Non-Nutritional Use of Human Milk Part 1: A Survey of the Use of Breast Milk as a Therapy for Mucosal Infections of Various Types in Poland

Human Breast Milk Enhances Cellular Proliferation in Cornea Wound Healing

PURPOSE

Corneal epithelial defects from trauma or surgery heal as new epithelial cells grow centripetally from the limbus and replenish the epithelium. Corneal wound healing requires cell signalling molecules. However, a topical treatment with these components is not available. Human breast milk (HBM) offers a potential, novel treatment as it contains bioactive molecules important in epithelial cell healing. This study seeks to investigate the potential of HBM in cornea wound healing.

METHODS

Balb/c mice, 8-12 weeks old, were anesthetized prior to creating a 2 mm central cornea epithelial defect. Mice were randomly assigned to a treatment group: HBM, ophthalmic ointment containing neomycin, polymyxin B, dexamethasone (RxTx), or saline and treated 4x/day for 2 days. Wound area was quantified by fluorescein and ImageJ at 0, 8, 24, and 48 h post wounding and eyes used for histology, RT-qPCR, and ELISA.

RESULTS

Wounded corneas treated with HBM demonstrated increased re-epithelialization at 8 h post injury compared to saline treatments. ELISA showed significantly higher Ki67 in HBM treated eyes vs. saline control at 8 h (p = 0.0278). Additionally, immunohistology revealed more Ki67 positive cells in the HBM group compared to saline at 8 h and 24 h (p = 0.0063 8 h; p = 0.0007 24 h). For inflammatory analysis, HBM group IL-1β levels were similar to the saline group, and higher than RxTx treated eyes (p < 0.05). Immunohistochemical staining for CD11b (macrophage marker) revealed HBM-treated eyes had significantly more positive cells vs. saline. RT-qPCR of limbal stem cell markers (LESCs) revealed upregulation of Integrin αV at 8 h with HBM vs. saline.

CONCLUSIONS

HBM treatment on corneas with debridement of epithelium demonstrated improved healing, cellular proliferation, and upregulation of the LESC gene transcript, integrin αV, after wounding. Future studies could investigate LESC response to different signalling molecules in HBM to better understand the efficacy of this potential therapy.

Parental experiences of caring for preterm infants in the neonatal intensive care unit, Limpopo Province: a descriptive qualitative study exploring the cultural determinants

BACKGROUND

Parent-infant interaction is highly recommended during the preterm infant hospitalisation period in the Neonatal Intensive Care Unit (NICU). Integrating culturally sensitive healthcare during hospitalisation of preterm infants is critical for positive health outcomes. However, there is still a paucity of evidence on parental experience regarding cultural practices that can be integrated into preterm infant care in the NICU. The study explored and described the cultural determinants of parents that can be integrated into the care of preterm infants in the NICU.

METHODS

A descriptive qualitative research design was followed where twenty (n=20) parents of preterm infants were purposively selected. The study was conducted in the NICU in Limpopo using in-depth individual interviews. Taguette software and a thematic analysis framework were used to analyse the data. The COREQ guidelines and checklist were employed to ensure reporting standardisation.

RESULTS

Four themes emerged from the thematic analysis: 1) Lived experienced by parents of preterm infants, 2) Interactions with healthcare professionals, 3) Cultural practices concerning preterm infant care, and 4) Indigenous healthcare practices for preterm infants.

CONCLUSIONS

The study emphasised a need for healthcare professionals to understand the challenges parents of preterm infants face in NICU care. Furthermore, healthcare professionals should know indigenous healthcare practices to ensure relevant, culturally sensitive care.

The effect of topical application of breast milk and education on preventing diaper dermatitis in children in rural areas

PURPOSE

This study aimed to ascertain the impact of topical breast milk and diaper-area care instruction on the prevention of diaper dermatitis in rural settings.

DESIGN AND METHODS

This was a pre-test-post-test experimental study with forty-eight 6-18-month-old children and their mothers. Participants were randomly assigned to three groups: two experimental groups (Group A: breast milk, Group B: education) and one control group (Group C). Data were collected face-to-face through home-visits. A sociodemographic data and diaper-area care practices form and The Scale for Assessing the Severity of Uncomplicated Diaper Dermatitis in Infants were used for data collection.

RESULTS

There was a statistically significant difference between children who used breast milk application to prevent dermatitis compared to children whose parents received diaper-area care education and a control group (p = 0.002).

CONCLUSIONS

It was determined that topical breast milk application and diaper-area care education given to mothers were effective in preventing diaper dermatitis, and the application of breast milk was found to be safe and more effective than education.

PRACTICE IMPLICATIONS

These findings highlight the need for education, information and practical solutions to prevent and appropriately treat diaper dermatitis.

Topical Use of Human Milk in the Neonatal Intensive Care Unit: An Integrative Review

BACKGROUND

Research has shown that the bioactive components in human milk could demonstrate efficacy when applied topically. One common neonatal skin issue is diaper dermatitis (DD). DD treatment and prevention guidelines often lack the inclusion of topical human milk as a viable option.

PURPOSE

To analyze the safety and efficacy of topical human milk application as a means to support future research of human milk as a topical treatment for DD.

DATA SOURCES

Google Scholar, CINAHL, PubMed, and Cochrane.

STUDY SELECTION

The search was limited to articles published between 2011 and 2023 in the English language. Disqualifying characteristics included nonhuman subjects, literature reviews, inability to obtain articles, and non-peer-reviewed articles.

DATA EXTRACTION

For Google Scholar, the search terms "human milk OR breast milk" and "topical" were used. For CINAHL, PubMed, and Cochrane, the search terms "human milk OR chest milk OR breast milk OR donor milk" and "topical" were used. Quantitative significance was defined by a P value of less than .05.

RESULTS

The search yielded 20 articles. The results of the review demonstrate that topical human milk application is a safe and effective topical treatment to skin integrity/inflammatory issues such as DD. It also identified that caregivers will likely show positive regard to the treatment, promoting its acceptance.

IMPLICATIONS FOR PRACTICE AND RESEARCH

The results provide evidence to support methodologic development for human milk application for the prevention and treatment of DD. Further studies can use the results to develop protocols that investigate the effects of human milk application.

TFOS Lifestyle: Impact of nutrition on the ocular surface

Nutrients, required by human bodies to perform life-sustaining functions, are obtained from the diet. They are broadly classified into macronutrients (carbohydrates, lipids, and proteins), micronutrients (vitamins and minerals) and water. All nutrients serve as a source of energy, provide structural support to the body and/or regulate the chemical processes of the body. Food and drinks also consist of non-nutrients that may be beneficial (e.g., antioxidants) or harmful (e.g., dyes or preservatives added to processed foods) to the body and the ocular surface. There is also a complex interplay between systemic disorders and an individual's nutritional status. Changes in the gut microbiome may lead to alterations at the ocular surface. Poor nutrition may exacerbate select systemic conditions. Similarly, certain systemic conditions may affect the uptake, processing and distribution of nutrients by the body. These disorders may lead to deficiencies in micro- and macro-nutrients that are important in maintaining ocular surface health. Medications used to treat these conditions may also cause ocular surface changes. The prevalence of nutrition-related chronic diseases is climbing worldwide. This report sought to review the evidence supporting the impact of nutrition on the ocular surface, either directly or as a consequence of the chronic diseases that result. To address a key question, a systematic review investigated the effects of intentional food restriction on ocular surface health; of the 25 included studies, most investigated Ramadan fasting (56%), followed by bariatric surgery (16%), anorexia nervosa (16%), but none were judged to be of high quality, with no randomized-controlled trials.

Wet Nurse or Milk Bank? Evolution in the Model of Human Lactation: New Challenges for the Islamic Population

(1) Introduction: The establishment of milk banks in the Islamic world as well as donation to Islamic families in Western countries remains a challenge in the context of human lactation. Religious reservations established since the Qur'an and regulated at the legal-religious and medical level equate milk kinship with consanguinity, which prevents donation. The aim of the study was to analyse the evolution in the model of breastfeeding and care in Islamic society. (2) Methods: The methodology of comparative history was applied, following the structural-dialectical model of care. Historical manuals, articles and databases were analysed. (3) Results: Paediatric care in medical manuals from the 10th-15th centuries is similar to that practiced by the Muslim population today, some beneficial, some harmful; the wet nurse had to follow a series of dietary habits and have a series of physical, moral and educational characteristics in order to be hired. They constituted a beginning of pseudo-professionalisation, in a domestic-family framework. Human milk was used as a remedy for different health problems. (4) Conclusions: Islamic society and nursing have to evolve towards transnational care adapted to the needs of the population.