of Experimental Sciences. Fuerzas Armadas Ave, University of Huelva, Huelva, 21007, Spain.,Department of Analytical Chemistry, Faculty of Chemistry, University of Seville, Professor García González Ave., Seville, 41012, Spain
| | - Francisco J Soto Cruz
- Research Center for Natural Resources, Health and the Environment (RENSMA), Department of Chemistry, Faculty of Experimental Sciences. Fuerzas Armadas Ave, University of Huelva, Huelva, 21007, Spain
| | - Marta Selma-Royo
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Agustin Escardino 7, 46980 Paterna, Valencia, Spain
| | - Christine Bäuerl
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Agustin Escardino 7, 46980 Paterna, Valencia, Spain
| | - Elia García Verdevio
- Department of Gynecology and Obstetrics, Hospital Universitario Doctor Peset, Valencia, 46017, Spain
| | - Francisco J Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), Barcelona, 08028, Spain.,Nutrition and Food Safety Research Institute (INSA-UB), Santa Coloma de Gramenet, 08921, Spain
| | - Carles Lerin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, 08950, Spain
| | - Inés Velasco López
- Department of Gynecology & Obstetrics, Hospital Universitari Germans Trias i Pujol, s/n Carretera del Canyet, Badalona, 08916, Spain
| | - Cecilia Martínez-Costa
- Department of Pediatrics, University of Valencia., INCLIVA Biomedical Research Institute, Avenida Blasco Ibáñez 15-17, Valencia, 46010, Spain
| | - M Carmen Collado
- Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Agustin Escardino 7, 46980 Paterna, Valencia, Spain
| | - Tamara García-Barrera
- Research Center for Natural Resources, Health and the Environment (RENSMA), Department of Chemistry, Faculty of Experimental Sciences. Fuerzas Armadas Ave, University of Huelva, Huelva, 21007, Spain
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Ma L, Geng LM, Zhou XH. [A comparative analysis of the efficacy of two vitamin D supplementation regimens in preterm infants: a prospective randomized controlled study]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:1061-1065. [PMID: 33059801 PMCID: PMC7568995 DOI: 10.7499/j.issn.1008-8830.2005062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the effect of different vitamin D supplementation regimens on the nutritional status of vitamin D on day 28 after birth in preterm infants with a gestational age of <34 weeks. METHODS A total of 59 preterm infants with a gestational age of <34 weeks who were born from October 2018 to October 2019 were enrolled and divided into an observation group with 30 infants and a control group with 29 infants. The infants in the observation group received a single-dose intramuscular injection of vitamin D3 (10 000 IU/kg), while those in the control group received oral vitamin D3 drops (900 IU/d) for 25 days. Venous blood samples were collected within 48 hours after birth (before vitamin D3 supplementation) and on day 28 after birth to measure the serum 25-hydroxyvitamin D [25(OH)D] level. RESULTS Within 48 hours after birth, the prevalence rate of vitamin D deficiency (≤15 ng/mL) was 78% among the 59 preterm infants. There were no significant differences in the serum 25(OH)D level and the prevalence rate of vitamin D deficiency between the two groups (P>0.05). Compared with the control group on day 28 after birth, the observation group had a significantly higher serum 25(OH)D level (P<0.05) and a significantly lower prevalence rate of vitamin D deficiency (P<0.05). There were no cases of vitamin D overdose or poisoning. CONCLUSIONS In preterm infants with a gestational age of <34 weeks, single-dose intramuscular injection of 10 000 IU/kg vitamin D3 can significantly increase serum 25(OH)D level on day 28 after birth and safely and effectively reduce the prevalence rate of vitamin D deficiency.
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Affiliation(s)
- Li Ma
- Department of Neonatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
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Abstract
Preterm infants are at risk of growth failure and metabolic bone disease due to insufficient nutrient supply in postnatal life. An ample provision of protein, energy, calcium and phosphates through parenteral or/and enteral nutrition is crucial for bone growth and mineralization. Additional vitamin D supplementation improves bone mineralization and enhance intestinal absorption of minerals.
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de Sousa Rebouças A, Costa Lemos da Silva AG, Freitas de Oliveira A, Thalia Pereira da Silva L, de Freitas Felgueiras V, Cruz MS, Silbiger VN, da Silva Ribeiro KD, Dimenstein R. Factors Associated with Increased Alpha-Tocopherol Content in Milk in Response to Maternal Supplementation with 800 IU of Vitamin E. Nutrients 2019; 11:nu11040900. [PMID: 31013594 PMCID: PMC6520676 DOI: 10.3390/nu11040900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Vitamin E supplementation might represent an efficient strategy to increase the vitamin E content in milk. The present study aimed to evaluate the impact of supplementation with 800 IU RRR-alpha-tocopherol on the alpha-tocopherol content of milk and the factors associated with the increase in vitamin E. Methods: Randomized clinical trial with 79 lactating women from Brazil, who were assigned to the control group, or to the supplemented group (800 IU of RRR-alpha-tocopherol). Milk and serum were collected between 30 and 90 days after delivery (collection 1), and on the next day (collection 2). Alpha-tocopherol was analyzed using high-performance liquid chromatography. Results: In the supplemented group, the alpha-tocopherol content in serum and milk increased after supplementation (p < 0.001). In the multivariate analysis, only alpha-tocopherol in milk (collection 1) was associated with the level of this vitamin in milk after supplementation (β = 0.927, p < 0.001), and binary logistic regression showed that the dietary intake was the only determinant for the greater effect of supplementation in milk. Conclusion: The pre-existing vitamin level in milk and diet are determinants for the efficacy of supplementation in milk, suggesting that in populations with vitamin E deficiency, high-dose supplementation can be used to restore its level in milk.
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Affiliation(s)
- Amanda de Sousa Rebouças
- Department of Biochemistry, Federal University of Rio Grande do Norte, 59078-970 Natal-RN, Brazil.
| | | | | | | | | | - Marina Sampaio Cruz
- Department of Pharmacy, Federal University of Rio Grande do Norte, 59012-570 Natal-RN, Brazil.
| | | | | | - Roberto Dimenstein
- Department of Biochemistry, Federal University of Rio Grande do Norte, 59078-970 Natal-RN, Brazil.
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Silva ALCD, Ribeiro KDDS, Melo LRMD, Bezerra DF, Queiroz JLCD, Lima MSR, Pires JF, Bezerra DS, Osório MM, Dimenstein R. VITAMIN E IN HUMAN MILK AND ITS RELATION TO THE NUTRITIONAL REQUIREMENT OF THE TERM NEWBORN. REVISTA PAULISTA DE PEDIATRIA 2018; 35:158-164. [PMID: 28977333 PMCID: PMC5496727 DOI: 10.1590/1984-0462/;2017;35;2;00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/11/2016] [Indexed: 11/29/2022]
Abstract
Objectives: To determine the alpha-tocopherol concentration in breast milk at different periods of lactation and to estimate the possible supply of vitamin E to the infant. Methods: A longitudinal observational study was carried out with 100 mothers at University Hospital Ana Bezerra (HUAB), at Universidade Federal do Rio Grande do Norte, in Santa Cruz (RN), Northeast Brazil. Samples of colostrum (n=100), transitional milk (n=77), and mature milk (n=63) were collected. Alpha-tocopherol was analyzed by high-performance liquid chromatography. Vitamin supply to the newborn was estimated by comparing the nutritional requirement of vitamin E (4 mg/day) with the potential daily intake of milk. Results: The mean alpha-tocopherol concentration found in colostrum, transitional, and mature milk was 40.5±15.0 µmol/L, 13.9±5.2 µmol/L, and 8.0±3.8 µmol/L, respectively (p<0.001). The possible effect of these milks offered to the infant 6.2 mg/day of vitamin E in colostrum, 4.7 mg/day in transitional milk, and 2.7 mg/day in mature milk (p<0.0001), shows that only the mature milk did not guarantee the recommended quantity of this vitamin. Conclusions: Alpha-tocopherol levels in human milk decrease through the progression of lactation, and the possible intake of colostrum and transitional milk met the nutritional requirement of the infant. Mature milk may provide smaller amounts of vitamin E. Thus, it is important to study the factors that are associated with such low levels.
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de Freitas BAC, Lima LM, Moreira MEL, Priore SE, Henriques BD, Carlos CFLV, Sabino JSN, do Carmo Castro Franceschini S. Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months. Clinics (Sao Paulo) 2016; 71:440-8. [PMID: 27626474 PMCID: PMC4975790 DOI: 10.6061/clinics/2016(08)06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/21/2016] [Accepted: 04/25/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.
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Affiliation(s)
| | - Luciana Moreira Lima
- Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil
| | | | - Silvia Eloiza Priore
- Universidade Federal de Vicosa (UFV), Departamento de Nutrição e Saúde, Viçosa/MG, Brazil
| | - Bruno David Henriques
- Universidade Federal de Viçosa (UFV), Departamento de Medicina e Enfermagem, Viçosa/MG, Brazil
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da Silva Ribeiro KD, Lima MSR, Medeiros JFP, de Sousa Rebouças A, Dantas RCS, Bezerra DS, Osório MM, Dimenstein R. Association between maternal vitamin E status and alpha-tocopherol levels in the newborn and colostrum. MATERNAL AND CHILD NUTRITION 2016; 12:801-7. [PMID: 26924492 DOI: 10.1111/mcn.12232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/01/2022]
Abstract
Vitamin E is important because of its antioxidant activity in situations of oxidative stress, especially postnatally. Hence, the objective was to verify whether maternal alpha-tocopherol level is associated with the alpha-tocopherol levels of the newborn and colostrum. This is a cross-sectional study of 58 women and their term newborns from a public hospital. Blood and colostrum were collected to measure alpha-tocopherol levels by high-performance liquid chromatography. Mothers with serum alpha-tocopherol levels <16.2 mmol L(-1) and newborns <11.6 mmol L(-1) were indicative of deficiency or low levels. Mothers were divided into two groups: <16.2 mmol L(-1) and those with levels ≥16.2 mmol L(-1) . The mean (95% confidence interval) serum alpha-tocopherol levels of mothers, umbilical cords and colostrum were 28 (24-32), 6 (5-8) and 39 mmol L(-1) (32-45), respectively (P < 0.001); 19% of the women and 90% of the newborns had low alpha-tocopherol levels. Maternal alpha-tocopherol level was associated with that of the umbilical cord. Newborns from mothers at risk of deficiency had low alpha-tocopherol levels (P < 0.001). Colostrum levels of vitamin E were not influenced by maternal serum. Maternal deficiency influenced the vitamin E level of the umbilical cord but does not in the colostrum, evidencing distinct transfer mechanisms via the mammary gland.
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Affiliation(s)
| | - Mayara Santa Rosa Lima
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | | - Danielle Soares Bezerra
- Faculdade de Ciências Médicas do Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Mônica Maria Osório
- Department of Nutrition, Federal University of Pernambuco, Recife, PE, Brazil
| | - Roberto Dimenstein
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Tapan S, Sertoglu E. Assessing vitamin D status in infants with very low birth weight. J Matern Fetal Neonatal Med 2016; 29:504. [DOI: 10.3109/14767058.2015.1009031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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