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Peila C, Spada E, Deantoni S, Borsani M, Asteggiano M, Chiale F, Moro GE, Giribaldi M, Cavallarin L, Cortinovis I, Coscia A. The Use of a Novel Donkey Milk-Derived Human Milk Fortified in the Neonatal Period Had No Effect on the Frequency of Allergic Manifestations During the First Years of Life: The "Fortilat Trial" Follow-Up. Breastfeed Med 2024; 19:223-227. [PMID: 38489532 DOI: 10.1089/bfm.2023.0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background: Since human milk contents does not meet the high need of very low birth weight infants, fortification of breast milk is a standard practice for this population. As donkey milk has been long considered for children allergic to cow's milk proteins due to its low allergic properties, a new donkey milk-derived fortifier (DF) has been recently evaluated as a valid alternative to bovine milk-derived fortifier (BF). It seems to improve feeding tolerance when compared with standard BF, with similar neurodevelopmental and auxological outcome at 18 months of age. The aim of this study is to evaluate the development of allergic manifestations occurring in the population of the "Fortilat Trial" at 6-8 years of age. Methods: Allergic manifestations were assessed by an ad hoc questionnaire administered to families. The occurrence of asthma, allergic rhinitis and oculorhinitis, rashes and atopic dermatitis, food allergies, accesses to an emergency department for allergic reactions, and the need of antihistamine have been investigated. Results: In total, 113 infants were enrolled in the study (BF arm: n = 60, DF arm: n = 53). No difference in risk was observed between the two groups for all the considered outcomes. In conclusion, our data suggest that DF does not impact the development of allergic manifestations in the first years of life. Clinical Trial Registration number: ISRCT N70022881.
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Affiliation(s)
- Chiara Peila
- Neonatal Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Elena Spada
- Neonatal Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Sonia Deantoni
- Neonatal Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Matteo Borsani
- Neonatal Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | | | - Federica Chiale
- Neonatal Intensive Care Unit, Maria Vittoria Hospital, Turin, Italy
| | - Guido E Moro
- Italian Association of Human Milk Banks, Milan, Italy
| | - Marzia Giribaldi
- Institute of Sciences of Food Production, National Research Council, Grugliasco, Italy
| | - Laura Cavallarin
- Institute of Sciences of Food Production, National Research Council, Grugliasco, Italy
| | - Ivan Cortinovis
- Laboratorio GA Maccacaro, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Alessandra Coscia
- Neonatal Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
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Živkov Baloš M, Ljubojević Pelić D, Jakšić S, Lazić S. Donkey Milk: An Overview of its Chemical Composition and Main Nutritional Properties or Human Health Benefit Properties. J Equine Vet Sci 2023; 121:104225. [PMID: 36649829 DOI: 10.1016/j.jevs.2023.104225] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
The donkey milk has a remarkable similarity to human milk, in addition to its valuable nutritional composition and content of numerous immune factors. The donkey milk is the subject of research worldwide, and data from the literature suggest significant differences with respect to the contents of individual components. However, some basic characteristics of donkey milk have been established: low contents of fat and cholesterol, total proteins and casein and high contents of lactose, whey proteins, calcium, selenium, and Vitamin D3. The donkey milk is rich in various protective proteins (α-lactalbumin, lysozyme, lactoferrin, lactoperoxidase, and immunoglobulins), and shows strong antioxidant, antibacterial, antiviral, antifungal, hypoglycemic, antiparasitic, and antitumor activity. Donkey milk can be considered functional food, having in mind that its fatty-acid profile and content of essential fatty acids are beneficial for cardiac health. The total fat content in donkey milk is low compared to human milk, and for this reason it is necessary to enrich donkey milk with other fat in order to provide enough calories in a diet for children. Commercialization of donkey milk and dairy products is still limited due to low production levels, that is lack of products on the market, and lack of product information. Considering the research data from the literature, there is a need for human clinical trials in order to obtain a stronger evidence of the therapeutic properties of donkey milk.
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Affiliation(s)
| | | | - Sandra Jakšić
- Scientific Veterinary Institute "Novi Sad", Novi Sad, Republic of Serbia
| | - Sava Lazić
- Scientific Veterinary Institute "Novi Sad", Novi Sad, Republic of Serbia
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Supplementing human milk with a donkey or bovine milk derived fortifier: consequences on proteolysis, lipolysis and particle structure under in vitro dynamic digestion. Food Chem 2022; 395:133579. [DOI: 10.1016/j.foodchem.2022.133579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022]
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Bergner EM, Taylor SN, Gollins LA, Hair AB. Human Milk Fortification: A Practical Analysis of Current Evidence. Clin Perinatol 2022; 49:447-460. [PMID: 35659096 DOI: 10.1016/j.clp.2022.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Human milk (HM) with appropriate fortification is the recommended nutrition for very low birth weight (VLBW) infants. Fortification provides additional nutrients, vitamins, and minerals to support the growing preterm infant during critical periods of development. This article discusses the variability of HM including differences between maternal and pasteurized donor human milk (DHM), fortification of HM through the use of single- and multi-nutrient fortifiers, and clinical controversies including the timing of fortification, volume of feedings, and future innovations in HM fortification.
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Affiliation(s)
- Erynn M Bergner
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 North Everett Drive, ETNP 7504 Oklahoma City, OK 73104, USA. https://twitter.com/ErynnBergner
| | - Sarah N Taylor
- Section of Neonatology, Department of Pediatrics, Yale School of Medicine, PO Box 208064 New Haven, CT 06520, USA
| | - Laura A Gollins
- Neonatal Nutrition Program, Neonatology, Texas Children's Hospital, 6621 Fannin Street, Suite WT6104, Houston, TX 77030, USA
| | - Amy B Hair
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, Suite WT6104, Houston, TX 77030, USA.
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Bertino E, Agosti M, Peila C, Corridori M, Pintus R, Fanos V. The Donkey Milk in Infant Nutrition. Nutrients 2022; 14:403. [PMID: 35276763 PMCID: PMC8840189 DOI: 10.3390/nu14030403] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022] Open
Abstract
In the history of the world, the donkey has always had a special place next to humans since the time of its domestication, about 10,000 years ago [...].
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Affiliation(s)
- Enrico Bertino
- Neonatal Care Unit of the University, City of Health and Science Hospital, 10100 Turin, Italy;
| | - Massimo Agosti
- Neonatal Intensive Care Unit, Human and Child Department, Ospedale “F. Del Ponte”, 21100 Varese, Italy;
| | - Chiara Peila
- Neonatal Care Unit of the University, City of Health and Science Hospital, 10100 Turin, Italy;
| | | | - Roberta Pintus
- Neonatal Intensive Care Unit, University Hospital of Cagliari, 09123 Cagliari, Italy; (R.P.); (V.F.)
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University Hospital of Cagliari, 09123 Cagliari, Italy; (R.P.); (V.F.)
- Department of Surgery, University of Cagliari, 09124 Cagliari, Italy
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Martini M, Altomonte I, Tricò D, Lapenta R, Salari F. Current Knowledge on Functionality and Potential Therapeutic Uses of Donkey Milk. Animals (Basel) 2021; 11:ani11051382. [PMID: 34067986 PMCID: PMC8152225 DOI: 10.3390/ani11051382] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary This paper examines scientific evidence on the positive effects of donkey milk consumption on human health and its possible therapeutic applications. The most investigated clinical use of donkey milk is in feeding infants with food allergies, in whom donkey milk is well tolerated in the 82.6–98.5% of cases. Donkey milk has shown several beneficial properties, including immunomodulatory activity, antioxidant and detoxifying effects, modulation of the intestinal microbiota, and lowering of blood sugar and triglycerides, which have been tested almost exclusively in experimental animals. Inhibitory actions on microorganisms have been also observed in vitro studies. This literature review highlights the need for new clinical trials to collect stronger evidence about the positive effects observed in experimental models which could lead to new therapeutic applications of donkey milk in humans. Abstract The increase of knowledge on the composition of donkey milk has revealed marked similarities to human milk, which led to a growing number of investigations focused on testing the potential effects of donkey milk in vitro and in vivo. This paper examines the scientific evidence regarding the beneficial effects of donkey milk on human health. Most clinical studies report a tolerability of donkey milk in 82.6–98.5% of infants with cow milk protein allergies. The average protein content of donkey milk is about 18 g/L. Caseins, which are main allergenic components of milk, are less represented compared to cow milk (56% of the total protein in donkey vs. 80% in cow milk). Donkey milk is well accepted by children due to its high concentration of lactose (about 60 g/L). Immunomodulatory properties have been reported in one study in humans and in several animal models. Donkey milk also seems to modulate the intestinal microbiota, enhance antioxidant defense mechanisms and detoxifying enzymes activities, reduce hyperglycemia and normalize dyslipidemia. Donkey milk has lower calorie and fat content compared with other milks used in human nutrition (fat ranges from 0.20% to 1.7%) and a more favourable fatty acid profile, being low in saturated fatty acids (3.02 g/L) and high in alpha-linolenic acid (about 7.25 g/100 g of fat). Until now, the beneficial properties of donkey milk have been mostly related to whey proteins, among which β-lactoglobulin is the most represented (6.06 g/L), followed by α-lactalbumin (about 2 g/L) and lysozyme (1.07 g/L). So far, the health functionality of donkey milk has been tested almost exclusively on animal models. Furthermore, in vitro studies have described inhibitory action against bacteria, viruses, and fungi. From the literature review emerges the need for new randomized clinical trials on humans to provide stronger evidence of the potential beneficial health effects of donkey milk, which could lead to new applications as an adjuvant in the treatment of cardiometabolic diseases, malnutrition, and aging.
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Affiliation(s)
- Mina Martini
- Department of Veterinary Science, University of Pisa, 56124 Pisa, Italy; (M.M.); (R.L.); (F.S.)
- Interdepartmental Center for Agricultural and Environmental Research “E. Avanzi,”, University of Pisa, San Piero a Gardo (PI), 56122 Pisa, Italy
| | - Iolanda Altomonte
- Interdepartmental Center for Agricultural and Environmental Research “E. Avanzi,”, University of Pisa, San Piero a Gardo (PI), 56122 Pisa, Italy
- Correspondence:
| | - Domenico Tricò
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56100 Pisa, Italy;
| | - Riccardo Lapenta
- Department of Veterinary Science, University of Pisa, 56124 Pisa, Italy; (M.M.); (R.L.); (F.S.)
| | - Federica Salari
- Department of Veterinary Science, University of Pisa, 56124 Pisa, Italy; (M.M.); (R.L.); (F.S.)
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