1
|
D'Alessandro A, Pastore A, Amadio P, D'Agostini M, Terreri S, Carsetti R, Argentieri M, Bernaschi P, Onetti Muda A, Porzio O, Dotta A, Salvatori G. Influence of Defatting and Pasteurization on Nutrients and Oxidative Stress Markers in Human Milk. J Hum Lact 2023; 39:278-287. [PMID: 36945737 DOI: 10.1177/08903344231156894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND It is well known that the best nutritional option for infants is human milk, and that when breastfeeding is not possible, human milk banks are a possible alternative. However, in the case of infants with fat transport disorder like chylothorax, defatting of human milk is mandatory. RESEARCH AIM The aim of the study was to reduce milk fat content without reducing other nutrients, increasing oxidative stress, or introducing harmful microorganisms. METHODS In this prospective, cross-sectional, observational study, we examined the influence of defatting and pasteurization of 50 donor samples on fat, macro- and micronutrients, as well as on oxidative stress markers. RESULTS Low-temperature centrifugation proved to be very efficient in defatting, reducing the concentration of triglycerides by 85% and cholesterol by 50%. The macronutrients (proteins, albumin, and Immunoglobulin A) did not undergo significant changes due to defatting and pasteurization procedures, while iron decreased by 36%. However, as the majority of iron is retained, this result does not remarkably change the milk composition. Furthermore, oxidative stress markers and antioxidant levels were unchanged, and the milk result was microbiologically safe. CONCLUSIONS Cold milk centrifugation proved to be an effective technique that allows the reduction of human milk lipids. The determination of triglycerides and cholesterol can be used as an indicator of skimming. This procedure is not accompanied by substantial modifications of other components present in the milk.
Collapse
Affiliation(s)
| | - Anna Pastore
- Research Unit of Diagnostic and Management Innovations, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizia Amadio
- Neonatal Intensive Care Unit and Human Milk Bank, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Matteo D'Agostini
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sara Terreri
- Diagnostic Immunology Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rita Carsetti
- Diagnostic Immunology Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marta Argentieri
- Microbiology Laboratory, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paola Bernaschi
- Microbiology Laboratory, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Onetti Muda
- Research Unit of Diagnostic and Management Innovations, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ottavia Porzio
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit and Human Milk Bank, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Guglielmo Salvatori
- Neonatal Intensive Care Unit and Human Milk Bank, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| |
Collapse
|
2
|
Ribeiro VPD, Tinoco RB, Chamon ALB, Pessoa IS, Santos TCD, Silva RS, Fronza M. The Influence of Time and Temperature on Human Milk Storage Antioxidant Properties, Oxidative Stress, and Total Protein. J Hum Lact 2022; 39:308-314. [PMID: 36189756 DOI: 10.1177/08903344221126669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human milk is an essential source of nutrition for an infant's health. When breastfeeding working mothers or students, for example, are unable to breastfeed, storing their milk is recommended. Therefore, it is crucial to know the storage conditions to ensure their antioxidant capacity and avoid oxidative damage. RESEARCH AIM To evaluate the stability of the antioxidant and pro-oxidant profiles and the amount of total protein in fresh human milk after different storage times (1, 2, 7, 14, and 21 days) and temperatures (4 ºC and -20 ºC). METHODS This was a prospective, longitudinal, and observational study with milk samples grouped according to age for comparisons, which included 20 lactating women. The antioxidant activity was evaluated using the colorimetric methods of free radical scavenging 2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid and the decrease of ferric ion. Oxidative stress was determined by the lipid peroxidation product formation through malondialdehyde concentration, and the total protein content was assessed by the Bradford method. RESULTS The antioxidant profile of human milk was maintained with minimal losses until the 14th day when stored at 4 ºC and -20 ºC. The evolution of malondialdehyde concentration over storage revealed significant changes only 21 days after human milk storage at 4 ºC. There was no change in the value of total protein content. CONCLUSIONS To sum up, there is no difference in the storage of human milk at a temperature of 4 °C or -20 °C over 14 days. Therefore, the lactating woman may choose the most convenient way of storage.
Collapse
Affiliation(s)
| | - Renata Braga Tinoco
- Curso de Medicina, Universidade Vila Velha, Vila Velha, Espirito Santo, Brazil
| | | | - Iana Soares Pessoa
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Vila Velha, Vila Velha, Espirito Santo, Brazil
| | - Tamires Cruz Dos Santos
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Vila Velha, Vila Velha, Espirito Santo, Brazil
| | | | - Marcio Fronza
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Vila Velha, Vila Velha, Espirito Santo, Brazil.,Pesquisador Sênior, Instituto Capixaba de Ciências e Administração (ICCA), Vila Velha, Brazil
| |
Collapse
|
3
|
Vass RA, Kiss G, Bell EF, Miseta A, Bódis J, Funke S, Bokor S, Molnár D, Kósa B, Kiss AA, Takács T, Dombai F, Ertl T. Thyroxine and Thyroid-Stimulating Hormone in Own Mother’s Milk, Donor Milk, and Infant Formula. Life (Basel) 2022; 12:life12040584. [PMID: 35455075 PMCID: PMC9025043 DOI: 10.3390/life12040584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022] Open
Abstract
Breastfeeding is widely supported in clinical and home practices, and it is known that different forms of infant feeding differ in hormone content. Thyroid hormones have essential physiological roles. In our study, we examined thyroid-stimulating hormone (TSH), thyroxine, and albumin levels in breast milk produced for term (n = 16) or preterm (n = 15) infants throughout the first 6 months of lactation. Moreover, we analyzed these components in donor human milk and in three different infant formulas. Term and preterm breast milk samples were collected monthly. The two groups had similar levels of TSH (18.4 ± 1.4 vs. 24.7 ± 2.9 nU/L), but term milk contained higher amounts of thyroxine (11,245.5 ± 73.8 vs. 671.6 ± 61.2 nmol/L) during the examination period. The albumin level was significantly higher in preterm breast milk than in term breast milk (328.6 ± 17.1 vs. 264.2 ± 6.8 mg/L). In preterm breast milk we detected downward trends in the levels of TSH (−30.2%) and thyroxine (−29.2%) in the 3rd through 6th month compared to the first 2 months of lactation. Microbiological safety of donor milk was ensured by Holder pasteurization (HoP). From the Breast Milk Collection Center of Pécs, Hungary, we enrolled 44 donor mothers into the study. HoP decreased TSH (−73.8%), thyroxine (−22.4%), and albumin (−20.9%) concentrations. Infant formulas used by the Neonatal Intensive Care Unit of the University of Pécs were found to not contain the investigated hormones, but their albumin levels were similar to the breast milk samples. The present study shows the lack of thyroid hormones in infant formulas compared to human milk and raises the question of whether formula-fed infants should be supplemented with thyroid hormones.
Collapse
Affiliation(s)
- Réka A. Vass
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
- Correspondence: ; Tel.: +36-30-253-2000
| | - Gabriella Kiss
- Department of Laboratory Medicine, University of Pécs Medical School, 7624 Pecs, Hungary; (G.K.); (A.M.)
| | - Edward F. Bell
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA;
| | - Attila Miseta
- Department of Laboratory Medicine, University of Pécs Medical School, 7624 Pecs, Hungary; (G.K.); (A.M.)
| | - József Bódis
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
| | - Simone Funke
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
| | - Szilvia Bokor
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
- Department of Pediatrics, University of Pécs Medical School, 7624 Pecs, Hungary
| | - Dénes Molnár
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
- Department of Pediatrics, University of Pécs Medical School, 7624 Pecs, Hungary
| | - Balázs Kósa
- Department of Interior, Applied and Creative Design, University of Pécs, 7624 Pecs, Hungary;
| | - Anna A. Kiss
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
| | - Timea Takács
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
| | - Flóra Dombai
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
| | - Tibor Ertl
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary; (J.B.); (S.F.); (A.A.K.); (T.T.); (F.D.); (T.E.)
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary; (S.B.); (D.M.)
| |
Collapse
|
4
|
Bagga N, Kurian S, Mohamed A, Reddy P, Chirla DK. Pasteurized Donor Human Milk Should Not Replace Mother's Own Milk in Preterm Neonates: A Quality Initiative Toward Decreasing the "PDHM Dependency". Breastfeed Med 2022; 17:252-258. [PMID: 34883022 DOI: 10.1089/bfm.2021.0155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Aim: Mother's own milk (MOM) is the preferred source of neonatal nutrition. Due to various challenges, mothers are often unable to provide exclusive MOM to neonates admitted in neonatal intensive care units (NICUs) and depend on pasteurized donor human milk (PDHM). The aim of this quality improvement (QI) initiative was to enable mothers to provide MOM and consequently decrease the "PDHM dependency." Methods: Neonates <32 weeks of gestation (n = 120) were included. A multidisciplinary team was formed, and a detailed root cause analysis was done to understand the cause of PDHM dependency during the observation phase (November 1 to December 15, 2019). Various evidence-based practices were planned, tested, and implemented through Plan-Do-Study-Act cycles during the intervention phase (December 16, 2019 to January 31, 2020). These were further strengthened and adopted as a unit culture during the maintenance phase (February 1 to July 31, 2020). Results from the observation and intervention phases were compared. Results: Within 6 weeks of QI interventions, the average proportion of MOM significantly increased from 74.4% to 93.5% (p = 0.0003), and the proportion of PDHM significantly decreased from 20.5% to 4.6% (p = 0.005). The proportion of MOM remained at 82.5% during the maintenance phase. There was a significant decrease in the number of days to reach full feeds and regain birth weight. Conclusions: Provision of PDHM from our newly functional milk bank led to a reduced drive to express MOM in mothers of NICU babies. Our QI project focused on various strategies to improve MOM feeding and reduce PDHM dependence.
Collapse
Affiliation(s)
- Nitasha Bagga
- Neonatology, Rainbow Children's Hospital, Hyderabad, India
| | - Simi Kurian
- Neonatology, Rainbow Children's Hospital, Hyderabad, India
| | - Ashik Mohamed
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
| | - Pradeep Reddy
- Neonatology, Rainbow Children's Hospital, Hyderabad, India
| | | |
Collapse
|
5
|
Peila C, Longini M, Toni AL, Sottemano S, Bertino E, Buonocore G, Coscia A. Prolonged refrigeration does not alter isoprostanes concentration in human milk. J Matern Fetal Neonatal Med 2021; 35:8892-8896. [PMID: 34806531 DOI: 10.1080/14767058.2021.2006626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The Academy of Breastfeeding Medicine published a clinical protocol for Human Milk storage, recommending refrigeration at a temperature of 4 °C up to 4 d as the optimal conditions for the safety and bactericidal capacity of Human Milk. However, few studies were conducted to evaluate the change in milk composition during this type of refrigeration storage. AIM To elucidate some uncertainties regarding the Human Milk composition and prolonged cold storage, we have investigated the effects of storage at 4 °C up to 96 h on an important category of oxidative stress markers: the Isoprostanes (F2-isoprostanes, F4-neuroprostanes and F3-isoprostanes). MATERIAL AND METHOD The experiment was repeated 3 times to ensure reproducibility of the results. We enrolled 3 donating healthy mothers for each time (total: 9 mothers). Milk was collected with standard extraction methods. Immediately after collection, each Human Milk sample from each mother was pooled and then divided into 5 aliquots. One aliquot (0 h) was immediately frozen at -80 °C until the analysis. The other aliquots (24 h, 48 h, 72 h, 96 h) were stored in a refrigerator at 4 °C respectively for 24, 48, 72 and 96 h, then immediately frozen at -80 °C until the analysis. Milk samples were then used to determine concentration of Isoprostanes in Liquid Chromatography - Mass Spectrometry and Liquid Chromatography - Tandem Mass Spectrometry. RESULTS Isoprostanes were detectable in all Human Milk samples. There was no significant trend of the concentration of the tested analytes over time. DISCUSSION AND CONCLUSION This study provides evidence of the presence in human milk of all the tested isoprostanes: in particular, F2-isoprostanes, F4-neuroprostanes and F3-isoprostanes. Refrigeration and storage of fresh Human Milk in controlled conditions for 96 h did not significantly affect its bioactivity and nutritional quality related with these biomarkers.
Collapse
Affiliation(s)
- Chiara Peila
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Mariangela Longini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,Department of Innovation, Clinical and Translational Trial and Research, UOC Clinical Pathology, University Hospital of Siena, Siena, Italy
| | - Anna Laura Toni
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Stefano Sottemano
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Enrico Bertino
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Giuseppe Buonocore
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Alessandra Coscia
- Neonatology Unit, Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| |
Collapse
|
6
|
Effect of Storage and Heat Treatment of Milk Destined for Cheese Production on Its Oxidative Characteristics. DAIRY 2021. [DOI: 10.3390/dairy2040046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The oxidative stability of milk and dairy products is a very interesting topic for the dairy industry due to the growing demand for foods containing bioactive compounds with positive health effects. The aim was to evaluate the oxidative stability of milk intended for cheese production. The effect of storage time, heat pre-treatment, and milk pasteurization temperature on the characteristics of milk and cheese was investigated. The cheese samples were produced with pasteurized milk at both 72 and 77 °C for a time of 15 s using three types of milk: raw fresh milk processed within 48 h of milking, raw stored milk processed within 96 h, and thermized milk that was heat-treated upon arrival at the dairy and processed within 96 h of milking. In total, three repetitions were carried out for each type of milk and pasteurization. Samples of milk before and after pasteurization and cheese at 14 days of storage were analyzed. Antioxidant activity decreased from starting milk to milk after pasteurization to final cheese. The longer storage time of the milk had significant effects on the antioxidant stability of the cheese (64.95 vs. 59.05% of antioxidant activity). Thermization of the milk further reduced the stability of the cheese (54.05% of antioxidant activity). The greater antioxidant stability of fresh milk and cheeses produced with fresh milk is the first result that encourages the production of cheese from a milk that best preserves its original characteristics.
Collapse
|
7
|
Nayak A, Tiozzo C, Lin X, Mejia C, Gurzenda E, Kim M, Hanna N. Is Lactoferrin Supplementation Beneficial for All Preterm Infants? Am J Perinatol 2021; 40:680-687. [PMID: 34058763 DOI: 10.1055/s-0041-1730433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Human milk (HM) has antibacterial properties due to the presence of immune-modulators, including lactoferrin (LF). This study will determine effect(s) of HM maturation, fortification, and storage conditions on LF levels and its antibacterial properties. STUDY DESIGN HM samples (n = 30) were obtained from preterm and term mothers. The LF levels were analyzed by ELISA, and the antibacterial activity was measured after inoculation with Escherichia coli. RESULTS The highest level of LF in preterm HM was observed in the first week of lactation. However, storage of preterm HM at 4°C decreased LF levels significantly. Both LF levels and antibacterial activity in preterm HM was lower compared with term HM, but significantly higher than donor HM even after HM-based fortification. LF supplementation of donor HM improved its antibacterial activity. CONCLUSION Preterm infants fed donor HM, formula, or stored HM at 4°C may benefits from LF supplementation to improve HM antibacterial properties. KEY POINTS · Milk LF levels vary with storage and maturity.. · Donor milk is deficient in LF even after adding HM-based fortification.. · Donor HM and formula fed infants may benefit from LF..
Collapse
Affiliation(s)
- Amrita Nayak
- Department of Pediatrics, NYU Langone Hospital-Long Island, Mineola, New York
| | - Caterina Tiozzo
- Department of Pediatrics, NYU Langone Hospital-Long Island, Mineola, New York.,Women and Children Research Laboratory, NYU Long Island School of Medicine, Mineola, New York
| | - Xinhua Lin
- Women and Children Research Laboratory, NYU Long Island School of Medicine, Mineola, New York
| | - Claudia Mejia
- Women and Children Research Laboratory, NYU Long Island School of Medicine, Mineola, New York
| | - Ellen Gurzenda
- Women and Children Research Laboratory, NYU Long Island School of Medicine, Mineola, New York
| | - Maureen Kim
- Department of Pediatrics, NYU Langone Hospital-Long Island, Mineola, New York
| | - Nazeeh Hanna
- Department of Pediatrics, NYU Langone Hospital-Long Island, Mineola, New York.,Women and Children Research Laboratory, NYU Long Island School of Medicine, Mineola, New York
| |
Collapse
|
8
|
Xu Y, Yu Z, Li Q, Zhou J, Yin X, Ma Y, Yin Y, Jiang S, Zhu R, Wu Y, Han L, Gao Y, Xue M, Qiao Y, Zhu L, Tu W, Wu M, Wan J, Wang W, Deng X, Li S, Wang S, Chen X, Zhou Q, Wang J, Cheng R, Wang J, Han S. Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants. BMC Pediatr 2020; 20:522. [PMID: 33190629 PMCID: PMC7666971 DOI: 10.1186/s12887-020-02394-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aim Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, studies on the association between the dose of human milk and BPD in China are limited. This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. The multivariate analysis was performed to compare the effect outcomes of daily graded doses [1–24 mL/(kg · day), 25–49 mL/(kg · day), and ≥ 50 mL/(kg · day) of body weight] of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, 128 (13.3%) received 1–24 ml/(kg · day), 139 (14.4%) received 25–49 ml/(kg · day), and 418 (43.4%) received ≥50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily [≥50 mL/(kg · day)] had lower incidences of BPD [27.5% in ≥50 mL/(kg · day) vs 40.1% in 0 mL/(kg · day) human milk, P = 0.001)], moderate and severe BPD [8.9% in ≥50 mL/(kg · day) vs 16.1% in 0 mL/(kg · day), P = 0.004], necrotizing enterocolitis [NEC; 3.8% in ≥50 mL/(kg · day) vs 10.8% in 0 mL/(kg · day), P = 0.001], late-onset sepsis [LOS; 9.3% in ≥50 mL/(kg · day) vs 19.7% in 0 mL/(kg · day), P <0.01], and extrauterine growth retardation [EUGR; 38.5% in ≥50 mL/(kg · day) vs 57.6% in 0 mL/(kg · day), P <0.01)]. The logistic regression indicated that those receiving ≥50 ml/kg · day human milk had lower odds of BPD [adjusted odds ratio (AOR) 0.453; 95% confidence interval (CI): 0.309, 0.666], moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥50 ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration ClinicalTrials.gov Identifier: NCT03453502. Registration date: March 5, 2018. This study was retrospectively registered. Supplementary information Supplementary information accompanies this paper at 10.1186/s12887-020-02394-1.
Collapse
Affiliation(s)
- Yan Xu
- Department of Neonatology, The Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Xuzhou, 221000, Jiangsu Province, China.,Department of Neonatology, The Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China
| | - Zhangbin Yu
- Department of Neonatology, The Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China
| | - Qianqian Li
- Department of Neonatology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 210009, Jiangsu, China
| | - Jinjun Zhou
- Department of Neonatology, Nantong Maternity and Child Health Care Hospital, Nantong, 226001, Jiangsu, China
| | - Xiaoguang Yin
- Department of Neonatology, Anhui women and Child Health Care Hospital, Hefei, 230001, Anhui, China
| | - Yuelan Ma
- Department of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University and Suzhou Municipal Hospital, Suzhou, 215002, Jiangsu, China
| | - Yujie Yin
- Department of Neonatology, Jiangsu Women and Children Health Hospital, Nanjing, 210036, Jiangsu, China
| | - Shanyu Jiang
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214002, Jiangsu, China
| | - Rongping Zhu
- Department of Neonatology, Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu, China
| | - Yue Wu
- Department of Neonatology, Nanjing Children's Hospital, Nanjing, 210008, Jiangsu, China
| | - Liangrong Han
- Department of Neonatology, Huaian Maternity and Child Health Care Hospital, Huaian, 223002, Jiangsu, China
| | - Yan Gao
- Department of Neonatology, Lianyungang Maternity and Child Health Care Hospital, Lianyungang, 222000, Jiangsu, China
| | - Mei Xue
- Department of Neonatology, Taizhou People's Hospital, Taizhou, 225300, Jiangsu, China
| | - Yu Qiao
- Department of Neonatology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
| | - Lingling Zhu
- Department of Neonatology, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu, China
| | - Wenjuan Tu
- Department of Neonatology, Changzhou Children's Hospital, Changzhou, 213003, Jiangsu, China
| | - Mingfu Wu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - Jun Wan
- Department of Neonatology, Jiangyin People's Hospital, Jiangyin, 214400, Jiangsu, China
| | - Weiyuan Wang
- Department of Neonatology, Suqian Maternity Hospital, Suqian, 223800, Jiangsu, China
| | - Xiaoyi Deng
- Department of Neonatology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, 210009, Jiangsu, China
| | - Shuangshuang Li
- Department of Neonatology, Nantong Maternity and Child Health Care Hospital, Nantong, 226001, Jiangsu, China
| | - Sannan Wang
- Department of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University and Suzhou Municipal Hospital, Suzhou, 215002, Jiangsu, China
| | - Xiaoqing Chen
- Department of Neonatology, Jiangsu Women and Children Health Hospital, Nanjing, 210036, Jiangsu, China
| | - Qin Zhou
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214002, Jiangsu, China
| | - Jinxiu Wang
- Department of Neonatology, Changzhou Maternity and Child Health Care Hospital, Changzhou, 213003, Jiangsu, China
| | - Rui Cheng
- Department of Neonatology, Nanjing Children's Hospital, Nanjing, 210008, Jiangsu, China
| | - Jun Wang
- Department of Neonatology, The Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Xuzhou, 221000, Jiangsu Province, China.
| | - Shuping Han
- Department of Neonatology, The Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China. .,Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, No. 123 Tian Fei Xiang, Mo Chou Road, Nanjing, Jiangsu Province, 210004, China.
| |
Collapse
|
9
|
Lorençoni MF, Silva RS, Azevedo Júnior R, Fronza M. EFFECT OF PASTEURIZATION ON THE ANTIOXIDANT AND OXIDANT PROPERTIES OF HUMAN MILK. REVISTA PAULISTA DE PEDIATRIA 2020; 39:e2019165. [PMID: 32785463 PMCID: PMC7418336 DOI: 10.1590/1984-0462/2021/39/2019165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 05/13/2020] [Indexed: 12/28/2022]
Abstract
Objective: To evaluate the effect of pasteurization on antioxidant and oxidant
properties of human milk. Methods: 42 samples of milk before and after pasteurisation were used to evaluate the
antioxidant activity by the ferric reducing capacity and by scavenging the
2,2’-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical. Lipid
peroxidation was estimated by the concentration of malondialdehyde product
using the thiobarbituric acid reactive substances assay and by the
evaluation of advanced oxidation protein products. Results: No significant difference was observed in fresh human milk and after
pasteurization in relation to antioxidant properties determined by the
ferric reducing capacity (50.0±3.4% and 48.8±3.0%, respectively) and by
scavenging the 2,2’-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid radical
(28.9±1.5% and 31.2±1.3%, respectively). The results of malondialdehyde
(62.6±4.1 and 64.3±3.6 µM/mg) and protein oxidation products (59.4±3.4 and
54.2±3.8 µM/L) of fresh and pasteurized milk, respectively, did not
exhibited any significant difference. Conclusions: This data showed that human milk has an important antioxidant activity and
that the pasteurizing process does not influence the antioxidant capacity,
avoiding the peroxidation of breast milk lipids and the formation of
advanced protein oxidation products.
Collapse
|
10
|
McGee M, Unger S, Hamilton J, Birken CS, Pausova Z, Kiss A, Bando N, O'Connor DL. Adiposity and Fat-Free Mass of Children Born with Very Low Birth Weight Do Not Differ in Children Fed Supplemental Donor Milk Compared with Those Fed Preterm Formula. J Nutr 2020; 150:331-339. [PMID: 31599955 DOI: 10.1093/jn/nxz234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/29/2019] [Accepted: 09/03/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Many mothers of very-low-birth-weight (VLBW) infants (<1500 g) are unable to provide sufficient breast milk, and supplemental pasteurized donor human milk (donor milk) or preterm formula is required. The composition of donor milk differs from that of mother's milk and infants fed with donor milk often exhibit slower growth during hospitalization. The long-term impact of nutrient-enriched donor milk on growth, body composition, or blood pressure is unknown. OBJECTIVE We aimed to determine the effects of nutrient-enriched donor milk compared with preterm formula on growth, body composition, and blood pressure of children born preterm and with VLBW. Associations with in-hospital mother's milk intake were explored. METHODS This study was a follow-up of children at 5.5-y of age who participated in a randomized controlled trial evaluating the effect of nutrient-enriched donor milk (commencing at ≥120 mL·kg-1·d-1) or preterm formula fed as a supplement when mother's milk was unavailable. The trial intervention lasted 90 d or until hospital discharge, whichever occurred first. In this follow-up investigation, differences in total body fat percentage determined by using air displacement plethysmography (primary outcome), fat-free mass, skinfold thickness, waist circumference, BMI z scores, and blood pressure] were evaluated using linear regressions. RESULTS Of 316 surviving infants from the earlier trial, 158 (50%) participated in the current study (53% male). Mean ± SD birth weight and gestational age were 1013 ± 264 g and 27.9 ± 2.5 wk. The median (IQR) intervention period was 67.5 d (52.0-91.0 d). Mean ± SD age and BMI z score at follow-up were 5.7 ± 0.2 y and -0.3 ± 1.2. Supplemental nutrient-enriched donor milk, compared to preterm formula, was not associated with growth, body composition, or blood pressure. In-hospital mother's milk intake was positively associated with height z score at 5.5 y (β: 0.07; 95% CI: 0.004, 0.1; P = 0.04). CONCLUSIONS Supplemental nutrient-enriched donor milk and preterm formula during initial hospitalization results in comparable long-term growth and body composition in young children born VLBW. This trial was registered at clinicaltrials.gov as NCT02759809 and at isrctn.com as ISRCTN35317141.
Collapse
Affiliation(s)
- Meghan McGee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill Hamilton
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine S Birken
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Zdenka Pausova
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Evaluative and Clinical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nicole Bando
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| |
Collapse
|
11
|
Ten-Doménech I, Ramos-Garcia V, Piñeiro-Ramos JD, Gormaz M, Parra-Llorca A, Vento M, Kuligowski J, Quintás G. Current Practice in Untargeted Human Milk Metabolomics. Metabolites 2020; 10:E43. [PMID: 31979022 PMCID: PMC7074033 DOI: 10.3390/metabo10020043] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/10/2020] [Accepted: 01/19/2020] [Indexed: 12/11/2022] Open
Abstract
Human milk (HM) is considered the gold standard for infant nutrition. HM contains macro- and micronutrients, as well as a range of bioactive compounds (hormones, growth factors, cell debris, etc.). The analysis of the complex and dynamic composition of HM has been a permanent challenge for researchers. The use of novel, cutting-edge techniques involving different metabolomics platforms has permitted to expand knowledge on the variable composition of HM. This review aims to present the state-of-the-art in untargeted metabolomic studies of HM, with emphasis on sampling, extraction and analysis steps. Workflows available from the literature have been critically revised and compared, including a comprehensive assessment of the achievable metabolome coverage. Based on the scientific evidence available, recommendations for future untargeted HM metabolomics studies are included.
Collapse
Affiliation(s)
- Isabel Ten-Doménech
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
| | - Victoria Ramos-Garcia
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
| | - José David Piñeiro-Ramos
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
| | - María Gormaz
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
- Division of Neonatology, University & Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Anna Parra-Llorca
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
| | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
- Division of Neonatology, University & Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Julia Kuligowski
- Neonatal Research Unit, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (I.T.-D.); (V.R.-G.); (J.D.P.-R.); (M.G.); (A.P.-L.); (M.V.)
| | - Guillermo Quintás
- Health and Biomedicine, Leitat Technological Center, Carrer de la Innovació, 2, 08225 Terrassa, Spain;
- Unidad Analítica, Health Research Institute La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
| |
Collapse
|
12
|
Bardanzellu F, Peila C, Fanos V, Coscia A. Clinical insights gained through metabolomic analysis of human breast milk. Expert Rev Proteomics 2019; 16:909-932. [PMID: 31825672 DOI: 10.1080/14789450.2019.1703679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Among the OMICS technologies, that have emerged in recent years, metabolomics has allowed relevant step forwards in clinical research. Several improvements in disease diagnosis and clinical management have been permitted, even in neonatology. Among potentially evaluable biofluids, breast milk (BM) results are highly interesting, representing a fluid of conjunction between mothers newborns, describing their interaction.Areas covered: in this review, updating a previous review article, we discuss research articles and reviews on BM metabolomics and found in MEDLINE using metabolomics, breast milk, neonatal nutrition, breastfeeding, human milk composition, and preterm neonates as keywords.Expert opinion: Our research group has a profound interest in metabolomics research. In 2012, we published the first metabolomic analysis on BM samples, reporting interesting data on its composition and relevant differences with formula milk (FM), useful to improve FM composition. As confirmed by successive studies, such technology can detect the specific BM composition and its dependence on several variables, including lactation stage, gestational age, maternal or environmental conditions. Moreover, since BM contaminants or drug levels can be detected, metabolomics also results useful to determine BM safety. These are only a few practical applications of BM analysis, which will be reviewed in this paper.
Collapse
Affiliation(s)
- Flaminia Bardanzellu
- Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU University of Cagliari, Monserrato, Italy
| | - Chiara Peila
- Neonatology Unit, Department of Public Health and Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU University of Cagliari, Monserrato, Italy
| | - Alessandra Coscia
- Neonatology Unit, Department of Public Health and Pediatrics, Università degli Studi di Torino, Turin, Italy
| |
Collapse
|